A is for Anxiety – Atopic Dermatitis ABC

Anxiety for Parents with Eczema Children

Anxiety – was it the first emotion when Atopic Dermatitis was diagnosed in your baby?

This year’s series is Atopic Dermatitis ABC – a lighthearted, be-there-with-you companion where the ABCs will act as your eczema survival guide. In just 5 minutes, I came up with 15 words that start with A that are related to atopic dermatitis (AD). I disregarded all of them (not because they’re wrong since we’d get to what is atopic dermatitis, autoimmune, allergies and avoidance), but because I remembered when I first learnt of my baby’s eczema, it’s not the medical terms that come to mind. It’s ANXIETY, and it comes from the heart. Your heart, my heart, the hearts of all parents who suddenly find themselves in a challenging situation. Something like this.

Atopic Dermatitis - Anxiety in Parents with Eczema Babies

This needs no caption.

It is normal to feel anxious when something has gone wrong, when something is happening to your baby, and when you’re not sure what that something is (didn’t the delivery hospital say rashes are to be expected? and ok?) and when even when you know what that something is, you can’t cure it and you’re never sure when it would come back? If your heart has started beating faster like mine, it may be that all these feelings and thoughts are anxious ones that come when we’re not in control. And the most paradoxical part is atopic dermatitis is about controlling the eczema, since you can’t quite cure it.

Wait, do you agree with me?

IS THIS ANXIETY EVEN REAL?

Fortunately, we’re not self-deluded. In an October 2016 study published in the Asia Pacific Allergy1 by researchers at Inha University Hospital, South Korea, 78 children with their parents took part in a study to examine the family quality of life (QoL). The mean age of parents was 37 years old (majority 87% mothers), and the mean age of their children was 5+ years old, having atopic dermatitis for about 2 years. The tests included questionnaires (including Satisfaction with Life Scale survey) and using score card to measure eczema severity (SCORAD index).

It was found that a low family quality of life was related to the eczema severity, when the children with atopic dermatitis were girls and the negative emotionality of parents. Parents of children with AD is known to be associated with depression and stress in previous studies.

In another study2 more than a decade earlier, published in British Journal of Dermatology in Feb 2004, researchers examined the psychosocial well-being of parents caring for a young child with AD. Out of 187 parents, it was observed that parents of children with a higher severity of atopic dermatitis reported a significantly higher impact on family functioning and a greater financial burden. The results showed the need to focus on parental well-being and ability to cope with stress and social strain.

The latest study3 on this was published in Acta Derm Venereol in February 2017 which concluded that quality of life was affected mothers more as moms spent more time caring for the eczema child and carried out more household duties.

NOW THAT YOU KNOW THE ANXIETY IS REAL, HOW DO YOU THINK YOU WOULD FARE ON THE SATISFACTION WITH LIFE SCALE?

Here’s the test4 that you can take:

Below are five statements that you may agree or disagree with. Using the 1 – 7 scale below, indicate your agreement with each item by placing the appropriate number on the line preceding that item. Please be open and honest in your responding.
7 – Strongly agree
6 – Agree
5 – Slightly agree
4 – Neither agree nor disagree
3 – Slightly disagree
2 – Disagree
1 – Strongly disagree

____ In most ways my life is close to my ideal.

____ The conditions of my life are excellent.

____ I am satisfied with my life.

____ So far I have gotten the important things I want in life.

____ If I could live my life over, I would change almost nothing.

31 – 35 Extremely satisfied
26 – 30 Satisfied
21 – 25 Slightly satisfied
20 Neutral
15 – 19 Slightly dissatisfied
10 – 14 Dissatisfied
5 –  9 Extremely dissatisfied

I hope you end up on the satisfied end of the scale, but if not, don’t be anxious – 5 questions are not going to determine your life’s happiness. Your child’s eczema condition is. (One question, in this eczema context).

References:

  1. Jang HJ, Hwang S, Ahn Y, Lim DH, Sohn M, Kim JH. Family quality of life among families of children with atopic dermatitis. Asia Pacific Allergy. 2016;6(4):213-219. doi:10.5415/apallergy.2016.6.4.213.

  2. Warschburger, P., Buchholz, H.TH. and Petermann, F. (2004), Psychological adjustment in parents of young children with atopic dermatitis: which factors predict parental quality of life?. British Journal of Dermatology, 150: 304–311. doi: 10.1111/j.1365-2133.2004.05743.x

  3. Acta Derm Venereol. 2017 Feb 16. doi: 10.2340/00015555-2633

  4. Ed Diener, Robert A. Emmons, Randy J. Larsen and Sharon Griffin as noted in the 1985 article in the Journal of Personality Assessment

Interview with Children Book authors of My Peace Place

My Peace Place's Book Tour Stop at EczemaBlues

My Peace Place’s Book Tour Stop at EczemaBlues

peace placeThis is a special interview with children book authors, Lori Bortnick and Mari Lumpkin, on their book My Peace Place. The book encourages children to find their ‘peace place’, especially in today’s high-strung world with busy schedules and much noise. I gladly agree to do a book review and interview Lori and Mari on EczemaBlues because eczema kids and parents have so much added stress in their life from managing eczema. Check out the book for tips on calming your child.

Mei’s Review of ‘My Peace Place’

The book is written by Lori Bortnick and Mari Lumpkin, illustrated by Natalia Buscaglia. The story itself fills up 15 pages of colored illustrations on various scenarios in a child’s life that create stress – for instance, being pushed in school or feeling ignored at home. The child then think of his peace place, where he can relax, breathe slowly and deeply and feel peaceful. The scenarios are realistic and thus offers parents a good chance to speak to the child on other similar stressors that may have happened in the day. It is easy to read for a preschooler who can definitely benefit from a parent’s participation in finding that peace place.

Apart from the story, the book also offers tips to parents as well as recommended yoga poses for the child. This is helpful as it further reinforces how stressful conditions are all around us and practical tips to calm ourselves. Overall, I enjoy the book and feel parents will find it helpful.

Interview with authors Lori and Mari

MarcieMom: Hi Lori and Mari, thanks for sharing with me your book. Can you share a little background on yourselves that lead you to focus on writing this book?

Lori: Thanks so much for having us and reviewing our book. I’m a preschool teacher and I love to help children think of ideas to have better lives. Lots of times, my children come to school sad about things they can’t control I think My Peace Place will help children gain a sense of control.

Mari: I’ve worked with children in many settings, usually as a literacy volunteer. I’m always amazed that people don’t see that much of the problem behavior we complain about our children exhibiting can be connected to their not having the tools to manage stress.

MarcieMom: At what age do you think children can benefit most from your book?

Lori: School aged children and kids in group situations.

Mari: I think children as young as three can benefit from the yoga poses and the deep breathing. I believe the ideas and techniques in the book could benefits everyone from age 3 to 103.

MarcieMom: If you were to write a follow-up to this book, what will you be focusing on?

Lori: How to bring peace to large groups. Once children learn to be peaceful in themselves, then they can learn to focus on reaching out and learn to find peaceful solutions in groups.

Mari: We’re also thinking of doing something about volunteering. That’s another healthy activity that releases people from their own worries and promotes peace.

Thank you both for sharing your book and this interview; it has been a pleasure and also a reminder to create peace in my home. One pet peeve that I believe in is de-cluttering the home because clutter equals noise in my mind!

Mari L Barnes writes for children under the pen name of Mari Lumpkin and for adults as ML Barnes. Her books, Parting River Jordan and Crossing River Jordan are proof that church can be funny. Mari’s company, Flying Turtle Publishing, specializes in books that families can share.

Lori Bortnick is an Illinois certified Early Educator with type 04 certification, a master’s degree in Teaching in Early Childhood and more 15 years of teaching experience in both private daycare and the public school system.

To see Flying Turtle Publishing’s Virtual Book Tour schedule and be entered to WIN a $10 Amazon Gift Card in our monthly drawing, click here.

Rise and Shine Feature – Seminar with Dr Lynn Chiam on Children Skin Conditions

Rise and Shine Expo Seminar with Dr Lynn Chiam, on Children's Skin

Rise and Shine Expo Seminar with Dr Lynn Chiam, on Children’s Skin

From 27 to 29 September 2013, Rise and Shine Expo, an informative expo to raise happy and healthy children was held in Singapore. There were more than 100 seminars, workshops and trial classes held and one of the seminars by dermatologist Dr Lynn Chiam was on ‘All about Children’s Skin’, a topic I’m very passionate about.

Dr Lynn Chiam of Children & Adult Skin Hair Laser Clinic is a consultant dermatologist who subspecializes in paediatric skin conditions at Mount Elizabeth Novena Specialist Medical Centre, Singapore. She was formerly the head of paediatric dermatology at National Skin Centre, Singapore before leaving for private practice. She has vast experience in childhood atopic dermatitis and childhood birthmarks. She has previously shared her expertise in this blog on Teen Eczema and Facial Eczema.

Other Children’s Skin Conditions

Last week, we have covered the common children’s skin conditions and today, we will cover the remaining that Dr Lynn briefed during the Rise and Shine seminar.

Sweaty hands and feet – Palmar Hyperhidrosis is the excessive and unpredictable sweating from hands, even when it is not hot or exercising.  This is due to overactive sweat glands. Primary hyperhidrosis refers to the excessive sweating from hands, feet and armpits and affect 2-3 percent of population with genes being a factor. Minimally invasive procedure can be carried out but for children, use of antiperspirant or prescriptions containing aluminium chloride.

Body Odour – Children may also experience body odour and it is the bacteria and not the sweat that creates the smell. Avoid tight clothing/foot wear and wash clothes thoroughly.

Alopecia Atreata (Hair Loss) – Alopecia atreata is a type of hair loss due to the immune system attacking the hair follicles (auto-immune condition). For most, the hair will grow back and if so, some opt not to treat the condition. Treatments can be topical corticosteroids, injections containing steroids or immunotherapy.

Sun and Skin

The UV rays can cause sun spots, wrinkles, enlargement of blood capillaries and even skin cancer. Particularly for children whose skin is thinner and less protected against UV rays, sun protection measures should always be taken. Avoid direct sunlight from 10am to 4pm, wear shades, hats and appropriate clothing. Also bear in mind that the sand and the sea can also reflect the rays, and thus sitting in a shaded area also requires sun protection.

Sunscreens are divided into chemical absorbers and physical reflectors; chemical absorbers absorbs the light and converts them into harmless rays but these are known to trigger more skin irritation than physical reflectors. Physical reflectors reflect the light off the skin. Be sure to put sufficient amount, one teaspoon on the face and to use one at least SPF30.

Stress and Skin

Stress is also known to trigger skin conditions such as eczema and pimples/acne and therefore parents are encouraged to share stress relaxation techniques such as massage and breathing with their children.

Q&A

Dealing with Drool – Dr Lynn answered a question on dealing with the child’s drool and her tip is to use a wet cloth to dap away the saliva, followed by a dry cloth to dap dry and then moisturize immediately.

Air-conditioning – Children with eczema can sleep in air-conditioned room, bearing in mind that there is no ideal environment as too hot can also trigger eczema. A temperature of 24 to 25 deg C is comfortably cool.

Oil as Moisturizer – Dr Lynn pointed out that oil is not as easily absorbed onto the skin as moisturizer, and thus does less to improve the skin barrier function.

Water as Irritant – Dr Lynn explained that eczema skin is like a crumbling brick wall and prolonged washing can weaken the skin barrier function. Therefore good skincare includes a bathing routine that is not in hot water and not longer than ten minutes.

Steroid cream – Dr Lynn explained that steroid potencies range from 1 to 7, 1 being the strongest and 7 the weakest. There is also new generation topical corticosteroids that have less side effects.

Next week, I’m asking questions for eczema children in relation to what Dr Lynn had shared during the Rise and Shine seminar, and as always, grateful to her for reviewing the above.

Doctor Claudia Video – Why Stressed Skin is More Skin Deep

Dr Claudia Aguirre answers questions on Why Stressed Skin is more than Skin Deep video

Dr Claudia Aguirre answers questions on Why Stressed Skin is more than Skin Deep video

Dr. Claudia Aguirre is a neuro-scientist and a skin industry expert at The International Dermal Institute and Dermalogica. She is passionate about skincare, frequently lectures worldwide, and is an editorial contributor to global trade and consumer media. You can find her at twitter.com/doctorclaudia.

Marcie Mom: Thank you Dr Claudia for taking time to answer questions on the video. In it, you shared that chronic stress is associated with many diseases including diabetes, cardiovascular diseases, autoimmune diseases and even cancer. Stress process begins in hypothalamus, that sends an initial signal to the pituitary gland, adrenal gland and triggers the release of adrenaline, noradrenaline and cortisol that travel through the body for a fight or flight response. Stress is also studied to be able to trigger neurogenic inflammation that can worsen eczema, psoriasis, premature aging, acne and rosacea.

Stress can dehydrate skin, leading to impaired skin barrier that makes the skin more vulnerable to allergens and irritants, and triggers eczema flares. Histamines released also contribute to the itch level experienced in the skin. Stress can also make the skin hypersensitive to allergens. Cortisol boosts oil production, leading to blocked pores and worsening acne.

Doctor Claudia shared that there is a new field Psychodermatology, which is the practice of treating skin disorders using both dermatological and psychiatric techniques. Treatments such as acupuncture, aromatherapy, breathing and massage techniques are also shared in the video.

Dr Claudia, an informative video as always – can you share briefly with us how the brain ‘talks’ to the skin and how differently a stressed brain talks to the skin?

Dr Claudia: The brain and the skin share an embryonic origin and are constantly communicating with one another. Think about sensation – your skin, once stroked, sends signals to the brain and the brain determines whether it is being tickled, stroked, or punctured. Of course the picture is more complex than that, as it involves countless nerve fibers, relayed information in the spinal cord and signals from brain to skin. They communicate using electrical impulses and chemical signals for the most part. A stressed brain will send more stress signals, or hormones, throughout the body including the skin.

MarcieMom: Eczema is a stressful condition to manage, and stress can also trigger eczema – a double whammy situation. For children with eczema, what do you think are some ways to break this vicious cycle?

Dr Claudia: The behavior should be modified to adapt to lifestyle changes early on. In children, this may be teaching them that they can keep their hands busy so they don’t idly scratch their skin. Teaching them to breathe deeply has also been shown to reduce anxiety and stress in children – some therapists put a ball or balloon on the belly of the child and make them move it while breathing deeply, lying on their back. This can help a child understand how to breathe from the belly, which can reduce stress. Maybe when they get particularly itchy, they can call out to mom or caretaker, who will apply a cool compress to relieve the itch without scratching the skin.

MarcieMom: You mentioned about touch being able to relieve stress. Do you think that a mother carrying or sleeping with an eczema baby can help relieve stress and offers the possibility to improve eczema? (I do co-sleep as I’ve read that it can reduce stress for the baby plus I’ll know if my baby is scratching. I understand co-sleeping does lead to more dust mite, due to more dead skin as the mite’s food source.)

Dr Claudia: Absolutely. Holding premature infants allows them to develop faster and carrying a baby or toddler is comforting in more ways than we know. Gently stroking them will also be soothing. As for co-sleeping, there are different viewpoints and it is up to the individual in the end. To relieve from dust mites, wash often with hypoallergenic detergent and vacuum frequently. Although they are a trigger, they are not the cause of eczema, so keeping the skin hydrated and lubricated will allow it to heal and prevent flare-ups.

Thanks Doctor Claudia, as always, very much appreciates your insights into skin.

Doctor Claudia Video – Eczema: Scratching the Surface

Doctor Claudia Aguirre's Video on Eczema: Scratching the Surface

Doctor Claudia Aguirre’s Video on Eczema: Scratching the Surface

Dr. Claudia Aguirre is a neuro-scientist and a skin industry expert at The International Dermal Institute and Dermalogica. She is passionate about skincare, frequently lectures worldwide, and is an editorial contributor to global trade and consumer media. You can find her at twitter.com/doctorclaudia.

Marcie Mom: In the video, Doctor Claudia explained atopic dermatitis and that elevated IgE (immunoglobulin E) triggered allergic response in certain people. There is no single cause of eczema identified, and no cure for the condition. It is instead a multi-factorial condition characterized by defective epidermal barrier that is more alkaline and has more enzyme activity that reduces the connectivity of the skin layers. Filaggrin is a protein that aids in the formation of skin layers (do watch the video to see the animated filaggrin) and converts to natural moisturizing factors. Dry skin lacks this normal functioning filaggrin gene, and has been linked to atopic diseases such as eczema, asthma and allergies.

Marcie Mom: Dr Claudia, in the video you mention that sweat is an irritant for many with eczema. Can you explain how the chemicals in our sweat can cause the allergic reaction? Shouldn’t our skin be used to our sweat?

Dr Claudia: Well an irritant reaction is not the same as an allergic reaction. I explained that sweat can be irritating to eczema skin, as this epidermal barrier may not be fully functional. This is an interesting question though, as we are still understanding the chemical composition of sweat (be that eccrine or apocrine). In general, sweat is composed of water, minerals (like sodium and magnesium), lactate, ammonia and various amino acids. It could be one of these compounds, the combination of them, the changing pH of the skin, or even the sweat’s water content that can cause the itching and stinging sensations to some people with Eczema.  Digging deeper, I found an interesting study that suggested the amino acid composition of sweat is similar to the composition of the protein profilaggrin (which is later converted to filaggrin). This is interesting because scientists can study filaggrin by using human sweat as a potential chemical model. In the end, sweat can make eczema skin uncomfortable, so I suggest bringing a cool damp towel to your workout, or maybe spritzing a hydrating spray, instead of rubbing or scratching this sensitive skin.

MarcieMom: Stress is also a common trigger for eczema and suggestion such as aromatherapy is mentioned in the video. Out of curiosity, does the aroma work the same way as fragrance in skin care products, which is to be avoided? Or is there a specific type of aromatherapy for those with eczema?

Dr Claudia: No, aroma in skin care products varies widely. What you want to avoid are synthetic fragrances which can cause an irritant or allergenic reaction in the skin. Some people use perfume for years before they get a skin reaction. Aromatherapy typically employs essential oils, which are natural compounds. However these can be quite potent, so a trained professional with a background in aromatherapy should be consulted before any treatment. The act of breathing deeply alone can also reduce stress. To find out more ways of reducing stress check out the latest webisode: http://youtu.be/EAcFAUd9-6Q

MarcieMom: In the video, you also recommended water-free barrier repairing products and oatmeal compress. Is water to be avoided in skin care due to preservatives being required if there is a high water content or is it because the eczema skin ‘loses’ the more liquid product easily? As for oatmeal compress, do explain to us (I’m using oatmeal bath oil, but not sure how an oatmeal compress works).

Dr Claudia: Great question. I suppose it could be both. Paraben alternatives are preservatives that have a greater potential of being irritating than parabens. So ‘paraben-free’ formulations may actually be more irritating. The amount of water lost to a skin care product from the skin is most likely negligible, so I recommend anhydrous barrier-repairing products because they contain silicones to protect skin. Our skin has a lipid (oil) layer, so you want to replenish those oils to ensure a properly working barrier. Colloidal oatmeal is a wonderful ingredient for eczema skin. There are many scientific studies on oats and dermatitis – and this should be your eczema skin’s best friend. Look for clinical colloidal oatmeal for best results. The compress is basically a wet wrap. This is used to lock in moisture and keep the actives on the skin. On wet skin, apply oat or other active ingredient, follow with a damp gauze and cover with dry wraps. This dry covering could be pajamas (good for kids), or other dry covering. Alternatively, a colloidal oatmeal masque is a really nice add-on to a skin treatment for hydrating and soothing skin.

Marcie Mom: Vitamin D has been mentioned much to boost immunity and for the skin. How exactly can one with eczema get vitamin D, and what’s your recommended minutes of sun exposure for those with eczema?

Doctor Claudia: Everyone has different needs, so there is no single recommended amount of sun exposure. I advise those wanting to know to consult with a dermatologist trained in a bit of photobiology. Or you could ask a scientist (they are hard to find!). At a recent conference I met Prof. Brian Diffey, an expert in this field. In a recent paper, he concluded “Messages concerning sun exposure should remain focused on the detrimental effects of excessive sun exposure and should avoid giving specific advice on what might be ‘optimal’ sun exposure. http://www.medscape.com/viewarticle/722853

Vitamin D is an essential hormone and we all need a good dose of it. So speak to a dietician or doctor to find which vitamin D supplements are good for you and be sun smart!

Marcie Mom: Thanks Doctor Claudia, your explanation is so helpful, as even though we can’t cure eczema – it doesn’t hurt to understand more of it in order to manage it confidently. I’m looking forward to more of your videos!

SOMEONE has Eczema and manages Occupation as Massage Therapist

Massage Therapist - Paola Bassanese

Massage Therapist – Paola Bassanese

This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Paola Bassanese, who has had eczema since her childhood years and whose work as a massage therapist requires frequent hand-washing. Paola is the founder of Energya, an award-winning massage therapy practice based in Central London.

Marcie Mom: Hi Paola, thanks for taking part in my new blog series ‘Someone has Eczema’ and for returning to my blog (the first interview with you was on massage for eczema). Let’s start with you sharing the severity of your eczema, whether it particularly affects your hands and what would trigger your eczema flares?

Paola: Hi Mei, thank you for giving me the opportunity to share my experience. My eczema is somewhat stress related and can also be triggered by external factors like contact with irritating substances, cold weather and wrong food choices. My eczema is often contact dermatisis and it appears solely on my hands causing cracking in the skin and bleeding.

The random fashion of my eczema flare ups make it difficult to prevent the reoccurence of eczema so my key strategy is to keep stress at bay. This is particularly important because if I am stressed and get eczema I can’t work and being self-employed I need to stay healthy to be able to treat my clients and to run  my business.

My worst eczema flare ups were when I worked in offices and my hands were bleeding and painful when I tried to type or move my fingers. In my first year as a massage therapist when I set up my practice after leaving a well paid office job my stress levels were very high and I had to manage my condition while trying to gain clients. Saying it was a difficult time is an understatement!

Marcie Mom: I haven’t had many massages before, and I think even for those who do, we may not be aware of the chemicals that we come into contact with, and therefore, a massage therapist would also be in contact with. Can you share some of these chemicals in the more common types of massages and whether they cause eczema rashes for you?

Paola: Chemicals don’t tend to be used in the massage industry in general and scent-free natural oils are often used. During the consultation form with a new client the therapist asks if there’s any allergies and will act accordingly. However, in salon and spas offering for example manicures and pedicures therapists are in daily contact with chemicals.

Aromatherapy oils (which I don’t use because of my eczema) can irritate the skin even if they are organic. These oils contain natural chemicals so when they come into contact with the skin they can cause reactions even after years of safe use.

Marcie Mom: Definitely there’s a lot of hand-washing and sanitizing involved in your work, how has it affected you?

Paola: I have become more aware of the types of soaps and detergents I use. I have to wash my hands constantly between clients and I only use mild soaps that don’t strip the skin from its own protection barrier. I then moisturise with creams I have tested that don’t give me an allergic or comedogenic reaction; however every so often I need to change the cream I use as over time I become either over-sensitive or it stops being effective.

Marcie Mom: One final question – you made amazing progress, and was awarded by the Chamber of Commerce for running your business in UK and raising the profile of your Italy hometown, Trieste. You must have known from the onset of your massage therapist career that hand-washing would be an issue, yet you persisted and even set up your own practice and won numerous awards. How did you manage this part of your job, and what advice would you give to others who have eczema and want to pursue an occupation they love (say massage therapist, nursing, dentist) that requires hand-washing?

Paola: Thank you Mei for the compliment. Well, looking back at my life I would say that my worst cases of eczema happened when I felt extremely stressed and did not have control over my work environment. So in that sense it doesn’t matter what job I was doing or what country I was in: it was all to do with mental attitude. Yes, of course contact with allergens and chemicals triggered some reactions but I was at my worst when I felt that my life was going nowhere and I needed more positive challenges and projects.

I would advise anyone who suffers from eczema and chooses a profession that requires frequent hand-washing to look at all these factors:

– Nutrition. Do you have any food allergies or sensitivities? Can you make some changes to your diet to reduce the intake of inflammatory foods?

– Stress. How stressed are you and what can you do to reduce your stress levels? Take time for yoruself and practice forms of relaxation like yoga and meditation

– Products. Do your research and look for cleaning products that are tested against allergies and apply barrier cream when you can.

Marcie Mom: Thanks Paola for taking time to share your journey with us, managing eczema and an occupation that has frequent hand-washing, and going on to be so successful in massage therapy is indeed inspiring!

Best of 2012 MarcieMom Eczema Twitter Tips – On the Emotional side of things..

For those of you who follow me on twitter (my twitter handle, ie twitter name is @MarcieMom), you would know that I tweet an eczema tip daily. For every wednesday of this final month of 2012, I’m celebrating and sharing the best of 2012 eczema twitter tips with you… via a blog post.

It’s a celebration because you’ll see that over the course of this year, I’ve drawn many cartoons that resonate with moms and dads! of eczema children – we all face similar issues, related to high stress and poor sleep. You will also see that EczemaBlues.com is blessed with having renowned doctors and experts throughout the world, lending a hand to parents. Enjoy!

17 of 366 MarcieMom Eczema Tip – Don’t keep saying ‘Stop Scratching!’, rewarding your child for not scratching is more effective (I know, I’m guilty of it too!)

I may not be shouting so loud, but I am SCREAMING inside..

27 of 366 MarcieMom Eczema Tip – Don’t feel guilty parenting your eczema child; You’re the Best Parent for your child

A support group helps with supporting each other in our parenting journey of kids with eczema!

29 of 366 MarcieMom Eczema Tip – Don’t blame on the ‘bad gene’ if child’s eczema is inherited from your spouse. It only creates tension.

Family Tree – Who has Eczema?

42 of 366 MarcieMom Eczema Tip – It’s Sunday and time to take a break & that includes getting off the net searching eczema information!

I remembered I was all nerves googling late into the night, when already tired from taking care of baby

153 of 366 MarcieMom Eczema Tip – Parenting eczema kids is complicated by scratching, don’t feel guilty and over-compensate

One guest I’ve known this year, is Sue Atkins, a parenting expert. You can see the post where she advises on discipline for eczema kids here.

Interview with Sue Atkins, The Parenting Expert

158 of 366 MarcieMom Eczema Tip – If scratching is habitual, consider combining conventional treatment with habit reversal

A repeat guest on my blog this year is Dr Christopher Bridgett, who is a psychiatrist with an interest in dermatology and written a manual that helps practitioners work with parents to reverse the habitual scratching, read here for more.

Parents noting child is scratching (picture credit atopicskindisease.com)

320 of 366 MarcieMom Eczema Tip – Be mindful of sharing what has worked for your child, everyone’s skin is different

Isn’t that so true? Do drop me a comment so that I know my sharing in this blog has worked for you, and also if it hasn’t! Do also help to share on your facebook the blog posts you like, will help me get these labored posts to more parents! Thank you!

Reducing Stress for Children

Lori Lite, Founder of Stress Free Kids

Eczema families face higher stress due to the constant attention required to manage our child’s skin, including the itch and the scratching. Marcie Mom interviews Lori Lite, founder of Stress Free Kids®, who has a line of books and CDs to help children, teens and adults reduce stress, anxiety and anger. Lori started her business when trying to settle her young son to sleep and reduce night terrors of her daughter. Her Indigo Dreams® audio book/CD series has been awarded the CNE Award of Excellence. Lori has been interviewed and/or featured in NY Times, MSNBC, ABC Radio, CBS News, USA Today, Web MD and Prevention Magazine. She is a certified children’s meditation facilitator and Sears’ Manage My Life parenting expert and gained national attention when she appeared on Shark Tank, an ABC/Mark Burnett production.

What is Stress

Stress is a reaction that affects our mind and/or body when we are confronted by a ‘stressor’ – something that angers, scares or worries us. For the child, stress can trigger or worsen the eczema – Dr Christopher Bridgett agreed that skin and stress are related and Dr Ava Shamban spoke about stress increasing cortisol, which in turn increases acne. Read more here about how stress impacts our immune system and skin.

Apart from impact on skin, stress can affect a child’s learning, sleep, emotions and ability to handle stressful situations. Not all stress is bad, as some normal stress encountered prior to a test may help the child to prepare for it. Unfortunately, with eczema, the stress can be chronic (just like eczema) as persistent eczema flares, scratching, lack of sleep and self-esteem can build up in a child.

MarcieMom: Lori, so good to have you on Eczemablues.com; can you share with parents how we can identify that our child is stressed, in particular, for an infant or toddler? Can a new-born be stressed? (I’m thinking of all the writhing and fidgeting of my baby when her eczema already affected her at two weeks old!)

Lori:  Recognizing stress in new-borns and toddlers is difficult. As you noted, you felt your baby’s body language was telling you something was out of balance at only two weeks old. Babies that stiffen their bodies, arch their backs, grimace, and cry frequently can be exhibiting signs of stress. I always tell parents to trust their instincts. Parents, especially moms, know when something is wrong with their children. Keep an eye out for a change in your child’s behavior.  For example: clingy behavior is a sign of stress in toddlers. However, some toddlers are clingy. So if your child is usually not the clingy type and they are suddenly attached to your leg, then that would be a change in behavior.

Some of the signs in children also include: no longer wanting to go to school, an increase in nightmares or night terrors, difficulty falling and staying asleep. Physical symptoms can present themselves as unexplained stomachaches, headaches, or other ailments. Sometimes the child will withdraw from friends and family members, or have frequent meltdowns, which is a common sign of stress for toddlers. It is important for moms or parents dealing with the additional challenges of eczema to be aware of and manage their own stress. Babies, children, and teens pick up on our stress. It is contagious and we must find healthy ways to manage stress and anxiety. We can set a great example to our family and send  a ripple of calm throughout the house.

Common Causes and Ways to Cope with Stress

In a survey of 1,206 young people, 44% are stressed over performance in school and 30% are stressed over family’s finances. In an article on StressFreeKids.com, it is mentioned by David Code, author of “Kids Pick Up on Everything” that “Parental stress can weaken the development of a child’s brain or immune system, increasing the risk of allergies, obesity, or mental disorders.” In other words, “Stress is highly contagious between parent and child, even if the parent is unaware of his or her own anxiety.”

Children cope with the stress they face, usually by doing activities that relax them, such as exercise, music, TV or talking to a friend. As a parent, we can try to help our child cope in a healthy manner, ways that help their mind and body and won’t cause harm such as hitting themselves or others.

MarcieMom: Lori, your books and CDs focus on a few techniques, namely breathing, muscle relaxation, affirmative statements and visualization. For breathing, you mention in this post to

(i)         Have your child lie on their back and put their hand on their belly.

(ii)        Take a slow deep breath in through their nose and let it out through their mouth with a gentle ah-h-h-h-h-h-h sound. (They should feel their belly rise and fall).

(iii)       Breathe in slowly through their nose and out through their mouth like they are trying to move a feather up in the air.

(iv)       Breathe in slowly to the count 2, 3, 4 and out 2, 3, 4.

(v)        In 2, 3, 4 and out 2, 3, 4.

For breathing and muscle relaxation exercises, which age is appropriate to start?

Lori: It is never too soon for a child to reap the benefits of relaxation and meditation. There are reports that state that stress levels during pregnancy can affect an unborn child. I used deep breathing throughout my last pregnancy and I believe that because of this my newborn was easier to soothe when I focused on my breathing. In general the age of 4 is when a child can start to participate in relaxation exercises, but I have seen children as young as 18 months copy breathing and positive statements. Self-care, relaxation and stress management can begin at any age and should be part of daily living. When you feel stressed, tell your children that you are takeing a minute to focus on your breathing. Add visualizing breathing in happy, calm air…Throw an affirmation in like, “I am calm.” Children will copy what they see. Don’t be surprised if they climb up on you lap and breathe with you.

MarcieMom: You also recommended using affirmative statements, and also asking ‘What-If’ positive scenario questions. What age is suitable for this, and can you recommend a few ‘what-if’ questions and affirmative statements that parents with eczema children can use? (I was thinking ‘What if you don’t feel itchy?’ but then I’m WORRIED that will get the child to think about the itch!)

Lori: As soon as children start asking “what-if” and inserting their own fear-filled or negative outcomes, this is the time to implement repeating their “what-if” question and finishing with a positive outcome. For example, the child says, “What if my eczema gets worse?” and the parent says, “What if your eczema gets better?” Another example would be if the child asks, “What if the kids laugh at me?” In turn, the parent should suggest, “What if you find friends that accept you?”  Many children with eczema have food based allergies and might say, “What if I can’t eat anything yummy ever again?” We can empower children by answering, “What if we find new foods together that we can have a picnic with?”

The important aspect in affirmative statements is helping the child see a positive side, and have them focus on a positive outcome that rather than negative. You intuitively knew not to use the word itch in an effort to avoid bringing attention to it. We also want to avoid saying “not.”

MarcieMom: Thank you Lori so much for giving us a few techniques to relieve the daily stress. p.s. to readers of eczemablues.com, I did not receive any money from Lori or StressFreeKids for this interview (else I would stress myself out what you’d think of me! lol)

Combined Approach Series – Stress, Attitude and Habit Reversal

Parents see an acute flare that needs treatment

This is a 4 post series centered on ‘The Combined Approach’ that is explained in the ‘Atopic Skin Disease’, a manual for practitioners authored by Christopher Bridgett, Peter Noren and Richard Staughton (copy of book viewable by joining here). The Combined Approach uses habit reversal to stop habitual scratching in atopic eczema. Dr Christopher Bridgett has previously helped in Friday Doctor Q&A from November 2011 to February 2012 and MarcieMom has invited him to share more about the Combined Approach.

Three Levels of Treatment

In the manual ‘Atopic Skin Disease’, three levels of treatment are stated, namely:

1. Emollient Therapy

2. Steroid

3. Habit reversal

It is advised in your manual that steroid should not be used without follow-up moisturizer but moisturizer can be without steroid application. In the course of recovery, level 3 can be stopped first, followed by 2 and 1. We’ve covered the basics of all three levels in previous posts. There are some further dimensions in the management of eczema as follow:

1. StressStress is one of the possible triggers for eczema. Can you help a parent to identify when a child is stressed and how to see if the child is stressed because of the eczema or because of something else? How can a parent help a child to relax?

Dr Bridgett:

Stress can cause emotional upset – unhappiness and apprehensiveness for example in anyone, young or old. In a child this may include tearfulness, and avoidance behaviour, just as in an adult. Certainly having eczema itself is stressful, for both the child and the parents. Careful observation may clarify if something else is the source of stress: stress comes from common causes, even for the youngest child, and family upsets may be especially important to think about. If there are no other causes and the eczema is troublesome, then adequate treatment of the eczema will be stress relieving – for everyone.

Helping a child to relax usually involves simple acts – giving attention, and comfort, with suitable play, and amusing distraction. Reading a favourite story is a tried and tested bedtime means of inducing relaxation and sleep. But when a child is stressed, enabling relaxation is more difficult, especially if the causes of stress are not identified and dealt with.

2. Attitudes – Positive attitudes are suggested in your manual, such as ‘Manage, Don’t be Managed’ and to be careful so the doctor/nurse does not to ‘spread’ helplessness during a consultation. Should a patient comes across a doctor who is passive about managing the eczema, what can he/she do to change the doctor’s attitude? (Obviously, the other choice is simply switch doctor! But as a service to other patients, someone ought to say something!)

Dr Bridgett:

I find myself saying something about this all the time! Of course the responsibility for a successful visit to a doctor rests with all those involved. Each person should consider first what they themselves can do, rather than seeing any problem as caused by someone else. Some really useful ideas about this were covered when Jennifer talked to me: see http://atopicskindisease.com/articles/20111216 This might make a good topic for people reading this post to comment on here: I suggest your readers share their thoughts and experiences with you.

At some health centres and doctors surgeries there are patient discussion groups to allow people to share ideas on how things can be improved. Has anyone had experience of such a group? Does your doctor ever conduct a patient satisfaction survey?

Review of Habit Reversal

In The Combined Approach, follow-up visits include asking the patient or parent their (i) scratching frequency (ii) when there’s most scratching (iii) % of scratching from itch (iv) severity of eczema (v) % new eczema vs old and (vi) where most eczema. If a parent cannot find a doctor or convince their current doctor to implement the Combined Approach, can the parents implement this on their own without a doctor doing the follow-up (i.e. monitoring scratching on their own)?

Dr Bridgett:

The questions that you detail are in the first stages of The Combined Approach, during the first 4 to 6 weeks when habit reversal is important. The later part of the programme we call follow-up, and then vigilance for acute flare-up is the important emphasis, with early and energetic treatment with topical treatment being the order of the day. Habit reversal is not important long term. It is optimal topical treatment that is essential to maintain the progress that The Combined Approach achieves.

How to use The Combined Approach depends on the resources available. The clinic-based format is very effective, but if it is not feasible a self-help format is a good alternative, as discussed at http://atopicskindisease.com/categories/20110423_18 (joining is necessary to read this, but joining www.AtopicSkinDisease.com is still free!).

Hopefully blogs like this, and websites like www.AtopicSkinDisease.com will now gradually help everyone everywhere to discover how to treat atopic eczema successfully. There is no need now for anyone to necessarilyLive With Eczema: there is now a possibility to learn how to Live Without Eczema.

MarcieMom: Thank you Dr Christopher Bridgett for taking time to explain The Combined Approach. I’m certainly very glad to collaborate on this series with you. Should there be more questions from parents, I’d certainly invite you for another Friday Doctor Q&A!

Dr SEARS L.E.A.N. Series: Raising Healthy, not Stressed Kids

Image from www.drsearslean.com

This is a fortnightly series focused on raising healthy children, following the advice on DrSearsLean.com. Marcie Mom came across Dr Sears’ Lifestyle-Exercise-Attitude-Nutrition approach for healthy families and found it to be practical and fun to follow. However, parents of eczema children may have reservation on certain healthy tips such as bringing their child for swimming (‘Lifestyle’) or eating fruits and vegetables (‘Nutrition’). This series examine if there’s truly a need to restrict eczema children from following the LEAN tips and take note of DrSearsLEAN’s recommendation at the end of each post!

‘Reduce Stress in Your Life’ – Laugh More and Be Grateful

As written on DrSearsLean.com Attitude tips, leading a healthier and happier life comes from having the right attitude to life, and that includes taking steps to reduce stress, increase laughter and be grateful. There are many practical tips to follow but as parents of eczema children, it may be hard to do so; for instance, it’s hard to think positively when the eczema flares yet again for no reason. Or it can be difficult to enjoy a dvd when your child keeps scratching during the movie. Worse, repeated failed attempts to keep the eczema under control could demoralize the parent so much that it’s hard to appreciate the good even in our spouse, not to mention someone we don’t like.  The stress that families with eczema faces is considerable and a study has shown that stress levels in mothers caring for young children with eczema are equivalent to those mothers of children with severe disabilities.

Stress Triggers Eczema

While it may be more difficult to keep the stress level low in families with eczema children, it is important to do so should stress be one of the triggers of the eczema. As stated in Adnan Nasir’s book Eczema Free for Life, stress is the number three trigger and can worsen eczema by:

(i)         Stimulating hormones to be released which result in an increase in inflammatory substances the skin is allergic to

(ii)        Suppressing the immune system which results in a decrease in defense proteins to protect the skin

(iii)       Weakening the lipid skin barrier which results in dry skin that is vulnerable to irritants

Furthermore, stress can also be passed on to our children. So, whatever the situation, take deep breaths and don’t be afraid to ask for help or some chill-out time.

DrSearsLEAN’s recommendation

DrSearsLean.com has several articles relating to stress, for instance:

Reducing Holiday Stress – Tips from Just Say No to Take A Power Nap!

Time and Stress Management – Tips from Planning your day to Managing Stress, using the 4 ‘A’s – Avoid unnecessary stress, alter the situation or change things so the problem doesn’t present itself in the future, adapt to the stressor, or accept the things you cannot change.

9 Great Ways to Keep your Body Happy & Avoid Inflammation – Tips from Staying Lean to Taking Care of your Gums!

MarcieMom: Thank you Dr. Sears for your recommendation. Next interview, we’ll check out museums, factory tours and swimming on your Lifestyle tips!

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