Speaker 1 00:00:03 Hello and welcome to a Wonder Care podcast. I'm Sheena Mitchell, pharmacist and mom of three. I combine healthcare and practical advice to support you on your parenting journey. This season is all about family skin care and it's proudly sponsored by real life. Real life. Believe your skin says how you feel, and this is so, so important as we explore family's skincare concerns. Today I'm going to be talking all about eczema and dermatitis. I'll be explaining what they are and how common it is. I'll be exploring what causes it and what makes it feel worse and what makes it feel better. I'll also be talking lots about different products and treatments that you can use to manage eczema. Even with the best management, sometimes a flare up happens. So of course today I'll also be giving you some advice on how to treat a flare up. After that, I'm just gonna give you some additional tips on what I have learned as both an eczema patient myself and as a pharmacist. Hopefully with all of this information you'll be able to look after your condition much, much better, right? Let's get started. Speaker 1 00:01:13 Eczema is a chronic inflammatory skin disease. Eczema and dermatitis are two words that are used interchangeably to define the same type of symptoms, eczema causes red, inflamed, itchy rashes on the skin. If it's uncontrolled, it can become infected or extremely inflamed and can require more aggressive treatment. As eczema is a chronic long-term condition, it's important to be proactive in finding a way to keep the skin calm and happy. Itchy, unhappy skin leads to scratching and damage to the skin cells. This then leads to impaired skin barrier function. The job of the skin barrier is to keep moisture in and irritants out. If this isn't working, then more irritation and skin dryness occurs. This is the most frustrating part of eczema and is commonly known as the itch scratch cycle. It is imperative to break this cycle in terms of statistics, eczema is the most common inflammatory skin condition in the whole world. Speaker 1 00:02:12 It affects 20% of children in Ireland and 3% of adults. This is good news in a way because it shows us that 85% of children do grow out of it. Usually if a child is going to suffer from eczema, it starts to appear before their first birthday. The most common places for it to occur are on the face, neck, trunk, and also the insides of the joints like wrists, elbows, and knees. My own memories of having eczema as a child was spent in junior infants to second class with my hands in bandages for the majority of time. One friend recently said she'll always remember holding my hand and the Lena and it being so, so dry, but that she thought it was great because her hands were always sweaty. That's what true friends are really made of. Thanks re prolonged itching and scratching eventually causes the epidermis to thicken. Speaker 1 00:02:59 This results in leathery looking skin with exaggerated markings. Nobody wants this. If only I hadn't been an eczema sufferer, I very well may have gone on to be a hand model. I guess now will never know what causes it. Often people will refer to the more chronic form of the disease in what's known as atopic individuals as eczema. An atopic person is someone who's more likely to develop an immunoglobulin e response, and there is often a genetic link with this type of eczema. Dermatitis is commonly used as a term to refer to contact reactions to external agents. Dermatitis can be caused by irritants like detergents or hair dye, et cetera, or by allergies, which is the result of a hypersensitivity to a sensitizing agent, such as nickel in jewelry or rubber in household gloves. So as time seems to be evolving, people do seem to be associating the word eczema more with the chronic dry skin, irritated flare, upy type genetic condition and dermatitis does seem to be used a little bit more frequently in my experience to refer to a contact or allergic reaction, and that's probably the easiest way for me to describe it as we go on through this podcast. Speaker 1 00:04:11 There's no real known cause of atopic eczema, but as I said there there is often a genetic link. There's also an association between eczema sufferers, asthma sufferers, and hay fever sufferers. I just want to pause for a second to tell you a little more about the award-winning real-life products. ReLife understands that your skin reflects how you feel, and if you or anyone in your family live with any skin condition from acne and eczema to dry skin or hyperpigmentation, then you also understand this. The good news is that ReLife is here to help with a range of dermatologically tested and scientifically proven skincare products. Check out the ReLife range on Wonder care.ie or in your local pharmacy and learn even more by visiting relife.ie. Speaker 1 00:05:02 What makes it worse? So for eczema infections, and these can be viral or bacterial can cause flareup, also irritants. So the use of soaps, detergents, shower gels, allergens, these can be food, they can be from contact or they can be inhaled. A flareup of eczema can also be caused by being in a very dry environment or being exposed to extremes of temperature. Another thing that can cause eczema to worsen is stress <laugh>, and there's nothing worse than feeling like you need to stop being stressed, but being stressed about being stressed, <laugh>, that's a vicious circle for children. The most common cause of an exacerbation is secondary infection. With staphylococcus aureus, a poorly functioning skin barrier can allow staph aureus to overproduce due to disruption in the normal skin microbiome. This is basically the natural balance of good and bad bacteria. This infection can cause and worsen flareups. Speaker 1 00:05:57 If food is suspected as a cause or a trigger in eczema in children, then do speak to your doctor about a referral to an allergy specialist. In terms of what makes dermatitis worse, well really we're talking about contact with an irritant or an allergen. So I did mention a few of these earlier, but common irritants include cleaning materials, hair dyes, tints, DIY products, gardening products and detergents. Common allergens include, so for contact allergies, things like the latex or rubber and gloves, nickel and jewelry, and it can also be in buttons on trousers and that kind of thing. Also, perfume, soap, cosmetics. And then for foods, some of the most common allergens include cows, milk or dairy, nuts, shellfish, eggs, and wheat. For inhaled allergens, the most common five would be pet dander, dust grass, pollen, tree pollen, and wheated pollen. Okay, so that's a whole big list of things that can make it worse. Speaker 1 00:06:58 So why don't we start looking at things that can make it better. There is one big headline here, emollient, emollient, emollient. They are annoying. You will wish you didn't have to rub lotions and potions into your skin every single day, week after week, month after month. I get it. I personally admire and envy people who can casually get outta the shower and just get dressed. The time saving, the ease actually can't imagine, and that right there is the single most important piece of information I'll give you today. You actually cannot imagine when you have eczema, you only have two choices. One is ignoring your condition and it's essential maintenance. This results in uncomfortable skin and regular flareups. The other option which is much, much better and I came to terms with a long, long time ago, is accepting that emollients are amazing and one of our strongest allies when it comes to keeping flare ups at bay. Speaker 1 00:07:58 With well-managed skincare, you can look good and feel good. What exactly are emollient? Emollients are topical hydrating agents that help to form a lipid barrier on the surface of your skin. This barrier helps to keep essential water in the epidermis. Keeping your skin barrier intact and healthy is the key to preventing itch and therefore redness, irritation, and then more itch. As the itch scratch cycle continues, you need to use them at least once daily. Whether you are young or old, use them liberally and regularly to reduce flareups. When you get out of the shower or bath, gently patch your skin dry Within three minutes, apply emollient as this will help to trap some of the moisture in the skin layers. A nice daily emollient is Reema ultra hydrating lotion. It should be used every day and it's suitable for kids and adults. While it's called a lotion, it's really more of a creamy texture, which I find more helpful than a lighter lotion. Speaker 1 00:08:53 It does still absorb well though and it contains a blend of vegetable oils and ceramides to hydrate and protect the skin. In addition to improving elasticity, which helps you to feel so much better, another good option is lip car, bam from Lara. These are my top two recommendations I mentioned the bath and shower there. Remember to avoid potentially irritating your skin with she and bath products, which are fragranced or not Dermatologically, tested for sensitive or delicate skin. This applies to adults as well as babies. Good bath products include rema, hydrating cleansing bath oil and lipo carte cleansing oil. The Reema bath oil is pediatrically tested and contains a blend of almond cotton seed and grape seed oil along with vitamin. Using a product like this can reduce the feeling of dryness experienced. When you get out of the bath or shower, you massage it in as an oil and it turns to a delicate foam, which can just be rinsed off. Speaker 1 00:09:46 It helps to cleanse your skin whilst also hydrating and calming drier sensitive skin. Remember to be careful getting out of the bath when using a bath oil or when holding your baby as sometimes oils can make the bath a little bit slippery. If you prefer a more creamy cleanser, then Lesa lipid replenishing cleanser is the one for you. Again, it forms a foam when gently massaged into the skin and it helps to restore the skin's natural barrier. It's handy for both the bath or shower due to its dispenser pump. You don't have to be fiddling with lids or caps. This is pediatrically tested so it's safe for the whole family. Do you remember not to rub your skin after bathing or showering as simple, gentle pat is best and then get your emollient on as quickly as possible as a shampoo. And remember that just because you're using all of your skin products, right, if you use a shampoo in the shower or bath, the shampoo will run down your skin when you're washing it off and this can irritate your skin. Speaker 1 00:10:40 So for a shampoo, I would use eLab as it's extremely gentle and free from soapy irritants. The natural glycerin and camomile extract helps to leave the scalp feeling comfortable without leaving any residue on your hair. It's also pediatrically and dermatologically tested. Another nice option is the Mugo shampoo and conditioners. These are quite popular in our house. They are gentle and calm in a handy to Spencer two. If your scalp is particularly dry or itchy or flaky, then I would use CAPAs therapeutic shampoo twice weekly until it improves. It's suitable for any age group. I'll pop links to all of these products in the show notes. So what do you do if you get a flareup with eczema and dermatitis? Flareups are not always avoidable and sometimes it can be really hard to figure out what your trigger is or if there is one at all. Speaker 1 00:11:30 So what do you do when one happens? Well, if you are treating someone over 12 years of age, I would recommend applying hydrocortisone 1% to the affected area once or twice daily. This is a mild steroid cream. You only need to apply a very thin layer of this product. So do use the sparingly, unlike your emollient. If your symptoms have not resolved within seven days, then do see the GP who can discuss other prescription treatment options with you. Similarly, if your skin is infected or broken, you'd be better. Go straight to the doctor. A brand available without prescription so that you can just buy over the counter in a pharmacy is tropin. I'll put a link to this in my show notes. This is just for kids or adults over 12 years of age and is not for use on the face unless a doctor has advised you otherwise. Speaker 1 00:12:17 If your child is under 12 years of age and has a flare up of red and itchy patches of contact dermatitis or eczema, then I would treat it with reema cream. This is a great steroid free option which is suitable for children or adults. It contains lipids, emollient, and antioxidants, and this helps to restore the physiological skin barrier and it has a moisturizing and soothing effect. Other options include syco, BM, and Muu, irritable skin bomb. If treating with reema cream is not improving your child's symptoms, then do see the GP as there are prescription items available for children as well. If your child is suffering from skin irritation near the genital or buttock area, then rema spray and go with zinc and panol will be my go-to product. It's a barrier cream in the form of a light protective and soothing spray that can be used in the sensitive areas. Speaker 1 00:13:10 And this isn't just for kids. The elderly or people suffering from irritation due to chafing or allergy or even heat can also use this product. It's become a firm favorite in our house where a barrier cream is needed, but you want to use something a little bit lighter for any little rashes on the hands or arms or anywhere on the body that's red and irritated as it soothes and protects the skin from further irritation. Remember to give the bottle a little shake before you use it and you can use it as often as needed for skin that's very, very dry and rough. eLife 20 moisturizing cream is great for helping break down rough patches as it contains 20% urea along with glycerin and lactic acid. You can use it as an all over body moisturizer because these ingredients work by restoring and reconstructing the damaged skin. Speaker 1 00:13:59 It absorbs quickly and it almost feels like a gel cream. You can use it several times a day if needed, but I have found that it leaves your skin feeling soft all day long. For people like me whose hands look like they belong to a 99 year old since they were four years of age, you life 30 regenerating hand cream is a must. It contains 30% of urea and really hydrates localized areas. It also contains deone to form a protective film on your skin. The eLife products should only be used from three years of age. Another group of people who commonly come into my pharmacy that I really feel would benefit from the eLife 30 hand cream are builders or people who do a lot of manual labor with their hands. Often their hands become very chapped and picked from using, from using whatever products builders use. Speaker 1 00:14:47 Oh my goodness, very sorry, my ignorance is really bad. However, from a lifetime of working in community pharmacy, yeah, builders, you'll know what I'm talking about. If your skin is really hard and rough, then you life 30 is the product for you. Now I have some additional little tips that will hopefully help you to manage your eczema a bit better. Apply your emollient in the direction of hair growth. Always use products that come in a tube or a pump as repeatedly sticking your hand into a tub can actually introduce dirt or infection into the tub, which then goes onto your skin. If you have a tub and you have no alternative but to use it, then I'd recommend using a spoon or a spatula to remove the product from the tub and then cleaning it each time. Always avoid aqueous cream as a moisturizer. It's absolutely fine as a soap substitute, but that's all it should ever be used for, never as a moisturizer, it's been shown that it can worsen the symptoms of eczema. Speaker 1 00:15:49 If you or your child are particularly itchy, then you can use an antihistamine like Zyrtec solution for children from two years of age or tablets from over six years of age. Remember to read the dosing info on the product leaflet and ask your pharmacist or GP if antihistamines are suitable for you. They're quite a good medication because they don't interact with an awful lot of medications and it can be really helpful to take them during itchy flareups to try and prevent itching during a bad flareup. Wet wraps can be used in the short term, so a wet wrap is basically when you apply your ent and then dressing is applied over that to keep the cream in place. This helps to prevent further skin damage through scratching for children vests or leggings can be used, but do remember to keep a close eye on their temperature as this can cause their temperature to fluctuate for babies. Speaker 1 00:16:45 In the six month to 24 month age group, there is a product called Mustela, Stella Utopia, skin Soothing Pajamas. These are extremely soft and comfortable and they're made with a hundred percent cotton and all of the seams are on the outside so that there's nothing irritating the skin. The material is infused with ceramides and avocado and sunflower oil, which help to support comfortable skin. I hope all of that information has been really, really helpful for you. There is still plenty of time before the summer to get your skin in top condition, but it does take a little bit of work and unfortunately there isn't any other way around it. For those of you dealing with teens with eczema or tweens, I hear you. I remember trying really hard to rebel against the products that were being given to me as, you know, a young teenager to use as an ent. Speaker 1 00:17:37 So my dad was a pharmacist and he always provided me with great ENT and products, but of course I wanted to use the really cheap fragrance nonsense, so I'd get my hands on some and I would try and use them and within a day or two, I'd instantly regret it. I'd either have broken out in a full rash or my skin would just be flaking off by lunchtime and it was just not worth it. It did take me about two solid years of trying to ignore my eczema to come to terms with that. So now the focus is really on finding the best products, the ones that are nicest to use and the ones that only need once daily application where possible so that you can apply it, forget about it, and at least know that your skin is in good condition to actually really important. Speaker 1 00:18:25 For any women out there who may be considering using tan, it is definitely a good idea to really up your emollient levels for the few days before applying fake tan and even afterwards applying moisturizer in the days afterwards as well. Because there is nothing worse than an eczema sufferer like me losing their tan, and you do start to look like some weird deformed snake. The patterns on your skin are not pleasant, so do get on top of your moisturizer now so that you are summer ready. And also for the children, you want them to be able to enjoy their summer without being itchy and irritated when the heat ramps up a little bit or a lot. If you know anyone who suffers from eczema or has an eczema or dermatitis patient in the house, please do share this episode with them and follow the show and absolutely give it a little review if you could on Apple Podcasts. I always love to get those. Thank you so so much for listening and thanks again to Relapse Skincare for supporting this season.