quarterly - eczema association of australasia inc · 4 eczema quarterly summer 2015 ea ert...

Summer 2015 www.eczema.org.au 1

quarterly

ECZEMA EMERGENCY

9 HomeRemedies

VITAMIN D & Eczema

KEY TO FOOD

2 Eczema Quarterly Summer 2015


Silver Members

Bronze Members

Gold Members

Introduction

Hello to all and hope you have not had too much trouble with your skin with the onset of the warmer weather.

During the last few months we attended the Brisbane and Melbourne GPCE’s, which are conferences for General Practitioners. We were very well received at both conferences, with many GP’s excited to learn that we existed and requesting information for their practices to distribute to eczema sufferers that they see.

I also attended the EANZ Summit in Auckland which spearheaded Eczema Awareness Week in New Zealand. We had wonderful support from our New Zealand corporate members and some fantastic speakers – Dr Diana Purvis, Paediatric Dermatologist, Dr Kahn Preece, Paediatric Immunologist, Pauline Brown, Clinical Nurse Specialist, Associate Professor Rohan Ameratunga, Allergy Specialist and Catherine Martin, Advisory Pharmacist. I learnt so much from listening to them all. There was also a heartrending story about her daughter’s eczema complications which resulted in surgery from Susan Domett, an eczema sufferer herself.

You may have noticed that we have changed our magazine name to ECZEMA QUARTERLY. We have decided to do this because ECZEMA emphasises the magazine’s impact and importance to the eczema community and identifies directly to its function as a specific Eczema educational, support and management publication and also to enable the publication to be relevant to the Australasian community (including New Zealand) as a whole. Thus the EAA can state that the publication is “The Official Magazine of the Eczema Association of Australia and New Zealand” as the EANZ was officially launched in November 2015.

We very much welcome on board our new Australian and New Zealand Corporate Members. Our sincere appreciation to all those who have been so supportive over the last 12 months – family members and our corporate members – your help is crucial to our existence. Thanks also to those medical professionals that have helped with advice and to Tony Maughan and Mike Chapman of MWC Media for their ongoing assistance with special thanks to Amirul Nasir who formats our fabulous magazine.

I would also like to thank all our volunteers, in particular Chris Dewey who does an outstanding job updating the EAA website.

The EAA office will be closed from Monday 21 December 2015 and will reopen on Monday 11 January 2016. From all of us at the EAA, hope you have a wonderful Christmas and Happy New Year.

Cheers & best wishes, Cheryl Talent

A message from the EAA President

03 From The President A message from the EAA President

04 The EAA Report The latest news that concerns you

08 Product News Information about the latest products

10 News 9 Home Remedies for Eczema

12 Feature Letter From a Sufferer

15 EANZ The Eczema Association of New Zealand officially Launches

16 Cover StoryIs Having a House too Clean giving your Children Eczema?

19 Case Study Vitamin D & Eczema

22 Education Childhood Atopic Eczema and Different Ethnic Skin Types

24 Myths & Facts Q&A on Sunscreen

26 Q&A Our Expert answers your questions

28 Great Recipe Ideas Delicious and easy eczema recipes

30 Opinions Eczema Emergency

All Correspondence to:Eczema Association of Australasia IncPO Box 1784 DCCleveland QLD 4163Ph: 1300 300 182 or 07 3206 3633Fax: 07 3206 3666www.eczema.org.au

Emails:[email protected] [email protected]

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EAA Quarterly Magazine Editorial & Advertising:[email protected]

DisclaimerReaders are advised that EAA Quarterly cannot be held responsible for the accuracy of statements made in the advertising. Opinions expressed throughout the publication are the contributors own and do not necessarily reflect views or policy of EAA Quarterly. While every reasonable effort has been taken to ensure the accuracy of the information contained in this publication, EAA Quarterly disclaim all responibility for any loss or damage suffered by readers of third parties in connection with the information contained in this publication.

Warranty and IndemnityAdvertisers and/or advertising agencies upon and by lodging material with EAA Quarterly for publication or authorizing or approving of the publication of any material indemnify EAA Quarterly, it’s servants and agents against all liability claims or proceedings whatsover arising from the publication and without limiting the generality of the foregoing to idemnify each of them in relation to defamation, slander of title, breach of copyright, infringement of trademark or names of publication titles, unfair competition or trade practices, royalties or violation of rights or privacy regulations and that its publication will not give rise to any rights against or liabilities against EAA, its servants or agents and in particular, that othing therein is capable of being misleading or deception or otherwise in breach of Part V of the Trade Practices Act 1974.



EAA Report

Researchers say this new type of cell may trigger severe food allergy reactions, and their discovery could lead to a possible treatment.

Researchers may have uncovered a new type of cell that could unlock some of the mysteries of severe food allergies and perhaps lead to new treatments.

The discovery was made by scientists at Cincinnati Children’s Hospital Medical Center.

They published their findings today in the journal Immunity.

In their report, the researchers said they have identified a cell that produces large amounts of an inflammatory immune protein that amplifies anaphylactic shock when foods such as peanuts and shellfish are eaten.

“Without these cells, you will not get severe food allergies,” said Yui-Hsi Wang, Ph.D., a researcher in the division of allergy and immunology at the Cincinnati medical center, in a statement.

Finding the Trigger Cells in Mice

In their research, Wang and his team fed an egg-white protein to trigger allergic reactions in several strains of lab-bred mice.

They noticed some of the mice developed large amounts of mucosal mast cells called MMC9. These cells produce significant amounts of the immune protein, interleukin 9 (IL-9), which is believed responsible for the severe reaction in some food allergies.

The researchers said the mice that produced intestinal MMC9 cells had serious allergic reactions. The mice that did not produce any MMC9 cells had only minor allergic responses.

Certain people must have this type of cell in their G.I. [gastrointestinal] tract.

Yui-His Wang, Cincinnati Children’s

Hospital Medical CenterTo confirm their results, the researchers

injected an antibody into the mice that had severe reactions. The antibody eliminated the MMC9 cells and the food allergy reactions dissipated.

When the cells were reintroduced into those mice, the food allergy reactions returned.

The researchers then examined small biopsy samples from the intestines of food allergy patients. They found significant genetic impressions of the IL-9 protein in those samples. The researchers are now trying to find the human equivalent of the MMC9 cells they found in the mice.

“Certain people must have this type of cell in their G.I. [gastrointestinal] tract,” Wang told Healthline.

How This Information Could Help

Food allergies affect 4 to 6 percent of children and 4 percent of adults, according to the Centers for Disease Control and Prevention.

Eight types of food account for 90 percent of all reactions, according to the American College of Allergy, Asthma and Immunology (ACAAI).

They are eggs, milk, peanuts, tree nuts, fish, shellfish, wheat, and soy. In children, the most common culprits are milk, eggs, and peanuts, according to the ACAAI website.

Wang noted that 40 percent of children have some food sensitivity, but only 8 percent of that group develops severe food

allergies that lead to anaphylactic shock.He said his team suspects that some

people are genetically wired to have higher food sensitivity, but they aren’t certain yet why some people have such violent reactions.

Wang said his team’s research could help pinpoint exact causes for this ailment.

He also hopes that identification of specific cell types could lead to biomarkers that could be used for blood tests to diagnosis food allergies.

A Treatment in the Future?

Right now, the best treatment for food allergies is to avoiding eating the foods that cause the reactions.

This is sometimes easier said than done, especially when people eat in restaurants or when children eat at schools.

Some allergists will prescribe an epinephrine auto-injector for patients with severe allergic reactions to food. In November 2013, President Obama signed a law that encourages states to require schools to have the auto-injectors on hand.

Wang said he hopes his research can lead to a treatment so people wouldn’t have to avoid certain foods or use an auto-injector in an emergency to stabilize a reaction.

However, Wang said such a treatment is most likely a number of years away.

“We’d like to identify some compounds that could inhibit this activity,” Wang said. “That is a dream for the future”.

www.healthline.com/health-news

Scientists Discover New Cell That May Be Key to Food AllergiesWritten by David Mills Published on 22 September 2015


EAA Report

Making Headway Toward Causes of Eczema Researchers say they now know of 31 gene variants linked to the skin condition

New gene variants associated with the skin condition eczema have been identified by an international team of researchers.

Eczema, characterized by itchy, red rashes, is known to run in families. The new findings add to the number of genetic variants known to increase risk for the condition, making the total 31.

The researchers did this by analyzing the genomes (genetic makeup) of 377,000 people worldwide.

"Though the genetic variants identified in this current study represent only a small proportion of the risk for developing eczema ... they do give new insights into important disease mechanisms," said study leader Lavinia Paternoster, an epidemiologist at the University of Bristol in England.

"Through ongoing research in this area, these findings could

be turned into treatments of the future," she said in a university news release.

All of the newly identified genetic changes play a role in immune system regulation and offer potential targets for scientists exploring new treatments for eczema, the study authors said.

The team of investigators also found evidence of some genetic overlap between eczema and other conditions such as inflammatory bowel disease. This suggests that studying these diseases together could improve understanding of the disorders and possibly lead to new treatments, the researchers said.

The study was published October 19 in the journal Nature Genetics.

Study co-author Dr. Sara Brown, an academic dermatologist at the University of Dundee in Scotland, said, "The very large numbers of participants in this research has allowed us to 'fine-tune' our understanding of eczema genetic risk, providing more detail on how the skin immune system can go wrong in eczema."

SOURCE: University of Bristol, news release, 19 October 2015

Naturopath & Medical Herbalist (specialising in skin disorders) Linda Parker ND, provides you with the knowledge and advice for getting to the CAUSE of your skin problems and curing them the natural way.

The Skin Program book, will help you de-mystify the truths about these conditions:

Before becoming a healer, as a young woman, Linda suffered from a chronic and debilitating skin condition for over 14 years. It was through her own personal discoveries and education in natural medicines that she successfully cured her own skin problem and improved her overall health. She has never looked back! Linda now shares with you the medical information and natural remedy

secrets she has learned along the way that are needed to rectify any skin problem. The Skin Program book is a step-by-step guide to lead you to clear skin! Discover and Learn:-1. How to identify hidden toxins2. Which tests are vital to have done and why3. How thyroid and hormonal imbalances affect the skin4. Common foods that you may be allergic to5. Which foods contain harmful ‘natural’ substances that may inflame

the skin6. How your home or work environments could be causing your skin

problem7. Which topical herbal creams are successful8. Specific skin visualisations to practice to recondition your mind9. Which vitamins, herbs and diet regime is critical to skin health

If you’ve had enough of bad skin, now is the time to find out how to fix it – the natural way. Linda’s excellent book will be an important part of the whole journey – not just to skin health, but to complete health.

Linda has kindly donated 50 books to the EAA. Each member will receive 3 raffle tickets, so please fill in your details on the right side of the raffle ticket/s and post them to us with your payment. Tickets are $2.00 each or 3 for $5.00. Good luck!

Member Raffle Competition

• Eczema• Rosacea• Psoriasis• Hives

• Acne• Dermatitis• Skin rashes of all

kinds


EAA Report

The EAA, under the last Queensland State Government, was informed that their state funding was to be cut after the year 2015. However, with a change of government, this funding has now been reinstated for the next 4 years. Cheryl Talent, EAA President and Terry Poulton, EAA Treasurer, attended a special afternoon tea at Parliament House in Brisbane where they met with Qld Premier Annastacia Palaszczuk & Qld Health Minister Cameron Dick (photos) who both gave terrific speeches about the importance of non-profit associations and how the government should support them as they fill resources in the health system that are not met anywhere else. Our sincere appreciation to the Queensland Health for recognising the work that we do and supporting us.

Ego Pharmaceuticals is testing a new cleanser and moisturiser that have been designed for use by those with moderate eczema

If you are over 18 years of age and have moderate eczema that has been diagnosed by a doctor, you may be eligible to participate in this trial looking at the benefits to eczema prone skin of these newly designed products. You will be asked to use the new products every day for 4 weeks.

The trial is being conducted in Sydney and participants must be available to attend 6 free dermatologist consultations (mostly on Saturdays) at a clinic in Kogarah over a 5-week period.

This trial is placebo-controlled, with half the participants receiving the active products, and half receiving the placebo products.

If you believe you are eligible please visit egopharm.com/clinical-trial

Should you have any questions about these requirements please contact Dennis from St George Dermatology on 02 9587 4277 between 10am and 3pm, Monday to Friday.

Thank you Queensland Health...

Eczema Clinical Trial

The EAA thank very much the following for their Donations:• L Reilly• I Jiang

Members Please Note:EAA new website & login details from 1 January 2016

Login: eaa2016Password: itchyskin

Special Thanks:The EAA very much appreciates the assistance given by Northline Transport, in particular Scott Dillon, Depot Manager, for organising delivery of our sample bags to the Melbourne GPCE.

NEW

Grahams Natural Alternatives was born out of the need to help our own son overcome severe Eczema as a baby back in the year 2000. After living with Eczema myself I did not want Ryan going down the same path with conventional cortisone creams that I had used over the years so my wife & I researched everything we could about skin problems.

We then started formulating products in our own kitchen with a cake mixer - we knew we needed a product that would help with controlling bacteria along with reducing the itch & inflammation associated with Eczema.

Initially we released Calendulis Plus cream & Grahams Bath oil to be used in conjunction along with an internal oil product called Mega Oil which research had taught us that people with skin problems are also lacking in the Essential fatty acids in the body.

Once approvals were completed we appeared on every national television A Current Affair programs in the early days telling our family story trying to help many Australian families going through the same problems with Eczema that we were and letting them know there is hope for a natural approach and not just conventional medicines that using long term use can have side effects.

Fast forward to 2015 and we now have a large range of products treating Eczema, Psoriasis & Dermatitis on a global scale and we are now very proud to become corporate members of the Eczema Association of Australasia Inc so please feel free to contact us anytime at 07 5596 1708 or visit www.itchy.net.au

Grahams Natural Alternatives

The ECZEMA ASSOCIATION OF AUSTRALASIA INC

relies on volunteers and part time staff.

Donations to the ECZEMA ASSOCIATION OF AUSTRALASIA INC

are tax deductible for Income Tax purposes.

Please support us by making a donation.

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Exciting news from Billie Goat! Eczema, psoriasis and dermatitis sufferers, their friends and family members can safely trust the team at Billie Goat, who have proudly pioneered Billie says “Ditch the Itch!” – a new program that offers a fun way to help kids feel comfortable in their own skin.

Billie says “Ditch the Itch!” provides insight into dealing with the issues that affect young children with eczema, psoriasis and dermatitis, which include coping with low self-esteem, managing sleepless nights and preventing infection. It can also be quite challenging for children to deal with the relentless itching and scratching, leading to loss of concentration, an inability to join in regular school activities or even days off school.

The most exciting part of Billie says “Ditch the Itch!” for kids, is a terrific trio called ‘The Itchies’ - Zema (Eczema), Erma (Dermatitis) and Sori (Psoriasis) are relatable children’s characters who have been introduced with Billie the Superhero. The motivation behind creating Billie and The Itchies was to help parents and children feel more comfortable discussing these skin conditions, removing any fear or embarrassing stigma that is usually associated with them.

We encourage everyone to register online at http://www.billiegoatsoap.com.au/cms/ditch_the_itch to take part in our 30-Day “Ditch the Itch” Challenge, follow our simple 2-step routine and be on the road to skin happiness!

And follow us on Facebook www.facebook.com/billiegoat to become part of Billie’s community, where you can share tips, success stories and experiences with other families!


Product News

increasing the moisture content and glycerine to support in the rehydration of skin.

Sebamed products DO NOT contain soap or alkali; they don’t have any colourants or irritants and are made from high quality medical grade ingredients to ensure your skin has the best protection.

Available from selected pharmacies, online at www.sebamed.com or call 1800 131 972.

that the skin is hydrated, nourished and balanced in tone. In addition, it is also almost magical in its ability to reduce photo damage, balance eczema and psoriasis and aid in scar healing” says Barbara Filokostas, Botáni Founder and Naturopath.

Loaded with Olive Squalene and enriched Vitamin C, Vitamin E and plant based nutrients Olive Skin Serum illuminates the skin, reducing fine lines, dryness and uneven skin tone, leaving a radiant, supple complexion; the perfect canvas for every beauty regime.

“Over time the Squalene that our skin produces naturally begins to decline therefore it is important to replicate these hydrating properties by replenishing the skin daily with the Squalene found in Olive Skin Serum. Hydration is proven to increase by 30% within 24 hours of the initial application.” says Barbara Filokostas.

Botáni Olive Skin Serum $31.95 rrp is available from Priceline, independent health food stores and pharmacies.

To learn more about how Botáni Olive Skin Serum intuitively hydrates and nourishes the skin please view: http://www.youtube.com/watch?v=giFq7u2W0LA and visit BOTANI SKINCARE on facebook for competition, specials and more information.

We have 25 Botáni Olive Skin Serum bottles to give to the first 25 members who visit www.botani.com.au and ring the EAA with the answer to this question “What does Olive Skin Serum contain?”

Ideal for the whole family, Sebamed medicinal skincare system is recommended by leading dermatologists for everyday care of healthy skin and to actively assist in the treatment of sensitive and problem skin.

Sebamed products have been developed by dermatologists to cater for the needs of your skin, even the most problematic of skin. The skins surface has a natural protective layer called the acid mantle. This protective layer has a slightly acidic pH value of 5.5 which helps our skin ward off harmful outside influences such as wind, sun and air pollution that cause our skin to become dry, stressed or irritated.

The entire Sebamed product range is balanced to the healthy pH of 5.5. Eczema suffers know the feeling of stressed, dry and irritated skin – they also know the feeling of crusty, scaly and sore skin – Never fear though, Sebamed is here!

Where most conventional soaps strip away the protective acid mantle; Sebamed cherishes, protects and aids the development and strengthening of beautiful skin.

Sebamed have specially formulated products to aid all eczema suffers to have soft, supple skin! Using ingredients like panthenol to aid in the regeneration of the skin, shea butter and jojoba oil for

Sebamed

Barbara Filokostas from Botáni - Naturopath and Owner - 13 year plant active based skincare range Q: What natural ingredient solutions can I consider for eczema skincare?A: Botáni Olive Skin Serum is a natural protective barrier for skins surface whilst allowing skin to breathe.

The active olive squalene resembles the natural squalene in the skin and has an excellent safety profile - protecting the skin from oxidation and preserving the integrity of the skin. Olive squalene has anti-inflammatory properties which calms itchy, eczema skin.

Other Botanical herbs, vitamins and minerals Barbara suggests adding to diet include organic olive oil for anti-inflammatory properties, zinc, vitamin A. Detoxifying herbs and juices are also recommended, strengthening the digestive system and and prioritise lowering stress!.

Send any Naturopathic questions to Barbara at: [email protected]

Botáni Olive Skin Serum is the ideal primer for under make up, ensuring


Product News

diseases and may prevent degenerative diseases (arthritis, cancer), disorders of the brain (depression, ADHD) as well as respiratory disorders (asthma).

Emu Oil’s benefits for Eczema are due to a combination of its penetrating and hydrating abilities, taking its nutrients through the skin’s layers, while decreasing inflammation.

Natural Body Basics stock 100% Pure Emu Oil, TGA approved, who have recognised its ability to provide relief from eczema and arthritis. Pure refined emu oil cannot grow bacteria (bacteriostatic), is anti-fungal, has no side effects, is virtually odourless, has a long shelf life and doesn’t require harmful additives. It is a natural preventative and first aid kit.

For more information visit www.naturalbodybasics.com.au or call 03 5221 7704.

Emu Oil is an amazing product which is beneficial due to its unique composition and is rich in Vitamin E, (an anti-oxidant and healing agent), Vitamin A (known to repair skin), Vitamin D and F. It contains terpenes (an antiseptic), sapiens (a skin softener), linolenic acid (a muscle and joint pain reliever) and oleic acid (a skin cell regenerator and anti-wrinkle agent). Emu Oil’s essential fatty acids (Omega 3, 6, 7, 9) have an anti-inflammatory effect on the dermal tissues as its composition is similar to our skin’s own fatty acid composition.

Emu oil can be applied directly onto the skin or taken as a capsule and due to its unique structure and Omega 9 content, it penetrates through skin without clogging pores. Used to treat skin conditions such as eczema, psoriasis, dermatitis, general dryness, rosacea, acne, nappy rash, cradle cap, stretch marks, cuts, bruises, sunburn and insect bites, emu oil has also been used in burns units to reduce pain, speed healing, promote regeneration of skin tissue and reduce scarring.

Emu Oil is a powerful anti-inflammatory that can benefit people with arthritis as it reduces pain, swelling and stiffness in the joints and muscles. Emu Oil’s Omega 3 is thought to reduce the risk of heart

Emu Oil - A Natural Healer!

Comvita Medihoney RangeNo matter how old or young you are, the irritation from dry skin conditions can cause a burden that may be difficult to manage. By using natural products that help lock in the moisture, you can find relief for your skin and live a life free of the constraints of eczema.

When your skin is imbalanced and dry, it’s important to create and maintain a balanced level of moisture and hydration for both comfort and relief. If your eczema becomes worse and results in cracked or broken skin, you will need to treat the affected area with a sterilised ointment to reduce the risk of infection and promote skin healing.

Eczema sufferers can find relief though the Comvita Medihoney® range. Medihoney is a topical application that is placed directly on the skin. It helps repair dry skin conditions by creating an environment that assists with healing through a moisture rich natural barrier against bacteria.

As the skin gains moisture and protection, the itchy, irritated condition lessens and the sufferer finds relief. Medical honey has been used for aiding skin conditions for centuries due to the antibacterial agents that are found within it naturally. It has been shown to help with healing and relief from skin irritation.

Comvita has developed a Medihoney® eczema care system designed to help manage the different stages of eczema. The

range of Medihoney® products has been dermatologically tested as suitable for all the family, and is specifically formulated to help bring relief to sensitive, dry or eczema-prone skin. With their pure source ingredients that have been harvested with care in order to preserve their natural healing properties, you can trust the freshness and purity of the Medihoney range.

Comvita Medihoney® is available in lotions, creams, gels and a soap free body wash, so it’s suitable for any member of the family to use, everyday. Find out more about how Medihoney® can help you have healthy skin at www.comvita.com.au/medihoney.


Feature

Scratch, scratch, scratch. That is the sound of eczema, and anyone who suffers from the condition knows that sound all too well. Nobody knows exactly what causes eczema. It could be genetics. It could be allergies. Or it could be caused when skin is exposed to certain irritants such as soaps, disinfectants, hot weather or cigarette smoke. Regardless of the cause, the condition itself is marked by dry, red, thickened patches of skin that are almost unbearably itchy.

Eczema is not contagious, but it is very common. According to the National Eczema Association, 31.6 million Americans suffer from eczema. In children, the ratio is as high as one in three. That’s a lot of itching and scratching! The good news is that there are a number of natural ways to relieve the symptoms of eczema at home. Here are a few to try:

1. Reduce stress. I know, I know. That’s easier said than done. But research shows that stress triggers or aggravates eczema. So if the condition is plaguing you, it makes sense to minimize stress as much as possible. Cognitive behavioral therapy may help you learn new techniques for dealing with the stressors in your life.

2. Avoid irritants. Foods such as tomatoes, dairy products, nuts, fish and eggs

have been known to aggravate eczema. So has exposure to wool, synthetic fibers, pollen, pet dander, cosmetics, detergents, certain soaps, cigarette smoke and sand. Learn which triggers affect you and make an effort to avoid them.

3. Slather on the oil. Many eczema sufferers swear by the moisturizing powers of coconut oil and/or jojoba oil to heal eczema flare-ups. Rub it on the affected areas to prevent itching and repeat throughout the day if necessary.

4. Sow your oats. Oatmeal in the tub is not only moisturizing, it also has anti-inflammatory properties that may help relieve the redness and itching of eczema. Pour about one cup of rolled oats into some cheesecloth and toss in the bath. Soak in the milky, smooth water for 10-15 minutes.

5. Make time for tea. If oatmeal doesn’t work for you, or if you want to try something else, check out chamomile tea. Put some dried tea leaves in cheesecloth and toss it in the bath. Soak for 10-15 minutes.

6. Get fishy. Research has shown that people who took a fish oil supplement experienced fewer eczema symptoms after 12 weeks than those who took a placebo. Fish oil may help heal your skin from the inside out by reducing the inflammation that can lead to itching. But talk to you doctor before adding any kind of supplement to your diet.

7. Go for the sweet stuff. Honey has both moisturizing and anti-inflammatory properties that are great for reducing the symptoms of eczema. Unfortunately, it is way too sticky to cover large patches of eczema. But if you have a small, irritated patch of skin, it may benefit from a dab of honey.

8. Heal blisters and open sores with witch hazel. All of the itching and scratching that comes along with eczema can lead to oozing blisters and open sores. To heal these wounds, you could try applying witch hazel — either by itself or as part of a paste made with natural green clay.

9. Probiotics. Research is divided on the effectiveness of using probiotics to treat eczema. But it may be worth a try if other methods don’t seem to be effective. Probiotics can be found in supplements or in foods such as yogurt, kefir, kimchi or miso.

9 Home Remedies for Eczema

By Jenn Savedgewww.mnn.com/health/fitness-well-being

Control flare-ups and reduce the itchiness of eczema with these natural treatments


Feature

What misery eczema presents! I exclaim this even though I have not experienced the disease on any body part myself. I am Joan and care for my elderly mother, Beryl. My darling mother developed eczema many years ago, lived through multiple decades with unsightly skin, and the pain and torture of its ravishing effects – the itching, the scratching, the bleeding and the scarring. Our household medical kit overflowed with washes, creams, lotions and dressings, many types and brands inclusive of numerous prescription items. Occasionally, we thought we had found a more soothing product, but to our dismay only a few days later the eczema returned, more angry and itchy than ever before.

Frustration availed. We had consulted with ‘experts’ extensively searched for relief via the library and Internet but could find no real answers. The hours of darkness proved to be more of a problem with the constant itching causing feelings of hopelessness with resultant sleep deprivation. There seemed to be no way out.

However, at about this period in time of crisis, I had met a new friend and was regularly walking a dog with her. During our walks we felt relaxed and chatted freely about anything and everything. It wasn’t long before the subject of eczema evolved and BINGO! – she knew Dr Harley Farmer from the UK, the founder of the Execzema Programme. She told me of his passion for his work

and assured me that he had the answers to end my mother’s eczema. I was dumfounded! How could he know how to stop eczema when everyone else believed that eczema could not be cured, only managed? How extraordinary!

A few weeks later Dr Harley came to Australia and whilst here, arranged a Toowoomba visit to speak to my mother and myself. We both desperately wanted to hear how he could end the eczema and listened attentively. He explained the Science of what had been happening to my mother’s skin, how she had developed eczema and why we were unable to stop it. What he told us made perfect sense!

We were ready to follow his advice and as they say, the rest is history………. My mother has now been free from eczema for the past 4 years and continues to use the Dr Harley Products.

You will find her story in Dr Harley’s newest book, “What is eczema? A path to ending the misery” pages 89-90.

Finally, a word which best sums up Dr Harley’s approach – I’m still deciding between care, trust, confidence, scientific, humility, balance and many more. They all fit; I encourage you to work with him to find which suits you best.

Joan Flint

Eczema is surrounded by confusion while many people suffer prolonged misery. Yet the vast majority of people who ever had eczema ‘grew out of it’ forever. Two distinct groups living in the same setting; why the difference?

I suffered from severe eczema for too many years, discovered how to end it and have remained an EXeczema success for decades. I believe my eczema is cured and am intrigued by those who say there’s no cure for eczema. Are they saying I’m not allowed to end my eczema? Obviously not but the effect’s the same. It’s all playing with words while people suffer.

I could be selfish, ignore the debate, and get on with my life or I could try to help bring the two sides together. My new book What is eczema? A path to ending the misery shows how much I care and want to help. It’s written in non-medical terms with an appendix containing an up-to-date review

of the medical evidence written in medical terms. It’s rewarding to see how many non-medical readers are happily devouring the medical review! Those people quickly learn why it’s so easy to control eczema once you understand it. They then help others end their eczema.

The book’s cover could have shown a miserable eczema child. Not my style. I chose a path gently winding beside a stream. The message is that it’s up to you when you begin your journey along that path, what speed you choose, whether you take a break part way or come back to the start and stay there, or whether you proceed to the happy end.

When you’ve read the book, please let me have your comments.Dr Harley Farmer PhD BVSc(hons) BVBiol(path) MRCVSProudly Australian. [email protected]

Letter from an Eczema Sufferer

What is Eczema?

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HELP REDUCEECZEMA

SYMPTOMS

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EANZ

On Sunday November 15, the Eczema Association of New Zealand (EANZ) launched Eczema Awareness Week in New Zealand.

From November 15 to 21, Eczema Awareness Week is about education and community support for those 1 in 5 New Zealanders who suffer from eczema. It is aimed to educate eczema sufferers and carers, along with the wider community and also aimed to greatly increase public awareness in all aspects of Eczema and its impact. Eczema Awareness Week also launched the New Zealand patient support 0800 ECZEMA hotline and website eczema.org.nz which aims to provide a caring and supportive voice and resource to those who require urgent patient support, education and management tools.

Eczema Awareness Week was supported with a Community Service Announcement featuring the EANZ’s Ethics and Compliance Committee head Dr Diana Purvis. Dr Purvis is both a Paediatrician and a Dermatologist, with experience in adolescent health, neonatology, allergy and rheumatology. Dr Purvis consults at the Starship Children’s Hospital in Auckland. She is a member of both the New Zealand Dermatological Society and the New Zealand Paediatric Society and belongs to the Allergy Special Interest Group. A good cross section of media exposure was initiated with Dr Purvis which included television, radio and print media interviews.

Also heavily promoted was the EANZ’s flagship launching event, the Eczema Summit which was held in Auckland on November 15. The Eczema Summit featured an array of speakers covering a variety of eczema care topics. The featured speakers included, EAA/EANZ President Cheryl Talent, Dr Diana Purvis, Dr Kahn Preece, Pauline Brown, Susan Domett, Associate Professor Rohan Ameratunga and Catherine Martin. The EANZ wish to formally acknowledge and thank them for the first class education provided to the audience which was made up of eczema sufferers and their carers.

The EANZ also thanks the corporate members who made it financially possible to stage the Eczema Summit and Eczema Awareness Week – they include Comvita, Johnson & Johnson, Galderma, Seqirus, Oasis Beauty and Hopes Relief.

The Eczema Association of New Zealand launches Eczema Awareness Week

New Zealand Eczema Awareness Week and The Eczema Summit was proudly supported by:

eczema association new zealand

support education management

eanz summiteczema

Alexandra Park Sunday November 15

eczema association new zealand

support education management

eanzthe

Dr. Diana Purvis

Susan Domett

Comvita Stand at The Eczema Summit


Feature

Hit or myth: Is being too cleaning affecting skin? A growing number of children are being diagnosed with the allergic skin condition eczema with rates tripling during the past three decades.

The latest figures from the National Eczema Society show a startling one in five children currently suffer from this itchy and often painful condition.

Many experts now believe a key factor behind this rise is our obsession with “ultra-cleanliness” which can disrupt the development of a healthy immune system in young kids.

A Swedish study this year added weight to this theory by revealing that kids whose parents washed the family’s dishes by hand – not in a dishwasher – were significantly less

likely to develop eczema.This implies that because hand-washing

plates is less effective, these ¬children are exposed to more bacteria which actually improves their immune system.

How the condition can affect children

Eczema is a chronic skin condition that usually starts in childhood and causes patches of skin to become dry, inflamed and often intensely itchy.

If not properly controlled, outbreaks can weep, bleed, crust over, become infected and cause extreme discomfort – including disturbing children’s sleep.

Research published in the journal Psychology Today found that over 80% of children with eczema have trouble

sleeping. It can also lead to time off school and ¬avoidance of swimming and PE lessons.

And, for kids with conspicuous rashes, there can be emotional consequences. “They can be teased or bullied,” says Dr Anthony Bewley, a consultant dermatologist at Barts Health. “One of the reasons I became a dermatologist was because I had eczema as a child. I still remember other kids being cruel and calling me names like ‘leper’.”

Why is it on the rise?

“Although the condition has a strong genetic component, our modern lifestyle habits are likely to be a factor in the soaring rates,” explains Dr Bewley.

Is having a house that’s too clean giving your children eczema?

Here we investigate the alarming rise in young eczema sufferers and how best to tackle it


Feature

Here are some of the key triggers:

It runs in the family If a parent has or had eczema, their child is 60% more likely to get it. This rises to 80% if both parents have it. This is almost certainly down to one or a group of eczema genes.

The inherited genes lead to a deficiency in a particular protein that’s important for keeping the skin moist by acting as its barrier. Not producing enough of this protein means the skin dries out, becoming itchy and inflamed.

Our homes are too clean

Its distinctive itchy patches of skin are a sign that your immune system has overreacted to harmless allergens and has triggered the inflammatory process.

This is where the so-called “hygiene hypothesis” comes in. The theory is based on the belief that early exposure to many different bugs and bacteria ensures our immune system develops properly so it doesn’t overreact to innocent substances.

Growing up in a clean environment may disrupt this process and increase the risk of allergic conditions – which may explain why research shows farm-born kids suffer less eczema.

“We also know that first borns get it more,” says Dr Bewley. “This may be because new parents are more concerned with hygiene and have more time to keep everything sterile, while with later kids, this tends to relax so they’re exposed to more germs and their immzztune system is better primed.”

We bath kids too much

Some 50 years ago, “bath day” was once a week, but today it’s a daily occurrence for many babies and kids. “Washing too frequently with detergent-based soaps – basically anything that foams – strips the skin of the natural oils which form a ¬protective barrier and lock in moisture,” says Dr Bewley. “We know this can trigger eczema flare-ups in susceptible patients.”

Life is more stressful

Exam stress, bullying and family problems can all make eczema worse in children. “This is because our brain is connected to the skin by nerves,” explains Dr Bewley. “When the brain is struggling to cope, it sends messages to nerves which trigger skin inflammation.”

What treatments will work?The good news is some 95% of children will grow out of eczema by the time they’re 11. In the meantime, here are the best ways to control it:

Keep skin well moisturised

It’s vital to protect the skin barrier at least twice daily with emollients – barrier-repairing moisturisers. A lotion, which rehydrates and protects skin from irritants, but needs application frequently or a cream which is longer lasting, both help restore the skin’s barrier. Either is suitable but make sure they are hypoallergenic and suitable for problem skin.

Be careful how you wash

Soap is too harsh for eczema sufferers and avoid any washes containing sodium laurel sulphate which can irritate skin. Emollient wash creams are best or hypoallergenic shower/bath oils.

Don’t be afraid to use a steroid cream

“They’re still the most effective way to get eczema under control quickly,” says Dr Bewley. “But there are so many misconceptions about safety that worried parents often use them too sparingly.”

Steroid creams treat eczema by reducing inflammation and are very effective in controlling flare-ups if applied correctly. But research shows that if you don’t use enough to cover the whole inflamed area, you won’t control the eczema and will end up using more of the cream in the long term.

“Yes, steroids can sometimes cause ¬thinning skin, but only when used without

supervision,” points out Dr Bewley. “The milder products most patients need to use are very safe.”

Control the itch One of the worst things about eczema for children and babies is the continual itching which causes sufferers to scratch their skin and make it bleed. This can, in turn, lead to skin infections that require antibiotic treatment. Oral antihistamines can be used to help control itchiness and help children to sleep through the night.

Nails should also be kept short and you can buy cotton gloves for babies to wear.

Cotton clothing worn next to skin is also better than wearing man-made fabrics.

Consider their diet

“Only a small number of ¬children with eczema, generally those under three, seem to be helped by changes in diet,” says Dr Bewley.

“In this case, it’s usually down to intolerance to dairy which can be cut out of the diet for six weeks to see if the skin improves.”

The omega-3 fats in certain fish may also ease eczema symptoms for some sufferers. This means eating a portion of oily fish such as salmon, fresh tuna or sardines once a week.

Kids aren’t often keen on the taste so they may be better off trying a chewable supplement such as Blackmores Kids Fruity Fishies.

Manage stress levels

Try to tackle any problems at school or at home by talking to your child – or your GP. “There’s also interesting work being done with a ¬“mindfulness” technique that focuses on habit reversal and can help some kids who have got into the habit of scratching all the time – even when their skin isn’t itching,” says Dr Bewley.

www.mirror.co.uk


Case Study

INTRODUCTION

A recent systematic review article on advances in our understanding of the treatment and prevention of atopic eczema, reviewed the published evidence between January 2012 and December 2013. An overarching concern expressed by the article was that studies carried out on eczema were not large enough nor were the trials methods consistent across the studies, meaning that results could not be accurately compared. Indeed the authors stated: ‘It is disappointing to find so many systematic reviews that have been unable to reach clinical conclusions because of variability of atopic eczema trials in terms of design, timing of outcome assessment, choice of outcomes and lack of basic methods to avoid bias.’

This is an important point as it reminds us that, whilst research is critical, actually what we really need is excellent research that provides answers to pertinent questions.

WHY IS VITAMIN D IMPORTANT?

Vitamin D is vital for bone health – lack of vitamin D is known to cause rickets in children and Osteomalacia in adults. This is related to absorption of calcium and the resulting bone strength. However, what is increasingly recognised is that vitamin D is likely to be important for numerous other health issues. The fact that many different types of body tissue, including skin, have receptors for vitamin D suggests that it is has a role for functioning of these organs, and may therefore have a role in the organ pathology.

Rebecca PenzerDermatology Specialist Nurse and Visiting Lecturer at the University of Hertfordshire.

Vitamin D & Eczema

It seems that vitamin D could help to treat eczema but as yet research hasn’t really shown us why, this article explores some of the evidence available and – although there aren’t answers yet – it is certainly an interesting area for research in the future.


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Vitamin D is a collective word used to describe a number of organic compounds that are responsible for enhancing intestinal absorption of calcium and phosphates. Two important, closely related forms of vitamin D and vitamin D2 (ergocaliferol) and vitamin d (cholecalciferol). The two main sources of vitamin D in the body are through diet and the action of UV light on the skin. Vitamin D is found in alfalfa shoots and mushrooms, while the most common source of vitamin D3 is fish.

Researchers are beginning to look at the role that vitamin D plays in immune development and immune-related disorders. Work looking at inflammatory disorders. Work looking at inflammatory bowel disease. The proposition is that this inflammatory response affects immune development and function and in turn may manifest itself through other inflammatory diseases such as eczema.

DOES VITAMIN D AFFECT ECZEMA?

As indicated at the start of this article the evidence for the impact of vitamin D on eczema is inconclusive. However, research in this area is in its infancy and in the future a causative link may yet be demonstrated. The results from various studies are as follows: Within Madhok et al’s 2015 article (mentioned in the introduction) was a small paragraph on Vitamin D and eczema. It made mention of three observational studies that formed part of a subgroup analysis in a review by Christensen et al. on the impact of vitamin D in pregnancy on extra skeletal health in children. Mothers-to-be took vitamin D supplements and the incidence of atopic eczema in their children was measured at various points following birth. One study suggested there was a decrease in eczema in the child (as reported by the parents) following maternal supplementation while the other two studies showed no positive benefit.

In a large American study where maternal prenatal blood samples and cord samples were examined, it appeared that low maternal vitamin D led to an increased chance of childhood eczema; the association was stronger in white children than black, but the differences were not statistically significant. The study also stated that children with higher levels of vitamin D had fewer allergy-related outcomes including eczema.

A smaller Taiwanese study also indicated that lower levels of maternal vitamin D are associated with a higher incidence of eczema in early childhood.

References1. Madhok V, Futamura M, Thomas KS & Barbarot S (2015.) What’s new in atopic eczema?

An analysis of systematic reviews published in 2012 and 2013. Part 2. Treatment and prevention. Clinical and Experimental Dermatology, 40(4):349-55

2. Christesen HT, Elvander C, Lamont RF & Jorgensen JS (2012) The impact of vitamin D in pregnancy on extra skeletal health in children: a systematic review. Acta Obstet Gynecol Scand 91:1368-80

3. Wegienka G, Havstad S, Zoratti EM, Kim H, Ownby DR & Cole Johnson C (2015) Association between vitamin D levels and allergy-related outcomes vary by race and other factors. Journal of Clinical Immunology June 2015 [E-pub ahead of print]

4. Chiu CY, Huang SY, Peng YC, Tsai MH, Hua MC, Yao TC, Yeh KW & Huang JL (2015) Maternal vitamin D levels are inversely related to allergic sensitization and atopic diseases in early childhood. Pediatric Allergy and Immunology 26(4):337-43

5. Galli E, Rocchi L, Carello R, Giampietro PG, Panei P & Meglio P (2015) Serum Vitamin D levels and Vitamin D supplementation do not correlate with the severity of chronic eczema in children. European Annals of Allergy and Clinical Immunology 47(2):41-7

6. National Institute for Health and Care Excellence (2014) Vitamin D: increasing supplement use among at-risk groups. www.nice.org.uk/guidance/ph56 [last accessed June 2015]

This article was obtained from Exchange Magazine published by the National Eczema Society

Another key area of research involves looking at whether childhood vitamin D levels correlate in any way to the severity of eczema experienced and whether taking vitamin D supplementation makes any difference. An Italian study showed that there was no difference between vitamin D levels in those with severe eczema and those with mild to moderate eczema. What’s more, supplementation did not influence disease severity or immune response.

CONCLUSION

The evidence for association between eczema and vitamin D remains weak and further well-designed studies in this area are required to provide clearers answers. As NICE guidance now recommends that all pregnant women take supplements, it will be interesting to see in the future whether population studies show a decrease in the incidence of eczema as two of the studies referred to in this article indicate they might.

Which groups are most at risk of vitamin D deficiency?

The National Institute for Health and Clinical Excellence recognises that there are five groups who are particularly at risk of vitamin D deficiency. These are:• all pregnant and breastfeeding women;• infants and children under the age of five;• adults over the age of 65;• People who have low or no exposure to sun. (for example: older

people who are not able to get outside – sunlight exposure through glass filters out essential UV rays and will therefore not generate vitamin D. women who, for cultural reasons, keep their skin covered);

• and People with darker skin as their mechanism for generating vitamin D from sunlight is less effective.

All these at-risk groups are advised to take vitamin D supplementation.

What is vitamin D and how is it produced on the body?

Case Study


Education

Childhood atopic eczemaand different ethnic skin typesThe UK has a multi-ethnic population. Eczema affects people of all ages and all ethnic skin types. Childhood atopic eczema is very common, and has increased significantly in the past few decades. It now affects 20% of children in the UK aged between 3 and 11 years.

Prevalence among ethnic populations Health population studies have shown that atopic eczema occurs more often in British-born Black African, Black Caribbean or Asian children than their counterparts in the Caribbean, India and Pakistan.1,2 In fact, one study showed that black children with atopic eczema have a six-fold increase in severe eczema, when compared to their counterparts growing up in the Caribbean. When children are taken back to their country of origin, their eczema improves, only to relapse on their return to the UK. This is partly explained by the differences in the UK environment in terms of lifestyle, climate and the home.

The changing in seasons and fluctuating temperatures indoors and outdoors in the UK can all aggravate eczema, whereas in places like India, Pakistan, Africa and the Caribbean, the temperature is more constant and the higher humidity can also be better for eczematous skin, compared with the dry atmosphere of centrally heated, poorly ventilated rooms in the UK. Although many people find that their eczema improves with visits to warmer, moist climates, some report a flare-up in hot weather. Cool, cotton clothing and lighter or less greasy emollients may be required at these times.

People in hot countries tend to spend more time outdoors and so are less exposed to the house-dust mite, another eczema trigger. Carpet and soft furnishings in UK homes harbour house-dust mites, while condensation in bathrooms and kitchens leads to the growth of mildew and mould, which can exacerbate eczema. And according to the ‘hygiene hypothesis’ our over-sanitised environment in the UK, may also contribute to the problem - in other words, increased contact with parasites and germs found in tropical and developing countries might provide some protection against eczema by generally boosting the immune system.

Familiarity with the condition and early intervention also make a difference in how eczema develops and responds to treatment. For example, severe eczema in black skin has a different appearance to eczema in white skin, and is not always so easily recognised by healthcare professionals.3 This might account for the increased incidence of severe eczema among this population. Although a study in Leicestershire 20 years ago revealed that atopic eczema was more common among Asian patients,4 a follow-up study in the mid-1990s suggested that there was no difference in the number of white and Asian children referred to the Leicestershire Royal Infirmary with atopic eczema – in fact, the increased numbers of referrals from the

Asian community in the area resulted from a lower level of familiarity about atopic eczema.

Cultural attitudes Eczema affects the quality of life not just for the person with eczema, but their family too. A study at Birmingham Children’s Hospital,5 using English and Urdu versions of standard dermatological questionnaires, showed that quality of live is affected to a similar degree in different ethnic groups. However, white children and their parents were more concerned about the pain and discomfort, whereas those from ethnic minorities were more upset by the appearance of their skin. Caucasians worried more about their eczema never getting better, whereas ethnic minority groups worried more about permanent scarring. In cultures where families focus on marriage prospects, appearance is particularly important.

Eczema in black skin When eczema affects people with black skin, the appearance may be varied, although some common presentations include ‘the reverse flexural pattern” in which the outer or extensor surfaces are involved, instead of the creases of the elbows, wrists and knees. Also, a popular pattern of eczema, characterised by fine bumps, is usually prominent over the trunk. The skin is often very dry and flaky and may have a whitish or ashen look if it is not frequently moisturised. Sometimes, diagnosis has to rely on other symptoms, such as lumpiness, tenderness, oozing, skin temperature or scratch marks.

Active eczema in black skin makes the skin inflamed and red, although – to those who are not familiar with examining dark skin – the redness or erythema may be difficult to detect. This often means that health professionals may underestimate eczema in black skin unless it is very severe. However, the affected individual or parent will usually be able to point out any redness on their own skin or that of their child. As inflammation settles, the colour of the skin in black people often changes to become very dark or hyper-pigmented. Alternatively, the skin may become lighter or hypo-pigmented. These dark or pale patches can take a long time to settle down and may be very distressing for those affected. Constant scratching and rubbing of itchy areas may lead to the skin at these sites becoming thickened with increased skin markings – this may look like the bark of a tree and is called ‘lichenification’. Long-term pigmentary changes can be minimised by early recognition and prompt and aggressive treatment of active eczema.

As with people of all skin colours, the mainstay of treatment is the use of emollients or medical moisturisers to all of the skin, and localised application of topical steroids or topical calcineurin inhibitors to the active areas only. Because most black people with eczema have dry or very dry skin, greasier moisturisers such as ointments are often preferred to creams or lotions, which have higher water content.


Eczema in South East Asian Skin Eczema in South East Asian skin usually looks similar to eczema in white skin. However, there is some variation, depending on skin tone. Generally, eczema appears as dark ashen or grey on darker skin tones and brownish on lighter skin tones. Inflammation is generally seen as red skin, as on white skin.

The distribution and pattern are similar to those found in white skin. Eczema tends to start on the face and then involve the flexures. Popular eczema may occur, but in our experience it is probably not as common as in black skin.

Diet may also have implications and food exposure and allergies in people with atopic eczema.

For example, a western diet tends to include more dairy than an Eastern diet, which is more likely to contain higher levels of soya, nuts, sesame and seafood.

Eczema in Asian skin The pattern of eczema in Asian skin is more similar to black rather than white skin. The extensor or outside surfaces of the knees, elbows and wrists tend to be more affected than the inside surfaces of these areas. The popular pattern, with small itchy bumps on the skin is also common. Lichenification or thickening of skin can be very severe (children have referred to this as their ‘rhinoceros skin’).

Different colour changes are seen in Asian skin. Darkening of areas of eczema, increased colour or hyper-pigmentation is due to the inflammatory process of eczema, which causes bright redness on white skin. If the eczema is severe and the skin is very inflamed, Asian skin can look red or even become red all over the body - this is known as erythroderma. It is important to tell patients that this is not due to treatments and is not permanent – the hyper-pigmentation will settle down if the eczema is controlled. As the eczema improves, the skin starts to lighten a shade from its normal tone – this is called ‘post-inflammatory hypo-pigmentation’. Again, these colour changes are not permanent but will settle down if the eczema remains controlled.

Asian skin tends to be very dry. Ointment-based moisturisers are best, as creams and lotions are usually too light to moisturise the skin adequately. Daily immersion baths and soaking with an emollient added to the water is preferable to bucket baths or showers. Some Asian parents worry about the health implications of bathing children daily but this concern is unfounded since children who are bathed daily are at no greater risk of catching colds and coughs or experience a worsening of their asthma. Rinsing after washing is part of the hygiene routine for some Asian people. It is important to avoid rinsing with fresh water after bathing, as this rinses off all the emollient used as a bath oil and soap substitutes used for washing. It is best to avoid using a shower to rinse – suggest instead adding bath oil to a jug of rinsing water to get round this.

Traditional and natural remedies are popular, but it is important to understand that these may not always be ‘natural’. Herbal treatments, often containing potent steroids, which can be found on the internet, in high-street stores and Asian stores, should not be bought or used. Mustard oil has been used for centuries in Asian communities as massage oil, but is an irritant for eczema.

Olive oil is also commonly used for massage but should also be avoided due to linoleic acid levels, which are now known to cause skin barrier breakdown. If you do massage your baby or young child with

eczema, it is best to use your medical moisturisers.Many Asian families shave their child’s hair from soon after birth and

at other times during childhood, as it is thought to produce thicker and healthier hair. Some parents also think that head shaving may get rid of eczema on the scalp. However, shaving children’s hair doesn’t get rid of eczema and re-growth may cause more irritation. It is better to cut with scissors and keep hair short so that emollients can be applied more easily to the scalp.

Conclusion Easily accessible and visual information is essential to help people with eczema and eczema treatments. TRADITIONAL AND OVER-THE-COUNTER REMEDIES• The use of certain traditional remedies or herbal creams that

claim to have all-natural ingredients – or that have no ingredients listed on the label – should be discouraged, especially in children. Products such as Wau Wau cream, Abido and OSAS aloe vera cream (often purchased over the internet for eczema treatment) can contain super-potent steroids such as clobetasol propionate, the same steroid that is found in Dermovate, a prescription-only topical treatment. Use of such products can result in steroid-induced side effects, which are irreversible.

• Chinese herbal treatments should also be considered potentially dangerous. Chinese herbs have been reported to benefit some patients, but dermatologists do not generally prescribe these, as the herbal ingredients are not regulated and products are often mislabelled. Potentially serious inflammation of the over has been known to occur with Chinese herbal treatment.

• Regular use of moisturisers such as coco butter and Shea butter is commonplace among people with black skin. However, these moisturisers and others purchased over the counter usually contain perfumes or fragrances, which may cause additional skin problems of irritation or allergy. For this reason, medical or prescribed moisturisers should be used as they are fragrance-free and will be more suitable for the skin.

• Patients should be discouraged from using bleaching agents to try to lighten dark patches as the patches generally improve with time and bleaching may cause more problems with pigmentation. Instead, frequent use of medical moisturisers and emollients as soap substitutes in the bath will help to minimise eczema activity and the resultant pigmentary changes that affect black and Asian skin.


References1 child FJ, Fuller LC, Higgins EM & Du Viview AW (1999). A study of the Spectrum of skin

disease. Occuring in a black population in South-east London. British Journal of Dermatology 141 (13): 512-17

2 Neame Rl, Berth-Jones J, Kurinczuk JJ & Graham-Brown RA (1995) Prevalence of atopic dermatitis in Leicester: a study of methodology and examination of possible ethnic variation. British Journal of Dermatology 132 (5):772-77

3 Ben-Gashir MA & Hay RJ (2002) Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterparts. British Journal of Dermatology 147 (5):920-25

4 Sladdeb MJ, Dure-Smith B, Berth-Jones J & Graham-Brown RA (1991) Ethnic differences in the pattern of skin disease seen in a dermatology department atopic dermatitis is more common among Asian referrals in Leicestershire. Clinical Experimental Dermatology 165(5):348-9

5 Chaudhry S, Moss C & Gilmour E (2001) Quality of life measurements in children with atopic eczema from different ethnic groups in Birmingham. British Journal of Dermatology 145 (59):45

Education

The EAA office will be closed from Monday 21 December 2015 & will

reopen on Monday 11 January 2016

Christmas & Happy New Year

Merry

Our sincere appreciation for your support during 2015

EAA Committee of Management 2015-2016

The EAA thanks all the Committee members and volunteers for their support and contribution during 2015

President:

Vice President (Shadow):

Treasurer:

Secretary & Memberships Officer:

Corporate Manager:

IT Services:

COM Members:

Volunteers:

Cheryl Talent

Michael Phillips

Terrence Poulton

Michelle Privitera

Tony Maughan

Christopher Dewey

Mike Chapman Alison Knowles Fredrick Roseé Sandra Plowright Carolyn Thomason Natasha Thomason

Sheneyse Bernhagen Amy Privitera Madeleine Webb


Cover Story

EAA: If someone is experiencing an eczema flare up and will be exposed to the sun, what sunscreen would you recommend, what ingredients should be avoided?KG: The best thing to do while experiencing a flare is to use physical sun protection measures such as clothing, hats, sunglasses and shade. If you need to use a sunscreen on an eczema flare, chose one that uses physical sunscreen actives only such as SUNSENSE Sensitive SPF 50+

EAA: What about for everyday use if we have eczema and sensitive skin?KG: For everyday use, chose sunscreens that are fragrance free and are produced by a company with a reputation of looking after sensitive and problem skin. Ingredients to avoid would be methylisothiazolinone and methychlorolisothiazolinone, as well as lanolin and Chlorphenesin – no Ego products contain these ingredients.

EAA: What is the difference between chemical and physical sunscreens?KG: A great way to remember the difference is to consider mirrors and sponges. A chemical sunscreen active will absorb the UV radiation and stop it reaching the skin, i.e. the sponge. While a

physical sunscreen will reflect the UV radiation away from the skin, i.e. the mirror. While sunscreens can use just physical or just chemical sunscreen actives, it is very common to find them being used together.

EAA: What’s the difference between UVA and UVB? KG: UVA rays are constantly present, no matter the season or the weather. UVA rays are mostly responsible for the signs of aging because they are able to penetrate much deeper into the surface of the skin, damaging the cells beneath. When you think of UVA rays, think sun spots, leathery skin and wrinkles.

UVB rays are the rays you can mostly blame when you get sunburnt. Unlike UVA rays, these rays aren’t always the same strength year round - they’re more prevalent in the summer months, however they are able to reflect off of water or snow, so it’s always important to protect yourself year-round. When you think of UVB rays, think sun burn.

Both UVA and UVB are known to contribute to our skin cancer risk.

EAA: Should we consider a specific sun protection product designed for sensitive areas rather than just a general sunscreen for the whole body?KG: A dedicated lip balm product for sun protection is a good idea. The lips differ from the rest of the skin on our body as they can’t produce the protective melanin pigment.

However, if a sunscreen is designed well, it should be able to be used all over the body. SunSense Ultra or Sport are two sunscreens

Dr Kerryn Greive (PhD)Scientific Affairs Manager at Ego Pharmaceuticals

Q&A on Sunscreens

The EAA office will be closed from Monday 21 December 2015 & will

reopen on Monday 11 January 2016

Christmas & Happy New Year

Merry

Our sincere appreciation for your support during 2015

EAA Committee of Management 2015-2016

The EAA thanks all the Committee members and volunteers for their support and contribution during 2015

President:

Vice President (Shadow):

Treasurer:

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Corporate Manager:

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Volunteers:

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Michael Phillips

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Tony Maughan

Christopher Dewey

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Cover Story

that have been designed to be used all over the body, face included. However dedicated facial sunscreens can be designed with additional benefits such as anti-aging ingredients, extra moisturising or a tinted finish. For example, SunSense Anti-ageing Face combines an SPF 50+ broad spectrum sun protection with the benefits of AHA’s and vitamin B3 and E.

EAA: Are there certain things we should look for when protecting the face, neck, lips and ears?KG: The most important thing to look for is the SPF. An SPF 50+ broad spectrum sunscreen is the first place to start. Scientific research has shown that wearing sunscreen can help protect from premature skin aging and skin cancer, so the better the protection we wear, the better our long term skin health will be. From there it is a matter of testing products to find the one that you find comfortable to wear regularly. Not all sunscreens are the same, so you may need to try a few to find your perfect match.

Once you have chosen your sunscreen you must wear it regularly. It will not do any good to spend the money on a good quality product and then leave it in the bathroom cabinet.

EAA: What’s a good pre-sun exposure routine that will help ensure maximum protection?KG: To ensure maximum protection we need to ensure we are putting on enough sunscreen. If you apply several products to your face in the morning, ensure you apply the sunscreen last. For a face and neck application you will need 5ml, or a teaspoon of product.

If you keep your skin nice and hydrated with moisturisers such as QV Skin Lotion or QV Cream, it will help you to apply a nice even layer of sunscreen, which is important for uniform protection.

If you want to simplify your morning routine, consider combination products such as QV Face Moisturising Day Cream SPF 30 or SunSunse Moisturising Face SPF 50+ that are both moisturising products and sunscreens.

EAA: Do we also need to consider the damaging effects of wind as well as sun?KG: While the wind can’t burn us the way the sun can, it can certainly dry our skin out. To protect our skin from the wind we need to use quality moisturisers both before and after exposure. Combination products such as QV Face Moisturising Day Cream SPF 30 or SunSense Moisturising Face SPF 50+ are both moisturisers and sunscreens, so they can help protect us from the drying effects of the wind and the damaging effects of the sun and both are suitable for sensitive skin.

EAA: What’s a good post-sun routine to preserve skin condition?KG: Spending time in the sun invariably means that our skin is going to get dehydrated, even if we are not sunburnt. After time in the sun our skin needs rehydration using a quality moisturiser. A product such as SunSense Aftersun Crème Gel is ideal as it offers hydration in a light gel-type base while also providing added benefits from vitamin B3, grape seed polyphenols and vitamin C. If you prefer a fragrance free option, a light moisturiser such as QV Skin Lotion is the ideal product.

EAA: Do you have any advice for treatment of mild sunburn?KG: Mild sunburn needs to be treated like any other burn. It is important to get the heat out of the skin first; a cool shower can be beneficial, as can a product such as SunSense Aftersun Cooling Spray. Once the skin has cooled down it should be kept hydrated with a quality moisturiser such as QV Skin Lotion. It is important to let the skin cool before applying a moisturiser; otherwise the moisturiser will trap the heat in the skin.

Once the heat has been removed, if you need a bit extra help to take the burn down, a gentle corticosteroid such as Dermaid Cream or Spray can work to reduce the redness and inflammation.

EAA: What are you top sun protection tips? What SunSense products do you use?KG: A big hat, big sunglasses and a big bottle of sunscreen…. and then use them! I love SunSense Ultra for my body and QV Face Moisturising Day Cream SPF 30 for my face. I use the SunSense Lip Balm pretty much all the time; it’s always in my hand bag. Its superior SPF 50+ makes it ideal for the whole family year round.

For more tips on skin and sun care throughout the year sign up to www.egoskinexpert.com.au


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Q&A

I was recently overweight and embarked on a weight-loss programme – I have lost 4 stone (25 Kg)! I am now doing lots of exercise and really enjoy using my exercise bike at home. The only problem

is that I have had moderately bad eczema ever since I was a small child and I am finding exercise difficult to combine with my eczema as sweat really flares my skin. Even though I have a cool shower after exercising and then moisturise, I am having to use more steroid creams to control the flares and am worried about ruining my skin. So my question is, how do I prevent my skin from getting irritated by sweat?

It can be tricky to balance the benefits of exercising to keep fit and lose weight, with the risk of exercise aggravating your eczema.

Sweat is marginally acidic and salty, and whilst that acidic characteristic is actually good for the skin surface, it can be an irritant especially to inflamed eczema. Furthermore, the skin barrier is less effective in eczema, so you are more vulnerable to dehydration from excessive sweating. You should therefore ensure you remain well hydrated at all times.

Tight clothing can cause further problems from friction – especially in eczema-prone sites, such as the armpits, elbows and knees. Therefore, ensure you always wear well-fitting, properly designed clothes appropriate for the exercise preferably made from natural materials such as cotton or silk.

You have already taken some very sensible steps. A pure water spray on your skin or clothes would limit your need to sweat whilst exercising. You could even use cold gel or ice packs to keep you cool during exercise. Additionally, try using a fan to blow over you whilst exercising. However, I wouldn’t recommend air-conditioning as it creates abnormally dry air that might aggravate your eczema.

A tepid bath or shower straight after exercise will wash off the sweat and help to cool you down.

Controlling excessive sweating by having a long soak in tepid water prior to exercise might help. Anticholinergic drugs (such as Oxybutinin) limit sweating, but I would avoid using topical antiperspirants, such as Aluminium chloride (Anhydrol forte-Driclor) as these would be too irritant to eczema.

Whilst using an exercise bike is clearly working extremely well for you, you may find swimming causes less of a problem with sweating, and friction would be less of an issue. The disinfectants (containing chlorine) used in public pools can, however, be quite concentrated and irritant. Also, chlorine gas evaporates off the surface of the water. If you can arrange to be in the pool just before chlorine is added, your skin might be affected less. Clearly, you should use a good-quality barrier emollient to protect your skin in the pool, and ideally apply it about 30 minutes before getting into the water. Immediately after you get out, have a good shower, washing with emollients.

The health benefits of slimming down are considerable. Eczema is aggravated by the rubbing of skin on skin and the trapping of moisture in skin creases in people who are obese. Furthermore, as you lose weight, your core body temperature is less well insulated and the need to sweat will reduce.

The really important message here is ‘keep up the good work.’ Re-moisturize your skin all over after washing off the sweat and concentrate on a really good emollient regimen. Also, use topical steroid (no more than once during the day and again at bedtime) for as long as you need to in order to regain control of your eczema, before stepping down that treatment. It is easier to keep eczema at bay than it is to regain control.

Dr George Moncrieff, GP

Ask the Expert!

Eczema and Exercise


I am a woman in my mid-60’s and I first developed eczema about 5 years ago. First of all, I am curious to know if eczema developing later in life is a common thing or not. When I tell my friends about

it, they are amazed – I, too, always thought eczema was a childhood condition. My skin is not too bad in the summer, but becomes much more dry, itchy and red in the autumn/winter. So my second question is, why does my eczema get worse in the colder months? Thirdly, is there anything I can do to prepare my skin for the winter and try to prevent my eczema returning with a vengeance?

I am sorry to hear you have developed eczema. Many people presume that eczema is a childhood condition, or that if you have eczema as an adult, you must have

had it as a child. But the truth is eczema can develop at any age or stage in life. There are also several types of eczema. Some more common in people over the age of 60 years – for example, asteatotic eczema (appears as dry, flaking itchy skin patches, which can look a bit like ‘crazy paving,’) discoid eczema (appears as round patches, often on the limbs, and can be red, weepy and itchy) and varicose eczema (affects the lower legs and is worse if you have poor circulation).Many people with eczema find that their skin condition changes with the seasons. As in your case, eczema is often worse in the

autumn and winter months, when temperature fluctuations – ie moving between a centrally heated indoor environment to the cold outdoors – can play havoc with their skin. It is good to think about ways in which you may be able to pre-empt an eczema flare. First, make sure you keep up a good emollient routine all year round, so you continually repair your skin barrier and prevent dry skin. Secondly, try to bring a flare of eczema under control very quickly. Any delay makes it more difficult to treat, so make sure you always have a range of topical steroid preparations prescribed and to hand for immediate use. Practical suggestions and tips to help in the winter months include making sure your home is not overheated – central heating removes moisture from the air and this can make your skin very dry and itchy. Keeping your home well ventilated and free from dust, and your bedroom cool will also help. If your skin is dryer in the colder weather, you may need different types of emollients in the autumn-winter than in the summer (eg ointments or humectant creams in autumn/winter.) Look out for signs of infection – usually red, weepy eczema, often with yellow crusts – as infection will always complicate eczema flares.

Julie Van Onselen, Dermatology Nurse

My daughter is 10 years old and her eczema has recently been getting progressively worse, particularly on her face. A real problem area is around her eyes and eyelids. She has also had three

episodes of conjunctivitis during the past year. I would like to find out if this is connected with her facial eczema? I am also concerned about using topical steroids on this sensitive area. I would be interested in hearing your opinion on eczema treatment around the eyes.

Having eyelid eczema can be very uncomfortable, itchy and difficult to treat. Symptoms – including itching, redness and watering from the eyes – are often worst

when the pollen season is at its peak. The discomfort can be exhausting and affect a person’s quality of life.

The delicate skin around the eyes is actually the thinnest on our body, so it requires special attention. Strong steroids are not usually recommended but milder ones, such as 0.5-1%, are an option for short treatment periods under supervision. If the eyelid area has persistent eczema, there may be an option to treat it with a topical immunomodulator such as pimecrolimus (Elidel®) as long as your daughter has no sign of skin infection. These treatments can also be used as maintenance treatments twice a week – but it is important to

avoid sun exposure, so they are best applied at night. They are useful to use in conjunction with topical steroids and may help to reduce topical steroids usage on her eyelids and around her eyes.

If your daughter has persistent problems with her eyelids and face, and her eczema is not responding to treatment, I suggest you discuss a dermatology referral with her GP. The dermatology team may recommend patch testing to investigate reactions to any creams or other topical treatments used. This is usually only performed on the over 8’s and is dependent on a paediatric patch testing service being available. Additionally, if there is a strong suspicion of airborne triggers, the child may have RAST or prick tests to identify allergens such as house-dust mite, grass or pollen. Antihistamines and eye drops may then be prescribed to help alleviate these symptoms.

It is unlikely that your daughter’s conjunctivitis has been caused by her facial eczema. However, if she does have infected eczema on her face, it is important to take her back to her GP for prompt treatment. Any infections in the eye itself should be managed by the GP or optometrist. In the event of damage to the eye from scratching or rubbing, the input from an ophthalmologist is essential. It is also possible that she may have developed a viral conjunctivitis, as her attacks are recurring, but you would need to get this diagnosed.

Julie Carr, Children’s Specialist Dermatology Nurse


Allergic eye disease and conjunctivitis in a child

Eczema and the changing seasons

Q&A


Recipes

NEWImprovedFormula

Delicious and easy Eczema friendly recipes

Bliss Balls

Ginger CakeGluten-free

Carrot, Feta and Dill QuicheGluten-free

INGREDIENTS• 1 cup walnuts• 1 cup deseeded medjool dates• 1 cup raisins• 1 tablespoon cacao/cocoa/carob• 1 teaspoon vanilla

METHOD1 Place ingredients into your blender or

food processor in the order listed above and blend together

2 Shape in balls and roll in coconut3 Chill and enjoy!!

SALAD• 50g snow pea sprouts, trimmed• 100g drained canned baby beets patted

dry with paper towel, quartered• 1 Lebanese cucumber, chopped

INGREDIENTS• 1 1/4 cups almond meal• 2 eggs• 10 medjool dates, soak in boiling water• 1 tablespoon ground ginger• 1 teaspoon mixed spice• 1/2 teaspoon concentrated natural vanilla

extract• Juice of half a lemon• 1/2 teaspoon bicarb soda• Pinch of salt• 1 tablespoon macadamia oil

PREP TIME 15 minutes + 30 minutes chilling

COOKING TIME 1- 1/4hours

SERVINGS Serves 4

METHOD1 Preheat your oven to 175°C. 2 Grease two mini loaf tins, 12cm x 5.5cm.3 Drain your dates and blend until smooth.

Add your almond meal, ginger, mixed spice, salt, vanilla and oil quickly pulse to combine. Add the eggs, combine. Mix in the lemon juice and bicarb.

4 Spoon into your prepared tins and level the top.

5 Bake for 20 -25 minutes. Allow to cool. Enjoy.

1 Line an oven tray with baking paper. Spray a 3cm-deep, 20cm (base measurement) loose-based flan tin with cooking spray. Roll out pastry on a lightly floured surface until large enough to line tin. Line tin, trimming edges and discarding any remaining pastry. Refrigerate for 30 mins.

2 Meanwhile, preheat oven to 190°C (fan forced). Heat oil in a small non-stick frying pan over a medium heat. Add onion and cook, stirring, for 2 minutes. Add water, cover and reduce heat to low. Cook for 4-5 mins or until onion is soft. Transfer to a bowl. Set aside for 10 mins.

3 Put flan tin on prepared tray. Cover with piece of baking paper and fill with baking beans or rice. Bake for 15 mins. Remove paper and beans. Reduce temperature to 170°C (fan-forced).

4 Bake for a further 8 mins. Set aside for 10 mins to cool.

5 Add carrot, dill and feta to onion mixture toss to combine. Add to pastry case. Whisk eggs, milk and pepper in a medium Bowl. Pour over vegies. Bake for 40-45mins or until set and light golden on top. Set aside For 10 mins. Remove from tin.

6 To make salad, divide sprouts, beet and Cucumber between serving plates. Serve with quiche.

INGREDIENTS• Olive Oil cooking spray• 1 sheet gluten-free puff pastry• Gluten free plain flour, for dusting• ¼ tsp extra virgin olive oil• 2 small brown onions, thinly sliced• 1 Tbsp water• 1 medium carrot, coarsely grated• 3 Tbsp chopped dill• 40g reduced-fat feta, crumbled• 4 x 50g eggs• 160ml (2/3 cup) low-fat milk• Freshly ground black pepper to season

METHOD


NEWImprovedFormula


Opinions

After a period of sustained ill-health – it led me to think about how prepared we all are – or can be – if our eczema hits rock bottom.

I’m on the severe end of the eczema spectrum. Sixteen years ago my eczema returned at the age of 21 and since then I have been on a journey of hospital admissions, endless blood tests in outpatients, visits aplenty to dermatology and the full range of treatments.

When you suffer with a chronic health problem like eczema, you develop routines for both treating the condition and living with it. I thought that those routines were robust enough not to safeguard against a rapid decline itself, but to cope with the aftermath. As it turns out, I was wrong.

Seemingly overnight, I became very ill. My weekly dose of the immunosuppressant azathioprine wasn’t doing much, and repeated, stubborn infections were making life intolerable.

This was probably the worst bout of eczema I’ve ever experienced. The process of becoming worryingly ill and the impact it had – and being let down by people I relied on when I most needed them – all taught me valuable lessons.

How prepared are you? There is a sliding scale in answering this question, which broadly relates to how bad your eczema can get. Being prepared for the worst is no bad thing as we all know how quickly our own skin can turn on us.

Medications, ointments and the myriad of treatment permutations for eczema require forethought, but basically boil down to this:

oDo you have enough medication to last you? oDoes that include an increase in dosage? oCan you get more in a hurry if you need to?

Stockpiling medicines isn’t recommended but, for a chronic condition, what you actually end up using fluctuates wildly from week to week. For example, the amount of emollient you use when your skin’s behaving versus during a dreadful flare might be very different.

While reviewing my eczema treatment, I switched pharmacists. Why? Inconveniently, my regular pharmacist often had to order in my medication rather than having it in stock and their opening hours were limited. My new pharmacist gets my repeat prescriptions in ahead of schedule, finds medications quickly and is open 7 days a week until late. My advice is to shop around and get to know the person handing over your vital medication.

Accessing treatment is partly down to you (ie how well organised you are), but equally important is that the chain of people involved in your treatment work together with you and with each other.

I needed to change my medication at short notice in the midst of an awful and sustained eczema flare lasting weeks, which was a nightmare.

My GP was willing to prescribe it – but only after a letter and certain safeguards were written in stone (or faxed) because of national guidelines for a serious drug that requires careful monitoring, and someone had to assume responsibility. There was also posturing between healthcare professionals relating to whose nurses would do which blood tests. As a result of this stalling, I got progressively worse.

Normally I can cope with a bit of delay… I have spent hundreds of hours in GP surgeries and I appreciate that there is a time zone for sorting health issues! But sometimes with eczema, you really need someone’s help right now! I erred in assuming that a drug I’d previously taken for years (methotrexate) could be re-issued at local, GP level – and at short notice – when I needed it.

Be prepared to intervene to speed things up yourself. I had to act as an intermediary between various parties to negotiate my own urgent treatment. Consider the different people in your treatment chain, what their relationship is like and how the system is currently working. If you get to know the people treating you, they’re more likely to go the extra mile when you need them. Finding the right GP who understands the vagaries of your eczema and how it behaves is vital.

Here’s a question: Do your doctor, specialist and pharmacist talk to each other – either literally or via letter or email? You assume they do but everyone is busy and no one has enough time, so asking these kinds of questions might elicit a few surprises.

An email address for your doctor and specialist is a precious commodity! Don’t then bombard them with weekly updates – I only contact my specialist by email when I need something urgently – they know that it’s critical time-wise and that they need to act promptly.

The healthcare system has its flaws – I feel I was let down when I most needed help. However, there are proactive steps we can take as patients in being as prepared as we can be.

Eczema EmergencyJohn Fuller asks: ‘What happens when your skin gets really bad?’


quarterly - eczema association of australasia inc · 4 eczema quarterly summer 2015 ea ert...

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