A Topic: Dermatitis

A Different Way Out

2010-06-05T02:00:00.008+03:00

As some of you may recall, I've been on methotrexate since 2008. However it was helping only partially and I was suffering from side effects. Reducing it didn't go so easy, as my body reacted to the lack of drug - the atopic all came back, full-blown with edema around the eyes, scratching all the time, the works.
Prof. B, when he saw me, said I should go back to the methotrexate. But he also knew I was in USA and he pulled out a name of a famous doctor from Oregon. Dr. HN was a pioneer in the field of atopic dermatitis and has seen it all. We decided to go.
Dr. HN's treatment was nothing I'd ever heard of. He took all my bath oils out ("You might've developed contact dermatitis") and made me bathe in plain water. Immediately after the bath, while the skin wet, I applied a steroid cream (betamethasone) on the entire body - including face(!). I did this twice a day for two days.
At this point I was willing to try anything so I gave it a shot. Believe it or not, it worked. The skin was nearly entirely clear at the end of those two days. Once that happened, I started tapering the creams (with Dr. HN's instruction) down to once a day, every other day, and so on until I now put it on twice a week. The face, neck and breasts get protopic (a non-steroidal, immunosuppressant cream), also twice a week.

I also added UV therapy, on which I won't write today.

Bottom line - my skin is clear, without systemic pills that kill my liver and who knows what else. While I'm not thrilled at the thought of putting steroids on, at least I'm treating where it hurts - the skin. And it's working! It's been four months now and my skin is clear as can be (except for my scalp - that's a matter for another post).

The real deal: products I actually use

2009-09-23T21:14:00.001+03:00

After years and years of testing, I'm bound to have some insights of my own, right?

Well I do. And here they are in front of you.
Please note I am not paid by any of these products/companies to endorse them.

Moisture Creams

My baseline, the best of all and most used by far, the one off of which all else is tested is the one and only Vanicream. This is your all-purpose moisturizer. I use jars of it. I use it twice a day for my entire body and carry it with me at all times (in a much smaller container, though). It basically has practically nothing to irritate your skin - the label says: "Free of dyes, Fragrance, ..." and so on. I use it because it's the best. In years of testing I've never found anything better than Vanicream for pure moisturizer. The only one that I've ever substituted for this is Eucerin, specifically Rambam's hospital-brewed version with extra olive oil.

Now, for some variety I use A-Derma's Exomega emollient cream ("for face and body"). It's good for flaky skin, as it seems to expedite new skin growth. I don't use it at all times but keep it in my closet for those flaky skin patches that tend to show up every once in a while.

Another moisturizer I recently discovered is Neutrogena's "Norwegian Formula: Moisture Wrap Body Lotion". This one helped me out of a tight spot, or rather, a red spot. I had a redness that wouldn't go away, and this one helped it disappear. This came at a cost, though - the skin was flaky when I finished, so take note.

Type-Specific Creams

I always keep a couple of prescription steroidal creams handy. These are good for rashes, scratches, and any nasties of that type.

Another type of cream I like to have is something containing Calendula, and I use it for rapid-healing of scratches or open wounds. It's amazing how fast these work. Right now I use Weleda Calendula Baby Cream, but pretty much any Caledula product will do the trick.

Finally, I keep an antibiotic cream handy for the folliculitis, or other infections that tend to cling to the skin.

Bath Products

I use a combination of two products for my bath: Balneum Hermal and Emol. Emol has a small bit of soap in it which helps keep infections away. I use a mix of 1:2 - 1 measuring cup of Balneum for every 2 cups of Emol. However, while Balneum is available from Canada, Emol is not to be found. I'll let you know what I find throughout my new tests...

Why America needs a health insurance plan or how to choose a health insurance

2009-09-23T02:59:00.002+03:00

This one is a guest post by G. Enjoy.

You might be lucky. Then, your employer will pay for your health insurance. It might even be a good health insurance. Of course, there is a down side to it. Once you are fired, or downsized, not only your credit is severed, but your health insurance as well. If you are fired, you are not allowed to be sick. So don't quit your day job, since you'll loose your health insurance.

But I am not lucky. I need to have health insurance on my own. For that, I need to learn which insurance is the best for me. True, my Ph.D. is in communications, but I can do some research. There are just a few things one needs to know. Deductible, co-payments, eligibility and few others. So I am off for the races. My wife's health insurance is not good enough. It only has 30K annual return, and I must have 50K. No go. Furthermore, my wife's insurance costs about 300$ a month for me. It has some good sides. It gives 100% coverage and all pre-conditions I have.

I am lucky. I do not have any pre-conditions. I am as healthy as an ox. If it is healthy. So I need to look for insurance. My university recommended a company. Let's look at it. No deductibles. That's great. I think. I am not really sure. Then again there is a 93$ payment every month. That's expensive, right? Not when you compare it to my wife's insurance. But what about the coverage? Well 90% on most procedures. That's nice. That's good. A hospital room of a semi-private rate. And 70% of non PPO procedures.

What's PPO? Well, each insurance company works with a chain of hospitals and doctors. This chain is called the PPO. If one goes to a member of the PPO, then it is 90% coverage, if one goes to non PPO member coverage is only 70%. In order to find out which hospital and doctor is part of the PPO you need to start yet another small research. I did not have the energy to look at this company's PPO. Still a 93$ a month for 90% coverage, is that good? Is that bad?

I continued searching. The university also tells about four other companies with which one can have insurance. So, I checked them out. One of them was giving a 80% coverage in a price much higher than the one recommended. Well, that's not a choice.

The second company is way, but way, cheaper. I am talking about 57$ and 69$ a month. Now, since I am healthy, why not opt for it? The coverage. Well, that's hard to tell. This company does not work with percentage of the bill the hospital gives you. Instead, it pays back a certain amount for every little thing. Say, a day in a hospital room, 1200$. Miscellaneous during hospitalization another 500$ a day, x-rays 350$ and so on and so forth. But, I don’t know how much a day at the hospital costs. It might be 3000$ and it might be 1000$. If it is the later amount, then I need to take this offer. If it is the first amount, then this offer is not very good. But how can one tell? Should I contact the hospital near by me and ask them how much a day costs? Come to think of it, that's might not be a bad idea after all.

Then there is another company. They use this strange term which caused me to strike them out immediately. They cover the usual, customary and reasonable costs. And they only cover 30% of it after negotiations. Negotiations with whom? I was wondering and about what? Do they negotiate with the hospital about the price or will they negotiate with me about what is reasonable, customary and usual? In any case, I was not about to negotiate with this company, reasonable or unreasonable as it may sound.

And then the last company. They have both deductible and co-payments. They let me choose how big of a deductible I want annually, and then the monthly rate is changed accordingly. If I want 1000$ deductible, I only pay 800$ annually. If I want 250$, I pay 1300$ annually. They also have three types of coverage, silver, which is the simplest, gold and platinum. Their premium varies accordingly. Then again they also use the URC as an acronym, it is that common. But, they do not negotiate and they do not give 90%. They give full coverage of a day at the hospital. No, I am wrong. They give in the silver plan 650$ per day at the hospital. In the gold they give full coverage. No, not full coverage but the Usual, Reasonable and Customary coverage for a semi-private room. In the platinum they give the URC for a private room. But again, I have no clue how much URC room costs. And this company is a bit more expensive than the one my school recommended. But the one my school recommended only covers 90% at the PPO. So I decided to go with the last company.

I re-read their benefits and saw that, wait a minute, they also have a PPO. They give the URC only at the PPO and 80% at non PPO. But where can I found if they have hospitals in my region as part of their PPO? And who is their PPO? And what is this company's real name? Because every company has several other companies which are the local brunches or insurances in every state. And in every state the one big company has a different name. and its PPO also have an unknown name, at least I could not find its name in the insurance company and only a google search led me to find the name of the of the PPO.

So I looked for hospitals of that PPO in my region. By now it was 8 p.m. and I was tired after starting my research at about 11 a.m. A long day of research. By now I've realized there is no way I would do my insurance today, since I got so confused from all the facts, different coverages, PPO, coinsurance, deductible, underwritten. But, then again, I had to find out if my favorite insurance plan has a PPO hospital in my region. Since I was tired I did the little mistake of giving the wrong zip code and therefore for about 10 minutes I was sure the PPO has no hospitals in my region. If this is the case, then of course I cannot have them as my health insurance company, can I?

Luckily, by the fifth time I ran that search I found my mistake and corrected it to realize that most insurance company works with most hospitals in most regions.

So what should I choose, paying 103$ a month to have a 500$ deductible + a full URC coverage or pay 93$ a night to have no deductible and 90% coinsurance of PPO treatment? In the next day I made my decision and fought the different forms I needed to fill out to have the insurance, which I am not sure I have it, just yet.

If you want to compare, in Israel you pay 3.1%-5% of your income as a health tax. If you do not have a job you pay flat fee of 92 NIS (equal to 25$) a month. Everyone is entitled to a not that bad basic coverage. One can add a second lair of insurance for an additional amount of 10-30$ a month, which includes the payment for a second opinion, choosing your own doctors in some places etc. one pays 5$ per quartile for visiting a professional doctor, unless one has a chronic disease then you do not pay at all, and the waiting time for visiting certain professions are long while others are short.

In any case, last year I spent around 424$ for my health insurance, and this year I will spend 1200$ on it. I can only hope I will not have the occasion to find out if this insurance gives me better or worse coverage than the one in Israel, though it sure costs much more. And one last small thing, in Israel I did not spent two work days to find out which health insurance I should buy, only to realize there is no educated way to make such a decision, as I found out happens in the USA.

Testing, testing: How to Test New Products

2009-09-07T08:24:00.007+03:00

There comes a time in every (atopic patient's) life when a new skincare product comes along. Maybe it looks good, or is cheap, sounds interesting or comes with a recommendation from a doctor or friend. How do you know if it's good for you?

Step 1. Think outside the box. Check the description, does it say "for dry skin"? Sensitive skin? Hypoallergenic? Those are a good start. Check the list of ingredients for any obvious no-nos. Fragrances are not recommended. Lanolin or Urea acid might be turn-offs as well.

Also pay attention to the descriptors. This may sound obvious, but "lotion", "cream" and "ointment" are different things, all belonging to the same family - things you spread on your skin. Whereas things that say "cleansing", "body wash" or the like are actually soap-like products to cleanse the skin, either in or out of the shower/tub. Separate once again from the bath oils family (and one that seems entirely absent from USA pharmacies). You probably need at least one product from each family, maybe more. (Why more? One cream might be too expensive to use on the entire body, but great quality, so you use it for your face, while using a second cream for the body. Or you may use a different product for different symptoms - one for rashes, one for scratches, one for infections AKA folliculitis, etc.)

Step 2. Try it once. Try it on a small area. Make sure the world didn't fall apart and neither did your skin. I admit I sometimes skip this step once I get the feeling the product is truly for sensitive skin. Do so at your own risk: you may have an adverse reaction to certain products.

Step 3. Try it methodically. Designate an area of the skin to try out the new product: e.g. one arm. Use the new product instead of your regular alternatives on this area only, and compare the two areas (say arms) after one day, and again after one week of usage. Notice any differences in skin texture, scabbing, rashes and so on. One cream may be better for rashes while another is better for healing scratches. One may leave your skin feeling smoother. Pay close attention.

Notice this step won't work for bath oils, you can't apply on one part of the bath. You just have to try and hope for the best.

Step 4. Make up your mind. Which is better for you? Often there will be no major difference, but sometimes you'll notice an improvement and that's great! Now you have a new member to your product arsenal. Use it as needed and as your budget allows. And you did it without exposing your skin to something harmful.

Coming up next:
The real deal: products I actually use.

Stop scratching!

2009-05-08T00:14:00.004+03:00

If you have atopic dermatitis, the above sentence is one you're probably used to hearing. Love it or hate it, I doubt that you can stay indifferent to it.

Let's start at the beginning. As I've mentioned before on this blog, it truly is unhealthy to scratch, as it aggravates the skin and worsens your condition. Those are the bare facts.

However, the flip side of the coin is that it's extremely hard to avoid scratching altogether. First of all you might be doing so unconciously, and even if you're aware of it - well, it friggin' itches, doesn't it?

So how the heck are you supposed not to scratch?

It's an open question. There's no real solution, with stupid ones including parents tying their kids' hands (was that an urban legend or the real deal? hmm) through things I've mentioned before like meditation and self-hypnosis, and hand-occupying hobbies to take your mind off scratching.

But let me tell you one very personal thing. I, for one, absolutely cannot stand it when people tell me to stop scratching. So "here's a plea, from my heart to you" - don't tell me to stop. I'll stop when I'm good and ready to.

There and back again

2009-05-08T00:11:00.003+03:00

It's been nearly a year since I posted last, my apologies.

I had focused most of my atopic-facing energies on opening a group for atopic dermatitis in Israel. We had some measured success with two face-to-face meetings of adult patients of atopic. But then we ran into a brick wall... nothing specific just got stuck. The organization we were working with got shut down and that took the wind out of our sails.

Anyway, I'm back to the blog and we'll see where it takes me. Thanks for listening.

Shout-out - Atopic Dermatitis Group forming in Israel

2008-04-06T16:57:00.005+03:00

Hey you, yes, you.
If you feel it's time to stop reading about atopic and start doing something about it...
If you're sick (in more than one sense) of feeling alone with your disease and you want to meet others with the same problem...
If you're a parent of a child that suffers from atopic dermatitis and you think there should be more being done...

... now's your big chance.

We are now in the preliminary stages of forming a group for atopic dermatitis. With the help of "Etza" (=literally "Advice"), the Israeli organization for Self and Mutual Help, two other atopic patients and I are forming the initial core of this group. We will be meeting, hopefully before Passover, to set our initial goals and priorities for this group.

You are very welcome to join us, whether you are an atopic patient yourself, or the parent of one. If you want to join us and influence the direction of this group, now's the time. (You can always join later, but now is better! :-)

Send me a mail: shiri.dori AT gmail.com
We would love to have you with us.

Urk! Urea/Uric Acid

2008-04-06T15:39:00.000+03:00

I don't do this often, but some things have just got to be stated.

If you have Atopic Dermatitis and you're looking for a moisturizer, here's a really important tip. Make sure the moisturizer you're about to buy (and possibly pay ridiculous sums of money for), does not, I repeat does not contain Urea, or Uric Acid.

I repeat once again. Be extremely careful with products with Urea or Uric Acid. If possible, just don't use them. (Those two are not quite the same thing; but they have the same effect anyhow.)

Why such an outright negative reaction, you ask?
The answer is simple - painful experience.

Many pharmacists hear about your dry skin and recommend products that contain Uric Acid, or Urea (I'll just say Urea from now on). Even (unknowing) doctors will sometimes recommend such products. They do so because Urea, which is actually a product of urine, can do wonders for extremely dry or chapped skin.

What they (and you) may not realize is that Urea may have a devastating effect on your atopic-sore skin. A small dab of a cream containing Urea on the skin can send an atopic patient into a small, personal hell. It creates a burning sensation (sometimes very extreme) in the area that may last for several minutes. And due to the slightly delayed action of the Urea on the skin, you may manage to cover large areas with the cream before realizing the pain involved.

As far as I understand it, this burning sensation is caused when the Uric Acid meets the atopic skin, that is not just dry, but actually contains dozens of miniature cracks that may not be visible, as well as open wounds, cuts, and lesions. For all these, the Uric acid acts like alcohol or saltwater on an open wound - it burns, with a vengeance.

So be cautioned - read the label well before starting a new cream.

And with all new products for your skin, test them on your skin in a small area first, see how it reacts (even overnight), and only then move on to larger areas.

An immunosuppressant druggie

2008-03-23T13:01:00.007+02:00

As a companion post to the immunosuppressants, and continuing the "druggie" series (see "an antihistamine druggie"), here's one for that type of crowd.

Disclaimer for this type of post: Please remember that I am not a health professional of any kind. My notes represent my own experience and reactions to the drugs in the past and present. Your reactions may be different. Nor am I paid by anyone to say either good or bad things about the drugs.

General notes:

In Israel (and possibly other countries), many of these drugs are not officially approved for atopic dermatitis, which means you'll have to get a special approval from the Ministry of Health (or FDA, or equivalent in your country). Your doctor should be able to explain how to request this approval, and/or do it him/herself.
For all the listed drugs, make sure you read the instructions and leaflet really carefully.

These are heavy artillery drugs, not to be taken lightly. Don't play around with'em.

Follow whatever it says on the leaflet, including, if necessary:

Avoiding alcohol
Using extra contraceptives - getting pregnant is not a good idea while taking most or all of these drugs (see original post) .
Whatever else it says on there!!! Don't argue, do it.

Pay attention to any side effects you may suffer from.

Go read the original post about immunosuppressants. This is just a companion to it.

Cyclosporine (Neoral, Sandimmune, etc.) - this is the most basic, and most often used immunosuppressant (at least in the department I'm treated in). It's well known for psoriasis and organ transplant. Generally, should not be used for long periods (over 3 months), although it can be, if necessary.
I've been on it for over 7 months now, although I finally seem to be on the right track for switching to a different drug. It worked (works) pretty well for me, but with one major caveat: I needed antibiotics nearly the whole period, for two reasons. (1) I kept catching the flu or getting my throat infected. I'm not a healthy person during the best of times and tend to catch anything that's around; much more so when on immunosuppressants. (2) My skin was also constantly getting infected, which did not help the skin to clear up. Folliculitis was a major issue and caused scratching.

Imuran (azathioprine) - an older generation drug. Considered a more slow-acting drug, but also one that can be taken for a long time with less severe effects. Didn't work for me at all, so I can't say much for it - sorry. Might work for you, or not. Prof. B. said that it does work on many patients, so maybe I'm the odd-man-out here.

Cellcept (mycophenolate mofetil) - a very new drug, as of this writing. It is supposedly in addition to cyclosporine, not instead of it. For me, it did the job terribly well, and I would recommend it warmly for most people. However (again - for me), it also had some pretty severe side effects which rendered the medication totally pointless. There was no way I could keep using it. [If you want, you can mail me privately and I'll expand.] Point being - take it if your doctor suggests, but be very aware of any ill effects. What with this drug being so new, even the experts aren't totally sure of how prevalent the various side-effects are. Note: in some countries (Israel included), this drug may not yet be approved or included in the subsidized drug list, especially not for atopic. Israelis, be ready to pay top dollar (err, shekel) for this one.

Methotrexate - a drug also used to treat certain types of cancer. I am now switching to this; so far, so good, but we'll have to wait and see. It is usually given once a week, not every day. There is some cross-drug interaction with cyclosporine, so make sure your dermatologist is aware that you're taking both. From what I understand, it is common to give a test dosage first and see what the body's reaction is, and only then up the dosage. Plus, this is the one drug I've seen that specifies birth defects caused from the male parent as well as the female. There's also some potential issues with blood clotting, which can be overcome by taking folic acid in a very specific manner. Ask your expert to make sure this is discussed.

More drugs will be added if I have the pleasure to interact with them...

Immunosuppressants for Atopic Dermatitis

2008-03-23T12:06:00.005+02:00

I talked about treatments and what constitutes treatment. Now, as the wise Rafiki said, "it is time". Time to talk about immunosuppressants for Atopic, what they are and what they do, the dangers and complications, and (soon) the different types available to you.

Immunosuppressants are drugs that an expert dermatologist can prescribe for you. Their basic effect is, well, what their name says: they suppress your immune system. [As an aside, their main usage is "in organ transplant surgery to prevent organ rejection" (taken from Answers.com) and sometimes they are originally chemotherapeutic agents].

Don't try this "at home", i.e. without the benefit of an expert. Do not, I repeat, do not count on your physician to cut it. He or she may know you best but they do not know the effects of these drugs best. Let the experts do their job; dermatologists spent four or five extra years studying this, and they treat cases like you all the time. And definitely do not take them without medical advice at all! Don't even think about it.

Why could this be good for you? Basically, your immune system working over-hard, "panicking" and fighting things that aren't really dangerous to you (namely, allergens). This useless fight is causing you to itch, scratch, etc. Therefore, telling your system to "cool it" means it should stop fighting so hard. So it should cause an improvement in your situation. Several immunosuppressants have been consistently shown to cause improvement in many cases of atopic.

Why could this be bad for you? Well, immunosuppressants are heavy artillery. There are several effects, first and foremost - a higher sensitivity to contagious diseases. You should be careful not to come in too close contact with too many people, especially if you know they're sick. What's more, there can be interference with all sorts of normal bodily functions. During the time you're taking them, you should be under nearly constant "surveillance": complete blood count (CBC - the most basic blood test) and blood tests for liver and kidney functions, as well as blood pressure. The exact battery of tests you should undergo varies with the precise medication.

What else should you know?

Using immunosuppressants should clear up your atopic symptoms, including infections (via a complex mechanism that I don't entirely understand), but there is a possibility that you will be more vulnerable to skin infections, such as folliculitis, in which case you may need to add antibiotics as a backup player (or switch to a different immunosuppressant). Consult your doctor!

Note for the sexually active -

females: for most of these drugs (if not all), you need to avoid pregnancy during the whole period of taking the medicine, and potentially for awhile after you stop. Plus, some of these drugs may reduce the efficiency of The Pill, so make sure you talk to your doctor about this, and add alternative contraception (condoms or otherwise).
males: mostly there should be no problem, but double-check. At least one of these drugs (methotrexate) may cause birth defects in an unborn child if your partner gets pregnant. Best to be on the safe side and ask your doctor.

So, when should you take them?

First of all, it's important to note that it's not totally your decision to make. An expert doctor (usually a dermatologist) will decide whether or not your situation and specific condition merits this kind of treatment. Of course, you do have some choice here - you can (a) suggest it in case your doctor doesn't, or (b) refuse to take it if your doctor does suggest it.

But let's take a look at the criteria. An expert dermatologist may look at:

How widespread your atopic is (are you erythrodermic?)
How resistant your case is (did you respond to other treatment? topical cortisons? maybe UV?)
How badly is atopic affecting your life (how much is it interfering with your day-to-day life?)
How do your blood tests look before you start the drug (as mentioned earlier - are liver and kidney functions OK?)
And potentially other things... see warning signs, and remember, I'm no doctor.

A separate post is coming up with the different types of drugs available to you.

And I'm off.

2008-03-04T23:28:00.003+02:00

Hospital, take 2.

This time I'm entering in a much better situation, relative to last time.

Still feel pretty awful, though.

It was just recommended this time, not required really. But the situation was going downhill so quickly I felt it would be better to listen to the good doctor.

And I'm off.

ManiCure

2008-01-25T23:44:00.000+02:00

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

2008-01-19T18:47:00.001+02:00

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

2008-01-19T17:45:00.000+02:00

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.

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).
Antihistamines. Lots of atopics are reacting to allergens, so do your body some good by helping it deal with the allergic reactions (histamine cells).
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.
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.
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.
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

2008-01-09T12:24:00.002+02:00

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):

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.
Immunosuppressants. These agents may calm your atopic dermatitis by way of lowering the resistance of your entire immune system.
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.

2008-01-09T12:16:00.000+02:00

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

.
.
.
...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.

Lady in Red: the clothes issue

2007-12-23T15:20:00.000+02:00

First off, allow me to apologize for the large space in between posts. Life sometimes gets in the way and I haven't been posting as often as I would like to.

So. Today I wanna talk clothes.
You may want to be dressed in red or whatever color you choose, but without actually being the Lady in red - literally. (Or gentleman in red.)
This may sound silly to some of you and completely obvious to others, but here goes.

My biggest piece of advice about clothes is:

WEAR 100% COTTON.

I mean it. Seriously. When things start going haywire, do NOT wear synthetic fabrics. Polyester, Lycra, Rayon and the sort are totally out of the question. Fleece? Nuh-uh. That's just a fancy name for polyester, which is actually plastic. Wool? Don't even think about it. Personally, I wouldn't go with linen either.
Cotton simply lets your skin breathe. Other fabrics might feel nicer at first, but put them on a vulnerable skin area and you've just created a potential flare-up.

Now, you don't have to take my word on this one, but I know what works for me. I recommend you try for yourself and see if it doesn't make a difference. I'm not saying wearing cotton will solve your problems; I'm just saying that NOT wearing cotton will make them worse.

Potential pitfalls:

No label on the clothes. You're looking through old articles of clothing and you've cut the labels off. Or else, you're in a store or flea-market with no labels.
"But this one is 30/50/80/92% cotton". Well, OK, this is a very personal thing. Maybe a certain percentage works for you and that is fine. What I've personally found is that 8% Lycra can turn a totally breathing shirt into a stretchy one. Sketchy, I say. The very reason designers use 8% Lycra in shirts (to make them look and feel like they're not cotton) is the same reason you don't want them.
The label says one thing but your skin says another. I know it sounds far-fetched, but I've found certain labels that simply lie outright about the content of their items. Also, some clothing items have insides and outside that are different, etc.

The solution? Learn the feel of a cotton shirt. Try your hand at touch tests and test yourself in stores that do have labels. By now I can usually recognize what's cotton and what's not just by touching it. Stick to the 100%, unless your skin signals otherwise. Once you gain confidence in your ability to sense cotton, use the touch-test to guide you. Is this or that fabric kind to your itchy skin? If it is, by all means go for it. Just make sure you follow up on your decision later to see if the skin is suffering from it.

And this goes for everything you are wearing.
Pants? Definitely. Jeans may be mostly cotton but might still itch because of the texture. Other pants might be better, or worse, depending on the material. Go with a combination of labels and intuition, then pay attention to signals from your skin.
Sweaters? Oh yeah. Nowadays it's totally possible to find 100% cotton sweaters. If you wear shirts under the sweaters, you may feel comfortable wearing other material on top. Just make sure the areas that contact the sweater (hands, neck) aren't suffering because of it.
Underwear? Socks? You betcha. Of course, this depends on where your itchiness and rashes are focused. You may not need to worry about these articles. Again, listen to the signals you're getting from your skin and pay attention to what it's telling you.
Winter wear, e.g. scarves, mittens, hats...? Umm. These are harder to find in cotton, and as above, you might not need them to be cotton. If you're really far gone, and itching everywhere, make an effort to find these at least in partial cotton (anything above 50% is better than nothing).
Summer wear, e.g. tank tops and shorts, bathing suits? Go with the exposure level that works for you, but try to stick to cotton in the summer especially: you're skin will need to breathe. As for bathing suits, obviously those don't come in cotton. There's a limit to how much you can do, I guess.
At work? On a date? Why not? There are plenty of cool, savvy and even formal clothes nowadays that are cotton. You just have to keep your eyes peeled for them.
Sportswear? For sure. You want to be super-comfy, not super-itchy, for your workout, right?
Housewear? Yes, yes, yes. If your work (or your fashion sense) demands you wear things that simply cannot be replaced with cotton, at the very least do yourself a favor and change into sweatpants and sweatshirts when you come home.

Now, ladies, the next one is truly for you. (Guys, you can skip ahead...)
Bras, my dears, a very problematic article of clothing. You will rarely find a really 100% cotton bra. You've gotta go with your instincts here, too, because the labels will often lie. A label may say 100% cotton when actually the shell is cotton but the interior is totally synthetic. The straps can be another problem if they're synthetic, as can the connector between the two cups.
My take on this? Play around with 80% cotton (or more) sports bras. Focus on the feeling of the interior. Hanes has some pretty good stuff that's mostly cotton. So do Victoria's Secret, and their padded kind is actually better than any other bra I own. (I stock up every time I'm in the states). One last trick: Wear your bra inside out. Yep, girls, I mean it. Most bras (except the sports bras) feel gentler on the outside than the inside.

A final word to the wise.
Depending on how good or bad your atopic situation is, you may want to forgo non-cotton cloths entirely. I say, refresh your wardrobe with some cotton clothes and see how it works for you. If cotton fulfills your day-to-day needs, great. If not, try to combine as many cotton articles as you can as often a possible (e.g. a cotton shirt underneath more formal wear, or cotton tights underneath a pair of jeans). You may end up looking a bit bulky, but if it helps your skin, that
may be a small price to pay.
The best advice I can give here (apart from "wear 100% cotton", heh) is to say once again: go with your instincts and you skin's signals to figure out what works for you. Good luck!

News Flash: Warning Signs

2007-10-27T22:23:00.001+02:00

Edit (6.4.08): just for clarification, these are warning signs of when your atopic is getting bad or worse. They are meant for people already diagnosed with atopic, not for the diagnosis. Only a doctor can diagnose you correctly (and even they can be wrong).

I had missed the signs. Some of them I chose to ignore, or repressed the fact they existed. Some of them I saw, but did not recognize them for the huge, flashing red bulbs that they should have been. Finally, some warning signs were written in a language I had never heard of and therefore I walked right by them.

So, know your warning signs.

You are scratching nonstop.

Recognition: I know, nonstop is very subjective. Still, try to be honest with yourself. When was the last time you sat still for an hour without scratching? Can you even do that? Or are you truly the itchy and scratchy show?

e.g. in my friend's wedding, same day as my birthday, there is a photo of me in which I am "hugging myself" - in other words I couldn't stop scratching my upper arms. And I was posing for this photo.
You may not be that far gone, but if you are scratching a lot more than your usual self, make note of this.

Result #1: The restless feeling of scratching alone can drive you nuts. Seriously. Self-image problems may also arise (can anyone say teenagers?).
Result #2: If you have atopic, you'll probably hate hearing this (I certainly do), but scratching really does aggravates the situation. as I understand it, scratching causes more Mast cells to release the histamines that are causing the allergy in the first place.

that doesn't mean I can tell you how to stop, or that people should in fact tell you to stop - sorry, that's a separate post. But it's definitely a warning sign.

You can't sleep because you're so itchy.

Recognition: One or even a few sleepless nights are not a major indication, although you should take notice. If there's a pattern of recurring sleepless nights, beware. Sleepless nights can be either that you can't fall asleep, or you wake up in the middle of the night and can't fall back asleep.
Result: short and long-term lack of sleep can (obviously) have a harmful effect on your entire well-being and health. It has a systemic effect, especially when it recurs frequently. You literally "need your beauty sleep".

Your skin is infected.

See post about infections.
Recognition: infections may have a few forms:

folliculitis: acne-like pimples wherever your hair grows. This alone may have nothing to do with atopic, but if it's in combination with rashes and itching of the same areas, that is a surefire sign.
secondary inflammation: bacteria may develop in the place your itching has left open wounds. Fluids exuding from the wound, or a honey-colored crust, are some indications of this. (termed secondary inflammation IIRC)

Result: This is more important than you may realize. I certainly didn't. When your skin is infected, it is not able to function as your body's barrier from the world. You become much more sensitive to outside effects such as other diseases. Skin infections can and should be treated.

Also, there is a claim that when your skin is infected, it itches more; I can certainly attest to that personally.

Erythroderma: cuts, scratches and rashes are spread over more than 80% of your body.

Recognition: if the atopic is contained in certain areas, that's bad enough, but if it's all over your body, that is a sure sign that something is very wrong.
Result: see number 1: you can't stop scratching. This is a vicious cycle that must be broken.

Flaky, scaly, peeling skin.

Recognition: do you leave a trail of white powder behind you? Is your skin falling apart in certain places? If the skin is peeling off or flaking off, this is not good. The more intense the flaking, the worse.
Result: your skin cannot heal, because it is involved in a continuous effort to grow back. The epidermis turns so thin that it breaks more easily, so scratching has an even more adverse effect.

If one or more of these signs are happening to you, run - don't walk - to your doctor. And remember, your physician is absolutely not enough for this. Go straight to the experts. It's worth your time and money to find a good doctor. Again, it's possible a combination of dermatologists and allergists will be needed.

Infectious Infections

2007-10-25T22:38:00.000+02:00

Now here's a topic I've been itching to write (no pun intended) ever since I got into the hospital. Remember those warning signs I said I had missed along the road? Those huge blinking lights I just didn't see? Well, infections were by far the most flashy of them. (The sleepless nights were all the dark spots between blinks, evidently, but that's a story for a different post.) And the effect they can have on your skin, and your entire body, can be devastating.

Now, I knew about one kind of infections - the folliculitis infections. You know, those acne-like pimples that give such a satisfying pop. You (OK, I) just love to hate them. Turns out, that for atopic patients they are often caused by a bacteria fondly known as Staph. No, not the cute sister from Full House; it's short for staphylococcus aureus. Now, nearly everybody has these nice little bacteria. The skin has an innate defense mechanism against them, and they just don't bother most people. Except atopic patients. First of all, they evidently have more of it (see paper 1 below). For reasons I won't get into here*, atopic patients then react worse to this bacteria. Then, as I understand it, they often develop an allergy to the bacteria, which causes worse itching (surprise surprise). But the thing is, I didn't have folliculitis before the hospitalization, so I thought I was home free in that domain.

But I had no idea this was only one of the infection types possible. When I was hospitalized, in fact, my skin was harboring three different types of bacteria. Not in the skin follicles, but all around. Especially in the cuts and open wounds. A couple more types and they could've started a party! What party-poopers those doctors were, gosh, I tell you.

Now, these infected/inflamed areas were recognizable by the fluids they were exuding out of the cuts (lesions?) and the yellowish crust they kept developing. This website lists another sign I saw but didn't recognize: my lymph nodes were swollen. It also mentions fatigue, which is a funny one, since I wasn't sleeping at all, so how could I not be tired? [By the way, that same page lists several other potential complications of atopic - worth a read for those of us who think we know all there is to know about atopic.]

These infections can and should be treated. The accepted treatment is usually oral antibiotics, although a cream that combines antibiotics and cortisones can be applied locally.

Now, the infections should go away when the antibiotics has run its course, but they might come back. That's what mine did. About month after I left the hospital I was already full of infections. This time Staph had much less open wounds to go for, so it came out as the folliculitis, my friend from days of yore, and the itching followed close behind. I took another course of antibiotics. Staph went away, but came back even faster this time around; within three days I was noticeably infected. So now, I'm taking them for the third time, and agreed with the doctor to keep taking it in a lower dose as a prophylactic.

A final note - due to a super cool explanation*, the immuno-suppressants I'm taking should not be worsening these infections. In fact, once they are in full operation, I shouldn't be so susceptible to Staph.

Some extra bibliography:
* Prof B told me the article he is co-authoring about this topic hasn't been published yet; once it is, I'll post a link.
1. Abeck, Mempel (1998) . Staphylococcus aureus colonization in atopic dermatitis and its therapeutic implications. (abstract)
2. Ihsan Edan Al-saimary, Sundis S. Bakr, Khalil E. Al-Hamdi: Staphylococcus Aureus As A Causative Agent Of Atopic Dermatitis/ Eczema Syndrome (ADES ) And Its Theraputic Implications. (full paper)

An antihistamine druggie

2007-09-29T19:57:00.000+02:00

Please remember that I am not a health professional of any kind. My notes represent my own experience and reactions to the drugs in the past and present. Your reactions may be different.

Oh, and I am not paid by anyone to say either good or bad things about the drugs.

Aerius (Desloratadine) - evidently this is America's Clarinex. I use it, it seems to do the job, although for me the restriction of one a day means I have to take another antihistamine to finish the job.

Histazine or Zyllergy (cetirizine dihydrocholride) - sold in Israel, apparently not in the states. It does not seem to be exactly the same as zyrtec (cetirizine hydrocholride, just one, not di) nor xyzal (levocetirizine dihydrochloride). Whatever. Works fine enough for me.

Profiten or Zaditen (ketotifen) - now that I look it up, it says that it is mostly used for asthma prevention. So maybe you (and I) shouldn't be using it for atopic dermatitis. Dunno. I took it twice daily as part of my switching scheme and it seemed to work OK at the time. But I'll try to pay more attention if I ever take it again.

Mizollen (Mizolastine) - the pages I read claim it has less sedative effects, but as I never suffer from sedation from the regular antihistamines, I failed to appreciate the gesture. In fact it gave me gases and caused my mouth to taste weird. If I recall correctly, this seemed to be caused by the inactive ingredient that had something to do with lactose (although I am not lactose intolerant as far as I know). Stopped once I switched to a different drug. Oh, seems to be European only - couldn't find it in the states.

The real sedative antihistamines:

Phenergan (promethazine), as stated in the previous post, is an antihistamine that causes some sedation/calming. The sedation part is supposed to calm down the itchy and scratchy show. For me it just sent me on a wild ride of dizziness, nausea, and major major headaches (caused, as far as I could tell, by extremely high hearing sensitivity. Think Clark Kent in Smallville when he first discovers superhearing).

Otarex (Hydroxyzine hydrochloride) (Atarax in the states) - it is considered as the same family of drugs as phenergan.It's supposed to relieve that itchiness that drives you bananas. Well, it did. It also, in both distant and recent past attempts, gave me those same severe headaches, as well as memory lapses. It affected my ability to think clearly, and caused extreme drowsiness. For me at least it was NOT worth it.

The Headaches with a capital H lasted for a few weeks after stopping to take Otarex (and I only took it for a week). But after I stopped Phenergan they stopped within a day or two.

The other allergy

2007-09-29T19:09:00.000+02:00

In trying to get rid of the many side effects I had been suffering due to the massive infusion of drugs that I was on, Dr. R in my first checkup recommended stopping to take Phenergan. This drug is an antihistamine that also induces calm and so is expected to ease itchiness. By this point I was sleeping fine at nights

Dr. R was right in a sense. My nasty side effects all but went away. The massive headaches due to noise sensitivity completely disappeared and the worst of the nuasea, dizziness etc. was gone with the wind.

However Dr. R (dermatologist) dismissed my question about replacing the phenergan with another antihistamine. After all, I was getting aerius, wasn't I? That should be enough, said the doctor.

Enough for the itching, maybe. But within two days, I was sniffling and sneezing, my nose was running a marathon, and I was coughing up mucus like it was fifth grade and I was in a spitting contest. In other words, my allergic rhinitis had reared its ugly head, with a little bit of asthmatic mucus as a side dish. After all, before changing to otarex (later switched to phenergan) I was balanced on a two-antihistamines-a-day diet. So backing down to one was definitely not good.

The good news? Once I put the histazine back on, the runny nose ran in to hide and it's back to normal. Or as normal as it gets around here, anyway.

So there's my reverse warning from the last post. Your dermtologist may discount your other allergies. You have been warned.

Drug info in the following post.

The right doctors: worth more than their weight in gold

2007-09-15T19:37:00.000+03:00

Dr. G told me he was the wrong doctor, but I didn't really listen. He's an allergist, and in fact the only doctor I was seeing regularly. He told me I needed a dermatologist. I found one but was inconsistent in my visits. In fact I found three or four dermatologists and did not persist in more than two or three visits to each. And then I went to a different allergist, because Dr. G wasn't doing anything about my atopic (he kept telling me I needed to see a dermatologist!)

Boy, was I wrong.

With atopic dermatitis, you've got two major factors at play. You've got your allergies, and they play a major part. But you can't just bank on the allergies. As Dr. H (dermatologist) once told me - but it didn't sink in - even if I were in a bubble, ate just lettuce and drank just water, I'd still have atopic dermatitis. In other words, allergies are a contributing factor - possibly a critical one - but not the sole cause. And when push comes to shove, and treating the allergies fails to solve the problem, you need a dermatologist.

I found this out the hard way. By the time I saw a dermatologist, it was in the hospital. Learn from my mistakes. Don't wait.

P.S. The reverse is also true. Don't put all your trust in a dermatologist without ever seeing an allergist; allergies may have a major effect on your atopic.

Crème de la Crème

2007-09-06T15:35:00.000+03:00

One thing that did not come as a surprise to me at the hospital was the insistence on moisturizing. I had been taking baths and putting creams on my skin for ages. However, the precise nature of these was slightly different than I was used to, especially regarding the creams.

The treatment began with very cortisone-heavy creams. However, as the days passed and my skin cleared up, these were gradually decreased - lower dosages, smaller areas, etc. The main treatment, they explained, will be the immuno-suppressants... and that I gotta keep up the moisture.

So, which creams? Up until now I had been using Vanicream for years. In the hospital they used Eucerin, but not the store-brand one. They mix it up with... olive oil. Precise measurements to follow soon. They recommended I keep using it, and I intend to for now. It leaves the skin feeling quite smooth.

Oh, one more thing. They recommend keeping the creams refrigerated. The idea, as I understand it, is that when you put on the cold cream it has a further soothing effect. Just don't keep it too cold.

And how should you spread the cream? With the palms of your hands, not your fingers. From top to bottom, in the direction of the hair growth, to avoid folliculitis (inflammation of the hair roots).

Baths will come in a separate post.

Edit: with cortisones you're supposed to spread a thin layer, but with the moisturizers, don't be stingy. Other than cost, there's practically no reason not to apply liberally. Just don't forget to use the fragrance-free, paraben-free, everything-free version.

Things that were, and things yet to come

2007-09-03T15:55:00.002+03:00

Phew. I haven't been very active lately, but there were some good reasons for that. So, I am going to tell you a little bit about what has been going on. I'm also going to mention a lot of things that will receive my fullest attention in separate posts. I want to do this right, so I will devote a post to any topic that seems relevant and not go into too many details here. So to avoid repeating myself a lot, I'll write "TBE" - to be explained - wherever I want to write more later. [Edit (6.4.08): these TBE's are now links to the relevant posts, wherever I actually wrote them.]

Around the last time I posted, my situation was already pretty severe, and it was getting worse by the day. I somehow managed to function although I was barely sleeping at nights, scratching constantly and so on.
My situation can be likened to the proverbial boiling frog. For nearly two years my situation was going from bad to worse, with only temporary remissions brought upon by use of cortisones in different formats. I will write a separate post about all the warning signs I missed, should have seen, or didn't know existed... TBE#1. But for now suffice it to say that by the beginning of August, I was near the boiling point.
In hindsight, my situation was actually dangerous (TBE [6.4.08 - due to infections and sleepless nights]). To make a long story short, I came to an appointment with an allergist. As I was waiting for him to show up, the nurses told me in no uncertain terms that they think I should go to the emergency room - a statement which managed to dull the surprise when the allergist took one look at me and said I needed hospitalization. Most importantly he said this should be seeing a dermatologist - that he as an allergist couldn't do enough for me (TBE).
So the very next morning I showed up in the Rambam hospital in Haifa, which evidently hosts one of Israel's best skin departments (if not the best one). I came to the upstairs clinic first, and met with the department head. He was also very clear on the fact that I needed to be hospitalized, and so I was admitted to the hospital.
I spent the following ten days there, and received all-around treatment that has turned my skin upside down, inside-out and altogether amazingly healthy. To me the best part of this was that I received no systemic cortisones but rather a combination of other treatments (TBE), the most important of which being an immuno-suppressive (TBE). Within two days of being there my skin was nearly entirely cleared up. I was still itching, though, and not sleeping at nights; this improved later on (TBE). Finally I was discharged home, and I will continue some of the treatments at home while others are over (TBE...).

With so many things yet to be explained, I want to wrap up this post now with a note of cautious optimism. Right now, my skin is in a wonderful condition, and I intend to do everything in my power to help it stay this way. To this end, and also to help other people be healthier, I plan to post a series of short posts on specific topics that I encountered immediately before and during the hospitalization. I hope that I can follow through with these ambitions.

Refreshing treatments

2007-07-24T21:56:00.000+03:00

So as of yesterday I started refreshing my day-to-day treatments. In fact, when it comes to antihistamines for atopic, doctors recommend you change your medication every so often as it stops being effective. Something about the receptors becoming blocked. Later you can switch back - the block isn't permanent. I forgot about this trick for a while there, but around March I went to an allergist/immunologist that reminded me of this, Dr. BZ. So I switched from Aerius(mornings) and Zyllergy(nights) to Profiten twice daily.

[Side note: some people get drowsy or sleepy from the antihistamines. Not me. Doesn't do a thing. Or like my mom would tell the doctors when I was a kid: "I wish it made her sleep".]

Seeing as my atopic's been getting worse lately, my mom reminded me of the switching scheme again just the other day. So now I'm back to the old regime: Aerius mornings, Zyllergy (aka Histazine) nights.

Plus, my boyfriend (smart guy) reminded me of a more natural tack that I had taken in the past and we agreed helped - Evening Primrose Oil. This natural dietary supplement is supposed to make your skin healthier and more moist. And indeed, I must say that last year when I stopped taking it I felt a marked decrease in the skin moisture, so I went back to it. For some odd reason I stopped taking it again later in the year and forgot about it completely. Well, now I'm back on it.

All this, by the way, is in addition to:

the homeopathic remedy that I've been taking for the past half year;
the moisturizing creams I use constantly; and
the oil and/or oat baths I take twice a day.

Sometimes it's hard to know what helps and what harms. But I do my best to figure that out as best I can.

Edit (29.9.07) : looking up drugs for this post, it turns out that Dr. BZ was pretty far off the mark in the actual recommendation. Profiten is more of an asthma prevention drug than a generic antihistamine. So even if it's a good idea to switch, don't be so sure that profiten is the drug of choice for atopic dermatitis.

Put on a Happy Face

2007-07-17T22:33:00.000+03:00

Hi there. As I said above, this blog will be devoted to my self-research, recommendations, insights and plain rambling about atopic dermatitis. Also known as skin asthma. If you're here you probably know what it is so I'm not going to bother too much with that. Welcome here.

I have it, and have had it since I was 8 months old. I'm now 23 years old which gives me over 22 years of experience to share, not to mention any number of doctor's recommendations that I've heard and unconventional treatments as well. As of right now my atopic is pretty darn severe. This comes and goes in waves of a few years at a time.

So I will begin with a funny insight I had the other day. I woke up after a good night's sleep (a rare occurence for me these days) but due to some renovation noise on the floor above me, my good mood soon turned annoyed. Took my bath and started putting creams on (more about all that later) and was really upset and itchy. This surprised me because, as I said, I woke up with a smile on my face after my first 8+ hour sleep, possibly in weeks. Yet twenty minutes later I was grumpy and as far from smiling as night from day. And then it hit me. I was down and couldn't bring myself to smile, for a very simple reason. My face was so dry that it actually hurt my muscles to smile. I immediately applied my favorite moisturizer to my face and, surprise! The smile came back. It was like magic. Try it the next time you're grumpy for no apparent reason.

By the way, I believe this realization took part in place due to the difficulties I was having in the previous evening's sports class - I attend a muscle-training/toning class. Usually I enjoy the class but that evening I was so dry that it was literally painful to stretch and work the muscles. The next mroning I recognized that very same feeling when I tried to smile. So take this for all muscles, not just your facial ones. Exercising can lift your mood as well as smiling, but if you have atopic, make sure your muscles are getting a reasonably moist skin to work with. Otherwise you will just be in pain.

Introduction to "A Topic: Dermatitis"

2007-07-17T22:15:00.000+03:00

Hi, my name is Shiri and this blog is about atopic dermatitis.

A few clarifications and disclaimers before I start. First and foremost, I am not, I repeat, not, medical personnel of any kind. I am a young woman who was diagnosed with atopic dermatitis at eight months I've lived with it nearly all my life, on and off. Any and all recommendations in this blog are my own personal opinion. They may be based in whole or in part on many doctor's recommendations, or other people's recommendations, but eventually synthesized in my own mind and doled out however I see fit.

In fact, I recommend to take everything anyone tells you about atopic, including myself, with a massive grain of salt. Atopic is one of the least understood conditions - certainly for a condition/disease so widespread, one could expect more research and comprehension of the problem but this is not the case. What's more, atopic often varies widely among individuals or even among the same person in different periods. It is extremely important that each and every atopic patient tailor the treatment(s) to his or her own special needs. Trial and error with careful tracking of results is the best way to go. Always be careful when starting a new treatment of any kind. Be aware of the consequences and any new reactions that may stem from it.

One more thing, I live in Israel, not that it's of great relevance but has some bearing on weather-oriented recommendations, so keep that in mind.

It is my intention here in this blog to raise awareness to atopic and provide people diagnosed with atopic (or their parents) with some basic tools to handle it. Atopic Dermatitis is a difficult disease to handle, one that is not well understood neither by doctors nor by society. While asthma is nowadays considered common and no one would be surprised if a kid pulls out an inhaler in the middle of nowhere, the alternative of that same child scratching is often misconstrued, ridiculed or just evokes confusion. Meanwhile the doctors (especially pediatricians who are not dermatologists) react in various ways, often contradicting ones. Recommendations are unclear, and day-to-day recommendations are confused with actual treatment. Prognosis is always foggy and usually completely unreliable.

I want to clear away some of that fog. But again, I implore you not to trust me. Try things for yourself. I'm here to offer you the options and to share my experiences with them. I also wish you the best of luck and invite you to share your experiences with me. I'd love to hear from you.

Thanks,
-Shiri