In terms of interventions, the patient should employ a well-rounded approach that includes:
- Identifying and avoiding triggers – click to access article
- Addressing the itch, reducing inflammation, maintaining moisture levels and managing barrier dysfunction – click to access article
- Managing sleep and reducing psycho/emotional/social stress
This article (3) covers the topic of managing sleep and reducing psychosocial stress.
In the acute phase, the most common sleep aids like magnesium and melatonin at low doses may not help at all. However sleep is crucial for the body to repair itself. In desperation, some patients use drowsy antihistamine Atarax aka Hydroxyzine to both reduce the itch as well as induce a drowsy state.
As the individual is recovering and past the acute flare stage, use of tryptophan-rich food can be considered. They include:
- rice, oats
- chicken and turkey
In addition to using that magnesium supplement (do consider MegaMeg liquid magnesium for convenience), do remember that green leafy vegetables are also rich in magnesium! Avoid caffeine after the early afternoon and use chamomile tea or lavender tea closer to bedtime.
Invest in pyjamas with hand covers (to prevent unconscious scratching at night). As relieving as it is in the moment, scratching can cause skin cells to produce more quickly, and patches of eczema to widen. Encourage compresses instead – such as oatmeal in cheesecloth, rooibos tea bags, or just a wet washcloth – to provide immediate relief.
Psychology is an oft-neglected component in the treatment of dermatoses. The role that stress and other psychological issues play in eczema is considerable. Inflammation, itch and pain are part of it. And then there is the social anxiety, depression and other psychological issues that may arise with the skin condition.
For many people with eczema, emotions and stress can worsen their skin condition or initiate flare-ups. The severity of an eczema flare is a function of the patient’s emotional world. Signs and symptoms of eczema can possibly be improved upon through simple psychological techniques.
Look out for good personal chemistry: someone you feel can understand you. Look for a depth of experience working with eczema and scratching. Someone can be a great therapist for people with other problems, yet ignorant and ineffective in this area. Ideally a therapist should be competent to address behaviour change, cognitive (thinking) issues, and also the emotional side of the problem and relevant personal history. A therapist who is too strictly committed to one approach or technique may have major blind spots.
Hypnosis & Self-hypnosis:
You may learn to actually change your skin from within. Here are some videos provided by one patient of mine who used it during the acute flare stage of Topical Steroid Withdrawal:
I know there will be people who will laugh at the idea of using these youtube videos to help them along their journey. However, for those who are suffering from TSW and truly unable to have a full night of sleep, these videos are good for three reasons.
- When you listen to these videos and intend to focus on the voice, you use that audio stimuli to override the sensory signals of itch.
- You are actually engaging in mindful focus, which can help train your brain for discipline not to relent into an itch fest.
- It is either you concentrate on the video or you loose concentration and go into slumber, even if for a while. Both are good for different reasons, certainly better than having nothing to focus on and only lapsing into itch fests.
Emotional stress can keep the most effective medical treatment from working. Yet, on the other hand, it can produce the most dramatic improvements.
If it is any encouragement at all, try reading this article by Ted Grossbart.
Ted Grossbart goes a little further to propose this: “If you don’t allow yourself to ‘feel your feelings’ you are more likely to develop physical symptoms.” He is suggesting that eczema can be the results of suppressed emotions.
How can you let your emotions out? There are several ways and if I do get a chance to, it would be an honor to introduce you to some of them.
Other Mind-Body Therapies:
There exists a smorgasbord of mind-body therapies out there. Here is a short article with a video on traditional and newfangled ways to ‘trick’ your brain to come to a place of less pain.