I always thought that being thick skinned meant that you didn’t upset easily when ridiculed.  There is however another meaning – when the thickness of the skin actually increases.

People with eczema often develop thick skin – and its not because of the hard time their friends give them, it is the physical result of the skin protecting itself from trauma.

It is not the eczema itself that will cause the skin to thicken but rather the continuous scratching and rubbing.  Over time the skin protects itself from this repeated trauma by producing more keratin (the tough protective protein found in skin cells).  This process is called keratinization and leads to lichenification of the skin.  In simple terms lichenification is when the skin becomes leathery, scaly and thick resulting in over exaggeration of the normal skin furrows and grooves.

So yes, people with eczema do often develop thick skin because the skin protects itself from the trauma of the scratching by laying down extra, tougher layers.

Do you suffer from eczema?

Can’t work out what is causing it?

Just look around you.

There has been a marked increase in atopic conditions, including eczema and asthma over recent years.  We blame it on our life style.  But if you look at the air around us many of us are living in a constant film of haze or smog.  The fact that when we look into the distance we can actually see the air is a sure sign that our air is not as clean as it used to be.

The haze could well be attributed to the increase in eczema.

“Haze is made up of chemicals and particulate matter” says consultant allergist Prof Dr M Yadav.  Amongst the particulate matter found in the air are dust, dirt, soot, smoke and liquid droplets.

Particulate and gaseous air pollutants are likely to exacerbate allergic reactions and so cause an increase in conditions such as eczema and asthma.

The immune system is also stimulated by the haze.  The toxic compounds and particles in the haze will cause cytokines to be produced by the immune system, which will promote an allergic reaction.

Continuous haze in larger cities

Luckily for most of us the haze is only prevalent during certain wind conditions.  However for many, especially those living in the larger cities haze is a continuous problem that needs to be dealt with on a daily basis.  The air is continuously contaminated with pollutants that we put in it through neglect and ignorance.

Avoiding the outdoors on a particularly hazy day is probably the safest approach when trying to control eczema and asthma.

Keeping fluid levels up will also help as a well-hydrated lining of the respiratory airways will make the area less vulnerable to irritation.

Prolonged exposure to the chemicals and particle matter of haze may result in particles getting deposited on the skin, which in turn causes further irritation.  Cleansing and moisturizing the skin regularly will help.

In a sense the pollution in our air is a part of our modern lifestyle, and unfortunately one that we as individuals have little control over.  But if each of us as a community were more conscious of our air and the importance of it perhaps we would be able to reduce the level of pollution that we breathe in and contaminate our bodies with each and every day.

I for one am glad I live in a smaller city where the smog or haze is at a minimum.

I frequently receive emails asking me if the Calendulis Plus Cream is safe to use on a baby.

Calendulis Plus Cream was originally developed for a baby.  It is suitable to be used on any age group including those only a couple of months old.  This does not however take away from the need to patch test.

Any topical treatment being used for the first time should be patch tested before being used on the affected area.  This is to determine whether the cream is compatible with the individual’s skin.

Although a reaction is rare it is not impossible and it should always be checked before the cream is used extensively.

Eczema is a chronic inflammatory skin condition that requires constant attention to be kept under control.  Whilst choosing the right creams for your skin are important adhering to your treatment regime is equally as important.

Dr Steven Feldman, M.D., from Wake Forest University School of Medicine wrote in an issue of Archives of Dermatology “non-compliance can explain why some skin conditions may seem resistant to treatment.”

Eczema is an individual condition

Eczema is a very individual condition and similarly treatment is also individual.  However, success of a treatment will often depend on how compliant the patient is with following the instructions.  Treatments need to be used for several days before they can safely be ruled out as ineffective.

Dr Feldman went on to say,  “Physicians must develop practical measures to improve patients’ compliance: establishing strong, trusting physician-patient relations, choosing medications that can fit patients’ lifestyles, using patient education materials designed to motivate without overly stressing risks and scheduling a follow-up visit shortly after initiating new treatment.”

Consider lifestyle when selecting treatments

A person’s lifestyle needs to be considered.  Some people find applying creams several times a day difficult but are able to take oral medication without any trouble.  Others find that treatments applied only at bath time or bedtime are easiest to comply with.

It is not only the type of treatment the patient is going to use that is relevant in the patients’ compliance but also the patient-doctor relationship.

Feldman noted that “Patients who are more satisfied with their visit are more trusting of their doctor, worry less about adverse effects and use their medication more regularly.”

These studies indicate the importance of doctors developing good relations with their patients and frequent follow-ups to ensure treatments are being used as instructed and offering the results required.

Patients using over the counter treatments to control their eczema need also to take these factors into consideration and select treatment forms that they feel they can comply with.

Having a positive outlook about the treatments being used will also assist in compliance and increase the chances of success with the treatment.

The involvement of magnesium in the body and its relevance to eczema is very complex.  I have tried to outline it simply to give you a basic understanding.

Magnesium essential for good health

Magnesium is a metallic element whose presence in our body is essential for good health.

A magnesium deficiency in the body will increase the body’s sensitivity to stress.  Likewise, an increase in stress will aggravate magnesium deficiency.  Thus creating a vicious cycle.  As you know stress tends to aggravate eczema.

Stress will also stop the production of the stomach acid, hydrochloric acid. (HCL).  The best known nutrient deficiency resulting from decreased HCL is a vitamin B12 deficiency.  Vitamin B12 assists in tissue repair.  A lack of HCL is prevalent specifically in atopic dermatitis.

Magnesium deficiency will also result in an increase in histamine production.  This in turn causes the blood vessels to swell and fluid to leak into the skin and underlying tissues.  The end result is red blotches on the skin and itchiness, again a classic symptom of eczema.

Lipid (fat) metabolism is also affected when there is a magnesium deficiency.  This causes changes to the skins protective barrier.  Scientists suspect that these changes are what make eczema sufferers more sensitive to irritants.  These people have lower levels of fatty acids in their skin.  Since fatty acids provide moisture and elasticity to the skin it stands to reason that a deficiency of fatty acids will result in dryness and a reduction in the skins ability to control inflammation – the dry inflamed patches of eczema.

Eczema is a very common condition affecting millions of adults and children worldwide and its occurrence is on the rise.

Below are some interesting facts:

• Atpoic eczema affects all races

• Less than 10% of atopic eczema is caused by food allergies, however some foods may trigger a flare up.

• 20% of people with atopic eczema are the only ones in the family with the condition despite it generally being passed through families

• Eczema is uncommon in the tropics

• Eczema is most common in urban areas

• Eczema affects 1 in 3 Australasians at some stage throughout their lives

• Over 1 million Australian adults have eczema

• 15 million people in the USA have a form of eczema

• 10 – 20% of all infants in the USA  have eczema

• 10 – 20% of school children in the UK have eczema

• 3 –5% of adults in the UK have eczema

• The incidence of eczema has increased 2 –5 fold over the past 30 years.

• Atpoic eczema is one of the most common inflammatory skin conditions affecting some 15 – 20% of children worldwide.

Much of the rise in the incidence of eczema can be attributed to modern society and the level of pollution.  There are approximately 85 000 chemicals in the environment worldwide; most of them when in contact with the skin, can induce irritant contact dermatitis.  This is just one form of eczema that we commonly see today, the most common, especially amongst children is atopic eczema.

The Eczema.com.au shop has been closed for the past few weeks.  It will reopen on the 20th April.  That’s not far away so place your orders now if you are running low on on your eczema and psoriasis treatments.

Respond quickly to any eczema breakout so it isn’t given a chance to develop.  Keep the skin well moisturized even when there is no eczema visible.  This will help to keep eczema at bay.

Read our 101 Eczema tips to find out more ways to help keep your eczema at bay.

We at Eczema.com.au would like to wish all of our customers a safe and happy Easter.

Chocolate and Easter

Ask any child what Easter means to them and they will say chocolate.  Sure they know the religious story that is Easter, but to them it is all about the chocolate.

It is one time of the year that we all let our diets go a little and indulge in those chocolate treats.  Most of us eat chocolate and think of our waistlines but for many eczema sufferers it is an indulgence they just can’t afford.

Dairy products, including chocolate are a common cause of food allergy, which may trigger an eczema flare up.  Avoiding chocolate is therefore a must for many.  But how can you ask a child to have Easter with out chocolate.

Find Other Treats

The secret is to find other treats.  Carob chocolate is dairy free and is therefore a safe substitute to chocolate.  Marshmallow bunnies are also a popular alternative.

If you decide to give your child a little chocolate knowing it will probably cause an eczema flare up be prepared.

• Be extra diligent with moisturising the skin, even before they have the chocolate.

• Have plenty of cream on hand ready to treat the eczema at the first signs of a break out.

• Keep their fluids up so they are well hydrated.  This will also help to moisten the skin.

• Give the chocolate as a treat after meals.  They will eat less if they are not hungry when they start eating it (or that is the plan anyway).

Stasis Eczema

Unlike most eczema’s Stasis Eczema is rarely found in children.  It occurs on the lower legs of older adults and is the result of a venous return problem.  Also known as venous eczema or gravitational eczema, stasis eczema presents as dry, red, scaly patches on the legs that are itchy and irritated.

Who is most at risk

As a person gets older the veins in their legs often become less efficient resulting in sluggish return of blood to the heart.  This causes excess fluid to pool in the lower limbs causing edema and a rash.

People with varicose veins, blood clots in the leg (DVT) or heart failure are most at risk of developing stasis eczema.  It is most common in people over the age of 50 and occurs in both men and women.

What it looks like

Typically a rash will develop on the lower leg, usually the inner aspect and will appear as discreet patches or may cover the whole area. Localized swelling becomes worse after prolonged standing and during hot weather.

The rash itself is red and scaly.  The surrounding skin becomes dry and the whole area will be itchy.  The rash may ooze, weep and crust if scratched or picked at and excessive scratching will cause the skin to thicken and break.

The risks

One of the main risks of stasis eczema is the development of a stasis ulcer if the area becomes damaged or traumatized. In some instances the eczema spreads to affect other areas of the body.

A secondary infection may also develop if the skin becomes broken and cellulitis is not uncommon due to the venous problems.  Any infection will be painful with increased heat and redness in the localized area. A doctor will need to treat the stasis eczema infection.

What to do

The eczema rash can be treated similarly to any other eczema rash.  The skin needs to be kept well moisturized and a cream to control the redness and itch needs to be used.  Traditionally doctors have prescribed steroid creams but some natural over the counter creams have also proved effective and are becoming increasingly popular.

The condition involves more than just treating the eczema rash.  The swelling in the legs needs also to be kept at a minimum.  This can be done by
•    elevating the legs as much as possible,
•    sleeping with a pillow under the feet,
•    taking regular walks,
•    avoiding standing for long periods
•    wearing compression stockings once the swelling has subsided.

If an infection develops or there is a break in the skin due to trauma a doctor needs to be contacted immediately so the complication can be treated promptly.  It is much easier to void an ulcer than it is to treat one so all care must be taken to protect the leg from trauma.

Once the eczema has been successfully treated a doctor needs to be consulted in order to enable the venous problems to be treated.  This is the only way to ensure the stasis eczema will not reappear.