This is a sponsored post about atopic dermatitis: I was compensated by Med-IQ through an educational grant from Sanofi Genzyme and Regeneron Pharmaceuticals to write about the signs, symptoms, and treatments available for eczema/atopic dermatitis. All opinions are my own.
I was six years old when I realized my dad’s legs looked different than those around us. It was the early 80s and my family had gone to a barbeque at the next-door neighbor’s house. My mom wore her Candies wooden sandals and brought a potato salad in a giant yellow Tupperware. My dad stood around a charcoal grill with the other dads, all sporting madras print shorts and collared shirts, each holding a can of Budweiser in their hands. As the kids ran amuck on that summer night, chasing fireflies and playing with now verboten sparklers, I remember noticing my dad’s calves for the first time.
His calf muscles were reddened and angry looking. He had splotches of white, scaly skin interspersed down his legs. Every so often, my dad would reach down and scratch at his legs, absentmindedly. It was rare that I saw my dad in shorts since he favored three-piece suits and ties as he headed to his job as an insurance agent. My six-year-old self looked down at my own legs and wondered what had happened to make his legs look so scary.
Over the years, I came to realize that my father had an ongoing issue with eczema, or atopic dermatitis (AD) as it is also known. An asthma sufferer from the time he was a small child, my father also had severe allergies to penicillin and eggs. And though he had bouts of eczema on other parts of his body, his legs were permanently scarred from years of scratching, oozing, and the lack of effective medical treatments for eczema. Until the day he died in 2012, my father’s eczema and his allergies were very much at the forefront of his daily life.
More than 31 million Americans have some form of eczema and around 16.5 million adults in the US have atopic dermatitis, with 6.6 million reporting moderate-to-severe symptoms.
Although atopic dermatitis most commonly develops early in life, it can persist into adulthood for many patients. (In fact, I spoke with Dr. Peter Lio, Assistant Professor of Dermatology and Pediatrics for Northwestern University during a Facebook live. Watch HERE.)
A few other facts about AD:
Atopic dermatitis affects all races; however, it is more common among Black children and Black and Hispanic children are more likely to experience more severe cases.
Atopic dermatitis is most commonly associated with other allergic/atopic conditions such as allergy, asthma, hay fever, and food allergies.
Atopic dermatitis is also associated with several mental health conditions including ADHD, anxiety, and depression.
Now, before we go any further, let’s clear up some lingo, shall we? As you’ll notice, I’m using the terms “eczema” and “atopic dermatitis” somewhat interchangeably and that’s okay because the medical community does, too. But, technically speaking, eczema is the general name for a group of dermatologic conditions that includes contact dermatitis, atopic dermatitis, and others. Atopic dermatitis is a chronic condition and it often requires long-term treatment.
Atopic dermatitis is a red, itchy rash that can happen any time of year. It is often worse in the winter months, but for some patients, it can worsen in the summer months due to the heat and humidity.
Having watched my father itch his legs raw while watching TV in the evening and avoid wearing shorts when his flare-ups were especially bad, I always wondered what his doctors told him about various treatments and itching relief methods. It always seemed as though he just tolerated eczema and accepted the fact that itching was a way of life.
And I’ve always thought that sucked.
So, when the opportunity arose to help educate the public about atopic dermatitis, I jumped at the chance. There is *a lot* of misinformation online about eczema and atopic dermatitis —only 1/3 of websites dedicating content to eczema are in agreement with current clinical thinking on this disease.
When I was thinking about how I wanted to write about eczema, I was reminded of a time a few years ago when I had the world’s worst case of poison ivy. After a marathon session of gardening, I’d managed to swipe a huge swath of poison ivy oil across my chest, left flank, and left side of my face. Within days, I was in agony: huge, weeping crusted pustules covered my body and as the days turned into weeks, my skin screamed at me for attention at every given moment.
I couldn’t sleep.
I couldn’t wear my favorite clothing because my lesions were constantly weeping.
And then came the steroids.
That’s when the real hell began. I’m a high energy person without the aid of stimulants (I really should switch to decaf, I know) and steroids make me a next-level handful, trust me.
For six weeks, every decision I made revolved around my skin: how to sit comfortably, what position made sleep come more easily, even bathing became a chore because nothing helped allay the itch that seemed to come from the inside out.
I was miserable, yes, but thankfully, I eventually healed and soon forgot about my six weeks of poison ivy hell.
But, 9-year-old Elizabeth told me that living with atopic dermatitis means that itching from the inside out is a way of life for her and, in her words, itchy skin makes her feel “bad” most of the time.
Elizabeth is the third child of my dear friend Carla and she’s one of the kids on our street that I’ve known since the moment Carla breathlessly told me in the school parking lot that baby #3 was on the way.
When Elizabeth was in first grade, her issues with asthma and eczema really started to flare up and it set their family on a course that now centers around Elizabeth’s skin care. According to statistics, 10% to 25% of children have atopic dermatitis; of which, approximately 1/3 have moderate-to-severe disease.
When I met with Elizabeth and Carla recently for a socially distanced discussion about how atopic dermatitis has affected their lives, Elisabeth was eager to tell me how much finding the right treatment has helped her feel better every day.
“Kids would look at my skin in the beginning and say, ‘Ewwww,’” she detailed. She told me that she wished that kids who were curious would just ask her what was wrong with her skin instead of being mean. Carla echoed the sentiment, “You almost just want to put a sign on your kid that announces she’s not contagious because people look at her with raised eyebrows in public.”
Both agreed that the hardest part of living with AD is that adults and kids can be cruel.
“I wish people would understand that if she could control the itching and the lesions, she would. She doesn’t have any control over what her skin does from day to day.”
Elizabeth also says that playing outside is often difficult because a warm day can exacerbate her symptoms. She described a pre-COVID trip to Disney World where she wore long sleeves and pants in the Florida heat because she didn’t want people to see her eczema. “But long sleeves mean I get overheated and it makes everything worse,” she says.
Thankfully, in the last year and with the help of a team of doctors at the Children’s Hospital of Philadelphia, Elizabeth’s eczema is much more under control. Carla described the nightly routine of showering, lotions and specialized ointments that have helped ease Elizabeth’s symptoms. “There were times a few years ago that we’d have to put socks on her hands to keep her from scratching when she was sleeping,” she says. Laundry detergent in their home must be dye-free and Elizabeth uses a special shampoo and conditioner every night, too.
When I asked Carla what advice she had for other parents who are trying to find solutions for their children with atopic dermatitis, she offered these tips:
Don’t Wait to Seek Proper Treatment for AD
Carla urges parents to find the right treatment sooner than later. Atopic eczema is chronic and does not just “go away”; it increases the risk of infections and affects patients’ ability to function in their daily lives, so parents of children and individuals with atopic eczema should be encouraged to seek treatment
Patience is A Must
“There are so many times when I see her itching and I just want to tell her to stop. Eczema is so frustrating and inconvenient on so many levels. Sometimes I wonder why she had to be the kid who has this. But, when my patience is low, Elizabeth reminds me that I don’t know what it’s like and it causes me to regroup. But it’s hard.”
As Carla and I sat on my back porch while Elizabeth and our other kids fooled around in our yard on a warm summer day, I thought about that barbeque when I first noticed my dad’s legs.
I can still smell the charcoal from the grill and feel the grass in my feet from that day when I close my eyes. What I realized, is that, though I remember noticing his legs that day, I more so remember my dad enjoying time with his friends and the fact that he was wearing a pair of Converse sneakers with Budweiser logos.
He was more than his eczema and, though it was part of his life, he didn’t let it define who he was, just like the plucky girl in my yard, wearing a headband with giant puffballs on her head.
“You can say ‘don’t itch’ over an over but think about it: if you had an itch on your nose, can you ignore it? Imagine and all over itch that doesn’t go away,” Carla said poignantly.
If you’d like more information about eczema and atopic dermatitis, head to American Academy of Dermatology’s Eczema Resource Center: www.aad.org/public/diseases/eczema
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