Therapeutic Bathing for Eczema

One of the many tools available in the treatment of eczema is therapeutic bathing. Bath additives ranging from colloidal oatmeal and apple cider vinegar to standard laundry bleach have been recommended increasingly by physicians over the last decade or more. The two bathing treatments that I have had the best success with are Epsom Salt and plain liquid laundry bleach. Both have been especially helpful in controlling the pain, inflammation, and deep itch associated with food and general allergic inflammation, as well as the bacterial/viral infected eczema that I have been suffering with since the Summer and Autumn of 2014.

When using bath treatments for eczema it is best to start with a clean bath tub, especially when other household members use various personal care products in the shower/bath that are unfriendly to eczematous skin. Eliminating tub residue containing possible triggers that can contaminate the bath water will greatly improve success.

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Microbial Colonisation & Infection in Eczematous Skin

Among the many and various contributors to eczematous inflammation is the colonisation and infection of the skin by a variety of bacteria, virus, and even fungi. As an example, as much as 90% of all eczema sufferers have affected skin that has been colonised by the bacteria Staphylococcus aureus (S. aureus), which can also be isolated from approximately 70% of unaffected skin. Approximately 30% of healthy individuals are asymptomatically colonised by S. aureus. However, virus such as Molluscum contagiosum as well as Herpes simplex, and yeasts such as Malassezia and Candida, can also colonise and exacerbate inflamed eczematous skin, increasing the severity of itch, redness, and cracking, even without the presence of an active infection. S. aureus and Herpes simplex appear to be the more common superinfections in eczema.

Keeping Eczematous Skin Clean with PureNakedSoap Naked Olive Castile Soap

Oh, how I missed that “squeaky-clean” feeling. Even for just a fleeting moment, between rinsing off in the shower and slathering on handfuls of petroleum jelly from head to toe, I was taken back more than thirty years to a time when bathing was such a simple process–and, one that actually got me clean. That was a time when I barely had to think about soap, let alone the ramifications of showering one way or another.

For the past thirty-odd years, though, I have been struggling with mediocre, if not wholly intolerable “cleansers” that replace actual soap with myriad detergents, emollients, emulsifiers, antimicrobials, humectants, etc.; labels emblazoned with “sensitive skin”, “moisturising”, “hypo-allergenic”, “fragrance-free”, and even “approved for eczema” seals of “acceptance”. Many simply failed to clean, most left my skin irritated and/or far too dry. None of them but one was at all useful, and even Cetaphil was my “least of the evils” option.

Finally, though, I have found an actual “soap” that does what none of those targeted products had ever done. And, I have realised that real soap is not nearly as bad for eczema as has been claimed by the many doctors I have seen for decades.

Food Suddenly Hates Me (Part 2)

Back in August of 2012 I wrote in Part 1 about my discovery of both newly acquired food allergies and a gastrointestinal condition called Leaky Gut Syndrome that appeared to be a possible cause for those new allergies. Two years later, after many lifestyle changes, lots of research, several visits to allergists, and a gastroenterologist, I have only a slightly better understanding of what’s actually going on. But, despite my ongoing pursuit of clarity on dietary troubles, I do seem to be moving in a beneficial direction, albeit slowly.

That Infernal Itch

Over the course of my personal history with eczema, itching was nearly a foreign concept to me. It was only really present when my skin had been reasonably clear, and excessive dryness appeared to be the primary factor associated with the sensation of itch. For me, the redness and inflammation had always been accompanied not by itching, but by deep and often intense burning. The patches of skin that remained rather clear would continue to itch to some degree. But, the patches of red, inflamed, and broken skin wanted to be passified by extreme heat or cold, not by the maniacal raking of my nails carving ruts and raising long welts across my flesh.

Apparently, things have changed.

Since my harrowing experience in July of this year, that on two occasions sent me to the emergency department at my local hospital, my skin has felt noticeably different. Unfortunately, it is difficult to characterise just what is “different”, and how; but, the “depth” and “quality” of the pain associated with the inflammation has changed, as has the way the inflammation feels as it “sits” on and in my skin. For anyone with eczema, this may be an easy concept to grasp. For someone who has never experienced eczema, I don’t expect this to make any sense whatsoever, and I can’t even attempt to bring some sense to it.

Job Hunting with Severe Eczema

Severe eczema, especially when it is exacerbated by environmental sensitivities and accompanied by allergic asthma, can be an enormous obstacle when trying to find employment. The home is usually the one environment we can control to make it as safe an island as possible in this hostile world of allergens and triggers. When placed in the position to make a major change in his life a person with an environmentally reactive disorder–whose body reacts drastically to changes in the air around him–carries an immense emotional and logistical burden: can he survive the change?

I had effectively been job hunting since early 2012, when the stress from my job hit an exceptional high. Despite that I had been working from home since early 2011–following a full year of exposure to an office building so saturated with personal fragrances that my body was disintegrating around me–my immune system was unable to fully recover. My eczema and asthma remained so sensitive that any stressor or minor exposure to a trigger was enough to spark a full-on skin flare and respiratory attack. My body, now in 2014, has still not recovered well, and it remains primed for catastrophe.

In late 2013 my ties to the dysfunctional-company-from-hell were broken, and I was free to spend my days hunting for my dream job, full time. Or, that was how I saw it at the beginning. Unfortunately, with the crumbling U.S. and World economies, jobs were (and, still are) very few and far between. The stress from the hunt, itself, combined with stress over an ever-dwindling financial reserve, helped to kept my eczema in an up-cycle, and my growing food allergies meant my available diet was rapidly shrinking to nothing.

Know Your Triggers

Eczema, or atopic dermatitis, is a complex, multi-factor, primary genetic immunodeficiency disease that involves both epidermal barrier deficiencies and disproportionate immunoglobulin (Ig) responses in the immune system. Eczema appears to affect as much as 17% of the population, depending on country, with a higher prevalence in females, and with a preference toward developed nations.

Determining the root cause of eczematous inflammation is essential to the successful treatment and management of this often debilitating disease. At this point, the underlying biological cause of eczema/atopic dermatitis is still uncertain, but several mechanisms are currently being investigated in clinical studies. There is presently no cure for eczema, and biologic treatments undergoing phase 1 and phase 2 trials are still many years away from FDA approval in the US.

With no reliable pharmaceutical treatment currently available to address the cause–as opposed to simply treating the symptoms–we are left to investigate the sources of our inflammation, or triggers, by closely examining our activities, habits, and the environments in which find ourselves on a daily basis.

While eczema is not in itself “an allergy”, one of the mechanisms behind eczematous inflammation does act along normal allergy pathways. So, it is important to have a basic understanding of the forms this immunological response can take.

The (Real) Truth About Topical Steroids

How steroids Work

The corticosteroids we use to treat eczema, called glucocorticoids, act to block the production of several chemicals involved in the immune system response that triggers inflammation. One of the mechanisms by which they do this is by constricting capillaries to reduce blood flow to the inflamed areas, resulting in a reduction of histamines and other inflammatory chemicals flowing to those areas.

Another mechanism is the interaction with DNA in the cell nucleus which causes the cell to produce proteins called lipocortins. These lipocortins then disable the production of arachidonic acid which in turn blocks the production of various chemicals involved in inflammation, including leukotrienes, prostaglandins, and platelet-activating factor.

Glucocorticoids also impact the production and distribution of certain white blood cells, called T and B lymphocytes, which are responsible for identifying and responding to very specific antigens. Lymphocytes are involved in the memorising of bacteria, virus, and other pathogens via the B lymphocyte produced immunoglobulin (Ig) proteins. Ig proteins, especially IgE, are involved in increased allergic responses, including various dermatoses.

Inflammation happens to be an integral part of the process by which our bodies fight infection, but in eczema and other diseases it can proceed out of control, and even occur when there is no real infection at all.

The body naturally produces its own steroids in a part of the adrenal gland called the adrenal cortex. The primary steroids produced here are cortisol, corticosterone, aldosterone, and dehydroepiandrosterone. Cortisol, which is most import to this discussion, is essential for metabolism, stress control, vascular and immune function, and the central nervous system.

Modern topical coricosteroids, which are similar to cortisol, have been engineered to very selectively block glucocorticoid receptors, helping to reduce some of the negative side effects of the medications, and to enhance effectiveness at treating skin inflammations.

Mangosteen & Eczema

Hello Mangosteens

Mangosteens are an odd, purple, fruit which contain several seeds each surrounded by a section of arillus, all of which is encased in a soft, woody-like pericarp. The arillus is eaten as the fruit, while the pericarp can be used to make tea.

I first met the Mangosteen (Garcinia mangostana L.) in 2009 while in the Philippines. At the time, my eczema had essentially been “in remission” for several years, so I made no connection between the fruit and any benefits for my skin. For me it was just a delicious treat. It wasn’t until my return to work, in the U.S., in 2010 that my eczema once again sought vengeance on me (see: my introduction).

While in the Philippines again, in 2012, my eczema cleared up remarkably–so much, that after a few weeks I had almost no need for triamcinolone. I had already been avoiding newly discovered food allergies since 2011, and my diet remained just as restrictive during my two-month visit to the Phils, apart from the addition of local fruits that I cannot easily get in the U.S. I attributed my improvement to the heat, sun, and the fresh fruits (literally, still on the branches) including rambutan, lansones and mangosteen; but, I could not begin to point at anything in particular as the cause. Until…

PERSONAL ECZEMA UPDATE: January 2013

It is now five months since I completely altered my lifestyle to account for “leaks in my gut”, and newly acquired food allergies (see: Food Suddenly Hates Me); so, where am I now? Well, it’s been a mildly bumpy road, with a few flare-ups, a “Super Storm”, and some mistakes around the holidays, but some significant overall improvement.

Just to review: on top of my need to avoid my long-identified airborne triggers such as perfumes/colognes, cleaning products, etc., I have the added mess of having to avoid certain foods due to my recently heavy use of both non-steroidal and steroidal medications, to treat my severe eczema symptoms, which apparently affected the way I digest things.

This has been a difficult road to follow, and I have fallen into a few ditches along the way–but, not for a lack of trying. The now-dreaded soy trigger is a very sneaky beast, and seems to ambush me when I least expect it.

In addition to soy protein sneak-attacks, “Super Storm Sandy” devastated a good portion of our area on 28th October 2012. With no power at home causing me quite a bit of stress, we also had to eat out for a bit, and restaurants–especially Chinese restaurants–can be a dangerous place for me right now.