After a couple of months of home tinkering, trying everything I knew with mixed results I was looking for more help. I had made progress since my first frustrating dermatologist appointment and my red camouflage had died down. Bleach baths, getting into the sun and trialling different ways of moisturising. Moisturising trials included drying a limb after a bath then moisturising, drying the next body part then moisturising. Putting moisturiser directly onto the wet skin without drying at all. The latest theory is to dry with a flannel only. Drying my hair first dampens the flannel. I then use the dampened flannel on the rest of the body to take the surface water off but leaves the skin damp. I then dry my face last. This worked pretty well and stopped me feeling like I was drying out between drying and moisturising. The latest moisturising regime that seems to work best (at the moment) is using a thin moisturiser to soak in followed by a heavier moisturiser. Some areas then needing a top up coat of a barrier cream.
Unfortunately, I was still quite red, particularly in the face. I also had an entrenched patch on my forehead that was being particularly stubborn. I imagined I would have been frustrated if this had occurred anywhere on my body, but my face! I felt paranoid and self-conscious enough.
In probably my boldest move, which 99% of people probably never noticed, I ditched the cap. My safety blanket. The barrier that stopped people seeing me or at least my forehead. Since I am a lot shorter than most I could hide under it. Removing this barrier left me feeling exposed, but I believed that exposure was important to healing. It was kinda scary for me but believed it helped.
My local doctor recommended trying a dermatologist again when I went back for a new shopping list of lotions and potions. I made my lack of confidence known but agreed to go, mainly because I had run out of options and was nearing witts end. My doctor later let me know I was pretty “cranky” that day. My wife has added after the fact that this was my general mindset at this time. I didn’t realise.
Three weeks later I managed to get an appointment with a new dermatologist. We had an introductory appointment which ironically covered off very similar information as the first appointment. Whether it was my slightly improved mindset, low expectations, bedside manner or knowledge of the new dermatologist that made me feel more comfortable with receiving this info. Eczema in adults is unlikely to be caused by allergies. He went on to explain it is more likely caused by an immune response issue and the association with allergies dates back to a theory that originated around World War II. Studies since the 1980′s have concluded that the influence in adults eczema of allergens is significantly reduced. Still, this allergy/eczema association is strongly held and perpetuated today. My own personal experience is that when my eczema is ok, allergens have a very small impact but when I am in flare up I allergens can hit me hard. A great analogy I read was that allergens, triggers, and illnesses can be like turning up the volume knob. It will amplify what is going on underneath. The then mitts help stop any skin damage during the ups and downs, at least provide some peace of mind and control.
The dermatologist also laid out a treatment plan that had rationale and progressions to it. He was also upfront and explained that this was his standard combination to see what impact it would have on my eczema. This combination included a moisturiser, a grunty greasy steroid and some face specific steroids. After the first 2 weeks on the hard steroids to start to wean off them. This plan was the same as the first dermatologist but there was openness and he explained the reasoning behind the approach.
The whole experience from the presentation of the rooms to arriving and how I was greeted at reception was 100% more professional. Maybe this put me in a more receptive mindset as well. I don’t know but it worked. I was still sceptical but more hopeful.
How it went with steroids will be discussed in the next blog
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