Everyone suffers from dryness now and again. But the occasional cracked elbow is but a scratch compared to the perpetual parchedness — and inescapable, unbearable itchiness — endured by those with chronic skin conditions, like eczema.
29 year old Samantha (an alias to protect her privacy) has always lived with eczema and has been prescribed strong topical steroids in an attempt to quell her condition ever since she can remember. “In elementary and high school, my classmates would make fun of and avoid me because of my skin,” she explains. “I was called by different names, like Anthrax and Spots. It was bad, and my self-esteem was really low. I graduated valedictorian in high school, but I had no friends because no one wanted to be friends.”
While normal skin works to retain moisture and protect your insides from bacteria, irritants and allergens, those with eczema have a gene variation that impedes their skin’s ability to provide that protection. This basically makes their skin incredibly sensitive to environmental pollutants, like irritants and allergens. Physically, this can manifest as constantly red, cracked and itchy skin, which can mature into infections and cause sleep problems. But as you can see from Samantha’s story, the mental toll can sometimes be just as bad as the physical.
As Samantha grew older, she eventually found companions who were more understanding, but the rude comments never stopped. She still expects new people to ask about her constant scratching, and she has grown accustomed to being on the receiving end of a constant stream of unhelpful suggestions, such as, “You should just be a neater person,” or, “You should take a shower.”
Samantha’s condition was once so bad, it nearly spoiled her lifelong dream of becoming a medical professional. “I had a really bad flare-up during my third year of undergrad,” she explains. “I was stressed, sleep-deprived and had anatomy classes — we had a tremendous exposure to latex gloves and formaldehyde from examining human cadavers for class. So I went to my dermatologist, and he told me the solution to my flare-up was to reduce stress, drink oral steroids, continue with topical steroids and stop scratching. He said, ‘If school is inducing this flare-up, just quit.’ I did not quit. I graduated and decided to try to de-stress as much as I could.”
This was far from the first time eczema almost ravaged a huge moment in Samantha’s life. “Two weeks before my wedding, I had a flare-up from the stress,” she says. “Not wanting my wedding guests to talk about my eczema, I went to a doctor, and she prescribed me Prednisone for five days, which made my skin amazing for my wedding. I’ve been married for two years and haven’t taken oral steroids ever since — I had a recent flare-up, and the doctor told me she can prescribe me oral steroids, but I respectfully declined.” Prednisone (and other oral steroids) can cause an assortment of side effects, ranging from insomnia to nausea and increased sweating, especially when taken over long periods of time.
Despite their side effects, these oral medications work well. “I have to admit, Prednisone would make my skin glow,” Samantha says. “It would be as if I’d never had eczema my whole life.”
Dermatologist Anthony Rossi suggests these stronger medications to anyone dealing with eczema that just won’t quit. “If you’re suffering from eczema, and regular topical corticosteroids, emollients and avoidance of triggers isn’t working, there are stronger medications now,” he says.
“I still use topical steroids,” Samantha adds. “They’re prescription-strength ones. I tried to stop taking them, but every time I do, I experience bad flare-ups. But I do try to use them sparingly now, like one tube every two to three months. I used to use two tubes every month.”
Samantha’s eczema has also creeped into various other aspects of her life, perhaps in less obvious ways. “Another adjustment I’ve made is buying long-sleeve turtlenecks so no one will notice my skin at work, and I’ve switched from cow’s milk to oat milk to see if that works,” she explains. “The key is lotion and moisturizer, but finding the right one can be so tedious. I try some, and then I have a flare-up because of some reaction to the ingredients — I wish I could try every lotion at a pharmacy and see what works.”
26 year old Jessie (another alias to protect their privacy) has a similar relationship with eczema and their skincare routine. “I’ve always had eczema, ever since I was a baby,” they explain. “I had to use baby soap until I was five, because anything else would break me out in a rash. My childhood was full of oatmeal baths and calamine lotion. Any piece of clothing that will be touching my skin directly has to be washed before I can wear it, even for just a few minutes.”
“I’ve mostly gotten a handle on it now in my late 20s,” Jessie continues. “I still have days when the only thing keeping me from ripping off all of my skin is an oatmeal bath [bathing in colloidal oatmeal, which can be made or bought over-the-counter, and can help soothe the skin by forming a protective barrier], when the pollen count is high, but for the most part, I have it under control. I still have to moisturize every inch of my body every day — twice a day in the winter.”
But hidden behind the thick turtlenecks and heaps of moisturizer is just someone trying their best. “Beyond this eczema is a well-meaning person who works in the health industry, enjoys coffee and travel and is curious sometimes if the cream cheese on her bagel is making her flare up,” Samantha says. “But I have no time to look up every ingredient on my grocery list.”