ManiCure

Treat your nails well, and they will treat you well.

What I mean by that is simply, that the better treated your nails are, the less harm your scratching will do. So what's an atopic's maniCure? Short and sweet.

Keep your nails cut super-short. File them if you need to, make sure there are no jagged edges to break the skin's surface.

Oh, and especially disregard the conventional wisdom about cutting your nails straight to avoid ingrowing nails. That may be true for normal people but you have atopic, dammit! In my humble opinion, you should cut your nails as round as they can be. You should be cutting them so often, anyways, that you'll avoid ingrowing nails because they won't manage to grow that far.

So if you scratched so hard that it's bleeding, treat your skin; but also, treat your nails.

This was another post brought to you by "An Ounce of Prevention is worth a Pound of Cure". Despite its misleading name, maniCure is prevention, not cure.

Comment on affected body areas

And if you need further convincing, here's another reason why an ounce of prevention is worth a pound of cure.

When things get bad, for any reason, you may make the following discovery the hard way (as I have myself many times). Areas of your body that were previously totally clean and unaffected may react and become part of your general scratching repertoire. And once affected, they will rarely truly stop being part of the sensitive skin.

Example: when I started with braces, I had to use a neck brace (back in the day when they needed those). The skin on the back of my neck started itching, and has not really stopped since. Before this episode it had never been itchy at all.

Similar situations have happened with my scalp, the back of my hands, the tops of my feet and even the palms of my hand and my fingers (when the shit really hit the fan, if you'll excuse my French). Some of these areas go back to normal at some points in time but then flare up again and again at other times.

So watch out for the signs. And take care of yourself even when things are looking up.

An Ounce of Prevention

The following can be considered preventive measures, and may be very helpful a such, as per the adage that "an ounce of prevention is worth a pound of cure". Still, they do not constitute a treatment, and once your situation gets real bad, they may not cut it by themselves.

1. Moisture, moisture, moisture. Oi, moisture. Dry skin is the enemy of atopics worldwide. Take a daily bath with oils, put moisture-loving creams on, the whole nine yards. Other methods may help (primrose oil AKA Omega 6 is claimed by some to be a good skin-moisture helper).
   
2. Antihistamines. Lots of atopics are reacting to allergens, so do your body some good by helping it deal with the allergic reactions (histamine cells).
   
3. Avoidance. Find out what you're allergic and/or sensitive to (those are two different things, by the way) and avoid it. Minimizing dust for example may be a huge factor for people allergic to dust. Contact with chemical agents can make life worse (hire a cleaning lady if you can afford it). Choose your clothes with care. Etc. I may write more about this someday.
   
4. Climate control. Rapid temperature changes make life difficult. If you live in a cold place, dress warmly and cover up as many areas as you can when stepping outside. Keep a relatively moist environment in the winter (AC for heating is bad; radiators are much better). For the summer, try not to sweat because sweating induces itching (AC is great then). Air pollution can make matters worse. In Israel, for example, there are dusty days ("ovech" in Hebrew); try to stay indoors in those days.
   
5. Stay cool in the other sense as well. Stress, anger and emotional pressure can worsen the situation. I know it sounds impossible, but try to keep your cool. Different approaches on this one, including my own varied attempts, but meditation and self-hypnosis can help to extend calm further. Work out your issues if you have any. See a shrink if you need one. Whatever works for you.
   
6. Keep your hands and your mind busy... I don't mean that you need to be a workaholic (or any other -holic either). But anything that makes you feel good and keeps you busy enough to forget scratching, is worth doing. Hand-engaging hobbies that you love may serve a double purpose by keeping both your mind and your hands off scratching.
   

Again, I want to stress that these methods are not likely to improve your situation once it is bad. But apply them at all times and you may just help yourself - if not totally preventing, they will certainly slow down any potential deterioration in your situation and possibly keep status quo.

Still, don't forget that when things get bad, you need to actually treat the situation. Here's a reminder for how to recognize things are going bad.

What constitutes a treatment

So, what constitutes a treatment for Atopic Dermatitis - according to conventional medicine, anyway?

According to Dr. H (dermatologist), here's what can constitute a treatment (I'm pretty sure he meant for medium to severe atopic):

1. Topical Steroids. Topical means on the spot, or in plain English, creams spread on your skin. in order to actually treat the atopic, they need to have steroids (cortisons) in them.
   
2. Immunosuppressants. These agents may calm your atopic dermatitis by way of lowering the resistance of your entire immune system.
   
3. Phototherapy - certain types of UV rays may be helpful for some cases of atopic dermatitis.
   

Now, each of these treatments has its own dangers and complications, I won't go into details right now. Let's just say, "don't try this at home". Consult an expert for the right options for you.

In a future post I'll write, accordingly, what doesn't constitute an actual treatment (but may well act as prevention).

One word of caution, according to Prof. B. (dermatologist): Systemic steroids (i.e. taken through the mouth, injected, etc.) should NOT be used for atopic, as they tend to cause a rebound reaction once the drug is discontinued. There is evidently a major difference in opinion among doctors on this point. Allergists and physicians may tend to recommend this type of treatment because it is effective for asthma and so assume it will work for atopic as well. Personally, I've experienced the rebound effect in both times I've taken systemic steroids. Readers beware.

poem.

Scratching

looks like red ink
maybe I just spilled a blob -
no, NO! Stop, stop it
stop hurting yourself,
oww, I can't,
go wash this off,
cut your nails,
look what you did.

Copyright (C) 2000 by Shiri Dori

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...Above is a poem I wrote several years ago. The odd thing is, my atopic was totally off at the time, but some triggers of extremely red color caused these deeply entrenched memories to jump to the surface and cause a very strong reaction (to me, anyway). I stumbled upon it today and decided it's worth sharing. I'll write more about scratching one of these days, but for now this is all I can say.