Tina and her family, Tina shares on moisturizing for her daughter with eczema
This is a series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Tina Santiago-Rodriguez, whose three-year-old daughter has had eczema since a year old and shares her journey in figuring out what to moisturize her child with. Tina is an award-winning writer at TrulyRichMom on her Catholic faith, homeschooling and parenting.
Marcie Mom: Hi Tina, thanks for taking part in my new blog series ‘Someone has Eczema’! Can you share with us the severity of your daughter’s eczema and what triggers her eczema?
Tina: Hi Mei! Thanks for “having me over” here on your blog. My daughter’s eczema is most seen on her legs — usually the back of her upper thighs to behind her knees. The rashes, when they come out, are quite itchy. Usually, the eczema is triggered when she eats certain food like chicken and eggs, or when there are changes in weather or the environment.
Marcie Mom: As we discussed which aspect of life you’d like to share, what oils you’re using for your daughter seem to come to your mind first – why is that so? Is your daughter allergic to some skincare products you’ve used and that motivated you to find the right one for her?
Tina: I was actually looking for skincare products that were not “artificial” i.e. natural and made from organic, natural sources. She didn’t/doesn’t seem to be allergic to other skincare products but I wanted to use products that are as gentle and “safe” as possible, which is why I was led to use nature-based oils.
Marcie Mom: Many parents have sort of settled on the bath oil and moisturizer to use for their child, and everyone goes through a process of figuring it out (I’m sure ALL of us had, at one point or another, shelves full of different brands!). Do share with us your journey to figure out what works for your daughter.
Tina: Actually, we’re still on that journey to find out what works for her, haha! Seriously though, I’m still using different brands of nature-based oils to see which works best for her. I have, however, chosen to limit her baths to once a day if possible, so that her skin won’t dry out that much. Come to think of it, we SHOULD probably try to use bath oil in her bathing water — I’ve never tried that! I have tried bath salts that were claimed to be good for skin conditions like eczema when she was younger, but they didn’t seem to work for her. So, you could say we’re still figuring things out. Hopefully, we’ll be able to come up with a good skincare regimen for her.
Marcie Mom: One final question – is there a super oil that you’d absolute swear by, one that you’d bring if your family is off for a holiday?
Tina: Yes, I’d TOTALLY recommend Mommy Patch’s Argan oil, which is available on Multiply and has distributors not only in the Philippines but also in Singapore, Malaysia and India. I noticed that when I use it, even just a bit, my daughter’s eczema improves considerably even in a short time.
Marcie Mom: Thanks Tina for taking time to share your journey with moisturizing oils; while every parent will decide on something that works for their child, it’d certainly be amusing and heartwarming to read each other’s journey!
For the past week, I took to Twitter to ask parenting experts their tips to distract eczema children from scratching. Why?
Because I realized that close to 2 years after this post – Saying (or Shouting) Stop Scratching to your Eczema Child, communicating effectively (other than shouting stop scratching) remains a difficult task for many families with eczema children, including myself!
So here are the responses, and many other friends around the world on Twitter also chipped in their tips! Add yours to the comment, and also let me know which one works best for you!
Tips from Parenting Experts & Expert Moms
Shara Lawrence-Weis, mother of 4 with background in education, early childhood & nanny work.
“Scratching might hurt your skin. Let’s think of other things you can do to help the itching.”
Dr Lynne Kenney, mom, mother of two, a practicing pediatric psychologist and author of The Family Coach Method.
“Did u know scratching is self-reinforcing cause it can release dopamine? Distraction from scratching is about finding other ways to use ones hands and still release dopamine (link)”
Erika Brodnock, mum of 5 & CEO of Karisma Kids that helps raise happy, confident & creative children.
“Gently patting the itchy areas while singing a song distracts in very itchy moments!!”
“Empathize: “Ooh, I know you’re itchy”. Action: “Let’s put some lotion on instead of scratching.”
Shadra Bruce, creator of MomsGetReal.com and also an author.
“Keep their hands and minds off the itch by keeping then focused on being creative! Arts, crafts, and hands-on helping moms.”
Mary Hartley, RD, Nutritionist, with her own practice
“Time to get moisturized!”
Shonette Bason, mom of 4 children and works full time as an outstanding primary teacher, author and consultant trainer for Early Years Education.
“Dough Disco (practising finger muscle control with dough and music!) is good for hands distraction!”
Ann Wu, MD, MPH, mom to eczema kids, Pediatrician and asthma researcher at Harvard medical school
“I usually say, “I know–it feels so good to itch! But I don’t want you to look like a red bean popsicle.”
Tips from Tweeps (friends who tweet):
I admit I do say Stop Scratching! followed by Put on some lotion! – Maria Wen Adcock, BiculturalMama
Today I fashioned some footed pajamas…using Egyptian magic cream and seeing what happens and it worked great. For the first time in almost a year, he slept without one scratch…I stayed up all night watching tho – Veena Goel Crownholm, Tiarastobabies
Sitting in a bath with some baking soda – MVOrganics
Depends on itch. if unthinking idle itch can simply put something in child’s hands, or distract non verbally. also need to accept that true burn of ezcema canNOT be ignored. so it depends on the habits and state of eczema flare – SarahJChapman
Depending on age, u could discuss beforehand and have a keyword that u both decide on that you say to remind them to stop. – Michelle Winters, Pediatric Sleep Consultant VASleepCoach
Make it a game: ‘I bet you can’t leave your arm alone’ – Ali_Nguyen
If you reduce the itch then hopefully they will stop scratching! – Dermasilk
I’ve to remind myself ‘Hubby, I love you!’ is a better conversation starter..
This is the 90th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
Jennifer shares on managing a second child when the first has eczema
This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Jennifer Roberge, whose eldest son Tristan has had eczema from three-month old and shares how she manages taking care of him while having another child. Jennifer is a blogger at It’s an Itchy Little World and a mompreneur who started her own company and online storeThe Eczema Company – she’s a return guest on my blog and you can read her first interview on her mompreneur journey here. Marcie Mom: Hi Jennifer, thanks for taking part in my 2013 blog series ‘Someone has Eczema’! Share with us a little on the severity of Tristan’s eczema when you were pregnant with your second child; was it tiring even before the second one was born?
Jennifer: During my pregnancy, Tristan (just shy of two years) had severe eczema behind his knees, around his midsection, around his ankles, wrists, and hands. It was dry, flaky, inflamed, and extremely itchy. My husband and I would lie awake with him at night trying to help him settle back down to sleep and try to forget the incredible, over powering urge to itch. So, we weren’t sleeping well to begin with – add to that the end of my pregnancy where sleep tends to evade mothers to be. They weren’t the easiest of times, that’s for sure. The eczema worsened after the baby was born, and continued to cover his body. Around three he was 90% covered, head-to-toe in eczema and resembled a burn victim. It was a difficult balancing act, trying to prevent my son from tearing up his fragile skin and managing an infant.
Marcie Mom: I know that Tristan has allergies too. Did you manage to figure out what’s triggering the majority of his eczema flares and his allergies before the birth of your second child? And did being able to manage somewhat his eczema helped in your decision to have a second child?
Jennifer: To be completely honest, when we decided to have a second child, Tristan’s skin was much less severe, so his condition didn’t really play much of a part in our decision. When things started to worsen during the pregnancy, my goal was to determine all of Tristan’s triggers and to get control over his eczema before the baby was born, but it didn’t happen that way. We hit rock bottom after the baby was born and when Tristan head-to-toe, severe eczema. No one in the house was sleeping, so we went for extreme methods and did a full elimination diet and saw results within days. It was nothing short of a miracle for our family.
Marcie Mom: Do share with us how you manage the breast-feeding, taking care of a new born, when Tristan I suppose do still need attention to his eczema and allergies? What was the toughest part?
Jennifer: Tristan needed constant supervision back then, not because he was only two, but because he’d scratch his skin raw if we left him alone for a minute. So, breast-feeding was extremely difficult. Tristan was very jealous and wasn’t a fan of my alone time with the baby during nursing, so when I was alone with the children, I’d cover Tristan’s hands with ScratchMeNot mittens and distract him with a book during nursing. Yes, I managed to learn how to read to him breast feeding! I also remember I relied on an infant wrap a lot during the first few months. I’d have my baby safely attached to me and I’d have free hands to help Tristan when he needed me. The wrap was essential back then. What was the hardest part of it all? When no one was sleeping – not the baby, not Tristan, not my husband or I. It’s one thing getting up to nurse throughout the night, but add to that frequent wakings and hours spent with an uncomfortable toddler that will do anything in his power to scratch until he draws blood.
Marcie Mom: One final question – what word of encouragement would you give to someone who just found out she is pregnant with a second child while the eldest has eczema?
Jennifer: Buy a good infant wrap or sling. Try to work on determining your child’s eczema triggers before the baby arrives – we waited too late. If your child wakes a lot during the night, try rotating nights with your partner. One night you take all the shifts with your restless child, the next time it’s your partner. And nap as often as you can to catch up on lack of sleep.
Marcie Mom: Thanks Jennifer for sharing your personal journey, it definitely strikes a chord with many moms out there!
This post is just what it is – The investigative bug has caught up with me and given that there are (i) more studies on impact of diet on eczema, and (ii) more people (experts or not) claiming that their diet is ‘proven’, I’m setting out in this post to POUR THROUGH ALL THE ECZEMA and DIET studies I can find and make sense of it for you here; Let’s see my investigation report!
Studies on Pregnancy Diets
Impact on Preventing or Reducing Severity of Eczema in Newborn
Antigen Avoidance Diet during Pregnancy
In a trial conducted with 952 participants, there was no evidence of protective effect of maternal dietary antigen avoidance during pregnancy on the incidence of atopic eczema during the first 18 months of life. Another two trials that had 523 participants similarly did not see benefit of avoidance of antigen during pregnancy for babies up till 18 months nor on their skin prick test results up to 7 year old.
Probiotics
In a review article of 21 trials from 1997 to 2007, there was evidence that probiotics prevented the onset of pediatric atopic dermatitis. In another article covering up to 2011, there was evidence of probiotics for the prevention of atopic dermatitis in infants, and this benefit was seen both for mother and child, and whether taken during pregnancy or early life of child.
Studies on Children Diets
Impact on Preventing or Reducing Severity of Eczema in Young Children
Timing of Introduction of Solids
In a consensus document, the conclusion from reviewing 52 studies from 1998 to 2006 was that early introduction of solids can increase food allergy. The recommendation was to introduce at 6 months, dairy products 12 months, hen’s egg 24 months, and peanut, tree nuts, fish, and seafood at least 36 months for those with higher risk of food allergy. An update on a study on early introduction of eggs done in August 2015 showed that the elevated immune responses to egg were established prior to egg ingestion at 4 months and were not affected by whether eggs were introduced early.
Using Hydrolyzed Milk Formula
In a review article of 12 studies up to 2006, there was (i) no evidence to support hydrolyzed formula to replace exclusive breastfeeding, and (2) limited evidence that supported hydrolyzed formula for high risk infants who could not be 100% breastfed. One article that provided such evidence concluded that partially hydrolyzed formula is more effective than standard formula for high risk infants.
Prolonging Breastfeeding
In a trial of close to 14,000 mothers, there was no evidence of protective effect of prolonged and exclusive breast feeding on asthma or allergy.
Using Soy Formula
In a review article of 3 studies up to 2006, there was no evidence of reduction in allergies for children fed with soy formula.
Adding Prebiotics to Infant Formula
In a review article covering 13 studies up to 2012, there was limited evidence of prebiotics added to infant formula can prevent eczema, but the authors cautioned that further research is needed prebiotics can be routinely prescribed.
Adding Probiotics to Infant Formula
In two review articles (one of 12 studies up to 2007, the other up to 2008), there was insufficient evidence to recommend adding probiotics to infant feed.
Consumption of Omega 3 and 6
In another review article covering 10 studies up to 2009, there was no evidence for reduced risk of allergic sensitization or a favourable immunological profile.
Impact on Minimizing Eczema Flare-ups for Children already diagnosed with Eczema
Elimination Diets
In a review article, the conclusion from reviewing 9 studies (up to 2006) was that there was (1) no evidence of benefit to an egg and milk free diet, (2) no evidence of benefit to an elemental or few-foods diet, (3) some benefit to egg-free diet for infants with positive IgE to eggs, with improved eczema.
Dietary Supplements
In a review article covering 11 studies up to 2011, there was no evidence of benefits of supplements in the treatment of eczema. The background of this study was that many patients turned to supplement to avoid steroid treatment, fearing long-term effects. However, there was no evidence for supplements like fish oil, olive oil, corn oil placebo, zinc sulphate, selenium, selenium plus vitamin E, vitamin D, pyridoxine, sea buckthorn seed oil, sea buckthorn pulp oil, hempseed oil, sunflower oil (linoleic acid) and DHA.
The Conclusion
1st, I’ve made it a point to look at the studies themselves, rather than articles that refer to studies (so that I minimize the lost in translation effect). I also urge parents who are taking the leap to try a specific diet to ask your doctor and read up on studies, instead of relying on fad posts or personal testimonies.
2nd, I must make it clear that I’m no expert in reading studies, the review articles mentioned were all written by medical professionals. Should any medical professional coming across this post and see any misinterpretation, do point it out to the rest of me.
3rd, after this investigation, the following seem to be actionable take-away that we parents can ask our doctors on and decide if we should apply them:
1. Consider Probiotics
2. Not to introduce solids before 6 months’ old, and check with doc on timing for other more common food allergens
3. If you can’t breastfeed exclusively, consider partially hydrolysed milk formula
This is the 89th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
Read on Julie sharing how she manages bathing and after-bath skin care
This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Julie C., a married mom, who has had eczema since she was 5 years old and shares how she manages her baths and after-bath skin care. Marcie Mom: Hi Julie, thanks for agreeing to be part of this series! You were sharing with me that your eczema may not be apparent to many, had it been more severe in your childhood?
Julie: Yes, as a child I had very visible eczema patches on my face, arms, and legs. Not only was the eczema painful but the other kids teased me about it. My parents tried to help, but none of the remedies recommended by our doctors worked. Unfortunately, it continued into my teenage years and made it difficult to date. Today, I get lots of compliments about how beautiful my skin is.
Marcie Mom: Were there any difficulties you had managing your bath and the after-bath skin care? And how have you finally figured out a routine that works for your skin?
Julie: Yes, there were. Many soaps and shower gels would burn. Many lotions would burn and make things worse – especially on my face.
For bathing, I use a mild soap which is safe for the face too. If I am having a flare up, plain warm water works best for me until the flare up passes. Sometimes when I feel a flare up coming on, I am able to use a liquid antihistamine to stop it.
As an adult, I’ve come to realize my eczema definitely has environmental triggers; however, for me,stress is big a trigger too. To manage stress, I exercise, eat well, and get enough sleep.
Just by doing a little observation and research, I learned what my environmental eczema triggers are, how to avoid them, and what to do if I accidentally come in contact with them.
One big environmental trigger isclothing. People with eczema may want to avoid red clothing. The red dyes seem to be a trigger. Also, be careful about what you wash your clothes with. Your laundry detergent doesn’t ever completely rinse out of your clothing and it could be contributing to your flare ups. The same thing applies to liquid fabric softeners.
Certain foods can lead to flare ups too. For example, there is a certain brand of spaghetti sauce which causes flare ups for me and my niece.
Marcie Mom: What about cosmetics? Any allergies to any cosmetics and what do you do to minimize any potential eczema flares, especially on the face?
Julie: I don’t have a need for foundation, but I do wear lipstick and it can be hit and miss. Most of the pricier brands seems to be safe; however, I once got an eczema break out on my lips from a specific shade in a brand I frequently use!
Marcie Mom: One final question – do you have a favorite facial mask for your face?
Julie: My facial regimen is surprisingly simple.
No facial masks at this point. For washing I use: a mild soap, sometimes I only wash my face with plain warm water, and sometimes I use a rice scrub for sensitive skin to exfoliate. (Warning: Never exfoliate when you’re in the middle of a flare up!) I always use my hands to wash my face – never a cloth or a sponge. I do not dry my face either. After cleansing, while my face is still wet / damp, I apply a very mild moisturizing lotion or a dot of petroleum jelly.
Marcie Mom: Thanks Julie for taking time to share this with me, and many other ladies out there will surely be able to identify with your routine!
Readers of this blog will know that I’m 100 percent focused on eczema, so why this post on Allergy and to tackle Myths! I came across an article ‘Eight Myths from the Food Allergy Clinic’ written by St Thomas Hospital and Kings College Hospital, London, UK and got very interested because I do think these myths are very common! My detective side got the better of me and I did a research and found many more – but I’m just highlighting to you those more applicable for parents with eczema children, so here you go!
MarcieMom Allergy Myth Number 1 – During the skin prick test, if the wheal is larger, it means that the allergen can cause a more severe allergic reaction
In reality: Should the wheal exceeds a certain size (usually 3-4 millimeter), then it can be considered as a positive reaction to the allergen. BUT a larger size wheal does not mean in reality, the child will show a more severe reaction versus another with a smaller wheal.
MarcieMom Allergy Myth Number 2 – Previous allergic reactions predicts the severity of future ones
In reality: As the conditions that were present in a previous allergic reaction would defer from the future one, parents should not assume that a child will react in the same way to the allergen every time. Factors include the amount, state (raw versus cooked), existing health conditions at the time of allergic reaction. Parents should however note that should a child had a previous anaphylactic reaction, the likelihood of the same allergen triggering a severe allergic reaction is more likely.
MarcieMom Allergy Myth Number 3 – A mom should avoid high risk foods during pregnancy and breastfeeding
In reality: No conclusive study on this, and the American Academy of Pediatrics had withdrawn its advice on avoidance of peanuts, eggs, cow’s milk and fish during pregnancy and lactation.
MarcieMom Allergy Myth Number 4 – Children with allergy to eggs cannot be administered with MMR vaccines
In reality: MMR vaccine is safe for children with egg allergy, see below from a previous Dr Q&ADr Liew: Vaccines are the one of the proven public health measures to reduce mortality from infectious diseases. Vaccines are produced for significant infectious diseases. There is no link between vaccination and allergies.Traces of egg proteins can be found in influenza vaccines and specialised vaccines like yellow fever. Egg allergic patients should discuss the risk benefit ratios of receiving these vaccines. MMR vaccines are safe for egg allergic patients.
MarcieMom Allergy Myth Number 5 – Cooking a food removes the allergy
In reality: Some proteins that trigger an allergic reaction are not destroyed by cooking, AAAAI’s recommendation on this: Most food allergens can cause reactions even after they are cooked or have undergone digestion in the intestines. There are some exceptions. For example, some allergens (usually fruits and vegetables) cause allergic reactions only if eaten in their raw form.
I actually thought of including a 6th myth, which is children with parents who have allergy are more likely to develop the same allergy to that specific allergen. Generally, children are more likely to have allergies if their parents have, but whether the allergy to a specific food is inherited is still pretty controversial. Found a study that showed male teens were more likely to be sensitized to dog if their fathers are, so this myth may not be a myth after all. Anyone has any thoughts?
Tubifast Garment (pic taken from www.molnlycke.com)
Time flies when you’re having fun! Last month’s Step by Step sharing by Sister Wong was such a hit, that this month’s 27 April (Sat)’s sharing session will be another Step by Step on Wet Wraps.
For this session, we have Tubifast to show you a step by step guide on wet wrap, including covering parts of the eczema child’s body that may be more difficult to wrap. You can read more about wet wraps here.
So MARK YOUR CALENDAR!
27 April 2013 (Saturday) – Venue, NSC Room 401, 10am to 11.30am
The program:
1. 10.00 – 10.15 am Introducing Ourselves – Feel free to bring your child, I usually bring mine but this month’s she’s having gym class. We have puzzles, coloring, balloon sculpture to keep your little ones occupied.
2. 10.15 – 10.50am Tubifast team will share on wet wraps. We can relax (especially me) and watch. Be prepared with your question, or better still, bring your child!
3. 10.50 – 11.15am I’ll share on some bedtime tricks I use for a better night’s sleep, can’t say I perfected it but at least I’m not panda-eyed in the morning!
Same note: No doctor present, so don’t expect to ‘Ask the Doc’. Information shared is not medical advice, please still see a doc. No selling anything or pretending to be a parent of eczema child and the session is for parents with eczema kids. Information on my blog is not pre-approved by NSC.
4. 11.15-11.30am – Light refreshments while we roam freely in the room to catch up with one another. Plus special giveaway of sample size packs of Cetaphil Restoradem.
5. YOU MUST RSVP – Our medical social worker who is helping with the Eczema Support Group will be in-charge of confirming your attendance, which isn’t confirmed till she says so! If you’re coming, please email me ([email protected]) your name, mobile and email, number of adults & kids coming, so that I can get her to contact you.
This is the 88th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
This is a eries focused on personal journey with eczema while managing a certain aspect of life. Today, we have Vida Lok, whose 4 year-old son has had eczema since he was a few months old and shares how she manages bedtime for her son. Vida blogs at MommyLok on her three children and book reviews written by her daughter.
Marcie Mom: Hi Vida, thanks for taking part in my new blog series ‘Someone has Eczema’! Can you share with us the severity of your son’s eczema and which are the triggers you’ve figured out?
Vida: Hi Marcie Mom! My pleasure and thank you so much for blogging specifically about eczema. I know this issue causes heartaches for many parents, including myself. The worst of my son’s eczema is primarily focused on the hands, feet and neck area (up to the ears). His skin can get so irritated that it causes bloody cracks all over his fingers and also at the bottom of his earlobe. Many times, I wake up to find blood spots all over the pillow and bed sheets. As for triggers, I haven’t determined what they are specifically though I would say it’s primarily weather-related.
Marcie Mom: Bedtime is the most difficult time to manage eczema for our children; the scratching intensifies when we just want to shut our eyes! Is your son sleeping well through the night, and what preparations do you take before, during sleep to minimize the scratching damage?
Vida: At 4 years old, I was hoping that he would be sleeping on his own by now. However, he still wakes up (I’d say at least 6 nights out of the week) screaming in the middle of the night because he is so agitated. It’s been a frustrating (and tiring) 4 years of this nightly routine. Children just do not deserve this sort of torment! Every day after his shower, we moisturize (mineral oil, creams and Vaseline) and then once again right before he sleeps. However, like my daughter who has suffered through the same thing, all the moisturizers just seem to dry up upon contact to his skin. It just does not seem to provide much relief. We also use the humidifier since winter is so dry, but it hasn’t had much of an effect on his relief either. The most effective preparation we have is to make sure that his fingernails are filed down every couple days to minimize the intensity of his scratching.
Marcie Mom: Many parents would love to figure out a way to get their children to sleep throughout, and for us, parents with eczema children – sleeping without scratching is already a dream come true! Is there a ‘magic’ trick that you’ve figured out, or anytime when your child slept without the scratching?
Vida: I really wish I could be that miracle mom and share the secrets of “curing” eczema for all the children who suffer from it. However, sadly, I just have to wait for those occasional lucky nights where my son’s eczema is slightly better than the previous nights and he can sleep a bit more comfortably.
Marcie Mom: One final question – is it difficult to manage bedtime for your toddler, when you’ve another two children to take care of? How did you get them all to bed?
Vida: You can say it’s a bit difficult! My two sons share a room so that causes a problem right there (they’re too tempted to play and talk all night!) Though sometimes it helps because if my toddler sees my older son going to bed, it’s easier to convince him that he should be in bed, as well. My daughter is 8 years old now so she’s a little easier to manage (and also because bribery is more effective on her!) As with most kids, I’m sure, some nights are easier than others. I try to spend as much time with them at nighttime (since I work during the day, bedtime is where I get to spend quality time with my children) so some nights they actually look forward to bedtime. Those other nights? If I’m repeating myself over and over again to them (“It’s bedtime, go to sleep!”), they’ll eventually settle down because they’re tired of hearing me be so annoying!
Marcie Mom: Thanks Vida for taking time to share your bedtime journey, I’m sure many many parents out there can identify with your sharing! and yes, bed time is quality time for me too!
Vida: Thank YOU for allowing me to share! And best of luck to all the parents out there.
Dr. Claudia Aguirre is a neuroscientist, a TED speaker and creator of Ted Education lessons. She is passionate about skincare, psychodermatology and frequently lectures worldwide. Also check out last week’s video on Aging Skin.
This video showcasing Dr Claudia Aguirre was when she worked at Dermalogica
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.
Sweat and Eczema
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.
Aromatherapy, Stress and Eczema
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.
Water in Skincare Products to be Avoided?
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 for Eczema
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.
Vitamin D and Eczema
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”.
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!
If you have something to share about the topics covered in this post, share in the comments or send this article to someone who has a similar experience. Your sharing will help others.
This is the 87th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
Andrea shares on managing childcare for her child with eczema
This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Andrea Thomas, whose daughter has eczema from 2 months old and shares how she manages finding childcare for her daughter. Andrea is the founder of ScratchMeNot mitten sleeves, and a return guest on my blog (you can read her mompreneur journey here.) Marcie Mom: Hi Andrea, thanks for taking part in my 2013 blog series ‘Someone has Eczema’! Despite the busyness of your thriving business! Share with us a little on the severity of your daughter’s eczema and at what level of manageability was her eczema at when you’re considering alternative childcare for her?
Andrea: Thank you for a chance to participate in this series! My daughter’s eczema started off with a few red patches on her elbows, knees and face at 2 months. It quickly spread to half of her face, scalp, calves, feet and arms. She was scratching at any chance she could get and I could not let her out of my sight.
Around 5 months old, I decided to stay home, instead of return to work so I could care for her. This was partially because I didn’t want to miss her baby milestones, but also because I was not sure a daycare would have the time to tend to her skin regimen. I took on the challenge to figure out what was causing her eczema. Her pediatrician & dermatologist both agreed that it was not food allergies. I later figured out that she was allergic to a few foods that was the cause of her eczema. I figured this out through an elimination diet. From there, I was then able to reduce symptoms and itching. And if I wanted to place her in childcare, I could, knowing her eczema would be manageable.
Marcie Mom: What would you say are some options available to you when you’re considering childcare? Preschool/ babysitter/ au pair? And what made you decide on the one you’ve settled on?
Andrea: I was considering daycare because I wanted my daughter to be around children her age and enjoy a play and learn schedule away from mommy and daddy. I looked into several locations and choose a daycare within our church. It provided her with some consistency with teachers and staff, and they had a plan for anaphylactic emergencies that may arise from accidental food ingestion that requires immediate attention. They were also a Nut-Free facility, which was important to me because this is her most severe allergen. I also gave them a Food Allergy Action Plan and went over it with them step by step. When she started daycare, her eczema was under control so the staff would not have to attend to her itchy skin, only focus on her food allergies.
Marcie Mom: Do share with us what are the planning required before you entrust your daughter with eczema to another caregiver.
Andrea: When I was beginning to consider childcare, I had no idea where to start, what questions to ask or how allergies and eczema care was typically handled. I did research online to determine how food allergies are typically handled within childcare, and came up with a list of questions of my own to ask. I found out there were procedures and forms, including the Food Allergy Action Plan which gives detailed instructions on when to use the Epi-Pens for allergies, how to designate which food allergies she has and anaphylactic emergencies. Some childcare services are willing to create procedures with you for additional needs such as a skin care regimen, daily medicine for eczema.
I also gave them a list of symptoms to look for if she comes across any foods that could trigger her eczema, as well as anaphylactic reactions. Since my daughter’s eczema was under control, the daycare staff did not have to apply her creams or provide daily medication. I was able to continue with my home skin care regimen. However, in the event my daughter began scratching, she wore protective clothing that her teacher could easily flip closed to prevent her scratching from damaging her skin. I made sure she also wore clothing to deter scratching, like onesies, long socks and jeans. Sometimes she scratched out of habit or self-soothing, not necessarily because she is itchy.
Marcie Mom: One final question – what communication tips would you give to another parent in the US?
Andrea: ASK QUESTIONS! As many as you need to feel comfortable leaving your child in with any childcare facility or person. Some of the staff have never dealt with allergies and reactions before, but know how to administer medicine or Epi-Pens. It’s important to talk to them as if they have never dealt with an allergic reaction or eczema before. This will allow you to be as detailed and thorough as possible. One more thing is to listen to your gut instincts, if you do not feel comfortable with staff, a daycare facility, nanny or babysitter, try another one. It’s important that both you and your child feel comfortable and safe!
Marcie Mom: Thank you Andrea for sharing your journey managing your girl’s eczema and finding the right childcare for her, am sure many parents can identify with this!
Dr. Claudia Aguirre is a neuroscientist, a TED speaker and creator of Ted Education lessons. She is passionate about skincare, psychodermatology and frequently lectures worldwide. Also check out next week’s video on Eczema Skin.
https://youtu.be/duACAsTVjlU
This video showcasing Dr Claudia Aguirre was when she worked at Dermalogica
Why Skin Aged
Marcie Mom: In the video, Doctor Claudia pointed out the growth of anti-aging skin products and treatments such as botox, dysport and hyaluronic acid injections. Topics covered in the video include (i) the difference between intrinsic and extrinsic aging and (ii) the biology of aging skin. Dr Claudia explained in the video that cells age due to oxidative stress and also pollution, lifestyle (smoking, stress) and ultra-violet rays (exposure to sun).
Characteristics of Aged Skin
Dr Claudia, I’ve been hearing of more and more elderly getting eczema, and scratching till they bleed. I saw in your video that ageing skin is drier, due to less renewed cells and a higher trans-epidermal moisture loss. Aged skin, as you pointed out, is characterized by epidermal thinning, wrinkles, flattened dermal-epidermal junction and collagen fragmentation. There is also less nutrient transfer and reduced sensation.
For eczema in elderly, is the thinner and weaker skin making the skin more vulnerable to allergens, thus triggering skin rashes?
Dr Claudia: The aging skin process can certainly make older skin more vulnerable to disease, but it’s important not to confuse dehydrated skin with eczema. Aged skin can be both dehydrated and dry, which can decrease the barrier function and allow more irritants and allergens to penetrate. In the elderly, another form of eczema known as asteatotic dermatitis commonly occurs on the shins, hands and trunk. This looks like a dry riverbed – dry, cracked and polygonally fissured skin. This can be due to aging, dehydrated skin and malnutrition. Overuse of soap and water can also trigger this. There may be other factors at play, so it’s important to get a proper medical diagnosis.
Prescription Medicine leading to Chronic Eczema
An interesting factor in elderly eczema has to do with the medication regimen older people often take. Prescription medications including diuretics and calcium channel blockers (CCB) can lead to chronic eczema. In fact, a recent French study concluded that “the long-term use of CCB is a risk factor for chronic eczematous eruptions of the elderly.” Those deficient in vitamin B6 may also have an increased risk of developing dermatitis. Since our skin needs essential fatty acids, those whose diets do not contain enough healthy fats may suffer from dry skin as well.
Menopause and Eczema
Marcie Mom: Can you also explain how menopause affects the skin of older women? Does this make the skin more susceptible to eczema?
Dr Claudia: Hormones sometimes play a role in developing eczema. In pregnancy, one of the most common skin conditions is eczema, where the hormonal changes shift the body’s immunity and predispose it towards allergic reactions and eczema. Of course, not all women suffer from this. For more read this post I wrote on the topic.
Hormones and Dry Skin
The female menopause results in a marked decrease in many hormones, and this decline can happen of a number or years. The decrease in hormones like estrogen and progesterone can lead to dry and dehydrated skin, and uneven pigmentation. Since the epidermal barrier required proper moisture and lipid content, this can cause more sensitivity and enhanced penetration of irritants and allergens. A decrease in thyroid hormones can also lead to dry skin. So reduced levels or female hormones can lead to dry, itchy, flaky skin – but not necessarily eczema skin.
For more info on hormones and skin, check out this article I wrote here.
Modern Diet Changes and Eczema
MarcieMom: Aging skin and menopause are part of natural body growth (age) yet I kept having friends tell me they never knew of eczema starting at elderly till it happened to their parents! Is there such a phenomenon in the US and could it have anything to do with our diet? As you pointed out in your video, too many free radicals (unstable molecules) create oxidative stress that lead to wrinkles, hyper-pigmentation and inflammation.
Dr Claudia: See my answer to Q1!
Marcie Mom: Thanks Doctor Claudia, your explanation will certainly help clarify some questions for those with elderly family members with eczema.
Nurse Sister Wong shared her experience caring for your child’s skin
On 23 March (last Saturday), the Eczema Support Group for Parents with Eczema Children held its 5th sharing session and it’s the 1st time we have a nurse sharing her expertise!
She shared on:
Moisturizing – how to choose between lotion, cream and ointment, for instance, a cream is preferable for most of the time and ointment for bedtime for many in hot, humid weather. Also to apply in the direction of hair growth and if applying a cool moisturizer helps reduce the itch, by all means put in the fridge – just be sure that your child will not mistake it for ice-cream!
Topical Steroid – various types of steroid creams, and their potency and how to measure using finger-tip
Antihistamine – various types of anti-histamines and to remember it takes about an hour to take effect
Wet-wrap & Bath oil & Bleach bath
For those of you who missed the session, there are some related posts I’ve written on above topics, here on moisturizing tips by Dr Bridgett, here on steroid potency, here on finger tip units, here on wet-wrap and here on bleach bath.
The date for next session has not been confirmed, email invites will be sent out once ready. Do note that this session is for parents with eczema children, adults and teens’ sessions are separately run by another co-chairperson.
Thank you to Nurse Wong for sharing and taking her Saturday to do so, NSC staff and also everyone for your sharing!
I hope my toddler is not planning her menu as such!
This is the 86th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
Connie shares how she manages her daughter’s eczema & feeding.
This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Connie, whose daughter has eczema since infant and shares how she manages feeding (infant). Connie blogs at rayconniebaby.
Marcie Mom: Hi Connie, thanks for taking part in my new blog series ‘Someone has Eczema’! Let’s start with you sharing a little of your daughter’s eczema, when did she first have it and what was the most difficult part of managing her eczema?
Connie: We first noticed this rash appearing on her cheeks when she was a few weeks old. We thought it was milk rash but it was confirmed by the doctor that it was not milk rash as he explained that eczema rash will appear dry and crusty and what appeared on my daughter’s face was exactly what the doctor had described. The most difficult part of it was that it recurs on every couple of days despite me using cool boiled water to cleanse her face after every feed.
Marcie Mom: I know that you had a difficult time figuring what milk works for her. For those of you in the same situation, you can refer to nutritionist Judy Converse’s interview here. So Connie, do share with us your journey – what makes you suspect milk as a trigger, and did you subsequently get confirmation from any doctor?
Connie: We didn’t suspect anything unusual as my elder son had a similar symptom (dry and crusty skin on the cheeks area). But for my daughter it seemed like her condition was worse and recovering time takes longer than compared to her brother. The doctor then confirmed her situation as eczema and strongly suggested that we switch her milk to either soy based or hydrolysed milk as an alternative and asked us to observed if her situation will get better. Our first choice for her switch was to soy, her skin condition did improve a little. Then we finally switched her to hydrolysed milk and the situation never comes back!
Marcie Mom: I know that I have stocked many types of brands and many types of milk, and I’m sure Connie and many other parents with eczema children went through the same issue. Do read nutritionist Judy Converse Q&A on ‘Just Milk, but Complicated’ here. Connie, did you eventually settle on a type of milk, say cow’s milk/ hydrolysed milk/ goat’s milk? (Rice milk is of inadequate nutrition, do avoid.)
Connie: Yes we did. We gave her hydrolsed milk and there is no turning back. Now at 13mths old, she is still on hydrolysed milk.
Marcie Mom: One final question – if you were to turn back the clock, would you have gone through the same steps you took to figure out the right infant milk for your daughter? (for me, I would have started with hydrolysed milk and then not stress over milk till she had her allergy test!)
Connie: Perhaps I would have started her with hydrolysed milk from newborn.
Marcie Mom: Thanks Connie for sharing your journey on infant milk feeding, am sure many can empathize with it!
I’m confessing, it’s me the guilty parent! Read the previous 2 cartoons if you’re lost!
This is the 85th of my “101 Things that Moms with Eczema Child Do Differently“, a tongue-in-cheek look at the many unique situations that we face. For more cartoons, click here to view.
Lisa shares on managing her son’s eczema when eating out
This is a new series focused on personal journey with eczema while managing a certain aspect of life. Today, we have Lisa, who is sharing on managing her son’s eczema when eating out. Lisa blogs at mybabyhaseczema.com and also LifeofaHappyMom.
Marcie Mom: Hi Lisa, thanks for taking part in my new blog series ‘Someone has Eczema’! Let’s start with you sharing a little of your son’s eczema, what’s the severity and his triggers?
Lisa: My older son’s eczema was quite severe as a baby, covering over 90% of his body. It is relatively mild now, but it still shows on his face and behind his knees, and he still itches other places.
There is no question that foods trigger his eczema. His gut is irritated, allowing food to pass through undigested, which the body attacks, causing inflammation, similar to how it attacks pollen in people who have environmental allergies. Once when he refused to eat for two days straight, his eczema almost disappeared. Eczema is not the only reaction he has, however; certain foods like milk can cause hives almost instantly, and some foods cause mild asthma-like symptoms which only last a few minutes.
Marcie Mom: Since your son’s eczema is triggered by food, can you share how his eczema flared when in contact with various types of food?
Lisa: He is more or less sensitive to most foods, but he doesn’t react to most of them instantly; they have to be absorbed and then he will show some reaction over time, in the form of more itchy red patches, usually on his face, neck, and behind his knees. It used to be all over. Eczema is not the only reaction he has, however; certain foods like milk can cause hives almost instantly, and some foods cause mild asthma-like symptoms which only last a few minutes. Recently he was playing in some white flour (I have some for science experiments, and his sister, who has no allergies, was digging for “dinosaur” bones in it on a rainy day for a school science project); he was fine until he rubbed his face, and then his eyelids began to swell and his face to feel hot and puffy. I rushed him to the bathroom and rinsed his face and washed his hands, and the reaction eventually subsided. He also has been known to throw up when he ingests certain foods; he used to throw up apples in all forms (even juice), but now he does okay as long as he eats only organic apples, and even those not every day.
Marcie Mom: Since we never really know what goes into outside food, how did you manage eating out? Do you take precautions (like epipen) or is there a tried and trusted way you identify where to eat to be safe?
Lisa: Because my son is not noticeably reactive to trace elements in food (if he were, I’d need two blenders!), and because of his tendency to throw up when he ingests too much of most high allergens, I have never gotten an epipen. However, since the list of things he cannot have is so extensive (including not just all the common allergens, but potatoes, corn, and other staples of many allergic and GF eaters), for most of his life I simply packed him a lunch. I would inform the server that he had allergies and so we had brought his lunch, and we never had a problem. Even in buffets, I would just tell them that he was allergic to everything (and when he was in the “I hate vegetables” stage, there was nothing he could and would eat), and they didn’t charge me for his meal. At 2 or 3, he didn’t care that he was eating something different from the family–that was the story of his life anyhow.
I once learned the hard way that you cannot assume a food will be safe. Once I found myself at the Olive Garden without his lunch. I had taken the bus, and we were too hungry to wait to go home. I ordered the GF pasta just olive oil and salt instead of the sauce, and double grapes, since he couldn’t have any of the juices they had. That night he had a rough time, wheezing and waking frequently. I wrote them and asked what was in the pasta (thinking back, I remembered it being a little yellow, as though it had corn). Not only did it indeed have corn, but also cheese and some other things that he is allergic to. So I learned to ask more questions about anything that wasn’t in it’s natural form.
Last month I once again forgot to pack his lunch, but this time we were eating at a buffet that had a huge salad bar. Since he has decided he likes veggies, though, it turned out okay. He ate lettuce, cauliflower, broccoli, cabbage, cucumbers, olives, kidney beans for protein, and jello for dessert. If I had planned better, I would have had a little something with more carbs in it, like bread or pancakes, but at least he ate enough. He did seem to react a bit more to that meal than he does at home, but I figure it is because we eat most produce organic, and he does do better on organic foods. But once in a while is okay for us.
Marcie Mom: One final question – do you have a fave restaurant or chef that dishes yummy food for your child and you have complete trust in?
Lisa: Yes! That buffet I just shared about is Sweet Tomatoes. There are several of them here in the Portland, OR area, as well as in other places. Besides salad, they have baked potatoes, several varieties of soups, muffins, faccocia bread, and pasta, as well as several dessert options. My husband is mildly sensitive to gluten, and I’m avoiding it while breastfeeding our youngest (who also has eczema, mostly in reaction to gluten and food colors, though I know there are some other triggers, just not strong enough to identify yet), and we both are able to eat as much as we want there. This last time I had two servings of salads, and he had a salad and a baked potato. They have a list of items on a card on the table that are gluten-free, and you can ask to see the ingredient list for any item available. Of course, if all you eat is salad, you know exactly what goes into it, and they have vinegar and oil available in bottles next to the dressings so that you can use those if you aren’t sure about the dressings, or are worried about contamination. Join their Veg Club and you’ll get coupons every week and never have to pay full price–they’ll even let you show the email on your smart phone so you don’t have to print it!
We have also found that in a pinch, my son will fill up on white rice, so Chinese and Thai food are also an option–but we usually try to at least bring some veggies and protein. But since we became concerned about GMOs, we have been leery of tofu and soy sauce unless we can read the label, so most of those places are not options for us now.
In summary, my advice to anyone would be to know your triggers, talk to managers if you are unsure about anything, and don’t be afraid to bring food if you or your child has allergies, especially if they can lead to life-threatening reactions when exposed to trace bits.
Marcie Mom: Thanks Lisa for sharing your journey with eating out with your son; it does take a lot of care and I’m wishing all moms and dads out there to have happy meals despite!
