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You are here: Home / Uncategorized / Itching from The Inside Out, Part 2: Climbing the Ladder of Atopic Dermatitis Treatment

Itching from The Inside Out, Part 2: Climbing the Ladder of Atopic Dermatitis Treatment

January 13, 2021 By Christine Leave a Comment

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 atopic dermatitis or eczema. All opinions are my own.

If you’ve followed this blog for a while, you’ll remember that, back in September, I introduced you to 8-year-old Elizabeth and chronicled her atopic dermatitis (AD) treatment journey. 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.

Because everyone loves a sequel, I’m happy to report that I caught up with Elizabeth and Carla a few weeks ago to check in with Elizabeth’s progress and treatment journey. And I can report that this sequel is not going to suck: without giving away too much, too soon, let’s just say Elizabeth was only too excited to tell me about her most recent visit to her big city allergy and dermatology specialists.

Elizabeth has moderate-to-severe atopic dermatitis and, as you can imagine, itching from the inside out is not high on the list of things 8-year-old aspiring YouTubers want to do. When she and I sat down in September, masked and socially distanced, to talk about what life was like with atopic dermatitis, she told me 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,” her mother  told me. 

Let’s review some quick stats about atopic dermatitis:

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.

10% to 25% of children have atopic dermatitis; of which, approximately one-third have moderate-to-severe disease

5% to 10% of adults have atopic dermatitis (3% of elderly); of which, approximately one-third have moderate-to-severe disease

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, Clinical Assistant Professor of Dermatology and Pediatrics for Northwestern University during a Facebook live. Watch HERE.)

Here are 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.

Perhaps the most poignant part of our conversation back in September came when Carla simply looked at me and said, “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. 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.”

Now for the sequel…

atopic dermatitis

When I asked her about Elizabeth’s treatment journey with atopic dermatitis, Carla detailed a long and winding road to what has ultimately become a solid eczema plan of treatment options for Elizabeth.

Via FaceTime, an exuberant Elizabeth proudly announced to me that she’s feeling better than she has in months. “My eczema is so much better!” she beamed.

Carla was quick to point out that building an eczema plan that centered around Elizabeth’s needs has been the key to their ongoing treatment success. But it’s not been an easy road to the current skin regimen that Elizabeth follows today. And, while Elizabeth’s skin lesions and irritations have been improving, something as simple as the weather turning colder and using the heat in the house can cause her skin to dry out quickly. 

“Having a child with atopic dermatitis means doing constant detective work. If she’s having a flare up, we have to retrace our steps and figure out whether she’s had milk (which causes her to flare up) or if it’s something as simple as getting nervous and sweaty before a test at school,” Carla explains.

“When her symptoms first started, we worked with our family doctor and Elizabeth would take rounds of oral steroids,” Carla explained. But, she says, as you can imagine, the steroids would work for a short period of time and Elizabeth’s symptom relief would quickly drop off after a few days off of the steroid dosage.

Eventually, Carla took Elizabeth to see a local allergist where, for about a year, they tried a combination of steroid creams and ointments several times a day. Carla detailed often frustrating visits with the doctor where Elizabeth was made to feel like she was “failing” at her treatments. “I’d find myself feeling upset. The doctor would almost be yelling at Elizabeth because the treatments weren’t working and she’d insinuate we were doing it all wrong.” 

An Eczema Plan is born

Not long after, Carla and her husband sought treatment at a large children’s hospital in a nearby major city. And, with some trial and error and meeting with doctors who were skilled in the latest treatments for AD, that’s when Elizabeth finally started to turn the corner.

Carla cannot stress enough that patients look for a healthcare provider who is a partner with them in their treatment journey. She says that finding a clinician who asks for your preferences, discusses your prior experiences, and partners with you to develop an eczema action plan makes all the difference. 

When they started working with their AD specialists, Elizabeth’s team started on the first rung of the treatment ladder:  gentle skin care treatments, using soaps and cleansers that are oil-based, do not contain preservatives, and moisturize the skin. Carla was previously told to avoid all soaps and cleansers and Elizabeth’s new doctors helped them identify the products that would be the best for bath time and bathing.

Next, Elizabeth’s doctors focused on the second step in the therapeutic ladder: topical corticosteroids. These options are best for mild or moderate atopic dermatitis or in combination with systemic therapies for more severe disease. Moving up the ladder can be necessary for moderate-to-severe atopic dermatitis patients.

These days, Elizabeth uses a mix of a steroid cream and a moisturizing lotion three times a day. Before bed, she bathes and uses what’s called a “wet wrap” for two hours after she applies her topical steroids. The “wet wrap” is a set of cotton clothing that Carla wets down and Elizabeth wears while watching TV before bed time. “As you can imagine, bed time takes a long time these days, from beginning to end,” Carla jokes.

Long term treatment plans are on the horizon

And, while Elizabeth is making progress, Carla shared that they have an appointment in January to discuss the third rung of the atopic dermatitis treatment ladder: systemic therapies (moderate-to-severe atopic dermatitis). One treatment option for these patients is nonspecific immunosuppressants, such as systemic corticosteroids. However, these can cause rebound flares and multiple adverse effects with long-term use.

“Her doctors think she’s a good candidate for the immunotherapy treatments and we are going to explore the options available to her,” Carla shared. Newer systemic agents are now available and approved by the FDA that target the underlying causes of atopic dermatitis, including the factors that cause itch and inflammation.

For now, though, Elizabeth is enjoying being symptom-free and she’s been able to more closely focus on what what’s really important when you are 8 and trapped at home during a pandemic: her budding YouTube channel and writing a chapter book with her mom. 

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

Med-IQ is conducting an anonymous survey and would appreciate your input. The survey will take less than 10 minutes to complete. Survey responses are shared only in aggregate. Your responses to these survey questions will provide Med-IQ with important information about your experiences with atopic dermatitis, which will help us develop future educational initiatives. 

If you’d like to participate, PLEASE CLICK HERE.

Once you’ve completed the survey, you will have the option of providing your email address to be entered into a drawing administered by SOMA Strategies to win 1 of 10 $100 VISA gift cards. If you choose to enter, your email address will be used only to randomly draw the winners and notify them of their prize. 

Links to external sites are provided as a convenience and for informational purposes only. They are not intended and should not be construed as legal or medical advice, nor are they endorsements of any organization. Med-IQ bears no responsibility for the accuracy, legality, or content of any external site. Contact the external site for answers to questions regarding its content.

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Nurse. Wife. Mom. Runner. Blogger. Writer. Thrift Shop Junkie. Sauvignon Blanc Snob.
Social Media Manager for @hermoneymedia and @jeanchatzky.

It’s time to let the world swallow your whole s It’s time to let the world swallow your  whole self, bitchachos. And you can hand the haters a glass of milk if they are having trouble. #bringit #momtruth #parentingtruth #iamwhoiam #nojoke #mywholeself
Can we all agree that our pets are the real winner Can we all agree that our pets are the real winners of the quarantine?
For six months, this dog has had four people to cuddle her, give her treats, and take her for walks at the drop of a hat. And she does not care if she interrupts a Zoom call to protect us from the UPS guy.
And, yes, she’s been forced to take more selfies than she’d like but sorry not sorry, #daisytheshihtzu.
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When I was thinking about how I wanted to write ab When I was thinking about how I wanted to write about eczema for a project with @mediqcme, 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.
Head to my IG stories to read more about life with #atopicdermatitis and how it affects almost 31 million Americans (10 million of which are kids).
#itchyskinhelp #chroniceczema #eczema #eczemarelief #atopicdermatitistreatment
Why is it that when the temp dips to 50 degrees in Why is it that when the temp dips to 50 degrees in September, I can’t wait to wear sweaters and scarves but, in April, I’m pretty much wearing shorts and tank tops?
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Do you have eczema? Does someone you know and love Do you have eczema? Does someone you know and love have atopic dermatitis, a chronic skin condition that affects more than 31 million Americans? 

Join me Tuesday, September 15 at 2p EST for a very special FB live conversation about Atopic Dermatitis with Dr. Peter Lio, Asst. Professor of Dermatology and Pediatrics at @northwesternu. 

We will be discussing what atopic dermatitis is, how it affects families, and the resources that you can trust if you, your kids, or family members are navigating a new (or ongoing) atopic dermatitis diagnosis.

Bring your questions because we will be answering them live!

Special thanks to @mediqcme for making this discussion possible!
#itchyskinhelp
On the day my son was born, my father sent us a ca On the day my son was born, my father sent us a card.
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She’s our last.
She was the last baby to walk with her fat feet on our hardwood floors.
She was the last one to go to kindergarten.
She was the one who napped on the go as her brother attended Mommy and Me classes and soccer practices.
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So. I did a thing today. I went to a NASCAR race. So.
I did a thing today.
I went to a NASCAR race.
My first.
During a pandemic.
I know, I can't believe it, either.
But, when you are married to a man who eats, sleeps, and breathes cars, eventually you come to a point in your marriage when you realize that a trip to a major speedway is a marital inevitability.
I managed to avoid it for 21 years but today was the day.
And I have thoughts, in no particular order:
1). I was not prepared for the noise of the engines. And by "noise," I mean the constant reverberation deep into your soul for three. solid. hours. Loud does not begin to cover it.
2). I watched 38 cars whizz by me 301 times. I enjoyed seeing #43 drive by 301 times. Car #32? Not so much (#32 finished 35th. I was fine with that).
3). Every single person in the grandstands complied with the mask restrictions. It's not that hard, people. I watched thousands of people do it today. You can, too.
4). We didn't see a single confederate flag. #FistBumpNASCAR 
5). I couldn't hear a thing my family said for three hours. Actually, almost four hours. This was a major bonus.
6). Earplugs are necessary. Again, see #5.
7). The universe did me a solid and provided me with an overcast day as I did my "wifely duty" and pretended to be interested in the parade of cars that monotonously sped by me every thirty seconds. If it had been 100 degrees (like it apparently was last year), this status would be very different.
8). 301 laps takes a really long time. Like, a really long time.
9). I think NASCAR would have a bigger fan base if they served frozé wine and provided charcuterie. Hear me out on this, NASCAR.
10). Watching my husband and Fruit Loop #1 scream at each other (because noise and ear plugs) and gesticulate wildly at whatever was happening on the track while they soaked in their first NASCAR race together made it all worth it. I think. #PleaseLetUsHaveUsedEnoughHandSanitizer.
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Well behaved women never make history...or some sh Well behaved women never make history...or some shit like that. 😏 
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143 days. I took this picture 143 days ago. I was 143 days.
I took this picture 143 days ago.
I was in Palm Springs and I had taken a tram ride with @mommybacktalk to San Jacinto National Park.
We hiked several miles for this view and I remember feeling relaxed and free of stress.
We were in PS to attend a conference and the whispers of an unknown virus were starting to swell.
“A virus out of China.”
“There’s no vaccine and it’s highly contagious. It could become a pandemic.”
“Wait. Corona is a beer...”
Though we didn’t shake hands with attendees, for the most part, we went about the business of “normal” life.
At a dinner with @monicagsakala and @mommybacktalk, we threw back glasses of wine and talked long into the night over gourmet macaroni and cheese that tasted like actual heaven on a fork.
We talked about politics, current events, and books we loved. No stories about kids, no griping about husbands. Just intelligent, stimulating conversation that I now realize was going to become a lifeline only a few weeks later.
I have no pictures of that dinner.
Just the memory of being with two good friends when life didn’t feel so fractured.
Now those friends are hours away, whether by car or plane, and I think about that night in CA almost every day.
The me from 143 days ago had no idea what was coming.
The me at the top of the mountain in the picture didn’t know that she should have savored the fresh air more, that she should have relished what it was like to be one in a crowd on a tram headed to scenic vistas.
I’ve been quiet here on IG because everything feels too much.
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I’ve been wearing a mask, using hand sanitizer, and obsessively watching the news for a sign that we are all going to be okay.
I’ve been looking for small pockets of joy in the middle of the dumpster fire that life has become.
And, I’m realizing that we are all climbing one hell of a mountain, together.
And, at some point, the view is going to be gorgeous.
We just have to keep climbing.
No matter how much our legs are telling us it's too hard to go on.
#keepclimbing
My old life was exhausting...what parts of your pr My old life was exhausting...what parts of your pre-quarantine life are you not going back to when your community opens up fully? @mommyneedsalife #quarantinelife #quarantineandchill #lifewithteens #parenting #parentingteens #momtruth #momhumor #momlife #motherhoodunplugged❤️
It was clear from the start that my kids got a goo It was clear from the start that my kids got a good one. ❤️ #happyfathersday2020 #pandemicparenting #lifewithteens #parentingteens #dadlifeisthebestlife #fathersday #fathersday2020 #quarantinelife
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Those words seemed to be on auto repeat last summer.
He had a social life.
I had the driver’s license.
He wanted to stay a half hour later.
I gave him all kinds of hell for upending my evening so that he could hang for a bit more with his friends.
But then he bought his car.
And passed his driver’s test not long after.
My car hasn’t found him folding his lanky frame into the passenger seat in almost a year.
I miss seeing him there.
Tonight, I wanted to see my friends for a couple of socially distanced glasses of wine and I didn’t want to drive.
“Hey, I’d like to hang out with my friends tonight. Can you give me a ride?” I said to him.
And of course, he took every opportunity to give me a dose of my own medicine in jest:
“You know, I have plans this evening, too, Mom.”
“I want you outside by 830p because I’ll be waiting.”
“No, you can’t stay til 9, I don’t care what the other moms are doing.”
It was a full circle moment.
After he picked me up and we swung by the local ice cream shop so he could get a treat for him and his sister, we drove home with the windows down on a summer night.
For a few moments, it was like old times.
I’ve missed him, even though we’ve been home together for months in quarantine.
And when Def Leppard blared on the radio and he dialed it up while singing every word, I remembered what it was like to be seventeen. @joe_burke0227 
#lifewithteens #momofteens #quarantinelife #quaranteens #pandemiclife #parentinginquarantine #momtruth #motherhoodunplugged #momofteenslife
We can get new backpacks and lunch boxes, too, rig We can get new backpacks and lunch boxes, too, right? @ellie_schnitt #pandemic2020 #pandemiclife #quarantinelife #quarantineandchill #workfromhomemom #workfromhomelife #momofteens
#blackoutday2020 #blackoutday2020
Moms are gonna drop it like it’s hot, yo. #tgif Moms are gonna drop it like it’s hot, yo. #tgif #thankgoditsfriday #pandemiclife #quarantineandchill #quarantineandchill2020 #momlife #momtruth #lifewithteensandtweens #lifewithteens #letsgetthispartystarted🎉 #quarantinesucks😷
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