Friday Feature – Stress Management Q&A with Dr. B

Q&A with Dr Christopher Bridgett

MarcieMom (@MarcieMom) met Dr Christopher Bridgett (@ckbridgett) through Twitter – and learnt that he had a special interest of using behavioural interventions to help people with atopic eczema. DrB trained in medicine at Corpus Christi College, Oxford and St Bartholomew’s Hospital, London, then as a psychiatrist in Oxford. He now works in private practice in London. He has co-authored several publications on The Combined Approach, that proposes using habit reversal to stop habitual scratching in atopic eczema. To find out more about behavioural dermatology, click http://www.atopicskindisease.com/articles/PeterNoren to read DrB’s interview with Peter Norén MD, the Swedish dermatologist who created The Combined Approach.

Marcie Mom: Good day Dr B, a stressful week has passed and  today’s questions are related to the stress that parents with eczema children face and the strain in their marriage: Most parents of eczema children have no time for themselves, let alone exercise. Obviously, we know exercise is good for us but how does exercise affect our psychological well-bring?

Dr B: Great question! We seem to live in stressful times. Under stress the body releases hormones like adrenaline, that facilitate fighting, or fleeing! In modern times we can’t do either usually, so its important to have a regular physical outlet. A healthy mind in a healthy body.

Marcie Mom: Also, parents of eczema child tend to have less couple time and higher stress in marriage. What simple and practical advice would you give them?

Dr B: The first step is the one you have already taken: recognize the problem. Coping always begins with confronting reality. Next how it leaves you feeling needs expression – don’t bottle it up, let it out, talk about it, understand it and think it through.

Then consider getting and accepting help – problems shared are problems halved. Experiment with new ways of doing things. Don’t take the situation for granted – there is usually a way of changing arrangements for the better. DrB

What I’ve learnt from Dr Ava Shamban’s Channel – Protecting Skin

Dr AVA MD’s Channel

Been watching Dr Ava Shamban’s Channel – a series of youtube videos relating to skincare. Dr. Ava Shamban–a renowned board-certified dermatologist licensed to practice medicine in California, New York and Hawaii–graduated magna cum laude from Harvard University before receiving her medical degree from Case Western Reserve Medical School. In addition to serving as Assistant Clinical Professor of Dermatology at the UCLA-Geffen School of Medicine, she is recognized as the “Extreme Makeover” dermatologist and the resident expert on the Emmy winning daytime talk show, “The Doctors.” Dr. Shamban is also author of the new book, Heal Your Skin: The Breakthrough Plan for Renewal (Wiley)

Here’s what I’ve learnt from various video, do check them out by clicking the video name 🙂
Exercise can increase circulation, thereby increasing nutrients to the skin and reducing toxins. Cortisol, produced by adrenal gland, will also be reduced (cortisol lowers immune system). Any exercise that can be carried out on daily/ every other day basis is good!
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Stress can manifest both internally and externally, on the skin. Stress, increases cortisol, which is viewed as a male-like hormone (androgen) and increases acne. To destress, relax and nap. A combination of rest and exercise is always beneficial.
See also my post here on stress on children with eczema.
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The skincare products suited for you may not necessarily be the most expensive; label-reading is important (which is why I’ve started the Sensitive Skin Products series with VMVHypoallergenics). Make sure that the active ingredient is in the first five ingredients and the product is fragrance-free. In Dr Ava’s words ‘If you want to use perfume, use perfume; but not on your face’.
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Choose a high SPF especially at least SPF50 on higher altitude. Choose one that is not too oily or greasy and comfortable to use (with make-up). If doing sports, need a water-proof or resistant one. Sunscreen on the face is formulated differently with that on the body.
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Sun-protection is discussed and Dr Ava’s recommendation is to have a high SPF sunscreen, wide-brimmed hat and wear sun-protective clothing (there’s even for babies with SPF 50 rating). Choose physical sunscreen that’s safer for children (you can see this post for more info). For face, a non-comedogenic lotion with SPF can also be used. There’re also certain foods that can help increase SPF, mainly red/purple fruits such as pomegranate, carrots, watermelons, blueberry and raspberry!

One more reason not to Stress your Child

Stress can be a trigger of eczema

Stress is one of the more common triggers of an eczema flare-up. Studies revealed that babies, young children and teenagers all suffer from stress, and usually go unnoticed by the parents.  Stress can come from many sources, such as separation from parents in preschool, academic pressure, peer pressure, knowledge of financial or work difficulties faced by parents, divorce, illness or death in the family and (depressing) world news.

Chronic stress, such as from divorce or death, affects the child more; and note this, stressed parents can pass on the stress to their children.

For an eczema child, stress may trigger a flare-up because

– Stress results in more hormones release, which in turn lead to over-production of cytokines that cause immune cells to release inflammatory substances which sensitive skin is allergic to.

– Stress suppresses the immune system, through the increased level of cortisol produced by the adrenal gland. The skin is less able to produce sufficient defense proteins, making it vulnerable.

–  Stress leads to lower skin cell growth and weakening of the fat/lipid skin barrier, resulting in drier skin. Dry skin is vulnerable to irritant.

Apart from triggering eczema, stress has other negative effects such as

– Impair the connection of brain circuits, resulting in smaller brain, slower learning and poorer memory

– Over-reactive to small problems, resulting in an inability to handle stress

So, how can you tell if your child is stressed?

– Behavioural/Emotional – acting out, refusing to go out, complaining, mood swings/outburst, withdrawn, too shy, fear of failure, worrying all the time, spent time alone, sucking thumb, twirling hair, biting nails, nightmares, clingy/fear being alone, anxiety, irritability, rocking, freezing up, obsessive about objects/food, constantly asking what’s next

– Physical – bed wetting, problem sleeping/eating, stomach ache, headache, regression in toileting, excessive crying, trembling, accident prone, over-react to sudden loud noise, sweaty palms

– Intellectual – Lack of concentration, inability to complete homework

And how do you help your stressed child?

– Establish a routine

– Ensure your child gets plenty of rest, and not ‘hurried’ to too many activities

– Give your child proper nutrition

– Spend time, listening and being there

– Exercise/ share activity with your child

– Encourage your child to keep a journal

Read more tips for parents on this link and also impact of stress article from National Eczema Society; I’m going to chill and read a book, so that I won’t be stressed!

Friday Feature – Eczema Q&A with Dr. B

Q&A with Dr Christopher Bridgett

MarcieMom (@MarcieMom) met Dr Christopher Bridgett (@ckbridgett) through Twitter – and learnt that he had a special interest of using behavioural interventions to help people with atopic eczema. DrB trained in medicine at Corpus Christi College, Oxford and St Bartholomew’s Hospital, London, then as a psychiatrist in Oxford. He now works in private practice in London. He has co-authored several publications on The Combined Approach, that proposes using habit reversal to stop habitual scratching in atopic eczema. To find out more about behavioural dermatology, click http://www.atopicskindisease.com/articles/PeterNoren to read DrB’s interview with Peter Norén MD, the Swedish dermatologist who created The Combined Approach.

MarcieMom: Welcome Dr B & on behalf of all parents, we’re delighted to have you on EczemaBlues.com to answer a question that we have every Friday.

Here’s today question:

Parents taking care of eczema children experience high stress levels, apparently as high as parents taking care of children with kidney illness. I’ve also read that stress can be passed onto babies, is there a chance that the stress that parents of newborn feel may worsen the eczema of the baby? Without making parents even more stressed (that they are passing on the stress!), are there any tips for them to manage their own stress or to prevent stressing their child inadvertently?

Dr B: The causation of atopic eczema is multifactorial – there is no one factor, there are many, and they can be divided up into those that we have to accept, and those that we can do something about. First we need to draw up the list that applies in a particular case – stress is usually there on the list, and stress is usually a factor we can do something about!

Stress and frustration directly affects the skin – the skin is very sensitive to our emotions, and we all tend to scratch more when stressed and frustrated, and scratching soon becomes habitual – which is the cause of chronic eczema. There is no doubt that stress can be part of family life; kids become how they are through their parents, don’t they?

Please learn more about stress and how it affects atopic eczema at www.atopicskindisease.com – where there is advice on stress management. Let me know what you think! – DrB.

10 reasons why parents with eczema child have a tougher time

Stressed out Mom

How often do you feel like tearing your hair out? Pretty often for me, especially when Marcie was between one to ten months old. Her eczema was all over her body, scalp and face and she didn’t know how to distract herself from scatching.

Having been both a stay-at-home and a working mom, I fully understand the additional demands of taking care of children with eczema, whether or not you’re working. I didn’t have a helper or another adult to help out during the day. I was alone at home, trying my best to stay calm taking care of my baby and to be a good home maker. The stress level was sky high, knowing that any attention lapse could result in scars/broken skin on my baby.

If your spouse/ family member is taking care of a child with eczema, do emphatise with them as you can see below it’s a lot tougher to care for an eczema kid.

1.       Not even a minute’s break. A child with eczema will scratch when the skin is ‘triggered’, tired, sleepy, hungry or for no reason at all. Marcie scratches whenever she’s not occupied or when left alone. At one point, I couldn’t go to pee or poo or bathe until my hubby return from work.

2.       Fatigue from lack of sleep. A child with eczema tends to wake up in the middle of the night and scratch. I am still co-sleeping with Marcie so that I can hold her hands whenever she scratches. Lack of sleep leads to fatigue which also raises the stress level. Since Marcie was born, I haven’t slept throughout the night (but I’ve got used to it).

3.       No time to eat! If the restaurant is not cool enough or contains allergens that a child is sensitive too, the child will start scratching soon enough. I lost more weight than my weight gain during pregnancy plus, I’ve got into a habit of gobbling down my food as I know I only got a few minutes before Marcie starts to scratch.

4.       No time for exercise! It is extremely difficult to gather the energy to exercise when (and that is a BIG WHEN) there is a little free time. When I do have the chance to jog, the exercise routine only last for 2 weeks before my baby changes her routine. Most days, I choose to chill with my hubby ‘cos we have so little time to ourselves.

It’s no wonder why you or a parent with an eczema child is so high-strung. The basic needs of sleep, eat, exercise, pee & poo can’t even be met properly. There is this study that concludes the stress levels in mothers caring for young children with eczema are equivalent to those mothers of children with severe disabilities. Below are some other emotional issues that you or the parent may face.

5. Guilt. It is easy to feel guilty when you are the only care giver and your baby ends the day with blood. I remembered feeling guilty when I dozed off for a minute and heard my baby scratching her neck. I remembered checking on her when I finished cooking and saw that she woke from her nap and scratched till blood from her ears run down to her face. I remembered checking on her when she was in a baby chair and realized she scratched her neck against the metal frame till bleeding. I remembered questioning myself if it was right to tie her up for a few minutes when I prepared her milk. It took me some time but I know now that I’m the best mom for Marcie and there’s no reason for guilt.

6. Isolation. A stay-at-home mom has no one to share your day and you lost your work status. For parents with eczema kids, it is very difficult to share with people who have not gone through the same. Worse, you tend to get suggestions that somehow point to you ‘mis-caring’ for your child.

7. Anger and blame. Eczema is an immunology disorder and it is half the time inherited. It took quite a few months before I stopped accusing my hubby about him passing on his ‘bad gene’. It does no good and doesn’t help our relationship.

8. Almost no time with spouse. That’s a big issue when the child takes so much attention, from both parents. I have yet to learn to enjoy the moment with my hubby when our baby is with us.

9. More housework. If the trigger for your child’s eczema is dust mite dropping, then you may spend more time vacuuming the house, changing bed sheets and cleaning the toys. More housework again means less time with spouse (and seldom both agree on how much housework to do!)

10. Less money. Moisturisers, bath oils, steroid, specialist appointments all don’t come cheap. Financial burden may place additional stress on the couple relationship.

One thing I’m glad to report though, it is possible to manage all of these better overtime. One good that comes out of taking care of Marcie for the past 15 months is that I’m proud of myself, my hubby for managing it so well and is more confident of our ability to weather difficulties together.

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