Eczema is a Physical and Emotional Burden We All Need to Understand
Eczema can be a physical and emotional burden. We’re bringing attention to how this chronic skin condition affects the quality of life of adults and kids alike.
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Maybe you already know what it feels like to live with eczema. If not you, someone in your household or someone you know is suffering from it. Finding a management plan, including treatments that work, can help ease the itch and discomfort to help improve the overall quality of life for them and their family. Dermatologist Dr. Sonya Abdulla helps us understand why eczema is more than skin-deep.
Eczema is a chronic inflammatory skin condition.1
Atopic dermatitis (AD), often referred to as eczema, is a chronic inflammatory skin condition.1 “It typically looks like red scaly patches — their appearance can vary — red and oozy or more dry and thickened,” Dr. Abdulla says.1 Though it can be anywhere on the skin,1 eczema usually appears behind the knees, the inside of the elbows, and on the face, neck and hands.2
Eczema almost always starts in infancy or before age 5.2 While it’s often thought of as a childhood condition, many suffer into adulthood.3 It is estimated that up to 17% of Canadians will suffer from eczema at some point in their lives.2 The condition usually runs in families.
It can be a constant struggle to cope with flares.
Most people with eczema go through periods of flare-ups with active or new patches and then a period of clearing.1,3,4 But for some, clear skin is elusive — 41% of respondents in a recent Eczema Society of Canada survey reported they live in a constant state of flare and never experience clearing.4
Flare-ups can be prompted by triggers such as soaps, fabrics, foods, stress, overheating and dust.1,2 Sometimes a flare-up occurs with no apparent trigger.1 There’s a seasonal impact on eczema too; the cold winter months with low humidity can cause skin to be even dryer and exacerbate the condition.6
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“Patients must familiarize themselves with their triggers and continually try to avoid them to minimize flare-ups,” says Dr. Abdulla.2 She typically recommends irritant avoidance, which may include repeated water exposure, fragrance, extremes of heat or cold and exposure to chemical substances.
Managing eczema can mean making many decisions: what to eat, which shampoo to buy, whether to switch laundry detergent, what fabrics to wear, which sheets to sleep on and makeup selection. It can involve extra vacuuming and cleaning to keeping the home free from dust.1,2
Eczema places a considerable physical and emotional burden on children and adults.3
According to Dr. Abdulla, one thing that’s common across all age groups is that most patients struggle with itch. “Itch can impact a person’s ability to concentrate or sleep, having a significant impact on quality of life.”4 The sufferer scratches and, in turn, it gets itchier — a terrible cycle of itching and scratching.1
Patients often struggle with other symptoms, which can include burning, stinging and even pain from cracking.4,5 Constant scratching can cause the skin to split, ooze and bleed, leaving it vulnerable to infection.4,5 A 2020 Eczema Society of Canada survey found that 48% of respondents experienced a flare crisis that required immediate medical intervention.4
“The emotional impact of any chronic disease can affect one’s social well-being and development,” she adds. Eczema can lead to low self-esteem, anxiety, frustration and social isolation.4 The condition can impact productivity, mental health and the ability to exercise and travel.4
There’s also the challenge of dealing with changes to one’s appearance. “Patients may not only be physically uncomfortable due to their skin disease but they may be self-conscious related to the appearance of their skin. This impacts a person’s ability to engage with others and may go as far as impacting their ability to form strong social relationships.”4,7,8
Patients may also find that the condition impacts their career path toward those that are less likely to flare their eczema. In fact, eczema contributed to 23% of survey patients changing careers or giving up certain activities.3
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For parents and caregivers, the heartbreak of watching their child suffer is real.
Understanding when they’re uncomfortable can be challenging since children communicate differently than adults, Dr. Abdulla tells us. “It involves a lot of interpretation of cues including scratching or rubbing and monitoring for signs of discomfort.”
Eczema can result in sleep loss and affect the child’s activities, acceptance by peers and education. In the Eczema Society of Canada survey, it was identified that 25% of children who miss school due to their eczema miss 10 or more days a year.3 All this can cause added stress, exhaustion, anxiety and guilt for parents and caregivers,3,4,8 on top of the commitment and effort it takes to manage the condition.
“Skincare and treatments play a large role in the management of young patients, which takes time. Time that may already be limited due to competing interests from other life commitments but also trying to engage the child in the active treatment plan.” Avoiding playtime triggers can be difficult too. “Many of the activities that kids engage in can flare their eczema. This includes anything that gets them messy as well as water activities.”
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While there’s no cure, a proper skincare routine along with a treatment plan can help manage eczema symptoms.2
Because of its recurring nature, eczema requires ongoing management that can include treatment routines, lifestyle changes, and moisturizing and bathing regimens.10 The first line of defence is keeping the skin moist.1 People with eczema lack an essential oil in their skin, making it dryer and more sensitive to irritants.9
Dr. Abdulla’s advice for maintenance skincare involves short, warm showers with gentle non-soap cleanser and regular moisturizer from head to toe.9 For those in whom skincare isn’t sufficient, medicated treatments may be necessary.
Treatment can relieve symptoms like itching.10 While 65% of survey respondents said they have used four or more different treatment options to manage their child’s eczema, less than one-third agreed that their child’s eczema was well controlled.3
“There are so many factors that go into the management of eczema — the relapsing, remitting nature as well as the number of potential triggers can be overwhelming,” she says. Giving patients strategies to prevent flares and manage them can be empowering for both patients and caregivers. “Working with your doctor to identify potential triggers, developing strategies for prevention and having an action plan for treatment of symptoms when flaring are among the best strategies. Early identification of an eczema flare and getting on top of the flare right away can decrease frustration.”
Find more information and resources about eczema at eczemahelp.ca
1 Eczema Society of Canada. (n.d.). About eczema. Retrieved November 14, 2020, from https://eczemahelp.ca/about-eczema/
2 Canadian Dermatology Association. (n.d.). Eczema > What is eczema. Retrieved November 15, 2020, from https://dermatology.ca/public-patients/skin/eczema/
3 Eczema Society of Canada. (2017). Atopic dermatitis: Patient insights report. Retrieved November 13, 2020 from https://eczemahelp.ca/wp-content/uploads/2019/02/ESC_Insights-Report_Nov-2017-1.pdf
4 Eczema Society of Canada. (2020). The atopic dermatitis patient journey. Retrieved November 14, 2020, from https://eczemahelp.ca/wp-content/uploads/2020/09/ESC-Atopic-Dermatitis-Patient-Journey-Report-2020.pdf
5 Eczema Society of Canada. (n.d.). Types of eczema. Retrieved November 14, 2020, from https://eczemahelp.ca/about-eczema/types-of-eczema/
6 National Eczema Association. (2020). Eczema in winter. Retrieved November 15, 2020, from https://nationaleczema.org/eczema-in-winter/
7 Eczema Society of Canada. (n.d.). Mental health. Retrieved November 15, 2020, from https://eczemahelp.ca/get-support/mental-health/
8 National Eczema Association. (n.d.). Eczema stats. Retrieved November 15, 2020, from https://nationaleczema.org/research/eczema-facts/
9 Canadian Dermatology Association. (n.d.). Eczema > Dealing with dry skin. Retrieved November 15, 2020, from https://dermatology.ca/public-patients/skin/eczema/
10 Canadian Dermatology Association. (n.d.). Eczema > Treatment. Retrieved November 15, 2020, from https://dermatology.ca/public-patients/skin/eczema/
11 Eczema Society of Canada. (n.d.). Treating eczema (atopic dermatitis). Retrieved November 15, 2020, from https://eczemahelp.ca/about-eczema/treating-eczema-atopic-dermatitis/