Tag Archives: Eczema

A summary of some of the regular reatments for eczema

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Eczema - Printed Diagnosis on Blue Background and Medical Composition - Stethoscope, Pills and Syringe. Medical Concept. Blurred Image.

I have been writing about our experiences with eczema (or more specifically Atopic Dermatitis) for almost 2 years now. I have written about the various treatments we have tried in various posts but I realised that I have not really written in details and in a comprehensive manner about the first, second line and third line treatments that are usually used to treat eczema.

(Please note: I will refer to Atopic Dermatitis as eczema in my post from here on to simplify matters)

In this post I have written about the regular medical treatment that is used once the moisturisers alone are not able to control the inflammation. Moisturisers are an essential part of the treatment for eczema and works very well in mild forms but may not be sufficient to bring the eczema under control once the skin becomes red and inflamed in moderate to severe eczema. I have myself been confused at times with the myriad topical, steroidal and non steroidal creams that are prescribed by the doctors at various points in time. Then there are also the oral steroid medications and different immunosuppressants and phototherapy treatment that we have used to control flare ups. I believe it would help a lot of parents (and those adults suffering from eczema) if they had some idea about the basics of the different types of treatments and medications that they may be using on their child or even on themselves. It would definitely help in controlling and reducing the side effects that some of these strong medications can have on a person if not used properly.

Topical steroids

Steroid cream.

Topical corticosteroids are prescribed by the doctor/dermatologist when the skin becomes red and inflamed and the eczema does not clear up in spite of maintaining a healthy and regular bathing and moisturising routine. The topical corticosteroids range from very mild to very potent and you should be very careful in following the doctor’s instructions in using the same for your child both in terms of quantity and duration. This is especially true for young children and babies. In any case, the topical corticosteroids are prescribed only when the risks from eczema far outweigh the risks from the side effects of using these medicines. When a child suffering from eczema is unable to sleep at night due to incessant itching and thus starts affecting daily life at school and home, there is a risk of infection due to the cuts and inflamed skin, it is wise to use steroid creams/ointments as per the doctor’s advice till the time the rashes have gone.

Some important points to remember while using these medications-

  • One should start using the lowest potency steroid and only step up if required
  • Topical steroids are most effective if applied immediately after a bath but should only be applied on affected areas and not as a moisturiser
  • One should follow the doctor’s advice on the frequency of application (usually twice a day is more than enough on severely inflamed skin) and should start tapering off as instructed instead of stopping abruptly
  • Step up and the step down method (in terms of potency and frequency of steroid) needs to be maintained while using the topical steroids to keep the risks of side effects of these medications as low as possible
  • One should avoid using these medications on the face and other sensitive areas and this is all the more true for children who have very sensitive and delicate skin

Given below are the various common (but certainly not exhaustive) topical corticosteroid creams/ointments that are available in India (and ones I am most familiar with) and their potency

  • Low potency– Hydrocortisone creams (1%) are available as an OTC (over the counter) medicine in various forms like cream, ointment and lotions. This is the least potent amongst all the topical steroids but still should be used with caution especially for a child. This is especially true since this is easily available and one can unknowingly use this as a moisturiser without realising that it is still a steroid cream/ointment
  • Mild to mid potency– Steroidal creams/ointments like Desonide, Mometasone fuorate and Fluticasone propionate are available at the lower to mid end of the potency spectrum. These are brands like Desowen, Momate/Elocon and Flutivate brands in India for the respective steroidal creams/ointments respectively. The doctors will prescribe a particular steroidal cream based on the level of inflammation and rashes
  • Potent to highly potent– Steroidal creams like Betamethasone dipropionate and Halobetasol propionate are at the potent end of the corticosteroidal creams/ointment. In India we have brands like Fucibet (which also includes fucidic acid which is an antibacterial medication) and Halovate which include these steroids respectively.

You should also know there is an overlap in these topical medications since they are usually available in both cream and ointment forms and the potency for the same dosage will differ based on the form. The cream form has roughly half water and half oil, they spread easily, are well absorbed and usually wash off with water. Ointments on the other had are about 80% oil and 20% water and are thus “occlusive” which means they trap moisture and help in better absorption of the main component. Being occlusive, an ointment will allow the medication to get absorbed much more completely than a cream and hence are more potent at the same dosage as a cream.  

https://www.psoriasis.org/sublearn03_mild_potency

Application and side effects

Topical corticosteroids should be used in a step up manner in terms of increasing potency starting from a low potency and only moving up if required. Usually the doctor will prescribe the milder ones like desonide cream (brand name- Desowen) and only graduate to a stronger medication like Fucibet if required later on. Similarly, once the rashes have been brought under control, one should use the step down method both in terms of potency as well as frequency as per the doctor’s instructions.

As mentioned earlier, these medications should only be applied on affected areas and not as a  moisturiser. However, sometimes the rashes may be quite widespread all over the body. In that case, the doctor may prescribe a 1:4 ratio of a mild potency steroid like desowen to an emollient like cetraban which is then mixed thoroughly and applied all over the affected areas.

Side effects from these steroidal creams are varied and depends on the age of the person, the frequency of application, the potency of the drug amongst other factors. The thinning of the skin or skin atrophy is one such side effect which can take place if potent to highly potent steroidal creams are applied too frequently or without any break. However, one can avoid this and other side effects by following the doctor’s instructions for using this treatment and thus using this treatment as and when required, in the required quantity and for an appropriate duration. The other thing to keep in mind that in case of excessive scratching due constant itchiness in case of under medication, the skin tends to become thick and discoloured. Thus the treatment needs to be carried out in a timely manner under the supervision of a doctor and the instructions should be properly followed to minimise the side effects.

(Further reading-http://www.eczema.org/corticosteroids)

Calcineurin inhibitors

Another type of topical treatment available for eczema is the group of medications known as Calcineurin inhibitors. These are non-steroidal immunomodulators and are of 2 types- pimecrolimus 1% (Pacroma and Elidel) and tacrolimus 0.3% (Protopic). These topical medications work by suppressing the immune system and are usually prescribed to children over 2 years of age and adults and are recommended for use as a second line treatment for eczema.pacroma-cream

As with steroidal medications, these type of immunomodulators should also be applied only when prescribed by the doctor and for the recommended duration of time. Even though it does not have the side effects like thinning of the skin which is associated with steroidal treatments, one still has to be cautious while using these medications since they are relatively new medications and not much is known about their long term usage. There is a possible risk of skin cancer only in the long run after prolonged usage but it is still advisable to apply these creams at night to avoid sunlight exposure. These medications are also prescribed for eczema on the face (unlike topical steroids) and are prescribed for moderate to severe eczema only when the combination of topical steroids and emollients have not been successful.

(Further reading- http://www.ncbi.nlm.nih.gov/books/NBK45568/

http://www.ncbi.nlm.nih.gov/pubmed/14693489)

Phototherapy or Narrow band UVB

Another treatment that is prescribed once the topical treatments have not really worked for a person in controlling the eczema is phototherapy. It is used as a safer alternative to avoid using  the third line treatments of  the powerful immunosuppressive medications like azathioprine, methotrexate and cyclosporine.

In this treatment light or a particular narrow band of Ultraviolet rays are used to treat the eczema which is beneficial for skin diseases. It can be used both for localised as well as general areas of the skin covering the entire body. This treatment works effectively for some people but not for everyone and usually takes about 1 to 2 months to show the desire results. If this treatment is effective then it can effectively put the eczema in remission for a while at least. It may also minimise the usage of topical steroids and there its side effects.

Phototherapy is carried out in a special booth filled with UV rays for general treatment of eczema all over the body and hand-held devices for treatment of specific areas like hands, ankles etc. Nowadays, a high intensity phototherapy treatment is available in the form of a laser called Excimer. It is much more powerful than the regular phototherapy and emits Ultraviolet rays of a particular frequency which is used to treat different skin conditions like eczema, psoriasis etc. It is given in the form of a hand-held gadget and takes much less time than a regular phototherapy due to the high intensity of the rays and is more useful for treatment for localised areas of the body. However, one needs to be careful in protecting the eyes when undergoing this treatment. The risks associated with prolonged treatment are skin burns, increased ageing and increased risk of skin cancer. Like any other such treatment this has to be carried out under the supervision of a medical professional and all the instructions need to be followed carefully. (I have written about our experience with phototherapy in my blog post https://eczema-anindianperspective.com/2013/10/17/when-the-going-gets-tough-part-1/).

(This treatment is currently offered in the Comprehensive Skin Care Clinic run by senior pediatric dermatologist Dr Manish Shah in South Mumbai and the website is http://www.cscc.co.in/)

Oral Steroids

Steroids

The third line of treatment for eczema is the use of systemic medications like oral steroids. Prednisone is one of the most commonly used oral steroids given in cases of severe eczema where an immediate result is required and is given under strict supervision of the doctor. It is given as a daily dose starting with a high dosage and then is slowly tapered down once the eczema is under control. Oral steroids work by suppressing the immune system and helps in controlling the overactive immune system in the case of a person suffering from eczema. But this also makes it possible for the person to catch infections easily due to a weakened immune system and hence has to be monitored at all times. Also, in the case of a child, oral steroids may slow down growth and development and hence again one needs to be very careful.

There are other side effects as well which can be minimised by following instructions carefully and keeping a lookout for any symptoms which may arise on taking this medication. This is also done by carrying regular blood tests to determine adverse side effects if any. Due to the various side effects of this medication and its quick action, oral steroids are usually prescribed for short periods of time when results are needed fast. Bottomline, like any strong medications, one needs to take this under strict supervision and follow the doctor’s instructions about dosages  and how to start and stop taking this medication.

(Further reading: http://www.ncbi.nlm.nih.gov/books/NBK260241/)

Immunosuppressive medications

various tablets pills in bottle

The other third line of systemic treatments include the immunosuppressive medications like azathioprine, cyclosporine and methotrexate. These are all very powerful medications and are given only when all other options have failed to yield the desired results. All of these medications work by suppressing the immune system and hence bring the eczema under control. But once again, due to the various side effects these medications have to be given under strict supervision of the doctor prescribing this and by following all the instructions carefully. Since eczema is a chronic condition and these medications may be required to be given for long periods of time, regular testing is required to ensure that there are no side effects.

Azathioprine

Azathioprine works by tweaking the growth of certain white blood cells which contribute to the inflammation associated with eczema and thus suppresses the immune system. It takes a while longer to show results than cyclosporine and may not suitable for acute flare ups.The main side effect of azathioprine is bone marrow suppression and that is why a specific test is carried out before prescribing this medication which is called the TPMT enzyme test. This test determines the suitability of the person by determining the ease by which the person is able to break down azathioprine in the normal way. However regular testing would be required to keep a track of any adverse effect on the immune system. This medication is taken orally in the form of tablets and on a daily basis in the prescribed dosage.

We had a traumatic experience with this medication which was prescribed by a leading pediatric dermatologist in London for our then 7 year old daughter. In her case, even though she had a normal TPMT result, her body reacted disastrously to this medication and she suffered from bone marrow suppression and had to fight for her life. This was a one in a million kind of event and has never happened before to someone with normal TPMT levels. I have written about our experience in my post in 2013  and you can read about it at https://eczema-anindianperspective.com/2013/10/27/the-tough-get-going-part-2/.

Cyclosporine

Cyclosporine is another systemic immunosuppressant used to bring severe eczema under control and works by specifically blocking an important pathway in the immune system, and has different side effects than steroids. It is prescribed in low doses for eczema under strict supervision and once the eczema is under control, the medication is tapered off. One of the main risks associated with this medication is damage to the kidney especially with increased dosage and duration of medication and hence regular tests would be required to monitor the kidney activity. This medication has to be taken orally on a daily basis as per the prescribed dosage.

(I have written more about our experience of dealing with cyclosporine and azathioprine medications in my blog post where I have compared both at https://eczema-anindianperspective.com/2014/02/10/azathioprine-and-cyclopsorin-an-overview-of-two-immunosuppressive-medicines-used-to-control-my-daughters-eczema-from-a-parents-point-of-view/).

Methotrexate

Methotrexate is another systemic immunosuppressant which is used mainly in treatment for psoriasis and different types of arthritis. It is also given in low doses in cases of severe eczema and usually takes longer to work than cyclosporine. It has anti inflammatory properties and works by altering the body’s use of folic acid (a vitamin) which is needed for cell growth. Thus a folic acid supplement is a must on a daily basis for those taking this medication. This medication is taken once a week in the form of tablets. This dosage may also be split up into 2 doses taken within 24 hours to minimise any nausea that may occur. One of the main possible side effects of this medication is again adverse effects on the immune system especially on the white blood cells (which fight infection) and platelets (which help stop bleeding). Thus regular blood tests are required to keep a look out for any adverse side effects.

(Further reading- http://rheuminfo.com/medications/methotrexate/methotrexate-detailed-information)

Sometimes the hardest thing and the right thing are the same

Sometimes we don’t have a choice as far as giving strong medications to our child is concerned when the child is suffering from a severe chronic condition which adversely affects daily living. Of course we would prefer to find some alternative which is much safer and without any of the side effects that I have mentioned above. As of now we have not managed to bring our daughter’s eczema into remission and she needs constant medication in order to live a relatively normal life.

Things can also go horribly wrong like it did in our case in spite the very best of intentions. We have been very lucky and have learned to take this in our stride and be more vigilant in the future since our daughter still requires immunosuppressants to keep her severe eczema under control. This has not stopped us from looking for other options and neither should you. As one wise person had said, it does not matter how slowly you go as long as you do not stop.

Green power!! (greener alternatives for laundry and cleaning products especially for eczema and sensitive skin)

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I am publishing an updated my article on ecofriendly and natural alternatives for laundry and cleaning needs at home. It is a primer for those of you who are looking for eco friendly and natural alternatives for a cleaner and greener home.

Cleaning word cloud concept

I find that it is important for me to highlight the fact that there are harmless, natural, environment friendly laundry, dish washing, and cleaning alternatives which are available to us. In this particular post I have focused on the laundry and household cleaning agents that we use (In subsequent articles I would be focusing on the impact of our food habits and diet). While most of us do all that we can as far as moisturizers and bathing products are concerned for children who have eczema, some of us are not aware that the regular dish washing, cleaning and laundry products used in a household can also have a large and harmful effect on sensitive skin and allergy/eczema prone children (and adults). In India especially, eczema and other allergies are a recent phenomenon as compared to the West.

While I was happy using regular detergents and cleaning products for my household cleaning and laundry needs, I was particularly happy using highly fragrances and foaming cleaning/laundry detergents and thought that all products which were labelled as “child/baby friendly” and “gentle on the skin/clothes” actually were child friendly and gentle on the skin. But after a bit of research I was quite surprised to find that quite a few of the products that I had been using all my adult life were cumulatively doing more harm than good to my entire family and this was especially true for my daughter who has severe eczema. That is when I started looking for alternatives and was pleasantly surprised to find out that there are much better, natural, harmless and environment friendly options which might also be much more economical for regular use. Now, over the past couple of years in my quest to manage my daughter’s severe eczema, I have made a lot of changes in our lifestyle which includes skincare products, laundry products, dish washing products as well as other household cleaning products.

Natural Non-Toxic Cleaning Products

Since I am sharing my own personal experience in using these products, I have restricted this post to products which are available to Indian consumers only. Also, please note that I am going by the information provided by the manufacturers as far as the ingredients are concerned, certifications as mentioned and in some cases I have taken into account the product reviews by other users. 

 All that foams is not soap!

 Soaps and detergents are two different things but are often mistaken to be the same. While soaps are traditionally made from fats and oils and have been around for centuries, detergents are usually of synthetic origin and is a much more recent phenomenon. Detergents react less to minerals (found in hard water) than soap and hence is now the preferred choice for most.

soap-bubble-kidsstoppress

  • Sulphates are surfactants which are used in a wide range of products especially laundry and dishwashing detergents in order to reduce the surface tension of water thereby improving its ability to wet things and remove the dirt.
  • Other products where Sulphates are found are bathing products like shampoos, shower gels etc, toothpastes and even baby care products and it provides the “foam” that we are so used to.
  • Nowadays most of the skincare and laundry detergents usually contain the gentler Sodium Laureth Sulphate (SLES) plus a host of other chemical fragrances and preservatives and not the much harsher surfactant Sodium Lauryl Sulphate (SLS).
  • But even SLES is a chemical which is harmful for sensitive skin and it is just one of the many chemicals which are present in any cleaning/skincare/laundry products.
  • The other common chemicals are preservatives like Parabens (Methyl, propyl, isbotyl to name a few) and Methylisothiazolinone fragrances which are mostly made of synthetic chemicals and synthetic colours,  found in many baby and child care products.
  • Many organic and natural products have preservatives like Parabens and foaming agents like SLES unless stated otherwise. Hence it is imperative while buying any such product to check the ingredients listed carefully no matter what the label says in the front. The good thing is that there are detergents (laundry and cleaning purposes) which are available to us today which use natural ingredients and are also fragrance free.

Soapnuts- the underrated cleaning agent

 Soapnuts (or reetha as it is known in India) is actually not a nut but a dried berry or fruit which is highly effective in powder and liquid form and can be used to clean clothes, jewellery, dishes, hair and other household items. It is found mostly in India and Nepal and was used extensively in India to wash clothes and hair long before liquid detergents and shampoos took over.

 

Nutshells of soapnuts in a cotton bagThe saponin which is found in the fleshy part of the soapnut is a 100 % natural hypoallergenic surfactant which is believed to have antibacterial and antifungal properties as well.

  • Soapnuts can be used for cleaning pretty much anything and is the only cleaning product which is completely natural. Any other product which is labelled ‘natural’ will contain at least some chemicals like preservatives, fragrances amongst others.
  • The other important aspect of using soapnut is that it extremely convenient to use in washing machines (front and top loading) and dishwashers (in liquid form).
  • We use soapnuts regularly as the main cleaning agent for all our clothes and white vinegar and essential oils (lemon is my favourite) as a fabric conditioner and to remove grease and add natural fragrance to the laundry.

Other laundry products

 Apart from soapnuts products which are natural, biodegradable and convenient to use either by hand or in washing machines are as given below.

Power Laundry, Liquid Laundry and Bio Laundry Bar from the Rustic Art brand: The main ingredients in these products are soda ash, natural neem soap powder, glycerine (for liquid laundry), non edible oils (for soap bar) and natural lemon extract. I use these products for my bed linen, towels, soft furnishings and other heavy materials, delicate clothes and woollens (Liquid laundry) and I use the Laundry bar for the tough stains.

rustic_art_power_laundry-kidsstoppress

Bio-D from Dailydump.org: Bio-D is a bio detergent by dailydump.org (a brand of Bangalore-based PBK Waste Solutions Pvt Ltd) which is a biodegradable product made from palm oil. I have been using it as an alternative to the Bio Laundry bar from Rustic Art for the past year or so for the clothes which are handwashed.

Another product which is relatively new and is available in India is Kyra Natural Detergent Powder which is made of organic soapnuts. I plan to use this in the near future.

Home clean home

 There are various household non toxic and environment friendly cleaning products which are available to us. One can use basic kitchen items like white vinegar, baking soda and lemon to make cleaning products. I have used a combination of these from time to time to clean my kitchen pretty effectively. ONe of my favourite recipe for a multipurpose cleaner is as given below-

All-Purpose Cleaner recipe from goodgirlgonegreen.com

3 parts filtered water

1 part vinegar

1-2 tsp lemon juice

5-7 drops of lemon essential oil

Source:http://www.goodgirlgonegreen.com/7-diy-cleaning-recipes-using-vinegar/#sthash.dwxieNSg.dpuf

(You can check out more useful articles on homemade and non toxic cleaners from the following websites-

http://www.goodhousekeeping.com/home/cleaning/tips/a24885/make-at-home-cleaners/

http://www.thenewhomemaker.com/cleanorg/vinegar.html)

Natural cleaner. Vinegar, baking soda, salt, lemon

But for those who want a more convenient off the shelf option there are other products available as well in India. These products are made using natural ingredients like essential oils, plant extracts which are thus biodegradable, non toxic and eco friendly as well. I regularly use the products listed below for my cleaning purposes:

  • Just Mop Spray- Multipurpose Household Cleaner and Just Mop- Herbal Surface Cleaner from the brand Herbal Strategi
  • Floor and bathroom cleaners from the brand SOIL
  • Floor cleaner from the brand Safe O Shine

Harmless dish washing alternatives

Dish washing detergents also use foaming agents, synthetic fragrances and other chemicals to make them extremely effective in cleaning grease and dirt. But if you are really interested in making a change for greener alternatives, there are other options available.

One option is to make a dishwashing liquid from basic items like washing soda, citric acid and vinegar like the recipe mentioned below from the blog myhealthygreenfamily.com (source: myhealthygreenfamily.com/blog/wordpress/homemade-borax-free-dishwasher-detergent-with-secret-ingredient/) which also can be used in the dishwasher

1 cup washing soda (old recipe used  baking soda)

1/4 c. citric acid

1/4 c. coarse salt

10-15 drops of citrus essential oil (Optional.  Orange, grapefruit, or lemon essential oils have great cleaning as well as antibacterial properties.)

Distilled white vinegar (in the rinse aid compartment)

Mix first 3 ingredients well in an air tight container. Add essential oil.  Mix again.  Fill your rinse aid compartment with undiluted white distilled vinegar.

Use 1 tsp. detergent for average loads.
Use 1 tbsp. detergent for extra greasy, dirty loads

White distilled vinegar can be thus be used along with lemon essential oil as a rinse aid thus eliminating the need for any artificial rinse aid products.

Another option is to buy a scrub made of the combination of soapnuts, shikaki (dried fruits of the Acacia tree native to Asia) and lemon peel which is a completely natural, non toxic and ecofriendly option for dish-washing by hand like the one by dailydump.org.

Availability and delivery in India

I have been able to find out about all the products mentioned earlier through a lot of research on this topic over the past few years. I have also managed to source these products in a few cases through the manufacturer’s own websites but more often than not through the various websites advocating a green, eco friendly and healthier way of life. These are websites which list organic foods, clothing, personal care, cleaning and other products.

Some of my favourite websites (with quick delivery and good service) are as listed below ( in no particular order):

  • DailyDump.org : A comprehensive website which promotes green, eco friendly and sustainable lifestyle through composting and non toxic products for home and garden. This website has the Vanastree soapnut and shikaki scrub (manufactured by Dailydump) that I use for my dishwashing needs and the Bio- D biodegradable detergent for laundry purposes. They also have their own brand of soap-nuts (108 Soapy Nuts).
  • Naturalmantra, Greenngood and naturallyyours.in: These are comprehensive websites which list organic foods, supplements, natural home care, personal care products etc and is very convenient to buy laundry and household cleaning products from. I use all of these websites from time to time for my house cleaning, laundry and other household and organic grocery requirements.

I have compiled some of the easy and convenient ways in which you can use non toxic, natural alternatives for your household cleaning, laundry and dishwashing needs and their availability. I hope that this will encourage you to make your home a greener, eco friendly place for your family and friends.

Please feel free to get in touch with me for any queries or if you have any suggestions on this topic.

The journey of a thousand miles begins with one step

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Our family’s journey began some years ago when our daughter was diagnosed with eczema (Atopic Dermatitis). Since then we have come a long way. It has motivated me to work towards increasing awareness about this condition in our country where it is very low. This will not only help my daughter but also countless others sufffering from this condition who have to deal not only with Atopic Dermatitis but also with a society which is not sensitised to this condition and hence increases the level of suffering and pain in myriad ways.

In this regard, the first “Walk for Eczema” in Mumbai was organised by the Eczema Support Group for Parents and my daughter’s dermatologist Dr Manish Shah (under the aegis of IADVL SIG Pediatric Dermatology ) on the 17th of May, Sunday at Bandra West. It was attended by our family, friends and other supporters as well as some prominent dermatologists from South Mumbai. We were able to reach out to many who were attending the Equal Streets Moevement in Bandra and pamphlets about eczema were handed out to them in three different languages.

The success of this walk is measured not only in terms of the number of people we were able to reach out to directly but also in terms of bringing together for the first time parents, patients and dermatologists who walked hand in hand for this common cause. This event has thus helped to pave the way for such future events which will go a long way in increasing awareness in our country.

Our first “Walk for Eczema” in Mumbai on the 17th of May, Sunday

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social awareness - isolated text in letterpress wood type

I am really happy to announce the first “Walk for Eczema” which has been organised in Mumbai on the 17th of May, Sunday. This has been organised in collaboration with IADVL SIG Pediatric Dermatology(an Indian body for Dermatologists and other skin conditions). This is the first such event of its kind in our city and a part of my ongoing endeavour to increase awareness about this condition in my country.

The complete details are as follows-

Event details

Where :   Equal Streets, HP Junction on Linking Road, Bandra(W)

When:     17th May, Sunday

Starts:     730 am

Ends :     9 am

Organized by: IADVL SIG Pediatric Dermatology and Eczema Support Group for Parents (Mumbai chapter)

Contact: Anindita Rungta/ Comprehensive Skin Care Clinique

Email:    walkforeczema@gmail.com

Contact no. +91 7738533913/ +91 22 23810304

There will be a brief Q&A session at the end of this walk with a senior pediatric dermatologist based in South Mumbai.

Please let us know incase you are interesting in joining us or know anyone who would benefit from this event.

You are what you eat (eczema and food)

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In my last post I had written briefly about the Eczema diet I had started for my daughter in October 2014. It is almost 6 months now and we have had some time to get used to her new diet. I have become very familiar with new foods (for me) like Spelt flour, quinoa, apple cider vinegar, Carob powder (alternative to cocoa) and have become well acquainted with foods like Sorghum (jowar), soya milk and beans, sweet potato, beetroot amongst others. More importantly, we have seen a gradual but definite improvement in her eczema under the combined influence of her immunosuppressive medication (Methotrexate) and her diet.

This is the first time in 3 years that she played a bit of Holi (a festival of colours in India) this year with safe, organic colours and it was delightful to see her so happy to take part in an activity which others can take for granted. There is one other thing that I want to point out in this regard. There have been a few of mild flare ups in the last 6 months- this has been partly due to introduction to new foods in her diet, sweating etc. But what stands out is the fact that usually tweaking the diet a bit for a short while helps to calm the flare up without the need for any additional medication like topical steroids etc every time. Now in fact, after a long time, Aiyana’s eczema is only on her neck and ankles and not all over the body. Her eczema is still a work in progress with a long way to go yet but each small step forward is a cause for celebration for all of us.

You are what you eat (so don’t be fast, easy, cheap or fake)

real food word cloud

Even though I am not a certified nutritionist or an expert and my family’s journey to control eczema through diet has just started, I want to share with you what I have learned so far. I hope that my story might encourage you to find out more about your own diet, lifestyle and its impact on your health and make changes if required. What I love most about using this path to treat my daughter’s eczema is that this is in my control  since I get to decide and control the quality of ingredients and nutrients which enter our systems. This is very different from giving medicines and trying out other treatments where there are various (and sometimes harsh) side effects, none of which are under our control.

One of the key learning for me this past couple of years has been the realisation that the foods that we eat have a far greater impact on our health and wellbeing than I could have ever imagined. I always knew that food gave us energy and was a necessary part of our lives but never knew or realised the critical role that it plays as far as our health is concerned. There is obviously no only one right diet for everyone. And we are talking about real food here and not which comes from a package. Our food habits have changed a lot in the past few generations and we have moved away quite a bit from natural, unprocessed and simple foods. In India though, the emphasis is still on fresh home-made foods for most of us on a daily basis. But packaged, processed, sugar laden foods have become a big part of urban Indian lifestyle as today and we have an increasing incidence of  lifestyle diseases like childhood obesity, type 2 diabetes amongst others.

Simply put, the food that we eat plays a vastly important role and has both negative and positive impact on the body depending on what foods we are consuming. Also, in addition to food there are several other important factors which affect our health. These are namely, the toxins and chemicals we are exposed to on a daily basis, how we live our lives, how much we exercise and what kind of support system we have in terms of family and friends. Of course, in spite of taking all precautions and leading a very healthy life one can still fall ill due to various reasons beyond our control.

Life gives us no guarantees of course! But isn’t it still better to make the most of what we have till such time we can instead of taking our health for granted?

One word of caution here though. My daughter suffered from a life threatening infection due to a major side effect of the drug azathioprine which was meant to control her eczema. But it was also antibiotics and the timely critical medical care which saved her life. So one needs to take a well thought out and balanced approach when deciding on medical care. There are times when one has to take whatever measures like surgery, treatments and medications that are required to fight an illness or a health situation. Other times if there is a chronic illness or condition which just doesn’t improve with medicines and surgery alone, one can look at a combination of holistic approach and medications. At all times one has to take a decision about the relevant and proper medical care depending on the circumstances. The type and combination of medical care and a well balanced diet will differ from individual to individual.

(Sources and further reading: http://www.ncbi.nlm.nih.gov/pubmed/15639678

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3028965/

http://www.ncbi.nlm.nih.gov/pubmed/11229668)

Our relationship with food

Our relationship with food can be a bit tricky at times. Sometimes we use it as a crutch to help us through difficult times; other times it forms a part of our celebration apart from simply filling our stomach. We may also have strong feelings associated with it depending on our relationship with food. However, like many others I was not aware of the healing power that food has to offer. Simply put, we maybe able to control and in some cases reverse the effect of various disorders (especially chronic conditions) by making the necessary dietary changes. Hence, the food that we eat is a critical part of our healing process and we need to understand and respect that.

I am learning more about it everyday and I am slowly but steadily incorporating it into my entire family’s diet. However, diet alone may not have the desired impact for those with medical conditions since a combination of other factors like environmental toxins, stress, a leaky gut and infections usually affect the desired results.

There are various reasons why we do not hear about our diet as an part of our healing process (in addition to life saving medications and surgery whenever required) and this has been very well captured by Dr Terry Wahls (clinical professor of Medicine at the University of Iowa) in the article below-

http://www.healthy-holistic-living.com/doctor-didnt-learn-medical-school.html

Stories that inspire me

inspiration word in metal type

Dr Terry Wahls is just one of many who have successfully controlled (and in her case even reversed) their medical condition. She used a combination of dietary changes, excercise, supplements, electrical stimulation, meditation (for stress management) to successfully stop and also reverse the rapid progress of Multiple sclerosis (a neurodegenerative disease where the immune system attacks the Central Nervous system and has a whole host of symptoms which differ from individual to individual). The treatment that she followed is based on the principles of Functional Medicine.

She has published the details of her treatment and recovery in the science magazine Neuroscience 2011 and the link to the abstract is as given below-

http://www.abstractsonline.com/Plan/ViewAbstract.aspx?mID=2773&sKey=09785855-9734-496b-b682-d5b790e3eb46&cKey=4f661b9f-223e-44e7-89cd-c464d1222d6d&mKey=%7b8334BE29-8911-4991-8C31-32B32DD5E6C8%7d

You can also read about her at-
http://terrywahls.com/about/about-terry-wahls/

Another physician, Dr Amy Myers, has had a similar experience with her struggle with an autoimmune disorder involving the thyroid gland called Grave’s disease and where conventional medicine could not provide any solution. Dr Myers unsuccessfully underwent ablation surgery (permanently destroying the thyroid gland) before using Functional Medicine successfully to control her condition and has helped many others do the same without resorting to ablation/surgery unless absolutely required.

You can read her story here-

http://www.amymyersmd.com/2014/02/hyperthyroidism/

(Functional Medicine is a customised approach to medicine which differs from person to person and imbibes the best of science, research and innovative tools to treat the patient. It is completely patient focussed and takes into account the genetic factors, environmental and lifestyle influences of each individual before starting any treatment and thus does not treat the symptoms of a disease only. It strives to combine the best of conventional medicine and integrative medicine like nutrition, exercise, supplements etc)

Another person I would like to mention in this regard is another physician, Dr Naomi Rachel Yemen. She follows a completely different path to deal with her severe chronic condition called Crohn’s disease. She is a pediatrician by profession and is currently a Clinical Professor at the University of California for Medicine. However, the way she has dealt with her severe autoimmune disorder, Crohn’s disease, from 15 years of age for more than 50 years is what I wanted to share with you. Though her doctors had given her a life expectancy of only 40 years she has embraced life and has lived through a coma, eight surgeries, intensive therapy with powerful drugs and surgical removal of her large intestine. She has used a holistic mind/body approach in combination with other medications and surgeries in order to not only survive but also to deal with her intense suffering and chronic pain. In the process she has cofounded one of the first cancer support groups in the US and helped countless others who were otherwise medically beyond help. Over the years of dealing with her patients she has come believe in the power of healing from within often when there is no cure as in her own case. She has shared her thoughts in the link given below-

http://www.rachelremen.com/some-thoughts-on-healing/

You can read more about her life and the books she has written on her website-

http://www.rachelremen.com/about/

There are countless other such cases even though I have highlighted only a few examples in this article. What is common in all these cases and countless others is that it was ultimately something beyond conventional medicine which made all the difference to the quality of life even when there is no cure. One has to find what combination works best.

The long and winding road

cross road on hillside meadow in mountain at sunset

My daughter has been dealing with her condition for some time now and it is hard and a lot for an eight year old to deal with at times. However, we face the good days and the not so good days as a family and it helps her to get through the rough patches. I started writing this post thinking I would be focusing solely on her diet but ended up sharing with you much more. But I felt that it was important to tell you about the people who inspire me on this journey.

In this post I decided to share with you a few of those genuine and real life stories about people which have shown me that none of us are ever the only ones with these kind of problems. There are many others who have such serious, chronic medical conditions and deal with them in such healthy and non conventional ways. It is definitely worth knowing more about them and then finding out what works best for you. In my next post later this month I will write in more details about the actual diet that I am following for my daughter and its impact so far.

I also realise that while we have seen some improvement in her skin condition with the dietary changes and the medication she is currently on, it is not enough. I plan to take the help of a Functional Medicine practitioner and I am currently in the process of getting in touch with one in London. (I do not know much about the Functional Medicine practice in India and would need to find out more about it). I plan to get the requisite tests done for my daughter for determining the condition of her gut health through bacterial dysbiosis test (test for small intestine bacterial overgrowth), yeast infection, food intolerance test etc depending on the recommendations.

Gut health is considered to be of immense importance in Functional Medicine and is considered to be the cause of many allergies, arthritis, autoimmune disorders, chronic fatigue amongst a host of other medical conditions. Hence a good digestive system is very important for a healthy body and it may be severely or mildly but adversely impacted by various factors like stress, diet, overuse of medications, low-grade chronic infections like yeast, bacteria etc. There are tests to determine the gut health which would help me to focus on the areas that would need special attention for restoring the gut health for my daughter instead of trying out everything all at once. This is very important in order to remove the inflammatory foods, replace them with foods and ingredients required for restoring gut health, increase good bacteria in the system and repair the system by adding nutrients like Omega 3 etc.

The last time when we dealt with an experienced and well-known pediatric dermatologist in London, he recommended a course of treatment after carrying out the requisite tests which had disastrous consequences (I have captured this in my earlier blog post- https://eczema-anindianperspective.com/2013/10/27/the-tough-get-going-part-2/). This time around the treatment is based primarily on food and other natural ingredients which are in my control and have very limited side effects (if at all). Also, the past 6 months of following a specific and restricted diet (wheat free, dairy free , egg free amongst others) has given me the knowledge and confidence to handle major changes in the way we eat.

(Sources and further reading about gut health: http://www.ncbi.nlm.nih.gov/pubmed/15790845

http://www.ncbi.nlm.nih.gov/pubmed/14522724)

It is not an easy journey for us as a family with restricted travel and social outings due to the dietary restrictions. But I try to make up for it at home in various ways with the help of my husband, other family members and friends. I now know that there are so many others like us who are on similar journeys of healing themselves with food and healthy lifestyles and I am truly inspired by them. We are in this together as a family and that gives each of us a lot of strength.

As a wise person once said ” Life is like a journey, so lets enjoy the ride!”

 

Eczema Support Group meeting for parents

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I am having the 4th Eczema Support Group meeting on the 21st of February, Saturday from 10 am till 11 am.

This is a meeting for the parents of children who are suffering from moderate to severe eczema. The objective is to provide a platform for parents to share their experiences and learnings with each other. In this meeting we will discuss various treatment options, personal experiences, skin care routine and other related topics as discussed by the members in advance. Infact parents often come up with various suggestions, information in terms of what has worked in managing and improving their child’s eczema which can benefit another child in the support group.
Also, sometimes it helps just to talk to another primary caregiver /parent who is going through a similar struggle of dealing with their child’s eczema.

Topics

  • Diet and its role in eczema/autoimmune disorders
  •  Skin care and bathing routine
  • Phototherapy treatment

Venue- Planet Godrej, Mahalaxmi, Mumbai

For further details and registration please get in touch with me via email at eczemaanindianperspective@gmail.com latest by the 18th of Wednesday.

Our new eczema diet and a heart full of gratitude

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It has been some time since I have put up a post. There have been a couple of developments at my end due to which I have been a bit tied up. The first and the most important one is that the combination of the new immunosuppressive medication, Methotrexate, and her new diet seem to be working for my daughter. I will be writing more on this particular diet later in this post.

The second one is that the support group for eczema that I started a few months back has been slowly gathering steam at a pace that I am comfortable with.

And last but not the least, I also want to express my gratitude and share with you this time the amazing team of doctors in Mumbai behind Aiyana’s medical treatment over the years all of whom have helped us in their own ways to deal with her severe eczema.

Diet and its impact on various disorders

diet

I had been reading about how diet affects one’s body in various ways and is especially important when dealing with autoimmune disorders and chronic conditions like eczema. Doctors do not really recommend any dietary changes unless allergy tests prove to be positive for various foods. However, I found that there more than a few genuine cases where people suffering from severe autoimmune and other disorders like Hashimoto, Lupus, Postural Tachycardia Syndrome, Irritable Bowel Syndrome as well as eczema have found relief from the symptoms due to dietary changes and have managed to go off medication completely over time.

It took me more than 6 months to come to this point of view after reading about the life altering experiences of these people and then figure out a diet which I was willing to try out on my daughter. The life stories of some of the people who influenced my decision to try out diet as an option for my daughter are captured in their blogs whose links are as given below-

http://deliciouslyella.com/philosophy/about/– This blog is by Ella who has Postural Tachycardia Syndrome, a relatively rare and painful illness with no known cure and she managed to go off her medications completely after about 18 months of changing her diet

http://www.naturallysassy.co.uk/about– This blog is by Saskia, a ballet dancer with chronic eczema since childhood and who has completely gotten rid of her eczema by altering her diet

http://www.choosingraw.com/about/– This blog is by Gena who has battled with anorexia, Irritable Bowel Syndrome and who now successfully uses a mix of raw and cooked vegan diet to keep herself healthy

http://www.amymyersmd.com/about/my-story/– The last link belongs to a website by Dr Amy Myers, a doctor of functional medicine suffering from Hashimoto’s ( a chronic and painful condition of the thyroid gland with no known cure) who has brought her severe thyroid condition under control after changing her diet/nutrition and life through meditation, yoga, supplements amongst others.

(Functional medicine integrates traditional Western medical practices with what is sometimes considered “alternative” or “integrative” medicine, creating a focus on prevention through nutrition, diet, and exercise; use of the latest laboratory testing and other diagnostic techniques; and prescribed combinations of drugs and/or botanical medicines, supplements, therapeutic diets, detoxification programs, or stress-management techniques.)

Source: https://www.functionalmedicine.org/

The Eczema Diet

Eczema-Diet-2nd-Ed-Front-Cover-192x300

In my post https://eczema-anindianperspective.com/2014/09/23/products-and-resources-which-help-to-manage-eczema/, I had very briefly mentioned that I was planning to start my daughter on a diet for eczema based on the book “The Eczema Diet” by the Australian nutritionist, Ms Karen Fischer. Her daughter had severe eczema as well when she was a 2-year-old and with changes in her diet, Karen managed to control the eczema successfully. She has since written this book based on her own experience with her daughter and the feedback over the years from her patients who have successfully brought their eczema under control using this diet.

This diet is practical and comprehensive with information on products and backed by research; it has menus and recipes for babies, children and adults. It also has non diet information like skin care products and general recommendations for eczema. The objective of this diet is to temporarily take out all the eczema unfriendly foods from the diet and add all foods which are highly nutritious and eczema safe.

There are 2 stages to this diet- Stage 1 and Stage 2 .

Stage 1 is primarily to heal the gut by avoiding foods with any kind of artificial chemicals and limiting naturally occurring eczema unfriendly chemicals (like MSG or salicylates) ; allergens (eggs, wheat or dairy products); anti nutrients (phytic acid, sugar, processed foods) and acid forming and other foods which increase itchiness (oranges, corn, tomato, dairy, grapes, dried fruits). This diet thus helps restore the acid alkaline balance in the body.

Stage 2 is an extension of the first stage where the food groups are gradually expanded by adding back different food groups in moderation ( no processed foods, artificial colourings, preservatives etc) depending on the improvement in the skin condition. The diet also has recommendations on supplements like vitamins, probiotic, glycine, flaxseed (Omega 3) amongst others which are very important in helping the body cope with eczema since the child might not be consuming adequate quantities of the same from food.

I started this diet for my daughter after going through it thoroughly and arranging for most of the eczema safe ingredients as there are quite a few changes in ingredients that we usually use at home. Infact, it took me almost a month to assimilate all the information, answer the different questionnaires and make notes and list down the essential foods and recipes as a part of my preparation before starting this diet.  It’s been about 2 months since I have started this diet for my daughter.

Since it is pretty restrictive in the first stage, I took my time to prepare my daughter mentally for what was to come in the following months by telling her about the diet. I also made her read excerpts from the book about other children who have benefited from this diet and have seen their eczema either disappear almost completely or finally come under control. Only when I was sure that she was ready for this change and that I had prepared adequately for this diet did I finally start the diet for her.

The recipes and menu

recipes

Over the past couple of months I have tried out various recipes from this book as well as developed and modified some recipes from this book using eczema safe ingredients. This is to ensure that Aiyana not only followed this diet completely with no exceptions but also had a wide variety of options to keep her from feeling deprived of all the store-bought and other foods that we are all so used to having nowadays. The good part about doing all this apart from the health benefits for my daughter is that my entire family now has much less processed foods, negligible amount of junk foods, healthier organic and fresh foods, homemade preparations of bakery and other  foods with no sugar and preservatives.

This has not been easy especially since I have had to cut out sugar, dairy, wheat, eggs and all processed foods, all spices ( apart from garlic and salt) out of her diet and give her a  very limited variety of fruits and vegetables. These last couple of months I have extremely been busy with this diet trying out the book’s recipes and new recipes almost on a daily basis since I have had to modify some of them to suit her needs and our Indian palette. This has been made more difficult since the recipes in the book are for meant to suit an European palette while we are used to our Indian spices and foods. What has helped me is my past experience with gluten-free cooking for my daughter in 2012 ( I have covered my experience in the post- “Eczema and diet” ) and my determination to ensure that I find a way to manage my daughter’s health in a more natural way in the long run.

The book can now be purchased both as a paperback and kindle version online at amazon.in.

When there’s a will there is a way

 inspire-31What encourages me is that Aiyana’s skin condition has improved in the last couple of months. Here I should also add that we had to start her new immunosuppressive medication around the same time as the diet and that the new medicine also takes 3 to 4 weeks to show results. But with my experience of giving her the third immunosuppressive medication (Cyclsosporine, Azathioprine, Methotrexate) I can say with conviction that the only medicine which has truly worked for her and made her skin completely smooth and normal all over has been oral steroid in high doses. The other medications have either just about helped keep her eczema under control (Cyclosporine) or brought about bone marrow suppression (Azathioprine); I have covered the effects of Azathioprine and our traumatic experience in my earlier post “…the tough get going (Part 2)“.

Hence, I am really happy to see that after starting her on this diet her face is totally clear of any rashes and has finally got back that healthy glow that had disappeared under the effect of all the strong medicines being given to her. I am willing to continue the hard work required to carry on with this diet and keep her motivated to follow the same for the next few months at least. I will keep you posted on further developments about my daughter’s skin condition in relation to this diet in my future posts.

 A heart full of gratitude

thank you

As the year comes to an end, I stop to count my blessings for all the good things in my life and my heart is filled with gratitude for all those doctors who have been with us in my family’s difficult journey in the past few years. In this post I would like to thank the amazing set of doctors behind Aiyana in her fight against eczema. I have briefly mentioned them in my earlier posts as well but have never mentioned their names which I do now with their consent.

 

 

Dr Shashi Merchant is Aiyana’s pediatrician from Breach Candy Hospital, Mumbai, and has known her since birth and held her as a newborn baby. She has been a pillar of strength and is unwavering in her support and care for my daughter. She gave us hope when we needed it the most in the darkest of moments when Aiyana was fighting for her life in the hospital last year. We are all lucky to have had her on our side in this journey.

Dr Amrita Talwar is Aiyana’s main dermatologist for the past 4 to 5 years now and has done much more and beyond than required as her role as a doctor. Without her help and guidance about the myriad aspects of dealing with eczema (including the essential but non medical ones) life would have been significantly more difficult for us. I have her to thank for encouraging me to write about our experience and starting this blog and for pushing me and helping me to start the Eczema Support Group.

Dr Manish Shah is a leading senior pediatric dermatologist and is the dermatologist whom we consult regarding her immunosuppressive medications and narrow band UVB treatment. He gives us advice when required and gives us much-needed guidance about giving these strong medications as well as dealing with and minimising the harsh side effects. We are very grateful to have him as Aiyana’s consultant dermatologist.

Dr Mahesh Balsekar is another well-known pediatrician in South Mumbai with Breach Candy Hospital. He is the one who diagnosed and admitted Aiyana to the hospital in time last year (Dr Merchant was on holiday at that time) which ultimately saved her life. Dr Balsekar thus gave her and the doctors at Breach Candy Hospital a chance of fighting her life threatening infection. My heart swells with gratitude for Dr Balsekar for keeping our family intact and saving my daughter’s life.

We are also grateful to the entire pediatric division of Breach Candy Hospital, haemotolgists Dr Antia and Dr Agarwal and the entire support staff at the hospital for playing a very important role in our daughter’s stay at the hospital last year.

A new year, a new beginning

new year

And so another year ends and a new one is about to begin soon. May the new year be filled with joy, laughter and good health. But may you also find the strength to overcome whatever obstacles lie in your path and remember to enjoy every precious moment with your friends and family.

From my family to yours–

A Happy 2015! 

 

Products and resources which help to manage eczema

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I have been meaning to put up a post of the resources and products (mostly natural formulations) that have proved beneficial in some way or the other in the past few years while treating my daughter’s eczema. These products have been recommended by other parents based on their experiences while treating their child’s eczema. I would like to mention that while my daughter is still on immunosuppressive medication to control her very severe eczema, some of them might prove to be extremely beneficial for your child like it has for many other children.

This is obviously not an exhaustive list by any means and I have listed a few products that have come to my notice and a few other products which I use on my children.

Creams, moisturisers and salves

I have written earlier about moisturisers and creams but these products deserve a special mention. I have put down a few completely natural products which are not mainstream and are mostly formulated by parents of children with eczema after they tried out various mainstream creams and moisturisers but to no avail. Furthermore, all these products are free of steroids, Sulphates, parabens and other preservatives, artificial fragrances, petrochemicals and are made mostly from natural organic ingredients. These products have proven to be beneficial to many children and in some cases, parents have been able to substitute topical steroid creams and moisturisers with preservatives and other chemicals with these natural and organic products successfully.

However, for mild to moderate eczema, you must use the steroid creams and medicines prescribed by the doctor to calm an infection or bad flare up for your child. But in the long-term if you can use a combination of natural moisturizer and other lifestyle and dietary changes to keep eczema successfully under control, that is the best situation one should work towards. I am still trying to figure out what is best for my daughter and how to manage her eczema without using steroids, immunosuppressant and other such powerful medicines and through our own journey it will really make me happy if I can help some other children and their families to cope with eczema.

I have used the first 2 products and coconut oil on both my children. I have found the Purepotions cream to be very effective on extremely dry patches and the organic coconut oil is the main moisturiser for my daughter. Some of the other products have been recommended by other parents of children with eczema and/or adults with eczema who have found relief by using these products. I have also come across some of these products while continuing my search for products to help my daughter and others like her suffering from Atopic Dermatitis.  

However, you have to be careful before using the products for the first time on your child and should check the label to see if your child is allergic to any of the ingredients in any such products.

 

  • Purepotions Intensive moisturising ointment– This natural salve was formulated in UK by a mother, Natalie Balmond, when she took matters into her own to find an alternative natural solution to alleviate her daughter’s suffering due to bleeding sores covering 90% of her body. It has Beeswax which acts as a natural antibacterial barrier protecting the skin from external irritants and locking moisture in as well as Hemp  which is extremely rich in essential fatty acids which are often lacking in those with dry skin. One can find out more about this cream and order on their website (they deliver to India) – http://www.purepotions.biz/ and once can also purchase this ointment through other websites like http://www.everythingforeczema.com/skin-salvation.html.

 

 

  •  Chickweed and Calendula cream– The founder of the website, Ms Gail Palmer is another such mother whose daughter had eczema when she was small and she struggled to bring it under control. She developed this product made of chickweed and Calendula especially for chaffed, dry skin like in the case of eczema. Chickweed has been traditionally used by herbalists to help sooth itching, and Calendula to reduce inflammation. She has her own website and blog and one can buy this product on her website http://www.everythingforeczema.com/chickweed-and-calendula-cream.htm

 

 

 

Emily skin soothers

 

  • Baby and adult skin soother from the brand Emily Skin Soothers– Made by an acupuncturist for his daughter’s eczema, this balm contains only natural ingredients. It contains just three chinese herbs in a base of olive oil and beeswax. This product is available on the website http://www.eczemacompany.com/natural-eczema-cream/ and is shipped to India by this website.

 

 

 

  • Odylique Repair Lotion and Ultra Rich Balm by Essential Care– these and other skin care products have been formulated by Margaret and her family since 1980s. She was motivated by the lack of products suitable for her own and her family’s very sensitive and eczema-prone skin and she formulated skin care products based only on organic herbs, plant oils and natural active ingredients. The lotion and the balm are the 2 products made specifically for eczema prone skin and one can purchase their products from their website http://www.essential-care.co.uk/organic-skincare-for-problem-skin/organic-skincare-for-itchy-skin.html 

 

 

LJs natural

 

  • Organic Scratchy Balm and Organic Scratchy Bath/Body Oil by LJs Natural– These products were formulated by Lisa Johnson who had been suffering from severe eczema for a long time after a lot of research and experimentation. The combination of these products and complementary therapy including diet helped bring her eczema under control ever since. The balm is a blend of organic shea butter, avocado oil, evening primrose oil and may help provide relief from itching due to dry skin conditions in a completely natural way. The bath and body oil can be used on children since it is a blend of lavender and chamomile (which are great essential oils good for dry and damaged skin and are very relaxing if used before bed time). This product is now available for delivery to India after I contacted her last week. You can check out her website at http://www.lj-natural.com/my-story/.

 

Organic coconut oil

  • Coconut oil (Organic)– This moisturiser is something we have been using for quite a while now and it has proved to be very helpful especially during the times when my daughter’s skin is broken at places due to constant itching. It is an excellent emollient for not only coating the skin but penetrating it as well, unlike a mineral oil that only coats the skin. This is readily available in India from brands like Conscious Foods, Down to Earth, Kama etc.

 

 

Therapeutic clothing and products

There are some specialised types of products available to help patients suffering from eczema cope with the aches and pains and sleepless nights associated with this skin condition and have to be used in combination to the regular medications and mositurisers. Amongst these, the most obvious and natural ones which help in reducing skin aggravation is the use of completely natural laundry cleaners. I have touched upon this topic in my earlier post – “Eczema- a change in lifestyle”  particularly in relation to availability of these products in our country.

Today I am writing about other products which have been specially formulated to help in reducing itchiness, increasing the comfort level and which might help in reducing the intensity and frequency of flare ups in some people. I have used The Tubifast Garments on my daughter when she still had mild eczema and was advised wet wrapping treatment by her dermatologist. I have also used the Dermasilk full sleeves roll neck t shirt on her and it helped to some extent to reduce her itching at times. In particular, the Dermasilk Elite Girl Brief has proved to be beneficial to my daughter and she wears it to school everyday. It has helped reduce the itching in her groin area to a large extent.

Again, I have shortlisted most of these products based on the reviews and recommendations of other parents who have found these to be beneficial in some way or the other. There must be many more which have been developed  and the good thing is that there are a whole host of products developed specifically to minimise discomfort and itching associated with Atopic Dermatitis and thus improving the overall quality of life for an eczema patient.

 

Dermasilk

  • Dermasilk Therapeutic Clothing–  This is a line of clothing used in the treatment of various forms of dermatitis, eczema and allergic skin conditions and is made of a special, knitted medical grade silk (not regular silk material) by Espere Healthcare in the UK. One can read more about them on their website- http://www.dermasilk.co.uk/. They manufacture full sleeves roll neck T shirts, full length footless leggings, tubular sleeves (for elbows and knees) , underwear (for boys and girls), child gloves, short sleeves T shirt amongst others. I have used the long sleeves T shirt and full leggings for my daughter but intermittently due to various reasons and she was pretty comfortable wearing this at night. You can buy their products on the website- http://www.theallergyshop.com.au/dermasilk-kids/ since this website delivers to India.

 

Tubifast

 

  • Tubifast Garments by Monlycke Healthcare– Tubifast Garments are specifically made to manage eczema using the Wet Wrapping Technique also called Wet Dressing Technique. They are found in various forms for children- gloves, leggings, full sleeves vests in all sizes. Apart from these, Tubifast Patch Wrap,  is used to soothe and protect isolated patches of eczema, especially behind the knees or the elbow and comes in pairs. One can read more about them on their website- http://www.molnlycke.com/patient/en/Products/Wound-care-products/Tubifast-Garments/.  The garments can be ordered at the website- http://www.theallergyshop.com.au/dermasilk-kids/ and they deliver to India as well.

 

 

  • Scratch Me Nots– This is a website where once again a mother, Andrea, developed a product looking for a way to stop her daughter from scratching all the time due to her eczema and wanted to stop the itch- scratch cycle. She then eventually figured out how to bring her eczema under control once her daughter stopped scratching and thereafter they could sleep at nights and decrease the visits to the doctors and the medications. She has developed ScratchMeNot Flip Mittens, ScratchMeNot Flip Mitten Body, Bamboo Bubby Bag, ScratchMeNot Mitten Sleeves all designed for babies and children upto 6 years of age to stop their scratching especially at night. These products are made with an unique blend of bamboo viscose, organic cotton & lycra and one can buy their products on the website- http://www.eczemacompany.com/scratchmenot-flip-mitten-sleeve-formerly-classic/ or the company website- http://www.scratchmenot.com/view-all/.

Skintoskin

  • Skin to Skin biofunctional clothing – These products were developed by a dermatologist especially for babies, children and adults with atopic skin conditions like eczema. These are made from 70% pure cotton and 20% brown algae (seaweed) which has been bonded with silver particles giving the remaining 10%. According to the company, the seaweed extract has natural properties that soothes and protects against itchiness and the silver adds antiseptic properties, drastically reducing the growth of any potentially harmful bacteria on the skin.  The products available are boxer shorts for girls/boys, long sleeves and short sleeves Tshirts, socks and leggings. One can buy these products at  http://www.everythingforeczema.com/skin-to-skin.html (they deliver to India) and their website is http://uk.skintoskin.eu/ incase you need further information.

Diet and eczema

The other aspect of managing eczema that keeps coming up again and again from other parents who have successfully brought their child’s eczema under control and others who have been able to manage their own eczema is through their diet. This is something which my husband and I have been contemplating for some time for our daughter but have not been able to implement by ourselves. For a child, a well-balanced nutritional diet is critical for growth and well being and this is even more true when the child is on a restrictive diet due to eczema, allergies etc.

Fortunately, I came to know of a naturopath based in Mumbai recently and we have approached him to help us streamline Aiyana’s diet to help us to possibly decrease her dependency on medications which keeps her eczema under control currently. Even though no doctor will really recommend a change in the diet for eczema unless it directly affects a person due to his or her allergies, more and more people with severe eczema are going down this path especially when their dependency on powerful medicines with equally powerful side effects becomes too great. Hence the role of naturopaths, natural formulations and home remedies in chronic conditions like eczema.

But you must take the same precautions that you would take before giving any mainstream medicines to your child by finding out about the impact of dietary changes, side effects of any supplements given, regular monitoring required etc. Thus even in the case of managing your child’s eczema through changes in the diet and supplements, you should be clear about why you are eliminating some foods while keeping or even increasing others and not just follow all the recommendations blindly. For a child, a well-balanced diet is very important for growth and the dietary changes should take into account protein, calcium requirements of a growing child amongst other things.

Eczema-Diet-2nd-Ed-Front-Cover-192x300

On this front, after quite a bit of research on the resources available on diet and eczema, I have come across a book called “The Eczema Diet” by an Australian nutritionist Karen Fisher. Twelve years ago Karen’s daughter developed eczema soon after she was born. By the age of two, her daughter’s eczema had become so severe that Karen decided it was time to find her own solution.  Karen successfully controlled her daughter’s severe eczema by formulating a diet plan for her daughter. This book is based on a decade of extensive research of the causes of eczema by Karen Fischer.  It has helped a lot of people to bring their eczema under control and has also helped a lot of parents to manage their child’s eczema in a much more natural way.

I had ordered this book on http://www.theallergyshop.com.au/the-eczema-diet-by-karen-fischer/. This book has recently been delivered to me and I am still going through the same. So far I have read about how it works, the top eczema safe foods as well as the ones which trigger eczema.  In case you have already taken help of this book and tried this diet on yourself or your child, I would be really happy to hear from you.

 

I have tried to bring together in one place a variety of products (creams, moisturisers, clothing) which have helped many children and adults control their eczema and live a comfortable life. Eczema, while not usually life threatening in nature, can really hamper a family’s quality of life on a daily basis since lack of sleep, discomfort, itchiness, medications and their side effects take a toll on children with eczema and their parents alike.  However, there have been a number of parents who have found a way that has worked for their child to some extent or the other and all the trial and error they have gone through has been worth it in the end. While I am also one of those parents still struggling to bring my daughter’s eczema under control with minimal or no medication at all, I would like to live you with a thought that I often have to remind myself on those days when it all seems so difficult-

“In between goals is a thing called life, that has to be lived and enjoyed”- Sid Caesar 

 

 

 

Our tryst with Ayurveda and our first Eczema Support Group meeting in Mumbai

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In my last couple of posts I had mentioned that I was trying out Ayurveda as an option of treatment for my daughter simultaneously with the immunosuppressive medication Cyclosporin that she is currently on. She was started on Ayurveda treatment in May and it carried on during her summer holidays till the end of June. She was given a mix of medicines  in the powder form ( made of natural ingredients) and others in the liquid form. In all there were quite a few medications before and after breakfast, evening snacks and dinner, and it is to my daughter’s credit that she took all the medicines without much fuss at regular intervals.

Dietary restrictions and Ayurveda

However, the more difficult part was to live with the many and varied dietary restrictions on a daily basis.  Foods which are restricted not only include food groups like fermented food products ( curd, yogurt, dosa, idli, cheese etc) ,cold foods like food straight from the refrigerator, ice creams, cold drinks or juices but also citrus foods like tomatoes, sweet lime, lemons; vegetables like potatoes, cauliflowers, leafy green vegetables like spinach; processed foods like cakes, pasta, noodles containing maida (refined wheat flour), fish and meat, cold cuts of meat, canned foods– the list was pretty comprehensive. Due to the fact that Aiyana was on vacation and at home, we did manage to follow almost all the restrictions but it was pretty tough for an 8 year old to remember and adhere to these restrictions on a daily basis. I guess given all that she has been through in the last couple of years she has matured beyond her age and understands what needs to be done even if she does not like it at all.

But inspite of following this treatment for almost 2 months, there was no marked improvement and infact her itching became progressively worse and she was unable to sleep throughout the night. It was once again a most difficult and stressful time for all of us and most of all for my daughter. As per our follow up which was scheduled in early July, I took her back to the institute and this time she was met by their skin specialist as well. Upon hearing that the medicines had made her very itchy, he changed most of her medicines and asked us to give it some more time.

Unfortunately, by that time Aiyana was extremely uncomfortable and I stopped all the ayurvedic medicines by second week of July. After showing her to her regular doctors (pediatrician and dermatologist), she was put on a low dose of oral steroids. Infact over the last couple of years we have noticed that whenever her skin has flared up or seems to be out of control even with her regular medication and routine, oral steroids is the only medication which brings it completely under control. Even cyclosporin has not had that effect on her in the past year that she has been on that medication. After consultation with her doctors, we were advised to increase and try a higher dose of cyclosporin (along with the oral steroids) for the next couple of months to see if that made her skin stable only after which it would be decided to change her medication.

The struggle is just a part of our story

Pinteresting with Koka Tawera Week 3

So this is where we are now, still looking for a stable alternative to her ongoing medication. We have our ups and downs and it has been a long journey for us since Aiyana was diagnosed with Atopic Dermatitis. But in the end, she is so much more than a child with eczema. Eczema and all the problems associated with it are just a part of our family’s walk through life.

There was always a risk trying out alternative medicine but I wanted to explore that option incase it proved to be a viable one for her and did not have the kind of risks associated with the side effects of the medication she is on currently. But the biggest risk in my opinion is that there is not much regulation with regards to the manufacturing of medicines. Unlike in mainstream medicines like steroids, immunosuppressive medication and other such medicines, ayurveda and other alternative medicines like homoeopathy are not that regulated. Thus I was not 100% sure about the purity of the medicine (especially since some of them were manufactured by little known Ayurvedic pharmaceutical companies in various parts of our country) and hence the efficacy and this always niggles at my mind.  I am not sure how this issue will be resolved in the near future and but this remains in my mind a stumbling block for ayurveda to become integrated with mainstream medicine. But there are ways to follow some of the simpler natural remedies prescribed in ayurveda by sourcing the natural ingredients and using them as home remedies as has been the case in many Indian families over the ages. In any case, this decision was taken out of our hands due to my daughter’s skin condition and I now look ahead in our family’s journey in dealing with eczema.

What kind of experience have you had in treating eczema with ayurveda (If any)? Please do let know your opinion on the same!

Eczema Support Group- our first meeting

I had mentioned that I was conducting the first Eczema Support Group meeting in Mumbai end of July. We finally had our first meeting early August and there were 4 of us, all mothers of children with severe eczema  residing in Mumbai who came together to share our experiences, stories, issues and most importantly our pain of watching our child suffer. Going ahead we will be sharing information and our own unique experiences in dealing with eczema, we will also have  experts talking to us on various topics associated with Atopic Dermatitis amongst other things. Incase you know someone residing in Mumbai who has a child suffering from moderate to severe eczema and wants to join our group, do ask them to get in touch with me at eczemaanindianperspective@gmail.com.

I had planned to write about some products that have been beneficial to my daughter and other children with eczema over the years but I realised that it is better if I write separately about that in my next post. Apart from natural supplements, moisturizer and creams, special therapeutic clothing (some formulated by other mothers whose children had severe eczema), there are some amazing books/CDs for children available  across the world which are immensely useful in dealing with eczema directly or indirectly by reducing the stress associated with this condition. These do much more than just provide information, they inspire and motivate children (and adults) in the face of eczema and other such difficulties. I will be putting up a post on this soon!

In the meantime, I leave you with a thought which is something that I try to live by and instill in my children-

“Happiness is not the absence of problems; it’s the ability to deal with them”– Steve Maraboli

Eczema Support Group in Mumbai- a beginning

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There have been a few developments at my end. The first one is that I am in the process of setting up a support group for the families of children suffering from moderate to severe eczema in Mumbai. Support groups play a very important role by not only alleviating the pain and suffering of patients of various medical conditions across the world but also by providing emotional support to their care givers (in this case parents).

I know firsthand what the impact of having a child with severe eczema is on a family who is dealing with this chronic condition on a daily basis. The parents (usually the mother in most cases) deal with the emotional and physical stress of managing their child’s eczema apart from the rigours of administering medicines and the long drawn (usually) moisturising and bathing routine of a child with eczema. Also, a lot of times the doctors are not in a position to give as much time as is required by some parents to understand properly how to manage their child’s daily moisturising, bathing routine which is critical in these cases and also to explain the other lifestyle and other changes required to keep eczema under control.

The objective of the support group is to thus fill this gap and make sure the parents are well informed about the same. Infact, parents themselves are able to come up with various suggestions, information at times of what has worked in managing and improving their child’s eczema which can benefit another child.

Also, sometimes it just helps to talk to someone else who is going through the same rigours of dealing with their child’s eczema as only someone who is in a similar situation is truly able to understand what the other is really going through.

The first meeting has been tentatively scheduled as per the details given below-
Planet Godrej
30 K K Marg,
Close to saatrasta
Mahalaxmi, Mumbai 400011
Date: 28th July, Monday
Time: 10 am

Incase you are interested in attending the same or any of our future meetings, please do get in touch with me. My email id is- eczemaanindianperspective@gmail.com.

The second development is a talk I had given at a forum which was an unique patient oriented meeting organised by IADVL SIG Pediatric Dermatology (Indian Association of Dermatologists, Venereologists and Leprologists) at Wadia Hospital, Parel on 22nd June 2014. The CASE meeting was attended by around 35 persons that included practising and teaching dermatologists, dermatology and pediatrics residents, and caregivers of Atopic Dermatitis patients.

My part in the same was on the topic “Our life with eczema- a family perspective” and captured our experience of dealing with our daughter’s severe eczema over the past few years.

The link to my talk is on youtube as given below-

Our life with eczema: A family perspective-  https://www.youtube.com/watch?v=sF17Cj1raAc

There you will also find the other videos on the talks given by the other doctors and the parent of another child with Atopic Dermatitis on various topics like “Eczema? Why me? How do I cope? – Dr. Manish K. Shah”; Coping with eczema everyday– Dr. Rajesh Jadhav; Eczema treatment highs and lows- Dr. Rui Fernandez; Infections and eczema- Dr. Manjyot Gautam; Wet wraps for eczema- Dr. Amrita Talwar; Overcoming eczema: It’s not impossible- Mrs Unnikrishnan. 

My endeavour is to increase awareness about this condition in my country as well as help other children and their families deal with Atopic Dermatitis. The formation of the support group, my blog and sharing my family’s experience in relevant forums are baby steps towards that goal.

Given below are some words that I keep close to my heart and which says it all-

“Some of the most comforting words in the universe are “me too.” That moment when you find out that your struggle is also someone else’s struggle and that you’re not alone fighting that same battle.”