A Day in the Life: Eczema Emergency Kit

I believe every person suffering from eczema should have an emergency kit. Just in case. Each emergency kit should have lotion, an emollient and topical steroids or immunomodulators. One emergency kit should be kept in a safe spot in your workplace and/ securily wrapped in your purse or pouch (be wary to prevent spills!).

My current emergency kit includes:

1. Cetaphil Lotion

2. Aveeno Eczema Care Lotion

3. A 4. Ounce container of Extra Virgin Olive Oil

4. A small container of Vaseline/Petroleum Jelly

5. Cortizone 10/ 1% hydrocortisone cream

Hope this helps!

Love, 

Lhea J.

A Day in the Life: When Skin Falls

After 13 years of suffering from eczema, my skin began to change. My skin, which normally forms a thickened rash when aggravated, began to dry and flake. This new, flaky skin comes off when I towel dry it, rolls off when I put lotion on it, brushes off when I touch it and falls off while I sleep.

The use of triamcinalone and hydrocortisone ointments have helped to thin my skin.

Now, after 3 years of shedding dry skin, my skin is so weak that healthy skin rolls off when I rub it or put lotion on.

Dermatologists don't seem to think that there is anything hazardous about thin skin. But, how can you ward off unwanted bacteria, if there are openings and cuts all over your skin?

So far, the thinning of the epidermis seems to be an irreversible side effect of topical and oral corticosteroids. I'll keep searching for solutions. 

Love,

Lhea J.

Professional Skin: Traveling with Eczema

Dear Frequent Flyers,

Sometimes if we are not careful, eczema, psoriasis and adult acne can become a debilitating condition. A physical condition, if not carefully monitered can begin to affect ones psychological and social health. 

Eczema does not have to harm your peace of mind, your social status or your professional career. 

Here are a few things you can do so that you can travel with ease:

1. Request a non-smoking hotel room

2. Travel with eczema travel kit

----- Daily Medication (if any)

----- 1% Hydrocortisone Cream (for unexpected breakouts)

-----  Vaseline (great emollient)

----- Olive Oil (In well sealed, small, portable container)

----- Lotion (stay away from hotel lotion. Cera Ve, Cetaphil, Eucerine work well)

----- Soap (stay away from hotel soap/detergent. Aveno, Cetaphil, Homemade Soap, or Oatmeal may work well)

---- Shampoo (stay away from hotel shampoo)

---- Plastic Covers for Pillows

I reckon, when you have eczema... you can never be too careful. 

Love,

Lhea J.

Brown Eczema: After the Rash is Gone

Dear Mahogany,

The primary difference between a brown skin person with eczema and another person with eczema is how the skin heals. A Caucasian person suffering from eczema may choose to take a corticosteroid (hydrocortisone, triamcinalone, etc.) or a TIM (protopic, elidel), after a few days the rash will have gone away, and only a red mark remains. The redness will soon fade as well. 

People of color have melanocytes, not only in the lowest layer of skin, but through out all three layers. When our rashes heal, a hyperpigmented area remains. A dark spot remains.

The rash is removed, the skin is healed. But your body still looks as if you are broken out because the darkened areas still remain where the rashes once were.

There are a few options that you and your dermatologist may discuss, after the rash is gone:

1. WAIT.

Even though dark spots remain where the rashes once were, they will fade away. For a dark skin person of my complexion it will take 6-12 months for the hyperpigmented area to clear up. That is 6 to 12 months without another outbreak in that same area. 

2. Bleaching Creams.

No, it's not the 70s. This is not to change your complete complexion. I'm sorry you weren't born with fairer skin. These may be prescribed and even recommended by some dermatologists to return the color of the darkened areas where rashes once were back to normal.

3. Corticosteroid Injections or Oral Medication

I am not sure why Atopic Steroids and Topical Immunomodulators (TIMs) leave hyperpigmentation and Corticosteroid Injections not only clear up the rash itself, but the hyperpigmentated area as well.  Oral Corticosteroid injections may actually remove hyperpigmentation as well.

Until the rash is gone, after the rash is gone, keep loving yourself until the dark spots are gone too. 

Love,

Lhea J.

Eczema Files: Protopic

Dear Cautious Customers,

As you may know, those suffering from chronic eczema experience perpetual pain, discomfort and embarrassment. For many years, to ease the pain and lessen the discomfort corticosteroids, such as hydrocortisone, have be prescribed as a cream or an ointment to reduce and eliminate body rash.

In recent years, the first non-steroid prescriptions drugs have become available for those suffering from Chronic Eczema. In 2000, the Food and Drug Administration approved a Topical Immunomodulator (TIM) by the name of Protopic (Tacrolimus). 

This drug is marketed as being a non-steroid ointment. The advantages are that these drugs alter the functions of the immune system related to the skin's inflammatory response without suppressing the entire immune system. Corticosteroids, such as hydrocortisone, triamcinolone and prednisone, may lead to skin thinning, discoloration and adrenal gland suppression.

Topical Immunomodulators appeared to be the panacea for Eczema-sufferers!

Until 1995, when the FDA issued a "Black Box Warning" for atopical immunomodulators. It takes at least 10 years to conduct studies connecting a particular drug to cancer. The truth is, no one knows what the long term effects of Topical Immunomodulators are. 

If your doctor prescribes Protopic or Elidel... use it for short periods of time. And, keep an eye out for recent scientific findings pertaining to TIMs.

Love,

Lhea J.

Eczema Files: Hydrocortisone

Dear Itchers and Rashers,

For people suffering from eczema, a hydrocortisone cream or ointment is the most frequently prescribed solution, temporary solution, to the problem.

Hydrocortisone is the chemical version of cortisol which is produced naturally by the body's adrenal complex. Cortisol, which is known as the stress hormone, fluctuates both naturally and when triggered by mood changes, depression, pain and extreme temperatures.

Hydrocortisone is used as an immunosuppressant with anti-inflamatory effects.

Unfortunately, your body may get used to hydrocortisone creams and the administration of the drug may become less effective overtime. 

Please beware of known side effects when treating chronic eczema over the course of your life:

-- Thinning of Skin

-- Slowed, Impaired healing of wounds

-- Mood Swings

-- High Blood Pressure

-- Osteoporosis

-- Cataracts

-- Muscle Weakness

In recent years, immunomodulators such as Protopic and Elidel have become a very popular replacement for corticosteroids. They have their side effects as well. Some researchers expect immunomodulators to be a carcinogen based on animal test results. 

Be healthy, be careful and be well.

Love,

Lhea J.

A Day in the Life: Life without Health Insurance

Dear Card Holders:

If you are one of the fortunate Americans who has health coverage, count yourself blessed. You will be able to use a combination of prescription drugs and home remedies to nurse your skin back to good health. 

If you, like me, are one of the 47 million Americans without health insurance, you will have to make the best of home remedies and over the counter drugs until your condition changes.

Within the last week, I have changed households. My skin is making the adjustment as well. 

When I was a child, I had atopic dermatitis or or atopic eczema. The rashes were a result of an allergen or irritant that I ingested.

Now that I am an adult,  have a combination of atopic dermatitis and contact dermatitis. My skin reacts to allergens and irritants that come in physical contact with my skin.

So, I my skin and my immune system is learning to cope with a new environment: an environment with cats!

I have discovered that the most important defense against eczema and psoriasis is CARING. No matter what your skin looks like, or how your skin feels, you must wake up every morning and care. Literally care for your skin.

1. Short daily showers - 10 minutes or less.

2. Olive Oil on body, avoid olive oil on face

3. Cetaphil on body and face (Or, my skin prefers Cera Ve)

4. Oatmeal face mask, once per day

5. At least 8 glasses of water per day

6. Leave the house everyday. I'm not sure if this house is skin friendly.

7. Purchase some over-the-counter hydrocortisone until I can get a prescription

Unfortunately, since changing households... my face has begun to swell into small hive patches on my cheeks. and my eyes have begun to swell with huge bags.

This is a sign that my skin is battling an infection, not just eczema.

If I had health insurance, this would be a great time to take an anti-biotic (Cephalexin). The swelling usually goes down, along with the raised patches of skin, within 24 hours.

Well, I'm doing the best I can. Hope you are, too. 

Love,

Lhea J.

Eczema Files: Triamcinalone

Dear Itchy Body,

I have a love-hate relationship with Triamcinalone creams and ointments.  Mainly hate.

Triamcinalone is a steroid often administered to patients with chronic eczema.

The first-time I was prescribed Triamcinalone was while I was in college. At the time, my eczema was only located in 6 distinct locations: the back of both knees, the inside of both elbows, the back of my neck, and the bridge between my lips and nose.

Most importantly, my skin only created raised, tough rashes. My skin never flaked, never dried up, never shed.

After the first time I used triamcinalone, I had a widespread reaction.  My entire neck broke out for the first time. My entire arm began to break out for the first time.  And spots of rashes began to appear all over my legs.

After a few days, my skin begun a lichenification and shedding process that never occurred any of the 21 years before. 

Since using triamcinalone, my eczema-rashes now occur all over my body.

Does triamcinalone work? Yes. While it may cause localized rashes to spread... it does eventually lessen the reaction and clear the rash. 

Another horrible side effect, it thins your skin. After a few years of use, you will find that your skin breaks from simply rubbing your skin too hard. 

If your doctor recommends triamcinalone- and you just have a few rashes on your body-Consider declining and requesting a higher percentage of hydrocortisone instead. 

If your case of eczema is as bad, and wide spread as mine is now... consider using the triamcinalone ointment over the thick cream. Personal preference.

Love,

Lhea J.

Brown Eczema: Do You Need a Black Dermatologist?

Dear Brown Skin, 

To be a member of a community which prides itself on its style/appearance and have eczema can be a devastating phenomenon. What is a black woman if she does not have her looks?

Luckily, you may never have to find the answer to that question.

The first step is to find a great dermatologist. While you don't need an African-American dermatologist, you do need a skin specialist who is used to observing Black skin. 

In the mean time, there are a few simple steps that you may take to keep your skin healthy and most importantly, within your control.

PREVENTION

to decrease the chances of flare-ups...

• Find a great dermatologist with experience in treating Black skin
• Increase your water intake (8-12 glasses per day)
  
• Olive Oil and Baby Oil Gel soothe the skin
  
• Cera Ve Cream or Cetaphil Cream lock in moisture
  
• Avoid extremely hot showers and baths (dries skin faster)
• Oatmeal, itself, or Oatmeal-based soaps (such as Aveeno) are gentle
  

REACTION

to decrease the effect of flare-ups, once they have occurred...

• Monitor your diet: Caffeine increases breakouts that already begun
  
• Monitor your diet: Citrus often increases breakouts that have already begun
  
• Monitor your diet: Soy may increase breakouts that have already begun
  
• During bathing, cloths may irritate skin
  
• After bathing, do not towel dry
  
• After bathing, apply Olive Oil, Baby Oil Gel or Cream while still wet
  
• Prescriptions: An antibiotic may stop reaction. Reactions are often perpetuated by an infection
  
• Prescriptions: Hydrocortisone may decrease flare-up
  
• Prescriptions: Protopic (non-steroid) is better on the face
  
• Prescriptions: Triamcinalone will decrease flare up, if Hydrocortisone no longer works. Please note: Use of Triamcinalone WILL make your skin thinner. Your skin will tear and bleed much easier than it did prior to use.
  
• Prescriptions: Predisone (oral or injection) will decrease flare up, but may have long term effects on internal organs. Please ask your doctor about all long term side-effects before using the medication.
  

What Flare ups look like, on Black skin: (Face, Arm & Neck, shown below)