I’ve spent 99% of my life with eczema. And probably about 99% of my body has at some point had eczema. When I was 15, the eczema on my hands got infected and I had to take a 10-day course of antibiotics and take five days off school. I remember a period where I had to wear a scarf when I went out just to cover the eczema I had on my neck. I’ve had plenty of flare-ups over the years and when I’m in the middle of one, it’s hard not to get self-conscious and lose a little bit of enthusiasm to go out to meet people.
When I was 21, I had the mother of all flare-ups while I was working abroad. My body was covered in deep wounds, and spread to parts of the body that had previously never had any issues. I had to go to the doctors, and got given the strongest steroid ointment available.
I had to take a few days off work, and I was experiencing a lot of physical and emotional pain. While most people with childhood eczema grew out of it, I was still there aged 21 with the worst it had ever been. I was feeling sorry for myself, and was almost completely resigned to a lifelong struggle with eczema. In anger, I searched on Google “How to cure eczema”, knowing that there wasn’t one.
But results came up. I found out that there was a book called The Eczema Solution by Sue Armstrong-Brown, an English sufferer of eczema that had developed “a revolutionary 6-week program to overcome eczema that will show results in 3 weeks!” I can’t remember what the price was, but at that point I would have probably paid hundreds or thousands of dollars if the book’s claims were really true. So I bought it and it was delivered within a few days.
In The Eczema Solution each chapter represents a visit to the doctor, and one chapter should be read per week. The opening introduction explains that 20-30% of the general population is atopic, meaning that they’re genetically prone to eczema, asthma, and hay fever. And although atopy cannot be cured, not every person who is atopic suffers with eczema. Only 2-10% of adults have eczema. In other words, there’s hope and it’s in your control!
Armstrong-Brown highlights that it’s not possible to have chronic eczema without scratching, since the skin can heal itself and become healthy again. But if scratched, it can get stuck in a vicious cycle of eczema where the eczema leads to dry skin and to itching and scratching. It’s also highlighted that itch is not the same as scratch. Itch is a feeling, and scratch is an action. And what happens a lot of the time in eczema is that the scratching can occur even without itching – that is, the behavior becomes unconscious and automatic, and does more to damage the skin.
So the tasks of the first appointment were to write a personal history of the eczema, to review where the eczema was and to what severity, and finally to become conscious of the scratching. The book tells you to buy a tally counter, and log how many times you scratch during the day, and notice when and in what situations you’re most likely to scratch.
On the first couple of days, I logged well over 100 instances of times when I scratched. I was astounded. There was no wonder that my eczema had gotten so severe because there was no time for my skin to heal at all. Even though the book didn’t advise any change in behavior, just simply knowing that I was scratching so much and being conscious of it, the number of daily scratched started decreasing as the week went on.
The next chapter of The Eczema Solution was an education on emollients (moisturizers) and steroid creams. I learned that emollients are best applied as frequently as possible, and instead of rubbing them, the approach should be to try not to wake up your skin. Using a variety of different emollients is a useful strategy too. Creams are easier to use for large areas of dry skin, while thicker ointments can be used for the driest areas. I also learned that the inflammation that comes from eczema occurs beneath the level of the skin too, which means that steroid application should continue for two weeks longer after the skin looks completely healed. I continued to log the number of scratches on a spreadsheet and started two new checkboxes to make sure I was applying the steroid cream each morning and night.
The third week of appointment addressed habit reversal a little more. It teaches that we need to create a new learned response to itch. Whenever the feeling of itchiness comes, instead of scratching immediately, leave your hands by your side and clench your fists for thirty seconds. If the itchiness is still there after thirty seconds, feel free to pinch the area of itchiness, without scratching. This should relieve the itch without damaging the skin. Armstrong-Brown also suggests to keep your hands busy as much as possible – you can only scratch if your hands are free.
This is the amazing thing – by the end of the third week of the six-week program, my skin had gone from the worst it had ever been to completely healed. I had gone from over 100 scratches per day, to single figures and by the end there were a few days of zero scratching. To put this into context – I had never been fully free from eczema for as long as I can remember. Hallelujah!
In the eight or so years since then, I’ve never had a flare-up as bad. I feel much more equipped to deal with any flare-ups that come my way, because I understand the disease much more than I did before I read those three chapters. I still haven’t read the remaining chapters.
The issue with psychosomatic disorders like eczema is the doctors that eczema sufferers usually visit spend about five minutes with the patient and then prescribe a steroid cream and emollient. At best they’ll receive a generic statement about how dry skin means itchy skin, and how often to apply their treatment. But there’s no insight into unconscious scratching or any other type of plan to stop the scratching that causes so much of the misery of eczema. This is why I recommend The Eczema Solution to any person who has eczema, especially severe eczema.
One topic that The Eczema Solution neglects is the influence of food on itchiness and inflammation of the skin. As I write this, I still have some eczema on my skin, and I still have to display the discipline not to scratch throughout each day. But some days I experience itchiness more than others, or I can feel that the layer below my skin is inflamed. It’s important then to think about any foods or environmental stressors that may have contributed to that particular bout of itchiness.
What makes The Eczema Solution so brilliant is that it provides the insight and knowledge about eczema that can empower the individual to be able to do something about it. Because so much of the disease is a behavioral, incorporating the methods outlined in the book is such an effective strategy. I now feel mentally and emotionally ready for any future challenges because of the understanding I now have about the disease.