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Living with Eczema

SOMEONE Manages her Eczema, Allergies and Food Intolerances

WhatAllergy on Eczema BluesThis is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Ruth who is sharing about her eczema, allergies, food intolerances and allergic march. Ruth is a copy writer and marketing communications specialist (Ruth Holroyd) and also has an allergy blog WhatAllergy.

Marcie Mom: Hi Ruth, thanks for sharing about your multiple allergic conditions. Let’s start with you sharing a little of your atopic history.

Ruth: Well I was born with eczema, I don’t ever remember NOT having it. Then a peanut allergy, hay fever, asthma and then allergic to dog and cat dander and I was on the allergic march.

I was also allergic to egg as a baby but I can eat eggs now when well cooked though I have to be careful not to overdo it or they can start to make me fell unwell. This now just an intolerant reaction which is easy to manage and I save eggs as something to eat when I eat out.

The eczema has been with me as long as I can remember but does seem to go in cycles. It does clear up sometimes for a few years then comes back to bite me.  I have it pretty well under control but I know that certain foods cause awful itchy eczema to flare up.  Dairy is the worst for this as well as tomato, celery and fresh coriander.  It gets me the day or even two days after eating and my skin will be boiling with pain, red, raw and like a think crusty hard scaly mask of pain. This mainly gets my face and neck but can be all over and even tiny traces can do this.

I have allergies now to all nuts, soya, dairy, kidney beans, celery, tomatoes and pretty much everything processed and any kind of lactic acid. Beetroot and cucumber are suspected foods but this seems to be a bit random.  And the thing is it’s a different reaction with each food. Often delayed and causing eczema so often doesn’t show up in allergy testing. But if I exercise WHAM – if I’ve eaten the above allergens, especially dairy or celery I’ll get anaphylaxis which is just terrifying.

Soya milk causes me immediate and severe asthma. Soya protein, flour and other types cause less dangerous asthma but I’m better avoiding any soya.  It has meant I have reduced my asthma medication drastically since discovering this was a trigger.

I also have a wheat intolerance which I often just don’t mention as it’s not life threatening but it’s really painful, causes extreme constipation and bloating and very very bad wind!  I know if I’ve eaten any.  Not great for anyone who is near when I eat any gluten or wheat.

Marcie Mom: How have so many allergic (and hypersensitivity) conditions affect your lifestyle and quality of life?

Ruth: I try not to let them affect my life but it’s impossible to completely achieve this.  You have to be really well prepared. So I try to have lots of fresh food in the house. I tend to just avoid the allergens and not use many freefrom branded goods because they often contain one of more of my allergens.   Home cooking from scratch is the norm but there are some amazing healthy freefrom ready meals coming out like ilumi which make life just a little more fun.  I tend to cook extra and freeze portions for days when I can’t face cooking.

Eating out is a huge challenge.  I do try to do this as you really miss out when you just never go out but I try to go for entertainment options where food is not involved like walks with a picnic, drinks instead of a meal, shopping, cinema etc. The options are endless. But eating out should be a treat and I have managed to have some lovely meals out but not without military planning, endless checking and just a little worry.

Going on holiday is a challenge too because you NEVER get a holiday from allergies.  We go self catering or camping and this works well.  Expensive hotels tend to be better too as they are less dusty and have better catering but small B&Bs can be wonderful if you can find one you trust which isn’t going to trigger any of your allergies. I find dust is one of my hardest as even in a busy pub I’ll be wheezing if it’s got carpet and curtains.

I know it’s tough on my husband and family too who have to cater to my every whim (Now wouldn’t that be nice?) and often change plans so I’m safe, take extra care in the kitchen etc.  Family and friends have been amazing at helping me stay safe, always have an eye out for mistakes I might make and often surprise me with their kindness and understanding.

Especially with the eczema. What I feel like is a raging, red, angry, miserable horrible person. What they is just me and often they say my skin looks fine. Just a little pink and maybe like sunburn. Not something to worry about but I imagine everyone is horrified.  Learning not to care what your face looks like and what people think is a hard lesson when you can feel it itching and burning but if you take your mind of your eczema and go out you scratch a little less so it’s well worth it.

Marcie Mom: Does your career choice have anything to do with your eczema and allergies?

Ruth: Probably not really but I did want to be a policewoman which was an instant no go when they discover I anaphylaxis AND multiple triggers caused by exercise. Not good really.  Working from home has made my life so much easier. I can take a morning off if I’ve had a really bad allergic reaction and I can catch up when I’m feeling better.  Noone can see me on really bad eczema days and this does take off the pressure.  If I was working full time I would have had a terrible work record over the last few years as the allergies have been so much worse. I’m getting them under control now though and working out ways to stay safe – I have been a bit lax and made lots of mistakes but we live and learn.

Marcie Mom: One final question – what advice would you give to a lady who wants to build confidence and meet more people, despite visible eczema?

Ruth: It really needed not be a life sentence although it often does feel like one.  My advice is always to try to accept it, so you have allergies. Big deal. You can live with this if you’re careful and on the plus side I am really healthy, don’t put on weight, have learnt to cook amazing tasty food, love cooking and baking now, have met some amazing inspiration people through blogging, judging on the freefrom food awards and public speaking.  I also organise an Allergy Support Group. This is a great way to meet like minded people and have a good moan in a friendly place where people really get you.  Get involved in local groups like this, join forums and learn as much as you can and make sure you get the support you need from your doctor and allergy specialists – not always easy but vital as these things change and can get worse without warning.

Keeping eczema and asthma under control can have huge impacts on allergic reactions. If skin is not moisturised well and breaks down allergens can and will penetrate your skin too. If you asthma is not well managed you could get far worse allergic reactions. By keeping these areas well managed you can greatly help your allergy health.

Exercise too for me is key. The fitter I am the less allergic I am. Not sure why but maybe you sweat out the allergens quicker or maybe the body is just better able to process allergens. Who knows, but it’s another way of enjoying a better life too. Eat well and exercise.

Also everyone should read my blog – it was voted in the top 5 UK allergy blogs last year and is jam packed with useful tips, product reviews and advice for living life to the full with life threatening allergies, eczema and asthma.  Life is for living and there is always someone worse off than you.  Life with allergies and eczema can have its positives too and lots of them so keep smiling and moisturise!

Marcie Mom: Thank you so much for sharing your eczema and multiple allergies. Many can identify with it and I do hope ladies reading your sharing will be encouraged.

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Doctor Q&A

Parent (Patient) Eczema Consultation Tips with Dr Susan J. Huang – After Consultation

Eczema Consultation How to Talk to Your Child Dermatologist Dr Susan Huang

I am privileged to know Dr Susan J. Huang, the chief resident at the Harvard Dermatology Residency Program, who works at multiple prestigious hospitals in the United States. She has written book chapters, published peer-reviewed articles, and presented at multiple national conferences on issues and topics in dermatology.

Marcie Mom: Thank you Dr Huang for last week’s tips on during consultation, this week we are focusing on after the consultation when the parent is now to manage and treat the child’s eczema, as advised by the doctor.

When to Call Your Child’s Dermatologist

A common scenario is that he/she would be doing all as told, but find that the child is still scratching incessantly (and sometimes, with blood and tears daily)! Eczema is a chronic condition to be managed and parent shouldn’t be expecting miraculously smooth skin just because a doctor has been consulted.

Under what circumstances would it be justified to call the doctor before the next consultation? 

Dr Susan Huang: Hopefully, the physician has talked about what to expect from treatment during the visit. As you said, eczema is indeed a chronic condition and does not go away overnight. Setting expectations for the short term and long term period is a good idea at every visit. However, if there are any questions after you go home, you should feel comfortable calling the doctor’s office to get those questions answered and to see whether you need a visit to the office sooner.

Setting expectations for the short term and long term period is a good idea at every visit

Should the Eczema Treatment include Lifestyle?

MarcieMom: As advised by Prof Hugo, I bring my child for swimming regularly to reduce the staph bacteria. Lately, after learning more about nutrition from Toby Amidor and Julie Daniluk, I also feed my toddler with more anti-inflammation food and flaxseed oil. I know that there is no conclusive study on nutrition’s impact on eczema, but can and should a doctor advice outside of standard treatment options to include lifestyle and nutrition?

Dr Susan Huang: While we often think of pills and medications when we think about the practice of medicine, medicine really is much more. There are many lifestyle practices that can help in eczema and learning about these practices is helpful. Bleach baths, wraps, use of emollients are all treatments that are behavioral and can help in eczema. It is always a good idea to ensure good nutrition for all patients as well.

Sharing Relevant Information to Dermatologist

MarcieMom: Some eczema patients do feedback that their doctors don’t seem interested to listen to what the parents have to say regarding the child’s skin and eczema. It may truly be the case but does a parent have to be mindful to share what’s relevant to the doctor? For instance, is it possible that parents worry too much and discuss too many (remote) triggers? What is a clear sign of a disinterested doctor or one that shows no empathy for eczema?

Dr Susan Huang: It is important to have a good relationship with your child’s eczema doctors since eczema is a chronic disease. This patient/parent-doctor relationship will be one that extend beyond the initial visit! Every patient/parent-doctor relationship is different and the dynamics of the conversation of each visit depends on this relationship as well. If you find that there is difficulty in communication, you should find a doctor with whom you feel comfortable communicating with.

What to Do if You are Changing Your Doctor

MarcieMom: Suppose a parent has found another doctor and wishes to stop seeing the current one. What should he/she ‘take-away’ from this doctor to the next? For instance, asking for the client-file? Does that belong to the hospital/doctor or to the patient? Also, I know that if a child is prescribed oral steroid, the follow-up consultations by the same doctor is important to assess the follow-up treatment options (and also completing the course as prescribed) Should a parent stick to the same doctor till the oral steroid course is over? (Do read my toddler’s positive experience with oral steroid)

Dr Susan Huang: It is helpful for your new doctor to know what evaluation has been done (including any lab tests, allergy tests) and what treatments have been tried. This way, you won’t “reinvent the wheel.”

Don’t Reinvent the (Eczema Treatment) Wheel

In the United States, patients can request a copy of their medical files. This can be done through the doctor’s office, or if you are in a larger hospital, you may need to go through the medical records department.

Since eczema is a chronic disease, it is helpful for the doctor to get a sense of what the course of the disease has been and what the response to a certain treatment has been (whether it is oral steroids or another treatment). This is often easier if it is the same doctor, but sometimes that is not possible. If it is not possible to stick with the same doctor, make sure to have the documents pertaining to your child’s care. Photos can help as well.

Thanks Dr Huang, it has been a very helpful 3 weeks and I’m sure many parents will find this series helpful; My take is no matter what, don’t forget to enjoy our children with eczema (despite the eczema)!

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Eczema Life Cartoon

Life of Eczema Girl – Newborn Babies (Inspired by Liza Donnelly)

Newborn Eczema Babies room - Inspired by New Yorker Cartoonist Liza Donnelly, from her book 'When do they Serve the Wine?'
Newborn Eczema Babies room – Inspired by New Yorker Cartoonist Liza Donnelly, from her book ‘When do they Serve the Wine?’

Half a year or so ago (who’s counting when you read cartoons), I came across the cartoon book ‘When do they Serve the Wine?‘, by New Yorker cartoonist Liza Donnelly. I instantly fell in love with it. This cartoon is inspired by Liza’s cartoon, where she drew about the baby boys being on one side and the baby girls on the other.

The lead eczema girl from last week is at the top left of this cartoon, and fyi, 20% of children have eczema, those who have (I suppose) have a darker world, hotter, crankier…well, we all have to go through life no matter what, we’ll see how it works out for our little eczema girl.

This is the 5th of my 2nd cartoon series, ‘LIFE OF AN ECZEMA GIRL’. For more cartoon in this series, check out here.

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Living with Eczema

SOMEONE Manages her Eczema, Allergies and Chronic Pain

Jen shares on managing eczema, allergies and chronic pain
Jen shares on managing eczema, allergies and chronic pain

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Camper Jen who is sharing about her eczema, allergies and how she manages it all along with her chronic pain. Camper Jen founded PainCamp and holds a license in her field of clinical social work with specialties in the areas of Mental Health, Medical and Chemical Dependency.

Marcie Mom: Hi Camper Jen, thanks for participating in this eczema sharing series. I know you have confirmed food and environmental allergies, can you share with us when you first got allergy tested and what prompted you to do so?

Camper Jen: As a baby, the doctor told my mother that I was allergic to dairy. Between the ages of 12-14, I was tested again with blood and skin tests. I also had testing done for sensitivities as well as allergies. All of the allergies and sensitivities were confirmed back then but I basically ignored the results (except for the 3 years of allergy shots). Two years ago I was diagnosed with Chronic Pain Syndrome (along with many other diagnoses). That brought me back to addressing my allergies, sensitivities and food intolerances as causes or contributors for some of my symptoms. This time around I am addressing them with direction from a naturopath.

Marcie Mom: What about your eczema – when did it start, and how is your skin now?

Camper Jen: I was diagnosed with eczema as a young teenager. I just had an appointment with the dermatologist a couple of weeks ago and she said I’m getting hives along with the eczema now. This is due to higher histamine levels as I’m probably reacting to something I’m eating (oops – corn) as well as my environmental allergies (it is summer time here). The areas that are most affected are my legs, backs of my knees and the inside of my elbows.

Marcie Mom: I read from your site that you also have Chronic Pain Syndrome and a lot of other health conditions. Did any of these conditions make it harder for you to manage your eczema, or even trigger eczema flare-ups?

Camper Jen: Early on in my diagnoses of Chronic Pain, I was using warm water pool therapy as a part of my pain management approach. Due to my Multiple Chemical Sensitivity (along with not having my food allergies/sensitivities under control), my eczema was not managed well during this time. After every visit to the pool (5x a week) I had uncontrollable eczema symptoms. I am not able to manage my eczema with conventional prescription lotions, creams and soaps that my Dermatologist has prescribed because I am sensitive to the chemicals that are in them. I’m trying to find a great organic and non-toxic lotion or cream to sample. If anyone knows of any that works for them, let me know!

Marcie Mom: One final question – what advice would you give to someone who is managing eczema and other chronic health conditions?

Camper Jen: I have experienced frustration with having eczema on top of other chronic health conditions. I have found some relief by addressing my allergies and sensitivities under the direction of a naturopath. My dermatologist is not familiar with holistic and organic approaches to treatment so I’ve started to look elsewhere for help. I would encourage people to look more closely at possible causes and triggers for their eczema (allergies and also sensitivities/intolerances) and seek consultation from a holistic practitioner. There are also other mind/body approaches I have found that helps take my mind off the itching sensation (tai chi chih and listening to music). If one approach doesn’t work, keep trying and don’t give up!

Marcie Mom: Thank you so much for sharing about your eczema, allergies and your journey in healing your body. Truly appreciate the positive vibes and good work you’re doing to help others!

Camper Jen: Thank you for this opportunity to share how eczema has affected my life. We can all learn from each other!

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Doctor Q&A

Parent (Patient) Eczema Consultation Tips with Dr Susan J. Huang – During Consultation

Eczema Consultation How to Talk to Your Child Dermatologist Dr Susan Huang

I am privileged to know Dr Susan J. Huang, the chief resident at the Harvard Dermatology Residency Program, who works at multiple prestigious hospitals in the United States. She has written book chapters, published peer-reviewed articles, and presented at multiple national conferences on issues and topics in dermatology.

MarcieMom: This week, we will focus on communication during the consultation. Most parents would have heard about allergy testing and after supposedly sharing with the doctor various suspected food & non-food triggers, he/she may expect to have an allergy test conducted for the child. Is that a reasonable expectation?

Are there justifiable circumstances when a doctor would say that an allergy test is not needed?

And should a parent always insist to have one? (as to how doctors decide on what triggers to test, refer to Prof Hugo and Dr Liew Q&A)

Allergy Testing for Your Child with Eczema

Dr Susan Huang: The decision whether or not to allergy test is one that is based on your child’s particular situation.  During your consultation, your physician will ask you questions about triggers to your child’s eczema.  Triggers may include food & non-food triggers as you mentioned.

As we discussed in the last post, it’s important to have the details of these triggers ready in preparation for the visit.  The visit will also include a physical examination to see whether findings are consistent with a food allergy.  If certain foods or other exposures are suspected, your physician can then work to help confirm the trigger and come up with an appropriate panel of tests.  Testing may include skin prick, RAST, or oral challenge testing.  If a contact dermatitis is suspected, patch testing is performed (this is where small quantities of different contactants are placed on the skin).

The role of allergy testing in eczema is still a debated topic but we certainly do know that allergies, asthma and eczema run together, creating the “atopic triad.”  Now, studies have shown that 1 in 28 suspected food allergies are not true food allergies, but rather “intolerances.”  So, it’s important to know whether one truly has a food allergy or not, because you don’t want to limit your child’s diet unnecessarily (providing well-balanced nutrition is important for the growth of your child!)

It’s important to know whether one truly has a food allergy or not, because you don’t want to limit your child’s diet unnecessarily

What to Ask after Getting a Prescription

MarcieMom: The prescription given by the doctor is typically moisturizing creams with topical steroid treatment and the instruction usually to moisturize frequently while steroid is to be used sparingly and not more than twice a day.

What would you advice the parent to find out more from the doctor?

For instance, asking how the eczema rash would appear after a week of application? And when it’d be cause to come back earlier than scheduled for another consultation? (I think doctors usually refrain from talking too much about specific creams, parents can refer to this Q&A with Dr Verallo to identify the top irritants in creams and also this Q&A with Dr Bridgett to learn how to apply topical cream and steroid, and this post on steroid strength and steroid-phobia.)

Dr Susan Huang: Great question.  Questions about the use of topical steroids frequently come up. Make sure you review an Eczema Action Plan with your physician before you and your child leave from your consultation.  Having this information written down is important so that you don’t forget the details. Action items may include non-medication therapies (e.g. moisturizing, bathing techniques include bleach baths, wet wraps or wet pajamas, etc) as well as medications (e.g. topical steroids).  It is important to clarify how much of the lotion/cream/ointment, to where it should be applied, and when it should be applied and for how many days.  As you mentioned, also ask what you should expect to see at the end of the treatment course that your physician has detailed to you.  It is important to have this information written down because it’s hard to remember all these details!  We provide these written eczema action plans in our clinics.

Make sure you review an Eczema Action Plan with your physician before you and your child leave from your consultation.

Your Child’s Eczema Action Plan

Eczema Action Plan Items
Non-Medication TherapiesMoisturizing
Bathing
Wet Wrap
Medication TherapiesTopical steroid
TCIs
Clarify 1. how much to apply
2. where it should be applied
3. when it should be applied
4. for how many days
What to expect at end of treatment
When to call the dermatologist

Absolutely clarify follow-up plans before you leave for your visit. Your physician may tell you when to come back or may say to come back if the rash does not get better. In addition, she/he may give you a list of warning signs to look out for, e.g. if your child’s rash doesn’t get better after the treatment course, develops fever/chills, the rash becomes crusty, weepy or ulcerated — showing signs of infection, etc.

From American Academy of Dermatology

MarcieMom: Thank you Dr Huang, it’s good to know your point of view as to what is acceptable to be asked during a consultation, as some parents may be too shy and leave promptly with many questions still unanswered and then (worse), not carry out the treatment as directed cos they are fearful of what has been prescribed.

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Eczema Life Cartoon

Life of Eczema Girl – Swaddling

Do a Swaddled Eczema Baby feel HOT?
Does a Swaddled Eczema Baby feel HOT?

This is the 4th of my 2nd cartoon series, ‘LIFE OF AN ECZEMA GIRL’. Every newborn baby is swaddled, and I always wonder if my baby had felt hot. And yes, either my swaddling technique is lousy or she squirms so much, the swaddle is usually a mess! For more cartoon in this series, check out here.

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Living with Eczema

SOMEONE Manages Eczema Herpeticum

Jenny with severe facial eczema
Jenny shares on her eczema herpeticum experience

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Jenny who is sharing about her eczema herpeticum experience. Jenny blogs about her own personal experiences with eczema at i-have-eczema. She also has a lovely blog at Little Jenny Wren on her crafts, cakes and fashion.

Marcie Mom: Hi Jenny, thanks for sharing about your eczema herpeticum experience. Let’s start with you sharing a little of eczema history.

Jenny: Hi Mei! Thanks for having me! Eczema only became a problem for me in my mid-teen years when I became a lot more exposed to environmental allergens. Since this time it has become very widespread affecting every part of my body except my nose, fingers and feet. As a child I suffered more so from asthma and hay fever but as an adult I suffer with severe eczema. 

Marcie Mom: When did your eczema herpeticum occur and what happened before and during treatment? (an archived post on Eczema Herpeticum – What is it and is it dangerous?)

Jenny: Since April 2012 I’ve contracted Eczema Herpeticum 7 times. Eczema Herpeticum is when the herpes simplex virus presents itself in an eczema sufferer, but instead of getting a cold sore or two, the virus spreads rapidly through areas that are affected by eczema. This can be an extremely dangerous condition, especially if not treated swiftly, as it can go on to affect organs and even cause septicemia and other life-threatening conditions.

My most recent outbreak is the worst I’ve ever experienced. It started in my eyes as a mild itch that I put down to being possible conjunctivitis. However over the course of the day the typical warning signs of eczema herpeticum became apparent as the cold sore-like vesicles presented themselves. It became so bad that I couldn’t even open my eyes. I also went on to develop a secondary infection of Periorbital Cellulitis so required emergency medical help. I then went on to spend 6 days in hospital being treated through an IV drip. It was pretty frightening as when I’ve suffered with eczema herpeticum in the past a dosage of Aciclovir tablets have been able to sort me out… but not this time.

Jenny on Eczema Herpeticum

Marcie Mom: Is there any medication and follow-up consultation required?

Jenny: In my case because I’ve contracted this virus so often, I am on a near-permanent course of Aciclovir tablets in order to keep it at bay. Most people would only require enough medication to treat the initial outbreak as it is uncommon for it to prevail as it has for me. I also see a dermatologist at the very least of once a month to ensure my skin is in good control.

Marcie Mom: One final question – what would be your biggest take-away from this experience?

Jenny: In all honesty I’m not sure how to answer this question. I’m now at a stage where I’m terrified that it will happen again to the extremity that I ended up hospitalised. It has only been a week since I was discharged after all. I guess in order to overcome it I need to get my immune system into a workable order as it is when you are run down and stressed that the herpes simplex virus breaks out. As an aside note, I have been taking immunosuppressants to control my severe eczema for a few years now and so these will not be helping to treat my immune system. If possible I would suggest to take eczema through the natural route to try to stop your immune system from getting into this state as mine has.

I’ll also add that I was never affected with the herpes simplex virus until I met my current partner who periodically suffers from cold sores. I never in my wildest dreams expected it to manifest in me as it has. Cold sores are such a common contagious infection that can be spread through something simple such as sharing towels and touching things that the infected person has touched. They’re pretty hard to escape from so always practise good hand hygiene where possible.

Marcie Mom: Thank you so much for sharing your eczema herpeticum journey, quite a few children had it too and parents reading this would have gained some insight.

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Doctor Q&A

Parent (Patient) Eczema Consultation Tips with Dr Susan J. Huang – Before Consultation

It’s fairly common to hear eczema patients lamenting that their doctors seem to be just prescribing creams and not listening enough. It can be even more difficult for parents, particularly as we are not the one ‘experiencing’ the eczema but we’ve got the responsibility to learn as much from the doctor (while keeping our toddler quiet)!

Eczema Consultation How to Talk to Your Child Dermatologist Dr Susan Huang

I am privileged to know Dr Susan J. Huang, the chief resident at the Harvard Dermatology Residency Program, who works at multiple prestigious hospitals in the United States. She has written book chapters, published peer-reviewed articles, and presented at multiple national conferences on issues and topics in dermatology.

Marcie Mom: Thank you Dr Huang for taking your time to offer tips to our parents on what they can do before, during and after consultation, as well as what they need to consider if changing their doctor. Let’s start right away with preparing for a doctor consultation.

How to Prepare for Your Eczema Consultation

MarcieMom: I’m assuming that the child has already been diagnosed with eczema and the parent is looking for a suitable doctor. In Singapore, there are many good doctors, some of whom listed here. I note that each doctor has their own specialty/ interest apart from being a pediatrician – immunology, allergy, asthma and/or dermatology.

Must a parent specifically ask for a doctor in a particular specialty?

Dr Susan Huang: When looking for a doctor for your child with eczema, it is important that the physician has taken care of many children with eczema and thus has sufficient experience and knowledge about eczema.  In the U.S., physicians who routinely take care of children with eczema consist primarily of dermatologists, allergists/immunologists, and pediatricians.  The relationship between the physician and the parent(s) and child is also very important.  Treatment of eczema involves many behavioral components and these take time to review and demonstrate at the visit.  You will likely be seeing this physician many times over years (unless you don’t like him/her!), so it’s important to have a good patient-physician relationship.

Communicating Your Child’s Eczema History

MarcieMom: One of the key reasons why I brought my baby to see a specialist in a children hospital was because allergy tests are not available at a general practitioner or even pediatric clinic. Read here for preparation before a skin prick test. Apart from physical preparation (no antihistamine, good health), how can a parent help the doctor who is seeing the child for the first time to learn as much about the eczema/skin condition?

How can a parent help the doctor who is seeing the child for the first time to learn as much about the eczema/skin condition?

Keep a food diary versus skin condition? If yes, for how long? Write down suspected triggers? Write down how the parent has been managing the skin, for instance, already using hypoallergenic detergent or vacuuming weekly?

Dr Susan Huang: Your physician will ask you questions to get your child’s eczema history. You will likely review whether there are any exacerbating or ameliorating factors to your child’s eczema.  These may include ingested foods or contact allergens.  Having details such as the temporal relationship between the trigger and effect on eczema is helpful. Note that the role of food allergy and food allergy testing in eczema is still a debated one.

Allergy Testing & Eczema Plan of Action

We do know that there is a tendency for allergy, asthma and eczema run together.  Many patients will also recall a clear history of a certain food triggering eczema. In this case, it is important to confirm this potential trigger through allergy testing.  Keep in mind that food allergy testing is not perfect (as is the case for any testing) and can lead to what we call “false positives.” So although it may be tempting to test to all allergens and via skin prick, RAST or oral challenge, it is important to discuss with your physician to come up with the appropriate testing for your child.

Regarding whether food allergy testing should be performed, the guidelines state that testing for milk, egg, peanut, wheat and soy allergy should be considered in “a child younger than 5 years old, and has eczema that does not go away with treatment, or has eczema and a history of allergic reactions to a specific food. Children with moderate to severe eczema are at risk for developing food allergy, especially allergy to mild, egg, and peanut. These children may benefit from a food allergy evaluation.”  If testing is performed, it is important to review with your physician what the plan of action will be.  It is a matter of figuring out which tested allergens are affecting your child’s eczema, and your child’s nutrition should be taken into account as well.

If allergy testing is performed, it is important to review with your physician what the plan of action will be. 

Keep a List of Prior Eczema Treatments

Also have a list of prior treatments on hand. These include medical and non-medical treatments.  In terms of medical treatments, make note of what medication was used, for how long, where it was used (for topical medications), how frequently and how much was used, and the effect the medication had.  Remember to also tell your provider about other treatments such as bleach baths, wet wraps, etc.

MacieMom: Thank you Dr Huang, you raised some points that I didn’t think of such as bleach bath, wet wrap, treatments that the parent may have implemented prior to seeing the doctor. Excited to read your tips for during consultation next week.

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Eczema Life Cartoon

Life of Eczema Girl – A Strong Grip

czema life girl cartoon2
My daughter was born fairly heavy, and had a very strong grip! Whose eczema child also have a strong grip?

This is the third of my 2nd cartoon series, ‘LIFE OF AN ECZEMA GIRL’. Wonder if any of your child with eczema also has a strong grip? For more cartoon in this series, check out here.

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Living with Eczema

SOMEONE Manages Allergy Testing for Child

Kristin on Allergy Testing on Eczema Blues
Kristin shares on managing allergy tests for child with multiple severe allergies

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Kristin Beltaos, whose son has severe food allergies and shares how she manages his allergies via allergy testing. Kristin is a member of the Anaphylaxis & Food Allergy Association of Minnesota’s Speakers’ Bureau and a consultant/licensed trainer and owner of A Gift of Miles.

Marcie Mom: Hi Kristin, thanks for taking time to share with us about allergy testing. Let’s start with you sharing your son’s allergy history – when did he have them and did it show up as rashes on the skin?

Kristin: Hi Marcie, thanks for asking me to participate. My son’s allergies exhibited themselves prior to us leaving the hospital from his birth. He vomited and scream-cried after breastfeeding multiple times a day; physicians and nurses attributed the vomiting to a baby’s underdeveloped digestive tract. At six weeks, his pediatrician decided to have an Upper GI Series to rule out pyloric stenosis, a narrowing of the pylorus, the opening from the stomach into the small intestine that causes severe projectile non-bilious vomiting in the first few months of life. This test came back negative. It was decided that he had severe acid reflux and prescribed Zantac and later Prevacid in order to control his condition.

For the next seven months his vomiting continued, he also had eczema, unexplained hives, did not transition to baby food or table food and was labeled borderline failure to thrive for 18-months.

Two particular instances made us think something more was happening than acid reflux. The first was that I tried to wean a breastfeeding and provided him with a milk-based formula. He literally had one drop on his lips; his head looked like a red, cherry tomato and he scream-cried for over an hour. At first I thought, ok, ok, you’re a breast man and you don’t want a bottle. Then connecting the dots had us questioning…is this a clue for something else?

The second was the straw for my husband and I. I’d describe my son as a happy, but fussy baby. I know that sounds contrary, but he really was happy. One morning, he was fussy and I picked him up and kissed him all over his head to make him laugh. For every kiss that I gave him he had a nickel size hive, there were eight hives for eight kisses. I had cereal that morning, and while my lips weren’t wet with milk, there was residue. Later we found he was allergic to milk by touch and ingestion, along with other allergens.

Lastly, because of missing the window between four and nine months when oral motor skills are developed, he served 18-months in the Children’s Hospitals and Clinics Feeding Clinic to learn how to orally manipulate his food, i.e., chew, transition food from side-to-side, learn how much to chew prior to attempt swallowing and work on food texture issues. Even after he was diagnosed with his food allergies at 11-months, his food challenges haunted him until he was just shy of his fourth birthday.

I have to say all the while this was going on, I always knew something was wrong. I knew the doctors were missing something. So I tell parents, especially mothers, know that you aren’t going crazy and to seek opinions until you find an answer.

Marcie Mom: When was your child’s first allergy test and how did the physician help you to interpret his test results? 

Kristin: At 11 months, my son had a Radioallergosorbent Test, commonly known as RAST Test, which is a blood test used to determine to what substances a person is allergic. Our pediatrician broke the news to us that he was allergic to Cow’s Milk (including by touch due to the cereal and kiss episode), Eggs, Peanuts and Tree Nuts. In the summer of 2011 we added Sesame to his list.

After his diagnosis, we moved to a board certified allergist for care.

Marcie Mom: How often is a repeat allergy test required? And did it benefit your family to learn of new/ outgrown allergies?

Kristin: Obviously allergy testing is recommended whenever you have a new and/or unexplained reaction of course. For management of already diagnosed food allergies, the recommendation may vary from allergist to allergist and based upon each patient’s individual allergies and needs. Personally, I have my son’s allergies reviewed on an annual basis.

Coincidentally, we just had his allergen review within the past week. We received good and bad news. His Cow’s Milk numbers have been on the rise in the past two years, very disappointing as you can imagine. In this last test, his numbers more than doubled, placing him in the next Class level, Class 4 that is labeled as a Strong Positive. Our allergist continues to encourage us to stay hopeful, that the big reveal would be closer to when he enters high school as to whether this may be a lifelong allergy. He’s only seven, soon to be eight, so we have some time yet.

His Egg numbers have stayed the same; however, we are able to do a Baked Egg Challenge to see if he might be able to consume Egg in a baked good, i.e., muffins, cupcakes, cake, bread, etc. This is a test done in a supervised medical environment, clinic or hospital, with your board certified allergist or other medical representative present. I should add that this type of Challenge is not something done at home in your own experimentation.

We’re also investigating, via another blood test, whether he might be a candidate for a Baked Milk Challenge. The results remain to be seen on this front.

Peanut is no longer tested for because his numbers are too high. It is believed that peanuts will be a lifelong allergy.

Interestingly enough, his Tree Nut results have come back negative, pointing to outgrowing this allergy. We will investigate with a skin test to confirm and of course orally test him by having him consume Tree Nut(s) that are processed on dedicated lines with no risk of cross contamination with peanuts.

Lastly, his Sesame results came back very low, which may point to him outgrowing this allergy as well. We will pursue a skin test, should he pass, a Sesame Oral Food Challenge would be in the cards for him.

As you can see, testing regularly not only allows you to know the status of a person’s allergies. Moreover, if a child outgrows an allergy or allergens, it permits the reintroduction of food items permitting an expansion in diet. An expanding diet is ALWAYS a good thing. : )

Marcie Mom: One final question – for a mom who has difficultly with figuring out false positives in test results, what would you recommend to do?

Kristin: I honestly do not have any recommendations regarding false positives. What I do recommend is finding and partnering with a board certified allergist that you truly trust. In doing so, you’ll feel confident in the recommendations provided and can go about living life to the fullest with food allergies.

Marcie Mom: Thank you so much for sharing your journey on managing allergies and allergy testing – many eczema families are also ‘figuring’ this out and your sharing will be useful for them!

About Kristin Beltaos, M.A. – Kristin is the owner of A Gift of Miles, offers food allergy one-on-one consulting, national and local trainings, school consulting, and parent/school advocacy; and serves the markets of stress, with subspecialties, and reproductive challenges. She is a Licensed Trainer with the Minnesota Center for Professional Development, teaching food allergy continuing education to early childhood and school age providers and educators, a member of the Anaphylaxis and Food Allergy Association of Minnesota’s (AFAA) Speaker’s Bureau and a former board member. Kristin wrote and drove the implementation of the first food allergy 504 Plan in her child’s school, was influential in creating a new school food policy which eliminated food celebrations (both in classroom and school wide) – a policy that other schools are interested in emulating. Kristin was named a Top 25 Food Allergy Mom, 2012 by Circle of Moms. Stay happy and informed by following Kristin on her Facebook, Twitter and Pinterest.

Categories
Support Group

Cancellation of Eczema Sharing Session

Hi! I think everyone’s eczema is well under control, because no one feedback for the support group’s session tomorrow. So, please do not turn up last minute for the session, as it has been cancelled. In the meantime, if there is a topic that you like to discuss, feel free to let me know!

Categories
Doctor Q&A

Common Summer Skin Rashes in Kids Series: Insect Bites

This is a 3-week series with Dr. Robin Schaffran, M.D., a caring mom and Pediatric Dermatologist. She is a board-certified Dermatologist and attending staff physician at Cedars Sinai Medical Center. She attended the University of Toronto Medical School where she graduated as a member of the Alpha-Omega-Alpha Honors Medical Society.

Common Summer Children Skin Rashes with Dr Robin Schaffran Pediatric Dermatologist

Rash is a common result from an insect bites, and during summer time, there are some insects that grow more, or come out during summer. There are various common insect bites, such as bed bug, mosquito bites, chigger bite.

What Insect Bites are likely for Kids?

MarcieMom: From your more than 10 years of practice, which insect bites (name two) are most common during summer, and most commonly affecting children?

Dr Robin: During the summer months, the 2 most common insect bites are mosquito bites and bee stings.

MarcieMom: How does the insect’s bite become a rash? Is it interaction with certain saliva or parts of the insect that trigger an inflammation?

Dr Robin: When an insect bites the skin it usually deposits a small amount of saliva into the skin. The rash or bump that results from the bite is due to an immune reaction in the skin directed against the foreign proteins in the saliva.

Appearance of Insect Bite Rash

MarcieMom: How is an insect bite diagnosed? And is it possible to know which insect the bite is from? Will the appearance of bites differ on eczema skin?

Dr Robin: There is a distinct look to an insect bite that makes it easy for a dermatologist to distinguish from eczema. Most bites appear as discrete red bumps that have a small spot in the center from where the insect bit. It is usually impossible to tell from the bite what insect caused the bite (other than certain spiders which result in a very distinct skin eruption).

How to Protect Your Child from Insect Bites?

MarcieMom: Can insect bite be prevented? Using insect repellent? For my toddler with eczema, I don’t put insect repellent on her (are these hypoallergenic?), instead I would put on the insect repellent patch. Are they equally effective?

Dr Robin: Insect bites are best prevented by using insect repellent. This is challenging with eczema skin because the insect repellents can irritate the skin, especially sensitive skin. If it’s not too hot, you can wear long sleeves and pants and spray the clothing with the insect repellent. Avon makes a product called ‘skin so soft’ which acts as an insect repellent (albeit not a very effective one). The repellent patches are okay but not as effective as the sprays.

Insect repellents irritate sensitive eczema skin

Treatment of Insect Bite Rash

MarcieMom: I understand that complications can occur from insect bites, such as anaphylaxis, shock, diarrhea, cramps, swelling, hives and confusion.

What are the complications that are due to the skin rash from insect bite?

Dr Robin: Most insect bites do not result in any complications other than itchy bumps that can result in a secondary skin infection from  repeated scratching.

MarcieMom: How should an insect bite be treated, and when will seeing a doctor be warranted?

Dr Robin: Insect bites are best treated with topical cortisone creams to treat the inflammation that leads to the itching. If the itching is severe or if the bite is suspected of being infected then it is best to see a doctor for evaluation and further treatment.

MarcieMom: Thank you Dr Robin, it is a very timely and protective series to know what to look out for during summer time while having fun with our children.

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Eczema Life Cartoon

Life of Eczema Girl – in the Womb

Eczema Child Girl Cartoon
On hindsight, I think it happened to me

This is the second of my 2nd cartoon series, and I’m calling it ‘LIFE OF AN ECZEMA GIRL’. I remembered when I was pregnant, there was a lot of kicking, I meant REALLY KICK! Just wondering if it’s hot in the womb and my daughter already started itching! Any one knows? lol

For the 1st cartoon in this series, have a laugh here!

Categories
Living with Eczema

SOMEONE Manages Baby with Severe Eczema

Lauren Son Eczema Blues
Lauren shares about managing severe eczema for her son in his first year

This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Lauren, whose 3 year old son has severe eczema in his first year, and shares how she manages eczema for a newborn. Lauren plays and teaches bassoon in Traverse City, Michigan.

Marcie Mom: Hi Lauren, it’s good to have you share in this series! Let’s start with you sharing a little of your son’s eczema – when did it start and how was his skin at his worst then?

Lauren: Hi, Mei. Rhys developed cradle cap (a yellow, scaly crust on his scalp) around two months of age and developed body-wide severe eczema at three months of age.  I first noticed a problem when one day he started to repeatedly rub his eyes and face with his hands.  He was not yet coordinated enough to truly scratch.  The red skin and rashes followed, at first on his face, and later nearly everywhere else.  At its worst, his skin was inflamed, crusty, and oozing and the plasma would soak through his clothes and bed sheets.  It was quite similar to a very bad reaction to poison ivy.

Marcie Mom: Allergy testing isn’t accurate in the first few months of a newborn’s life  – did you have difficulty finding out his triggers in the first year?

Lauren: My husband and I had tremendous difficulty and often had disagreements stemming from the mystery of it all.  That first year we took Rhys to three different doctors and also to non-traditional (in the American sense) healers.  I stopped consuming dairy for about a month because I was breastfeeding, we eliminated all detergents from our home – even shampoos and toothpastes containing detergents, and we kept Rhys away from our cats.  No lifestyle change seemed to make an obvious improvement.

Marcie Mom: How and when did the eczema improve?

Lauren: During the first year, it was a combination of two events.  First, Rhys’s pediatrician realized he couldn’t fully help and referred us to a dermatologist.  The dermatologist prescribed Triamcinolone, a strong topical steroid, and frequent moisturizing.  I believe he gave us samples of CeraVe. Second, around the same time, I spoke with a friend whose son has food allergies.  She told me dairy consumption was often a trigger for eczema breakouts and other allergic reactions and convinced me to again eliminate dairy from my diet.  She also told me about a friend of hers whose child had severe eczema.  The pediatric dermatologist in that case had advised to (1) give the child three lukewarm baths a day, using cleanser only on soiled areas, (2) use topical steroid as needed on “hot spots” after the bath, and (3) moisturize on still-damp skin.  The triamcinolone broke the cycle of inflammation and the frequent bathing and moisturizing helped his skin’s resiliency.  Moisturizing red and oozing skin never worked; it was really only effective at maintaining healthy skin.

As you mentioned, Rhys is now three.  We no longer give him baths three times a day, but we do moisturize after baths and as needed throughout the day and we use the steroid Fluticasone Propionate Cream for break-outs.  We still avoid detergents and products with synthetic scents.  Rhys underwent allergy testing late last summer and due to the results and personal experience, we now avoid peanuts, tree nuts, legumes, dairy, and eggs.  If Rhys begins to scratch uncontrollably, the dermatologist gave us permission to give him children’s strength antihistamine.  We have so many more pieces of the puzzle figured out now, not all, but many.  Most of Rhys’s skin is now smooth and healthy.

Marcie Mom: One final question – what advice would you give to a mom who has a family history of eczema/allergy and preparing for the newborn?

Lauren: Eat the healthiest possible foods while pregnant.  Some might even advise you to eat as much chemical-free and organic food as possible while pregnant.  If your baby develops the symptoms I mentioned, do your best to keep the baby from scratching and seek help.  If your child’s healthcare provider has never seen such a severe case of eczema, find a healthcare provider who has already seen and treated a case like your child’s before.  And don’t blame yourself.  Your baby will outgrow some triggers, like the drooling that accompanies teething.

Marcie Mom: Thank you Lauren for your sharing, many moms can identify with it and hopefully every baby grows out of eczema.

Categories
Eczema Tips

How to Support your Spouse be a Better Parent

How to Support Spouse Parenting Eczema Blues
Tweet Wisdom from Around the World

Last month, I’ve interviewed Bruce Sallan, founder of #DadChat, and one of the question was “What do you suppose a wife can help her Spouse to Be a Better Dad?”

Bruce’s reply was: This question made me smile. I will first answer simply of my wife and myself. Personally, I need validation. When my wife praises me, it reinforces my good behavior. When I’m doing a good job, I want to know that those around me – especially my wife – not only notice, but appreciate it. So, verbal affirmation is very important for me.

That said, just as we often say that what we parents “model” is what our kids will learn, I think a wife modeling good parenting will rub off on her husband. But, men tend to be dense and sometimes we men need to be hit over the head to get a point. So, this is where communication comes to bear. Sit down with your husband and talk. Never assume he will simply know what to do – or what YOU want him to do.

And I’ve got hooked on finding out from more Dads what they think, because frankly, parents with eczema child (“ME”) do need help and reminders, esp. when sometimes eczema consume my mind, instead of supporting my spouse or parenting.

So here are some tweet wisdom from Dads:

Mocha Dad: The main thing spouses can do is understand that dads do things differently and accept that his way is okay.

Harley Rotbart MDTake over your partner’s chores a couple times a week so he or she can spend more time with kids.

Scott Wild: Coaching legend John Wooden once said the most important thing a Dad can do for his kids is LOVE their mother!

Jim Martin: It’s also important to provide a safe space for dads to discuss approaches that are different from the moms.

GeekDad248: Always take time to listen

Tony Leachon MD: We fail to be better dads if there’s no clarity of thoughts to motivate them. Wives should remind busy dads. A good chat before bedtime and periodic trips together can be bonding time to discuss steps to enhance role as dad.

I then decided to ask the ladies, and here are their tweet wisdom:

Marion Ross PhDLead by example, communicate better, drop judgment and be compassionate

Dr Vicki PanaccioneGive positive reinforcement to anything he does that makes him a good parent ie “I love it when you _______ with the kids!”

Crystal Marcos: Reinforcing what the other says. Making sure that one parent isn’t contradicting the other.

Emily KnightLove it when my hubby takes the time to tell me I’m a good parent. It makes me feel noticed and appreciated.

Heidi Murkoff: The way I see it, there is nothing that a mom can do that a dad can’t do just as well if not better given the chance. The problem is, often moms (&media) don’t give dads a chance – there are too many expectations that moms do a better job, but not so.

Deborah Gilboa, MD: Explore common goals (for the child’s life and parenting outcome)

Naomi Richards: My thing is you need to parent together and use same rules etc.. Get some time just the 2 of you to discuss how to parent. Be difficult to support spouse if don’t agree with parenting skills. Be collaborative and discuss first.

I think many men and women are different when parenting – depends on who has children – if separate or together. I think back him up if you think he is doing the right thing. If not – discuss away from the children how you see things differently

Anne Parris: I try not to contradict him when he’s parenting the children. It’s hard!

Christy GarrettAgree to disagree when comes to compromising on a disciplining solution. And plan parent kid date nights.

RaiseSavvyKidsEmpathy, even if it means one partner taking a back seat, goes a long way. It’s like leading from behind. And there are many smart women who know how to adapt depending on the situation.

Lisa Sunbury: My best advice is to model, resist criticizing & allow spouse to develop their own relationship with child.

Alicia Gonzalez: We have to stop thinking “our” way is the only right way. When spouse wants to engage in parenting..support it, don’t criticize it.

Mary Jo Rapini: Extract from her post:

When your husband does a loving act for your child say aloud, “Did daddy do that for you?” Follow that with, “You have a great dad.”

Respect your husband as your child’s father. Never cut your husband down in front of the kids. Eye rolling, or shushing your husband are passive aggressive forms of disrespect. Kids know what they mean.

Understand time pressures and give him a break. Helping him make one day of the week his with the kids is good for everyone.

Dawn LanteroRead a parenting book together and discuss it. Set a calendar with couple time, family time and individual time.

Kelli Smithgall: My thoughts on this are to not criticize, extend grace, and prayer.

Categories
Doctor Q&A

Common Summer Skin Rashes in Kids Series: Heat Rash

This is a 3-week series with Dr. Robin Schaffran, M.D., a caring mom and Pediatric Dermatologist. She is a board-certified Dermatologist and attending staff physician at Cedars Sinai Medical Center. She attended the University of Toronto Medical School where she graduated as a member of the Alpha-Omega-Alpha Honors Medical Society.

Common Summer Children Skin Rashes with Dr Robin Schaffran Pediatric Dermatologist

Is Heat Rash in Kids due to Sweat, Clothes or Foods?

Heat rash is a common term, and in Asia, it may be thought of rashes that come out from consuming ‘heaty’ foods. Is that right? Let’s find out, with the help of Dr Robin.

Heat rash’s scientific term is Miliaria, also known as sweat rash or prickly rash. It is common during summer, especially if it’s hot and humid. It affects children especially due to their underdeveloped sweat glands, which are more prone to becoming blocked and therefore causing rash.

Can you explain to us the interaction of heat and sweat, and the glands that cause a rash in miliaria?

Dr Robin: Miiaria occurs under conditions of high heat and humidity that lead to excessive sweating. Occlusion of the skin from too much clothing or blankets can aggravate the pooling of sweat on the skin surface leading to overhydration of the skin. In susceptible persons such as infants who have immature sweat glands, this often leads to transient blockage of the sweat ducts. Therefore, as more sweat is produced, there becomes and inability to secrete the sweat because of the blockage. This results in the appearance of a rash called miliaria.

What is Child Eczema is Triggered by Rash?

MarcieMom: For a child with eczema whose eczema is triggered by sweat, what is the difference between atopic (to sweat?) versus a heat rash?

Dr Robin: Eczema is an inflammation of the skin, usually genetic, which is often aggravated by sweat and looks completely different than the appearance of miliaria. Eczema triggered by sweat looks like eczema triggered by any other trigger. Miliaria (heat rash) on the other hand, looks like small, tiny red bumps or vesicles which is usually asymptomatic.

Appearance of Heat Rash

Heat rash looks like dots or tiny pimples, and usually doesn’t require medical attention.

MarcieMom: Dr Robin, can you share with us where are the common body parts where heat rash occur? Is it more likely to be inside clothing due to heat trapped from wearing too much?

Dr Robin: The most common area of involvement for heat rash is the trunk area because of occlusion from clothing and blankets.

Treatment of Heat Rash

MarcieMom: When will heat rash require seeing a doctor?

Dr Robin: Heat rash is usually self limiting and asymptomatic so there is no reason to treat it. The reason to see a doctor is to ensure that the eruption is indeed heat rash and not something else that would require treatment.

MarcieMom: How should heat rash be treated at home?

I’ve read that calamine lotion can be applied to sooth the irritability but will that be drying for the skin (thus not suitable for a child with eczema)?

Dr Robin: The mainstay of managing heat rash involves controlling heat and humidity so that sweating is not stimulated. Measures include removing occlusive clothing, limiting activity or providing air conditioning. Topical treatments involve lotions containing calamine and menthol and are for soothing purposes only and are not necessary. They can be drying to the skin and would not recommended to a patient with eczema.

Calamine and Menthol can be Drying for Eczema Skin

Does Drinking Water help with Heat Rash?

MarcieMom: Drinking water is important in hot weather to prevent dehydration. Does drinking more water help prevent heat rash?

Dr Robin: Drinking water is important for hydration but heat rash is not a result of dehydration so drinking more water would have no effect on preventing heat rash.

MarcieMom: Thank you Dr Robin, your reply helps parents understand more about heat rash, and next week, we will be covering insect bites.

Categories
Eczema Life Cartoon

Where It All Begin – Eczema is in the Gene

Luke 12:6-7 “Are not five sparrows sold for two pennies? Yet not one of them is forgotten by God. Indeed, the very hairs of your head are all numbered. Don’t be afraid; you are worth more than many sparrows.”

Eczema skin defective barrier is partly due to gene
SERIOUSLY? The sperm with the eczema gene?

This is the first of my new (second) eczema cartoon series – about the life of a girl with eczema. I haven’t decided what to call this series, any thoughts?

But I do KNOW that from the very beginning, eczema is partly due to the defective skin barrier, that one is born with. Why the bible? God knows even the hairs on our head, He would know that my child and yours have eczema. I, like many of you, struggled emotionally and spiritually during those tiring times of taking care of a baby with eczema. I can never say that I’m glad my child has eczema, but I can say I’m very blessed to be a blessing to all of you who are reading my blog.

Give my ideas for next week’s cartoon, will you?

Categories
Living with Eczema

SOMEONE Manages Child with Multiple Allergies

Child Allergies Eczema EczemaBluesThis is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have a father, known as Spanish Key, who has a daughter with eczema and multiple allergies, and shares how he manages her daughter’s conditions. Spanish Key blogs at End Eczema and also started the Eczema Map Project.

Marcie Mom: Hi Spanish Key, it’s good to have a dad to share. Let’s start with you sharing a little of your daughter’s eczema and allergy history.

Spanish Key: My daughter’s four years old. She’s got moderate-to-severe eczema and mild asthma. Her history is part of an ongoing family history of atopy, since my grandfather, a cousin, and myself all had or have eczema. Shortly after she was born we noticed the eczema and blood in her stool. The blood was apparently from food allergies through breast milk.

We had her skin- and blood-tested and she was positive to virtually everything. The allergist said we should feed her nothing but rice, banana and zucchini. Obviously that was nutritional nonsense so we asked her pediatrician who expanded the list to nine items including chicken and carrot. She ate nothing but those things for two and a half years—and my wife, while breastfeeding her, had to avoid all the major allergens as well.

Her eczema flares up worst on her hands. It happens every six months or so. In between we see it on her feet and scattered all over. Asthma shows up when she gets sick with a cold.

Marcie Mom: You’ve shared about your daughter’s allergies – which would be the ones which have been tested positive and for which she experienced moderate to severe reactions?

Spanish Key: Things are changing over time. We get her skin- and blood-tested once a year, and challenge her orally with new items. There was an exciting moment when we went from a short list of things she COULD eat to a short list of things she COULDN’T eat. Right now the known positives are nuts (all kinds), dairy (all kinds), and sesame. Just last week we introduced beef and coconut. She had no reaction to those. We also know she’s allergic to horse dander—she has horse-riding lessons every two weeks and always comes back blotchy-faced and itchy, so we included that in the testing.

Eczema Food Allergy List
Food Chart at 3 year old

Her dairy and sesame allergies don’t obviously make her skin flare up. Instead, she vomits almost immediately. The allergist says this is not the typical reaction but it’s still most likely an allergy and not an intolerance.

Our biggest fear is not eczema but that she’ll develop an anaphylactic nut allergy. We are not sure whether we should be avoiding nut products ourselves. We eat nuts and peanut butter in the kitchen. This might be good because it is exposing her to small amounts and inducing tolerance—or it might not.

Marcie Mom: How do you manage so many triggers and allergies? Does it affect her nutrition and lifestyle?

Spanish Key: Most of her life we have made all her food from scratch. I do it myself since I’m the cook. I know what goes into her food. In the last year or so we’ve let her have some packaged candy after we read the ingredient list.

For the first four years, we gave her special vitamin powder http://www.solacenutrition.com/products/nanovm/nanovm.html, because all the children’s vitamin pills we could find contained coconut. But as of two weeks ago, she’s been taking regular kiddie vitamins and loving them.

I do my best to balance her diet. But it’s frustrating because she either was a picky eater to begin with or has become one, from lack of variety. Now she is able to eat a wide variety of foods, but she doesn’t like many of them. In practice she eats a lot of pasta, rice, and soy. These foods are not so great for her teeth which are in worse shape than her brother’s. She’s getting enough calories—actually we worry she might be a bit chubby—but she really ought to eat more vegetables. But you could say that about me too!

Marcie Mom: One final question – what would be your top 3 tips to another parent whose child tested positive to lots of allergens?

Spanish Key:

  1. Make all their food yourself from scratch.
  2. If you give them packaged food, always check the ingredients. Always. Most soy sauce contains wheat. Most bread and margarine contain milk. Vitamin pills can contain nuts.
  3. And make sure their teachers know that they have food allergies, because treats often get shared at school.

Marcie Mom: Thank you so much for sharing your journey managing your child’s eczema and multiple allergies (and from a dad’s point of view!).

Categories
101 things that Mothers with Eczema Child do Differently

And the Winner of Pinterest Eczema Cartoon Contest is…

EczemaBlues Pinterest Cartoon Contest Winner
The Winner of the Pinterest Contest is Marissa Adams!

As you know my cartoon series ‘101 things that Moms with Eczema Child do Differently‘ has come to a finale this Monday (after running for 2 years!), and I’ve organized a Pinterest contest for some fun for my readers! EIGHT people put in their contest boards, and the selected winner is

Marissa Adams, with her EczemaBlues Cartoon board 

Marissa is a mom of eczema child, whose son started having eczema around 4 months. View her board and see how many parents have shared experience and the cartoons do tell it all.

It was a close contest with Ace the Journey’s board and also my deepest gratitude to Selena, Pucci Laveau, Christine, Tasha, Elizabeth, Tiffany and Connie for your support.  Many of you bring joy and friendship to me everyday on Twitter.

So Marissa has won US$25 cash, and what’s happening next on Monday? It will be an inspirational cartoon series of Where it All Begin!

Categories
Doctor Q&A

Common Summer Skin Rashes in Kids Series: Sunburn

This is a 3-week series with Dr. Robin Schaffran, M.D., a caring mom and Pediatric Dermatologist. She is a board-certified Dermatologist and attending staff physician at Cedars Sinai Medical Center. She attended the University of Toronto Medical School where she graduated as a member of the Alpha-Omega-Alpha Honors Medical Society.

Common Summer Children Skin Rashes with Dr Robin Schaffran Pediatric Dermatologist

Sun and Child’s Skin

MarcieMom: Finally, there’s sun everyday and it is a great season to have family activities outdoors. We know that the ultraviolet rays damage the skin, and have seen images whereby a middle-aged twin who likes to suntan looks visibly years older than one who doesn’t. I also understand that skin damaged by the sun, is not only more prone to skin cancer but loses some ability to heal itself.

Can you explain to us how the sun interacts with the child’s skin?

For instance, which layer of skin does it penetrate? Does the sun have some function, for instance, synthesis of Vitamin D? Does sun exposure also carry risk?

Dr Robin: Ultraviolet light are rays from the sun that penetrate through the epidermis and dermis layers of the skin and do damage at all levels. Ultraviolet light damages DNA in skin cells  in the epidermis and damages collagen and elastin in the dermis. Ultraviolet light is necessary for the skin to synthesize Vitamin D. And yes we know that too much sun exposure carries risk of skin cancer and premature aging later in life.

Should Child Eczema Skin have Sun Exposure?

For a child with eczema, should he/she have fewer hours under the sun? How does the sun interact differently on eczema skin?

Dr Robin: A child with eczema does not need fewer hours under the sun than other children. If anything, ultraviolet light has some benefit for eczema skin and is often used to treat recalcitrant eczema. However, the side effects of ultraviolet light (i.e. premature aging of the skin and skin cancer) make this a less desirable treatment.

What to do if your Child get Sunburn?

A child may get sunburn, and the appearance of the skin may differ at various times after being outdoors, generally from pinkish to turning burned the next day. There are also instances that warrant calling the doctor, for instance, an infant’s skin (below a year old) turning pink may require a check with the doctor or when there are signs of blisters, swelling, infection, fever or extreme pain in an older child.

MarcieMom: Dr Robin, how would a parent recognize that the child’s skin is burned, and what is happening to the skin?

Under what circumstances would you recommend them to see a doctor?

Dr Robin: The first signs of a burn are usually redness of the skin. A sunburn is like a burn from any other cause. The skin is injured/ burned by the ultraviolet light (specifically UVB rays). The severity of the burn is based on how deep the burn is. If it’s a deeper injury it usually results in blistering and will likely need medical attention to help with wound care.

Will the appearance of sunburn look different for a child with eczema?

Dr Robin: A sunburn looks the same regardless of eczema skin or not.

MarcieMom: How should sunburn be treated at home? I’ve also read that thick ointment will prevent heat from escaping, and best to use lotion instead to prevent peeling. Why is this so and does it mean that a child with eczema should use only lotion to moisturize before sunburn recovers?

Dr Robin: A sunburn is best treated with soothing lotions such as aloe vera, cool compresses or cool baths. Anti-inflammatory medication such as ibuprofen can also be helpful. Thick ointments such as Aquaphor are best for skin healing and do not prevent heat from escaping.

What Sun Protection Tips For Your Kid?

Apart from not going to the sun during the hottest time of the day, there are sun protection measures such as applying sunscreen, wearing hat, sunglass and light long sleeve shirt and pants.

For a child, what sunscreen lotion would you recommend?

Eg. Sunscreen ingredients – physical reflectors, SPF. Also what would be the common wrong way to wear sunscreen and the right way to do it?

Dr Robin: For children, I recommend mineral based, chemical-free sunscreens that include either zinc oxide and/or titanium dioxide as the active ingredients. These are considered to be physical blockers of the ultraviolet rays. The right way to wear sunscreen is to apply a lot of it and rub it all over so all exposed body surfaces are covered and to remember to reapply after 2 hours of being outside or after swimming or sweating.

MarcieMom: For protection when in contact with water, say at the pool or sea, what would be the additional or different sun protection measures? Does water reflect more light onto the skin (despite feeling cool in it)?

Dr Robin: When in contact with water, protection is the same, ie. Liberally use sunscreen and remember to reapply after emerging from the water. It’s best to use a water resistant sunscreen when in the water. Water does reflect more rays onto the skin so there is more exposure when in the water.

MarcieMom: Thank you Dr Robin for taking time to help protect our child from sun eg sunscreen, something I know you are deeply passionate about. Next week, we will be discussing heat rash.