How to Relieve an Itch That’s Beneath Your Skin
Dealing with an itch that’s underneath your skin can be quite a challenge. Unfortunately, you can’t simply scratch it away. I remember when I was 15, I would often notice bubbles forming beneath the skin on my hands. These bubbles would then turn into fluid-filled blisters that caused intense itching and discomfort. Grim, right? To make matters worse, removing the dressings that covered the blisters or undergoing wet wrap treatments was excruciatingly painful. My already fragile self-esteem took another hit when I had to cover my fingers with gauze. Eczema, the condition responsible for my troubles, is essentially a malfunction of the skin barrier caused by genetics and environmental factors. I developed it when I was four years old. Back then, it was more of a rash-like condition. I would often wonder why I was the only one affected by it, which made me feel ashamed whenever other kids asked me about it in disgust. I did have some help, though, given that my father was a dermatologist. “We tried every possible treatment to heal and manage the eczema, but the only significant improvement came after rounds of homoeopathy,” he recalls, as an old friend who was a medic had suggested it. The homoeopathy treatment did help, at least until I reached my teenage years. From then on, I have never been without eczema, even if it’s just a small patch. What’s more, each flare-up of my eczema has been different from the last. Sometimes it presents as a rash-like atopic eczema, while other times it’s an ultra-itchy discoid eczema. I’ve also experienced contact dermatitis, which is triggered when my skin comes into contact with certain substances. (For me, it’s nickel, so I take precautions like painting clear nail polish on metal buttons that touch my skin.) Additionally, I’ve dealt with red, scaly seborrhoeic eczema on my scalp and eyebrows. And let’s not forget that horrendous blistering eczema that plagued me during my teenage years, which is known as dyshidrotic eczema or pompholyx. Up to this point, I haven’t seen signs of varicose eczema, which commonly affects the lower legs, but I’m not one to do things halfway, so maybe it’s just a matter of time. Sadly, there is no cure for eczema. I’ve been told that the best I can do is control it, which can feel incredibly unfair, especially since children are affected by eczema more than adults. In fact, in the UK, one in five children and one in ten adults have eczema due to a combination of our “naive infant immune systems, sensitive skin barriers, and exposure to possible environmental triggers,” according to Dr. Derrick Phillips, a consultant dermatologist at Montrose London. Women are more likely than men to develop eczema, and those with a family history of the condition or with hayfever and asthma are also at higher risk. Interestingly, research in the US has shown that Native Americans, Pacific Islanders, and Asians are the ethnic groups most affected by eczema, followed by white people, while black people are the least likely to have it. Other studies suggest that people living in high-income regions or in higher social and economic classes are more prone to eczema due to environmental issues like car pollution. Interestingly, I’ve personally discovered that my ADHD medication, while helpful for my focus, seems to exacerbate my anxiety. And research has shown a link between ADHD and eczema in children. My most recent and ongoing flare-up started in 2020 while I was working on my book proposal for “Ugly.” The stress of writing caused a flare-up on my face and body, but I naively believed it would go away once I signed the book deal. Instead, it got worse. Unfortunately, the timing was terrible because I was regularly appearing on television, trying to give beauty advice with a face that was constantly weeping and flaking. At night, my body was so raw that I would coat myself in multiple creams and wear a onesie to avoid the discomfort of waistbands and buttons on pajamas. When I finally sought specialist help, the dermatologist was shocked that I had been tolerating my eczema for so long. I went through two courses of oral steroids and used topical steroid creams and Milton bleach baths (which help reduce itching and bacterial growth). These treatments provided temporary relief, but my symptoms soon returned. Being an eczema sufferer in the beauty industry has been a rollercoaster ride. I often struggle with posting on social media, where your appearance is key. How can I do a makeup tutorial when half my face is flaking off? It’s the opposite of inspirational. Nevertheless, I try to do it anyway, to challenge the notion that we need to look perfect to have value in this world. When my eczema flared up again in 2020, I received a range of suggestions to find relief. Some suggested phototherapy, a UV light therapy that requires weekly treatments over a period of months. Others proposed drugs that suppress the immune system to control inflammation, such as cyclosporin or methotrexate. However, this wasn’t the right time for me to try these options, particularly during a pandemic. So, I embarked on a journey of trial and error. In addition to using potent topical steroid creams, I eliminated most fragrances from my detergent and shower gels to reduce irritation. When my skin becomes irritated, I rely on the gentle Avène Tolerance range. Instead of applying heavy moisturizers and oils twice a day as I used to, I’ve found that CeraVe moisturizing cream, which contains ceramides, has made a significant difference. Now, I use it only once a day. I also discovered that while I was previously fine with them, dairy and gluten now seem to trigger flare-ups. Dr. Thivi Maruthappu, a consultant dermatologist and the author of “Skin Food,” explains that the unpredictability of eczema is a real challenge, making it difficult to pinpoint triggers. While food is unlikely to cause eczema, food allergies can worsen the condition. We now know that the gut microbiome can also influence eczema, so it’s important to maintain adequate vitamin D levels and consider omega-3 supplementation if necessary. In my search for relief, I sought the expertise of Dr. Mazin Al-Khafaji, a practitioner of traditional Chinese medicine and the founder of Dermatology M. He specializes in customized skin management using herbs, topical products, and acupuncture. According to Dr. Al-Khafaji, sufferers of atopic eczema may have a disordered skin barrier, but there is more to the story. Steroid treatments, whether topical or systemic, only address the acute phases of inflammation. In contrast, Chinese medicine can effectively treat the inflammatory stages and provide relief beyond that. Although my eczema is now mostly under control, I’m still on the lookout for triggers to prevent further flare-ups. Stress seems to be the common denominator for me—my earliest bouts of eczema coincided with starting a new school, while other flare-ups were triggered by stressful periods in my life. As a result, I’ve made significant lifestyle changes, including incorporating meditation and slower, mindful movement like yoga (although I’m still a work in progress with that). However, my eczema journey has also had some unexpected downsides, such as thinning skin in certain areas due to the use of steroid creams. According to Dr. Phillips, there has been an explosion of eczema treatments in the past five years. He mentions oral treatments like dupilumab and JAK inhibitors, as well as tralokinumab injections, all of which aim to treat eczema internally. Additionally, there are more novel treatments in the works. Overall, my main focus is on stress management. As my dad likes to say, “The pill you really need is a chill pill.” And begrudgingly, I have to admit that he’s right.
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