Tuesday, May 13, 2008

Intro, how it happened

This page recorded my fight with eczema outbreak in early 2008. There’s my explanation (from a Chinese med kind of view) and review of the products and treatment I used. (feel free to skip down to the treatment section)

Background
I am now 26 and have eczema from a very young age. Before, eczema did not terribly affect my life. Sometimes, red patches showed up occasionally at my inner elbows, inner knees and fingers. My eczema is not food related although I know sweat and stress can make it worse. I normally applied steroid cream and the symptom goes away within days (although stronger cream has to be used in recent years). I have seen dermatologists and they said no cure, sorry. Also I know eczema, asthma and sinus allergy normally comes hand in hand. I also had asthma till I grew out of it in my teens, but not eczema.

Outbreak
It all began in Nov 2007. First it started off as small rashes under my chest. I thought, no big deal, just put some steroid cream on like before and it will go away. Yes, it did go away. Only more rashes return, so more steroid cream was applied. Because I was so used to it and because at the time I had public exam and I didn’t find the time to see my PD. I think the stress of the exam has fuel the disease and at the end of Dec the rash has turned into patches and spread down my waist. I went to see my PD.

The failure of western medicine

The PD prescribed steroid and allergy drugs and strong cream. For the first few days, the rash subsided a bit. Then it started to show up at other places, like my back. So even stronger drugs were used. At the end of the two week treatment, it just got worse and worse. Because of the drugs I took, although my body itch , it’s not very terrible and I can still sleep. At the time patches covered both sides of my lower chest, waist, upper hip, lower arms to elbows… The PD can only tell me to apply creams on the outbreaks. At that point I really had reservation if I should cover that much area of my body in steroid. I am quite sure it’s going to be a long term side effect.
I basically lose my confidence in western med and I went to see Chinese doctor. For some other reasons, I also quitted my job around that time. It’s a good decision because I could not have perform my job for the next two months.

Theory and explaination

Chinese medicine’s explaination of eczema

Or my understanding of Chinese med is this: Chinese medicine believes to treat the body as a whole. Inflammation of the skin is linked to the sickness of the internal organs, more specifically, the sickness of the liver. In our daily lives, we ingest different types of “toxic” from chemical in water, junk food, polluted air, alchol and so on. The function of the liver is to get rid of the toxic in our blood. The root cause of eczema is the failure of the liver in performing detoxification. When a sick liver fails to get rid of the toxic in our body, the toxic will accumulate in the liver and circulate in the blood. Normally, a sick liver can self-recover given enough time. But a poor lifestyle, junk food, not enough sleep may harm the liver beyond self-repair. The toxic in the blood eventually reflected on the skin as inflammation, eczema. (In contrast, the food allergy type of eczema is because the liver has problem dealing with a particular food protein. As soon as the patient stop ingesting the food, the symptom will clear.) The toxic may also weaken the digestive system.

Western medicine has no idea what cause eczema, and only tries to cure eczema symptom by using anti-inflammation drug like steroid. This is bad because,
1. By subpressing the symptoms, the patient is unaware of the seriousness of the disease. He/she may not take any corrective action to reduce the toxic level in the body.
2. Toxic continue to accumulate in the liver and eventually slow down the functioning of the liver for self recovery.
3. Steriod itself is toxic to the body, yes, even the cream type.

What to expect from Chinese medicine?

The Chinese doctor can use many methods to diagnose a disease and formulate a treatment. The doctor will normally look at the symptoms, ask the patient of the sleeping pattern, appetite, look at the colour of the patient’s tongue and taking the pulse. Because each person has an unique body type, the prescriptions can vary from person to person. As the healing progress, prescription for each stage of treatment is a bit different. That’s why the doctor would only prescript 3 -4 days of drugs at most.
The prescription would be of the herbal variety and must be boil and drink everyday. It’s important not to stop medication until fully recovered. (much like the antibiotic cycle) Because of the complication of eczema, treatment can last from 1 month for a mild case to up to 6 months for serious case. Do not take western medication with Chinese medicine as it can cause unpredicted side effects.
The symptoms can get worse before it gets better. For a serious case, the first week of treatment is probably the worst, esp if the patient was a prolong steroid user. I lack a theory to explain this but I suspect that because the Chinese med assists the liver in expelling the toxic. The toxic leaves the liver and temporarily concentrate in the blood. This can worsen the illness and cause intense itchness. (refer to as healing crisis, see link)The itchness is the worst at midnight for most people. Chinese medicine believe the organs take turns to rest at night. My Chinese doctor said the liver is shut down from 12-2am. I suspect the increase itchness has to do with this.
Recovery can follow a zip-zag upward trend. While the body surely gets better on the long run, the patient can experience the symptoms getting worse (or even mini-localized outbreak) for 1-2 days. This is normal, be patience and keep faith.
The drawback of Chinese medicine is that it is mild and can take a long term to clear all toxic from the body. Also, the arsenal of Chinese herbs seems to lack something to deal with the itchness. This can cause some major degrade in sleeping quality.

Healing history

Treatment timetable (week 1 to week 15)

Week 1 – Start taking Chinese medicine. First two days there’s no real effect.
Feel~ Major itching started on the third night. It’s really bad that I was rolling in bed from 12-3am. I know scratching wouldn’t do me any good, but it’s impossible not to scratch! I was tired just scratching for hours rolling in bed. I could catch some shut eyes after 4am and wake up at 11 feeling tired. My body did not itch much in the day.
Look~ Patches also started to show in my thigh, upper arms. It seems to get worse than before. But I don’t see there’s way for turning back as steroid is not an option.
I later learnt that this may be my “healing crisis” (a term used by Shirley in her life long fight with eczema using natural method http://www.shirleys-wellness-cafe.com/eczema.htm).

Week 2 – I talked to my Chinese doc for milder medicine before I tear my skin off.
Feel ~With the milder med, itchness is not bad when I was awake and grew strong the moment I close my eyes. Could not sleep from 12-3. Very tiring overall.
Look~ New rash slow down on my waist, new rash sped up on thigh, upper arms, shoulders.

Week 3 – Continue medication
Feel ~ Similar to week 2. Only sleep from 4~11am
Look~rash at my waist and hip darkened a bit. Appearing of new rash continue to slow down.

Week 4 – My Chinese doc went on New Year vacation for a week. I just buy Chinese herbs on my own based on the last prescription from the doc. Not seeking immediate medical attention proved to be a very bad idea!
Feel ~ )&(#&(*#@#_ terrible, The itchness is almost painful at midnight. I felt quite hot and sweat in bed.
Look~ Rash started on my forehead and slowly on my face!

Week 5 – I found another chineses doc near my home. Major medication change. Started drinking flaxseed oil.
Feel ~ Much better than week 4. Still very itchy at early part of the night.
Look~ Skin dry up and flank off on my waist, hip, thigh. Drying up of skin is a natural healing process. I have problem moving my arms and turning my body in the morning because of the dry skin in these area. I went to shower in the morning to rehydrate my skin. It helps to wash off the dead skin and soften the skin at the joints. Eczema turns up on face, neck, armpit, side of chest.

Week 6- Week 8
Improvement with occasional minor flare.
Feel ~ Itchy night is a given and I kind of grew used to it. Sleeping quality continue to be poor. From 12-3 I always wake myself up by sctaching too hard. Occasionally I can sleep from 2am afterwards, but most night I really started my sleep at 3am.
Eczema on the face is specially bad. Irregular red patches on cheeks, around my eyes deal a great blow to my confidence. I am afraid to go out and aware of how other people look at me.

Look~ More skin flank off and my bed is covered in dead skin. I have to vaccum my bed every morning. At week 8, my thigh and waist seem to clear up a lot. Only darken marks remained. Major troubling area included upper arm, inner elbow, inner keens, neck, face.

Week 9 – 10
Feel ~ Itchness subsided a bit more. Occasioanlly, I could sleep undistribed throughout the night. Area of itchness included inner elbows and neck. Skin feel dry.
Look ~ Healing in progress. Skin flank off have completed on body but going strong at face and neck. The patches on my face “weep” a bit after shower.

Week 11- 14
Started sea salt treatment. Major improvement on face.
Feel ~ No longer itchy at night. Sleep improved. Sleeping is back to normal. Skin felt less dry.
Look ~ Skin regeneration sped up. Only very minor rash in inner elbows. Face and neck cured up.

Week 15 – Now
I think I am 95% recovered. The skin is a bit dry. I sometimes felt itchy on my face. Still continue to take Chinese medication and sea salt treatment for two more weeks to be safe. I feel normal overall.

Treatment, diet and product reviews

Treatment
There are tonnes of different treatments and products I saw online. Some people swear by the effect of certain product. To be fair, I can only talk about those that I have used. Even so, different patient can react differently to the same product.

Diet
This is probably the most important component. If you want to help out the liver in expelling toxic, the first thing is to stop eating food with toxic.

Avoid:
Diary product, butter, CHEESE, EGG, BEEF, crab, PRAWNS, LOBSTAR, clams, GEESE, DUCKS, junk food, fried food, chocolate, coffee, curry, spices, MANGO, pineapple, yams, ALCOHOL
Reduce:
Chicken, lamb, sugar
More:
Vegetable, sea fish, tomato, pumpkin, apple, berries, olive oil.

You may question the decision to avoid beef, cheese etc if you are not allergic to these food. Why are these food “toxic” anyway?
No, we are not talking about snake’s vernom kind of toxic. The toxic we are talking about is anything that can burden the liver. Complex proteins, chemicals that the liver must work hard to break down. Try to avoid the food that burdens the liver and you can see immediate improvement. Going on a strict vegetarian diet for a couple weeks at the beginning of treatment may be the best. Of course, you have to make sure you get enough protein, iron and calcium after cutting out the meat, (eg iron= Spinach, oatmeal, bran flakes, tofu, calcium =beet, broccoli, spinach, pumpkin, protein = beans, peas, soy, bread, nuts and seeds) If you have to eat meat, sea fish is safe (salmon is good), pork and turkey are ok.


Supplements

Cod fish Oil – The theory is that it is rich in the simpliest form of omega-3 which inhabit inflammation of the body. I used it from week 3 to week 6, for three soup spoons a day. The improvement is not noticeable to marginal. Some people say one has to use it for months to see the difference. I don’t rule out it can do something for you. Also, it taste good and benefit the heart.
Conclusion: Worth a try.

Flaxseed Oil – It is rich in omega-3 which inhabit inflammation of the body. The omega-3 is in a more complex form of ALA which must be convert internally. How efficient the body can convert ALA to omega-3 varies. I used it from week 5 to now, for 2 teaspoons a day. It can also be added to salad and bread. It seems to have some effect on the dryness of my skin. Again it takes a while to see the difference.
I also used flaxseed oil as a lotion and rub it on the itchy red patches. Apply after shower or anytime your skin is dry. Similar to other eczema lotion, it’s best to apply when the skin is not totally dry. (pat yourself dry after shower, stand there for 2 min to let the skin breath out the excess moisture, then apply oil) . It spread very well and take some time to massage the oil in. After ten minute or so, you will notice the oil has been totally absorb by the skin. It will also work when the skin is flacking off in the healing stage. You just have to apply an extra layer. It can reduce the inflammation. It soothes the itchness and protect the skin from skatching. It can leave yellow stain on the clothing. Therefore don’t put on your designer clothing while on it.
Conclusion: Strongly recommended for external application.

Lotion/Cream

Dermaveen – I used a cream called Dermaveen Eczema Cream from Australia. They do not sell the Aveeno brand of cream in my corner of the world. Similar to Aveeno, Dermaveen has oatmeal extract that would help with the itchness. I used it extensively after shower and found it to protect the skin well. The only problem is that when I have raw and exposed red patches, it stinks quite a lot in the first couple minutes after putting it on, quite painful when eczema is all over my body.
Conclusion: Highly recommended

Cetaphil – Another cream I tried. It’s not as thick as Dermaveen. The moisturizing effect does not last very long when skin is flacking off. It can be useful in milder case. To be fair, it’s not design specially for eczema.
Conclusion: Not recommended

Aloe Vera Gel – Aloe Vera Gel is useful when it is inconvient to put on other cream that require me to pre-dampen my skin. It is very soothing and moist the chronic dry skin well. Make sure you select a gel which is at least 98% pure aloe, with no alchol and at little additive as possible.
Conclusion: Recommended

Flaxseed Oil – Refer to the supplement section.

Bathing/Showering products

Do not use soap. Soap can dry up the skin in no time because it washes away all natural oil on the skin. Water itself is a good solvent and will make you clean.

Chinese medicine – If you are taking Chinese medicine, you can ask you doctor to prescribe some herbs for bathing. It will help the skin to heal faster. The remain of the Chinese medicine you boil for drinking may also be used for bathing. Add 6-8 liters of water to the left over herbs. Bring it to a boil and use low flame to boil for 30 minutes. Let it cool to a bathing temperature and wash the body with a small towel. Do not rinse and pat dry. Put on cream of your choice.
Recommended

Oilutum (omillient) – The solution is a substitute of soap as a cleaning agent and will envelop the body in mineral oil. The oil traps the moisture in the skin. Even when the dead skin is peeling off like snowflakes, the skin is chronically dry at the peak of the attack and the body is covered in scarred tissue, use it in shower will leave me with soft and smooth skin. I have my reservation though. The problem I encountered is that the mineral oil trapped “too much” moisture in the skin. I question overloading the eczema skin with moisture as I think part of the reason for the symptoms is the inability of the skin to regulate water. I say use it when absolutely necessary.
Recommended.

Sea salt – I accidental found out sea water is good for the skin on my vacation to Malaysia. My skin greatly improved when I swam in the sea for days. There’s also a control experiement done that dead sea salt has healing effect on eczema skin. Even common table salt reduce inflammation but by a smaller margin. Go swim in the sea if you are in warm climate. I do it sometimes but when the weather is bad I just add sea salt to a small bucket of warm water for bathing. Soak the symptom covered skin in the solution for 30 minutes, rinse off and pat dry. It has magnesium sulphate and other mineral that helps with eczema. Dead sea salt should be even better because it has many times the mineral content of sea salt. You may have to order it online since I just didn’t see it on sale in the supermarket.
Highly recommended.

Other treatment that may help
Drinking honey – I am drinking honey for two weeks now and see if it can further improve my skin
Yoga – Anything that helps internal balance may help strengthen the liver function.

Baby Eczema

Baby eczema

Eczema is very common in babies now. The figure grew from 1/10 forty years ago to 1/5 in recent studies. It is also worse in developed countries than undeveloped countries. It must be something we introduced in the last 40 years that contributed to the situation.

I suspected the culprit is baby formula. Baby formula can be “refined” from cow’s milk. Cow’s milk is good for calves but the benefit on babies is doubtful. Cow’s milk must be modified before it can be used in the formula. Proteins and enzymes the babies can’t absorb are removed or altered. Other chemicals the manufacturers believe are good for the babies (or good for promotion) are introduced. Is this chemical cocktail cause allergic eczema reaction in babies?

There was a TV program recently looking at the danger of baby formulas. A 3-month old baby covered in the program defecated blood resulted from sore and bleeding intestines. The doctor suspected the baby formula caused severe allergic reaction in the baby. As soon as the baby switched back to breast milk, the symptom went away. This may be an isolated case, but it shows baby formula is not a quick fix for every baby. Case 2 was that another baby has facial eczema but he’s not taking formulas. The mother tried everything she could, changed the detergent, clothing, bedding for the baby but the eczema did not go away. Then she remembered she’s taking cow’s milk herself to replenish calcium and she suspected the enzymes presented in cow’s milk were passed to her baby through breast milk, causing allergic reaction. She stopped drinking milk herself and the eczema on the baby cleared in a week.

Remember your parent’s generation or your grandparent’s generation. They did not grow up drinking formulas and cow’s milk and did turn out ok. My parents grew up drinking breast milk and then move on to mash up table food. Back then, cow’s milk is a luxury for kids. They seldom have cow’s milk or other diary products as kids and still grew up well. It’s hard to know if over consuming diary product everyday is causing more harm than goods.

Read more about baby formula http://en.wikipedia.org/wiki/Infant_formula