It’s spring, so dust in the house and dust in the air (in the form of pollen)are very common.  It’s a common time for allergies to flare up and the scratching of eczema to begin.

Where there’s dust, there’s dust mites

We have known of the dangers of dust mite for those who suffer from allergies for longer than the word allergies has been around.  And they are difficult to avoid.

Dust mites are everywhere

Dust mites live off organic debris and their preferred diet is skin cells.  Dust mite can therefore be found wherever humans are.  They are most abundant where dead human skin cells are most plentiful – bedding, rugs, upholstered furniture.  They thrive in warm moist environments.

Dust mites are resilient

Dust mites are also very resilient.  They can survive in warm soapy water and can withstand freezing temperatures for up to 5 hours.  Bedding and furnishings should therefore be laundered regularly in the hottest water possible and then put through the hottest cycle of a clothes dryer.

It is best to replace children’s soft plush covered toys with toys that have smooth plastic bodies and washable clothes.  If children have special toys they just can’t part with they should be washed 2 –3 times a week in very hot water to kill the dust mite or placed in a plastic bag and put in the freezer overnight.  The next morning they can be washed in warm water to remove the dead mites.

Although regular vacuuming will not totally rid a room of mites it will remove up to 70% of them.  However they will be back to their original numbers within a week.  Regular vacuuming is therefore essential.

The most effective way to keep your environment as dust mite free as possible is to vacuum regularly, launder in hot water regularly and replace what ever can’t be laundered with that which can be laundered easily in hot water.

Psoriasis is an autoimmune disease causing an overproduction of skin cells.  This results in thickened patches of skin, which are red and scaly and often itchy and painful.  The patches most commonly appear on the knees, elbows, scalp, hands, feet, back, fingernails and toenails.  The condition may also lead to arthritis.

Treatment options range from topical emollients and vitamin D therapy through to powerful systemic medications.  The treatment of psoriasis is very individualised meaning that what works well for one person may have a negative or no effect on another person. Similarly the effect of various foods will have varying effects on each individual’s psoriasis.

Diet does help

Whilst many psoriasis sufferers have long claimed that certain foods affect their psoriasis it is only recently that doctors and specialists have come to consider the diet when treating psoriasis.

Psoriasis is a condition affecting the immune system.  A diet that focuses on a healthy immune system is therefore desirable, as it will help to reduce inflammation.  While there are no set rules that will guarantee to improve your psoriasis there are some guidelines now available that will help.

Psoriasis may be helped by a diet high in antioxidants, which are nutrients that play a vital role in cellular health.  Natural antioxidants found in fruit and vegetables are better than supplements.

A gluten free diet has also been found to help some people with psoriasis.  This involves excluding all foods containing wheat, barley, rye and oats.

A diet high in probiotics may also improve the immune system and in turn reduce psoriasis symptoms.  Probiotics are foods high in good bacteria.  We all have bacteria in our intestines and for most the good out number the bad.  Ensuring you have more good bacteria than bad bacteria will improve the immune system and decrease the symptoms of psoriasis.  Yogurts and some milks with added live cultures will do this.

A healthy diet can also help to maintain a balance of bacteria in the intestines.  A diet high in fruit and vegetables, whole grains and beans and low in simple sugars will help to maintain this balance and a healthy immune system.

Omega 3 has amazing effects on psoriasis

Modifying your fat intake is one of the best dietary ways to control your psoriasis.  Increasing the essential fatty acid Omega 3 in your diet may help.  Omega 3 is responsible for the inflammatory process in the body and today’s modern diet has many of us consuming very small amounts  (if any at all ) of Omega 3.

Increasing the amount of fish oils, flaxseed oil and nuts in our diets will help but in reality a dietary supplement will probably be needed for the omega 3 to have a positive effect on psoriasis.

There are many supplements available in health stores that are high in omega 3.  The Grahams Mega Oil is a dietary oil supplement designed specifically for this purpose.  Not only is it high in omega 3 but it has a calculated ration of omegas 3, 6 and 9 that will enhance the immune system and decrease inflammation even more than omega 3 on its own.

Adopt a healthy diet and control your psoriasis

In summary adopting a healthy diet high in fruit and vegetables, whole grains, legumes, nuts, seeds and omega 3 supplements is what we should all be doing.  It will not only help to reduce the symptoms of psoriasis but may also help to reduce the risk of other medical problems like heart disease, diabetes, high cholesterol, kidney problems, Attention Deficit Disorder and many others.

Baby eczema oozes and crusts

Although born with a predisposition to develop eczema it is rare for the condition to develop before the age of 2 months.  The eczema rash, which usually appears on the skin of a baby developing eczema between the ages of 2 – 4 months, will typically be red and inflamed with oozing and crusting.

A child not developing eczema until the age of 2 years will generally find that the eczema rash is drier and more scaly.  Despite the differences in the presentation of the rash the eczema rash is still quite easy to identify and fortunately for most children their eczema and the rash will be outgrown by the time they start school.

The rash is dry, red and scaly

For some the eczema continues on into the teens and adulthood.  Eczema at this age is typically characterised by dry, red skin that is scaly and inflamed.  The itch is always present resulting in the presence of numerous scratch marks covering the rash and in some cases the skin over the eczema rash will become broken and possibly infected.

Eczema developing in adulthood is often quite different in appearance to that of the eczema rash found in children.  And the location of the rash is often more confined.  Whilst children will often find the eczema rash appears mainly on the face and behind the knees and elbows, adults will be more prone to develop eczema on the hands or sometimes in patches on the lower leg.

Of course this is a generalisation and the eczema rash can cover any part of the body at any age and the severity of the rash will vary from person to person.

Adult eczema often affects the hands – look out for the rash

The most common form of eczema experienced by children is atopic eczema.  Whilst adults can also develop atopic eczema, contact dermatitis of the hands is more common.  Here the eczema rash will appear in response to the hands coming in contact with something they are sensitive to.

Another form of eczema common amongst older adults is nummular eczema, where the eczema rash presents as small, red, coin shaped lesions usually on the legs.  As the rash heals it develops an appearance not unlike ringworm.

Regardless of the appearance of the eczema rash or the type of eczema experienced it is important to take care of the affected skin and remember to keep it well moisturised at all times.  Consult your doctor if your eczema rash takes on a different appearance of if you are having difficulty controlling it.

Whilst moisturising is important and will help in controlling the dryness and itching associated with eczema, the rash itself will usually only be brought under control by the use of a treating cream designed to control the symptoms of eczema.

Definition: Itching is a subjective sensation controlled and affected by a complex of psychological, neural and biochemical factors.

Any Wiser?  No?  I did warn you that itching is very complicated!

What we do know is that individual reactions to itching stimuli vary and itching may be continuous or come in bursts.  Because each individual will interpret an itch differently it is difficult to quantify.

The itch sensation is transmitted through nerves and biochemical reactions.  The sensation will travel along the same nerve fibres that transmit touch and the hot and cold sensation.  In the brain a sensory impulse is transmitted to a motor impulse that causes the physical act of scratching.

More simply the brain receives an impulse saying the skin has been irritated and feels itchy.  So the brain sends an impulse out in reply saying scratch the itch.

Eczema is always itchy

Many things cause or contribute to itching, not the least are skin diseases.  In fact all of the dermatitis group produce an itch.

Other stimuli include:

• climatic changes
• inefficient sweating
• topical skin irritants
• clothing
• medications
• internal diseases
• foods: tea, coffee, chocolate
• alcohol, tobacco
• psychological variations
• emotional reactions, and the list goes on

How do we prevent itching?

So what can we do to prevent itching?  It’s easy.  Avoid all causes and contributing factors and don’t develop skin conditions.

If only it were that easy.  The fact is we are all going to develop different itches at different times and relieving the itch will depend primarily on the cause of the itch.

As a general rule with any itch, try to avoid scratching. Scratching damages the skin and increases the itch sensation.  Try not to overheat the skin, or let it become excessively dry, and if possible avoid any irritants that you know will irritate your skin.

Controlling the eczema itch

Eczema and dry skin go hand in hand so it is very important to keep the skin well moisturised when you have eczema.  Moist skin is less likely to break out in eczema and it is also less itchy.  Remember that most treating creams are not moisturisers so a separate moisturiser needs to be used.

A barrier cream will help to protect skin exposed to water or saliva, thus helping to prevent further damage to the skin whilst locking the moisture into the skin.

Blisters are caused by an allergic reaction, which causes an increase in fluid accumulation in the skin’s tissues.  Blisters usually break easily releasing their fluid onto the skin’s surface.  When the fluid dries yellow crusts like scabs may remain on the skin.

Although not commonly recognised as a main symptom of eczema, blisters can be present in most types of eczema.  They are however mainly associated with Dyshidrotic eczema. Nummular eczema and Atopic eczema may also have blisters but they are a less distinctive part of the conditions.

This belief leads to many cases of eczema in adults going undiagnosed.  Whilst the eczema often presents in different forms in adults it is still eczema with many of the same symptoms seen in childhood eczema – dry skin, itching, red scaly rash.

The most common forms of eczema seen in adults include Atopic eczema, Dyshidrotic eczema, Nummular eczema, Varicose eczema and Contact Dermatitis.

Atopic Eczema

Atopic eczema is most commonly seen in adults who as a child suffered from the same condition.  Whilst most Atopic eczema resolves in childhood some continues on into adulthood.

In these cases a rash appears anywhere on the body and is accompanied by dry skin and an unbearable itch.  The flare-ups are triggered by allergy and the condition has a familial tendency.

Dyshidrotic Eczema

Dyshidrotic eczema appears as clear fluid filled blisters (vesicles) on the palms of the hands and the soles of the feet.  This recurrent skin condition runs in families and is usually the result of an allergy.

Common allergens causing an outbreak of Dyshidrotic eczema include prolonged contact with water, deodorant soaps, strong detergents, solvents, stressful situations and rubber / latex gloves.

Although there is no known quick cure, Dyshidrotic eczema usually resolves without problems. Excessive scratching can however result in thickening of the skin, which is easily irritated.

Nummular Eczema

Nummular eczema also known as Discoid eczema has no known cause or cure.  It most frequently occurs in adults with extremely dry skin.  Occurrence is increased during times of cold weather, low humidity, stressful situations and overly frequent bathing.

It appears as coin shaped, inflamed, scaly lesions, which are very itchy.  As the condition clears the lesions heal from the inside out creating a red ring similar in appearance to ring worm.  This appearance frequently results in misdiagnosis.  Accurate diagnosis requires a doctor consultation.

Varicose Eczema

Also known as Gravitational Eczema or Stasis Eczema, Varicose Eczema affects the lower legs and is more common in middle aged to older people with poor circulation in the lower legs. The skin in this area becomes blotchy, inflamed, swollen, itchy and discoloured.

Contact Dermatitis

Contact dermatitis usually occurs on the hands and is very common in adulthood.  As in Atopic eczema contact dermatitis is often the result of an allergy (allergic contact dermatitis) but more commonly it will be the result of the skin coming in contact with an irritant (Irritant contact dermatitis).

Contact dermatitis causes the skin on the hands to become dry, red and inflamed.  As avoidance of the irritant is often difficult the hands frequently become cracked and painful.

Treatment Of Adult Eczema

Regardless of the type of eczema the treatment is the same.  As the skin is always excessively dry regular moisturisers are essential.  A topical cream to reduce the rash and itch is also required.

Traditionally steroid creams were used however today the preferred treatment are natural over the counter creams. Avoiding known allergens or irritating substances will also reduce flare-ups.

If over the counter treatments do not clear the eczema professional advice should be obtained.  It is also important to have any rash diagnosed by a doctor to ensure the correct treatment is being used. Varicose eczema will always require medical treatment as the poor circulation will need treating for the condition to be brought under control and to prevent serious complications.

The two go hand in hand.  If we could cut out allergies we could significantly reduce the amount of eczema.

At last there is hope of a solution

An immunization that is being hailed as the “Holy Grail” of vaccine research that would ward off allergy is nearing completion of the developmental stage.

An Allergy Conference in London has heard that scientists from Cytos Biotechnology, a firm based in Zurich, have developed a vaccine that could largely eradicate multiple allergies with a single jab.

The jab at this stage is only known as CYT003-QbG10 but initial human trials indicate that it will have the power to protect against asthma, eczema, hay fever, dust, and cat and peanut allergies.

A Single Jab

The beauty of the jab is that it is believed that a single jab will have the ability to protect against multiple allergies making it more cost effective and easier to manufacture and administer.

Dr Wolfgang Renner, from the jab’s inventors Cytos Biotechnology, said: ‘We think it is a one-size-fits-all mechanism. We are very excited about it.’

Small scale human trials have commenced and Dr Renner hopes for the first large scale trials to commence next year and the immunisation on sale in four to five years.

Atopic eczema, the most common form of eczema, is an allergy based condition treated by topical creams, steroids and anti-histamine pills.  All of these treatments are short acting and only control the symptoms.  None are getting at the root of the cause of the allergies.

Reprogramming The Immune System

It is believed that the new jab is reprogramming the immune system.  At the heart of the jab is synthetic DNA that fools the body into thinking it is under attack from a dangerous bug.  This causes the immune system to start a multi-pronged immune response.

Immunotherapy, where patients are repeatedly injected with small doses of the compound they are allergic to is already available, although not widely used because of fears over its safety and the extended period of time (years) required for the course to be given.

New Jab Has Few Side Effects

Leanne Metcalf, director of Research at Asthma UK, said: ‘We are, excited about the potential of this vaccine to make a real difference to people with asthma and allergies, especially as it has been shown in clinical trials to have relatively few side effects.’

It is not clear how often the new vaccine would have to be given.

But the Cytos scientists envisage an initial short course of jabs, followed up by a booster session two or three years later.

Psoriasis is an inflammatory skin condition – a fact we have known for generations.  But it is so much more than that.  Psoriasis is also a systemic inflammatory condition and autoimmune disease and has similarities to other inflammatory immune disorders.

For unknown reasons the immune system of the psoriasis sufferer does not function properly.  However evidence suggests a complex interaction between genes, environment and lifestyle influences being the cause.  Approximately 40% of all people with psoriasis have a close relative with the condition, this coupled with obesity, smoking, heavy drinking, stress, strep infection or some medications may cause the immune system to overreact resulting in psoriasis.

Higher incidence of atherosclerosis and heart attack

Studies show that people with psoriasis have a higher incidence of atherosclerosis (hardening of the arteries), peripheral vascular disease, heart attacks and strokes than people with out the condition, regardless of what initially triggers it.

It is important to note that psoriasis does not cause any of these conditions but rather all the conditions share similar features – inflammation and the activity of cytokine proteins (small secreted proteins which mediate and regulate immunity and inflammation).

Study comparing heart attack risks

A recent study led by Dr Joel Gelfand, assistant professor of dermatology of the University Of Pennsylvania School of Medicine in Philadelphia, compared heart attack risks in approximately 131 000 psoriasis sufferers (almost 4000 of those had severe psoriasis) and a control group of over 500 000 matched people who did not have psoriasis.

The important factor here is that the control group was matched for age, gender, elevated cholesterol, diabetes, smoking and other risk factors. This had not been done in previous studies.

“The study showed that psoriasis was associated with an elevated risk of heart attack in all groups, but especially in younger patients with severe disease. “ (www.healthjockey.com)

For example the results found that a 40 year old person with mild psoriasis has a 20% greater risk of having a heart attack than a 40 year old with out psoriasis.  This risk will double for a 40 year old with severe psoriasis.

“The absolute risk is still low, even for someone who has severe disease,” Gelfand says.  “If you’re in your 40s or 50s, your risk of having a heart attack each year due to psoriasis is about one in 400 to one in 600.  Over 10 years, that adds up to about one in 40-60.  So it does become a significant risk factor over time.”

“Only in the last 15 years have we come to understand that psoriasis is an autoimmune disease,” Gelfand says.  “Only in the past 10 years have we learned that psoriasis is promoted by the same immune pathways that are active in atherosclerosis.”

Learning that psoriasis increases the risk of heart attack and atherosclerosis is important as patients and doctors alike need to discuss these risk factors and take actions to minimise the risks.

You may have Psoriasis of the scalp.

Conditions affecting the scalp are often given the prefix of seborrheic to classify their location.  Hence Psoriasis of the scalp is often referred to as seborrheic psoriasis.  This term refers to the location of the psoriasis rather than the type of psoriasis.

90% of psoriasis sufferers will have Plaque Psoriasis and it will usually affect the scalp.  Unlike eczema psoriasis is rare in young children and usually strikes in the teen or early adult years.

Plaque psoriasis appears as a well defined rash with very thick white scales that are often very firmly attached to the hair. The borders of each patch are well defined and small points of bleeding will occur if the scales are picked off.  Each individual patch may come and go but it is more common for them to be present for years.

Rarely affects the face

The psoriasis may cover a small area at the back of the head or upper neck or it may involve the whole scalp. This type of psoriasis may spread onto the forehead and into the ears however the face is rarely affected.

Although hair loss is not generally caused by seborrheic psoriasis the hair is usually thinner in the affected areas.

The typical appearance of plaque psoriasis is the basis for diagnosis however seborrheic psoriasis and seborrheic dermatitis (dandruff) are often confused and even with biopsy may be difficult to tell apart. Doctors may refer to the rash as “seborrhiasis” if they are unable to separate the two conditions.

What to do

Although not the cause of psoriasis, hair care treatments will often exacerbate the condition.  It is therefore important to use shampoos and conditioners that are designed for sensitive skin and are free from Sodium Lauryl Sulphate and Propolene Glycol – the two main ingredients that people are sensitive to and may trigger a flare up.

It is reasonable also to expect that the use of any harsh chemicals on the scalp will worsen the psoriasis.  Perms and dyes are therefore best avoided.

One of the most natural treatments for psoriasis is vitamin D.  Exposure to sunlight will also help to control psoriasis of the scalp – remembering of course to protect from the dangers of sunlight that we know so well.

Although anything can trigger eczema it simply depends on what each individual is sensitive to.  There are however some things that more commonly cause eczema flare ups:

Dust Mites
Pets and Dander
Cleaning Products
Pollen

Dust Mite

Dust mites live off organic debris and their preferred diet is skin cells.  Dust mites can therefore be found everywhere humans are.  They are most abundant where dead human skin cells are most plentiful – bedding, rugs, upholstered furniture. They thrive in warm moist environments.

Dust mite are also very resilient.  They can survive in warm soapy water and can withstand freezing temperatures for up to 5 hours.  Bedding and furnishings should therefore be laundered regularly in the hottest water possible and then put through the hottest cycle of the clothes dryer (that the product can withstand).

The most effective way to keep your environment as dust mite free as possible is to vacuum regularly, launder clothes and soft toys in hot water regularly and replace what ever can’t be laundered with that which can be laundered easily in hot water.

Also damp dust regularly and replace carpet with tiles or floor boards that will not harbour dust mite and use mats that can be taken outside and shaken.

Pets and Dander

For the eczema sufferer there may be good points and bad points about having a pet.  Pets often trigger eczema flare ups.  The aspects most commonly triggering allergy are pet fur, dander (dried skin), urine and saliva.

However the benefits of owning a pet are well documented.  They provide company, decrease stress, provide hours of endless pleasure and distract from worries.  These benefits are important for your eczema.

Allergic to Pet or Product?

Of course if you are actually allergic to your pet the disadvantages may outweigh the advantages.  But before you send your beloved pet off to a new home check that it is your pet you are allergic to and not the products you are using to care for him.  It is not uncommon for pet shampoo or flea care products to cause an allergic reaction and not the fur or the pet himself.

If you choose to have a pet select your pet carefully.  Perhaps a goldfish would be a better alternative.  If it is a cat or dog that you are wanting select one that does not malt, keep him clean and well groomed.  Don’t allow him to sleep on your bed or chairs and wash your hands after contact.  Try to keep your pet outside or buy one that can be kept in a cage.

Cleaning Products

Chemicals and detergents are found everywhere in modern society.  Our lives are filled with artificial cleaning agents designed to clean our homes, our clothes, our bodies.

The problem is they dry the skin, stripping it of its natural oils and they are commonly the cause of allergic reactions especially in contact dermatitis and the cause of many a flare up in atopic eczema.

House cleaning

Wear gloves when washing the dishes or cleaning using any chemicals.  Cotton liners under rubber gloves will help to prevent irritation from the rubber.

Wash your hands after using chemicals and always remoisturise after having your hands in water.  Try to select cleaning agents that are less harsh on your hands and our environment.

Cleaning Clothes

Use a mild detergent to wash your clothes in.  Don’t chop and change your detergent.  It is usually the detergent residue left in the clothes after washing rather than the detergent itself that irritates the skin so wash your clothes, towels and bedding twice – Once in detergent and once in plain water as an extra rinse.

Body Cleaning

We have become a society with obsessive personal hygiene.  Over washing or prolonged exposure to water strips the skin of its natural oils resulting in dry, cracked skin.  This is a problem for anyone but for the eczema sufferer it is a major problem.  Dry skin coupled with a sensitivity to many of the additives found in our personal cleaning agents often triggers an eczema flare up.

There are many soap substitutes available that make using soaps unnecessary.  Try using a cleansing bar, body wash, skin cream or emulsifying ointment.  These non soap cleansing lotions have a neutral pH and are unperfumed.

Avoid using perfumes or after shave lotions that are scented.  Choose deodorants that are natural or manufactured for sensitive skin.  It may take some trial and error but it is worth shopping around to find the products that best suit your skin.

Outdoors and Pollen

Pollen is commonly associated with allergic reactions, especially those involving asthma and hay fever, but it can be a problem for eczema sufferers as well.  It is from mid spring until the end of summer that pollen is a major problem.

The idea then is to minimise your exposure to pollen.  This can be done by:

• Change clothes when coming inside and shower to remove any specks of pollen.

• Keep windows shut during the summer months.

• Consider replacing lawns with pebbles or paving.

• If you must keep a lawn have some one else mow if for you and avoid mowing on windy days.

• Avoid having plants in your garden that are known allergen-producing plants.

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