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.

An antihistamine druggie

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

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.

Refreshing treatments

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.