1. What is Eczema
Topics Covered in this module
The Definition of Eczema
The Symptoms of Eczema
Living a Normal Life with Eczema
Part One - The Definition of Eczema
Most of us have an idea what eczema is. We know it’s an itchy skin condition, generally including a rash. However, for people living with eczema, it’s often a disease that makes their lives really uncomfortable and often debilitating. Many times their condition prevents them from wanting to leave their homes, either from pain or from embarrassment.
Eczema is the name given to a group of conditions that cause the skin to become itchy, inflamed, or have a rash-like appearance. It doesn’t really mean anything, It’s a catch all term that means, very simply, skin ailment. It also includes a million unexplained symptoms that have been grouped under this word eczema. You should think of it more as code for “Something weird is going on with my skin and we don’t really know what it is.'“
There are seven types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. It’s very important to understand eczema is not contagious. You can’t catch eczema from someone else. While the exact cause of eczema is unknown, research shows people develop eczema because of a combination of genes and environmental triggers.
Many people successfully manage, reduce and even stop their eczema flare-ups with improved lifestyle choices. We will cover all of these in detail throughout this course.
Eczema Suffers
The simple fact is anyone can have eczema. A whopping 31 million people (10%) in the U.S. have some form of eczema. One in 10 individuals will develop eczema during their lifetime, peaking in early childhood. People of all skin colors, races and ethnicities can be affected by eczema.
If you have sensitive skin you may need to change your skincare routine into some non toxic products, and some skin types don’t respond well to particular chemicals and fragrances found in many body washes and soaps. This is an area we will explore throughout this course in other modules.
The point I am making here, is that eczema is something you must make a priority and manage in order to have a normal pain-free life, but it is not a sign that you are any less healthy or clean than the general population. Actually, when you start to take control of your eczema condition, often you will start to become healthier, because you’ll eat more nutritious, clean foods, eliminate chemicals from your household, and start to move your body’s more. This is something we all need to do.
“Later in this course we’ll discuss the genetic link. Science has found eczema often runs in the family. People with relatives who have any form of dermatitis or allergies such as hay fever, have a greater risk of developing eczema.”
The difference in Normal Heathy Skin and Skin Affected by Eczema
Skin is the largest organ of the body, actually we should start by saying that skin is an actual organ of the body, this is news to many. It’s an organ just like your heart or liver. It has a specialized set of tissues that works together to perform necessary biological functions. Your skin keeps water inside your body, regulates temperature, protects your internal organs, turns sunlight into Vitamin D and flushes toxins out of your body. We treat the skin as if it’s a shield protecting our inside from the outside world, a shield we want to keep looking glowing and smooth. The truth is your skin belongs to the incredible and interconnected whole that is your body. So let’s take a look at this outer layer that is covering you. It is made up of three layers:
Your epidermis is the top layer of your skin. It contains four types of skin cells. Keratinocytes produce keratin, a fibrous protein that guards your body against heat, bacteria, and chemicals. Melanocytes produce melanin, which is responsible for the color of your skin and protects you from the sun by absorbing UV light. Langerhans cells function like the immune system of your skin by helping produce antibodies that fight infection. And the Merkel cells, which connect to your nerve cells and allow you to experience the sensation of touch. Your epidermis is about a tenth of a millimeter thick, except on your palms and feet, which are layered with an extra two millimeters of cushioning.
Your dermis is right underneath your epidermis, and it is made up of proteins you've heard of many times: elastin and collagen. They make your skin strong, stretchy, and, as you may have guessed, elastic. When you cut your skin, your dermis produces extra collagen to fill and heal the wound. Your dermis also produces hyaluronic acid, a chemical that helps hold hydration in the skin, making you look youthful.
The constant activity in your dermis is what we correlate with "healthy" skin: it's doing all of the work behind-the-scenes to make your skin look soft and vibrant.
Beneath these two layers is your subcutaneous fat, which, as its name suggests, is a layer of fat that connects the nerves from your dermis and epidermis to the rest of your body, while also protecting your insides with a really cushion.
These three layers work together to give your skin a set o natural super powers. Skin is capable of regenerating itself. You are constantly shedding dead skin cells around 40,000 a minute. This is happening regardless what you are applying topically.
Normal healthy skin means skin containing enough water to create a protective barrier against damage and infection. It also refers to the number of fats and oils produced which help retain water. This normal healthy skin process helps to regulate body temperature and prevent harmful toxins and bacteria from entering our bodies largest organ, the skin. This is our immune systems first line of defense.
Eczematous skin does not produce as much fat and oils as the body requires, as a result the skin is unable to retain enough water. Ruptures start to occur between individual skin cells because they are not sufficiently filled with water. The result is the skin starts to dry out. It is important to note that it is moisture, and not fats eczematous skin needs to have replenished.
Part Two - The symptoms of Eczema
So you are probably wondering how does skin change from being just dry, into being red and insanely itchy with a rash? The fact is, eczema, or atopic dermatitis, is an auto immune disease. This means eczema has a connection to your immune system, and your immune, as we know, is our bodies defense system against harmful irritants and infections.
When the skin becomes weak, the immune system become sensitive to a variety of discomforts. Inflammation can then occur in the deeper layers of the skin, resulting in rashes on the limbs of the body. Often these discomforts have no impact on people with normal healthy skin as their immune is not compromised.
Inflammation in the body is called a flare-up. Occasional flare-ups can be effectively managed however when flare-ups become more frequent, re-occurring over and over, the eczema becomes a long-term condition. Many people with severe atopic dermatitis show visible signs as they are in a continual flareup. Meaning something is triggering inflammation in their body.
Itchiness
Eczema typically starts with an itchy symptom, a prickly feeling just below the skin surface. The immune cells in the deeper layers of the skin are sending inflammatory signals to the skin surface, and this is what is causing the itchiness. Changes within certain nerves in the upper layer of the skin, called C fibers, may also be a cause of eczema. These changes may increase skin sensitivity, making the skin more prone to itching and scratching. As the condition progresses, people with eczema may even scratch their skin without realizing it. Feeling itchy from eczema can come and go, and some rashes are more intense than others. If the itchiness is quite intense, this can may keep suffer’s up at night, leading to sleeplessness and daytime fatigue.
Skin Rash
When eczema suffers scratch the rash to ease the itchiness, they end up tearing at their skin and breaking down the exterior layer, enabling further allergens and germs to enter. The more they itch, the more this happens, and the more the immune system continues to send signals to the surface. This causes an itch loop of further redness and itching.
Scaly or Peeling Skin
The peeling of eczema may resemble that of sunburn or a peeling blister or callus. In some cases, the skin may peel resulting in raw skin or open wounds. This generally occurs in the creases of the elbows, knees and on the face, neck, and wrists. This is an uncomfortable symptom marked by scaling, itching, and skin cracking.
Dark, colored Rashes
A constant itch and scratch cycle can frequently result in skin hyperpigmentation, this is when the skin becomes darker than usual. Inflammation can also cause depigmentation on dark skin. This is when the skin loses color and becomes lighter than usual. These discolourations can last for months causing unhappiness and often anxious feelings for the sufferer. Eczema on dark skin can look very different to how it shows on white skin. Generally people with black or brown skin, are inflicted with hyperpigmentation in affected areas.
Weeping and Blistered Skin
Tiny blisters may appear on the skin surface. Scratching these can cause a clear fluid to seep out. This weeping is often a sign the eczema has become infected, and if it continues to worsen, you should seek medical advice.
Effect on the Quality of Life
Eczema is a skin condition, however the impacts of the disease are more than superficial. People with severe atopic dermatitis can be affected not just physically but psychologically too.Depression and anxiety are common in individuals with eczema. Sufferers can experience considerable discrimination and social isolation. People often stare or step back in fear from those who have this condition. The end result for patients can be a lifetime of struggling with their sense of worth and self-esteem.
Physical Impact
Eczema can increase the risk of developing other hypersensitivities such as asthma, hay-fever and food allergies. Eczema is an immune disease, people with eczema are at greater risk of internal infections, including upper respiratory tract and urinary tract. Doctors also believe that eczema can increase the possibility of cardiovascular disease, because severe atopic dermatitis can negativity impact sleep and regular movement.
Psychological Impact
A visible chronic disease like eczema, can make a patient, as well as his or her parents, feel helpless and powerless to manage the situation. It can be exhausting in a way, with each new flare-up bringing a sense of disappointment. The mental impact of eczema can be just as debilitating, and often ever more than the physical impact. That’s because visible signs of eczema attracts attention from strangers, and no-one wants to be stared at. This has obvious negative impacts on their self-esteem.
Eczema flareups can raise feelings of anxiety and depression. Eczema sufferers often choose to avoid social gatherings, work meetings because they feel embarrassed about their condition, they feel the need to cover up and not want to draw attention to their visible flare-up.
As a result, this may lead many to develop anxious feelings leading to depression. It can be a vicious cycle. Add this on-top of everything else they are dealing with, their condition may be further aggravated by stress, poor quality sleep and lack of movement.
Part three: Living a Normal Life with Eczema
The first part of this course is acknowledging and understanding the hardships some people face with this autoimmune disease. However throughout most of this course we will create strategies and solutions to support living as normal life as possible with eczema.
As we proceed through this course, we will discuss various strategies, however as a base for this learning, here are a few foundations to absorb:
Know your triggers - we will discuss in detail the primary triggers of your flareups. It’s important to know, everyone experiences different triggers. Your goal is to figure out what your specific triggers are and then avoid them as much as possible. I’ve got plenty of tools for you coming up so you are well supported.
Prioritize Sleep – You may be scratching your head thinking, what has sleep got to do wit my eczema flareups. Well my friend it has everything to do with your skin condition. We will go into sleep in more detail later in the course. It can be difficult to sleep when you are itching all over and you’re in pain. If you or your child are having difficulty sleeping as a result of eczema, I have many support tools for you throughout this course. For example, you might decide to take an antihistamine before bed. This type of medicine can stop itching as well as make you sleepy. Or you could go for a natural option - essential oils - with no side effects and extremely effective.
Fun Fact: Throughout this course you will learn there are man natural alternatives to the traditional prescribed eczema medication. One example is Lemon, Peppermint and Lavender essential oils. In combination, these three oils are a natural antihistamine which do not disrupt the gut like synthetic medication can. We will discuss the use of essential oils as a very effective way to treat your eczema in future modules.
Focus on your nutrition – Many people say their symptoms get worse after eating particular foods. They feel a flareup. Nutrition is important for skin across all body systems, it makes sense to avoid foods that trigger a flareup. Eating clean, healthy food will boost your energy and additionally your mood, which helps you make better decisions each day. I always say Eat good food - make better choices.
Focus on your movement – exercise is a great way to destroy stress. When we move our bodies we activate the Vagus nerve. Moving our body helps to move the anxious feelings out of our mind and out of our body. Be careful though, if sweat triggers your eczema then always take a cool or lukewarm shower soon after your workout to wash it off.
Relax and be still – relaxation is also a great way to help manage your eczema. The truth is we don’t slow down and relax enough to allow our bodies time to repair. Stillness, deep breathing meditations, yoga practice, journal writing, and even curling up with a good book can all help lower your anxious feelings and take your mind off your symptoms.
A relaxation practice, like meditation or yoga Nidra are great support tools when you experience an aggressive eczema flare up, helping to improve concentration and give you a sense of control over your itching. To bring you back to center when it seems the world is crumbling under your feet.