Eczema Association of Australasia Inc - Changing Times€¦ · 4 Eczema Quarterly Spring 2017 The ECZEMA ASSOCIATION OF AUSTRALASIA INC relies on volunteers and part time staff. Donations

Spring 2017 www.eczema.org.au 1

quarterlySPRING 2017

Volume 19 Issue 3

Changing TimesClaire Moulds looks at how to tackle the major milestones on life’s journey when eczema is your ever-present travelling companion.

COVER STORY

What is involved?

Clinical Research Battling for answers

Allergy Proof Your Home

2 Eczema Quarterly Spring 2017

Well, here we are again at one of our favourite (?) times of the year!! Spring definitely presents many challenges for those of us who unfortunately suffer from eczema and often hay fever as well (myself included). Of course, some poor folks also have asthma too!!

Therefore, it is a great time of the year to reassess your skin regime, update your medications which may include a trip to the health professional, and review your skin products. We all know that the basis of managing our skin condition is a good skin plan – however sometimes even the best plans fall a little by the wayside due to circumstances we can’t avoid.

Here are some simple tips that can help you or your child feel less allergies and more fun this spring:

When the wind is blowing, it’s a good idea to stay inside. Wind often carries pollen, mould, and spores; and can even knock them loose from plants and trees adding to how much is in the air. A small spring breeze may be okay, but anything really noticeable may be a good sign to have an indoor play day.

Some expert allergists recommend anti-histamines and other allergy-blockers during the spring. Don’t hesitate talking to your health professional to find out if some extra support might help you out this season.

Try to take note of days, weather conditions, times of day, and other environmental factors that are present when your allergies and eczema flare up. You may be surprised to find that after a week or collecting data you are able to pinpoint some triggers that you can avoid moving forward.

Try to focus on a low-allergen diet during the spring to give your immune system as much extra energy as possible. The more reactions you can prevent, the better!

We have a fantastic raffle prize just in time for Christmas for our members from Ego Pharmaceuticals – please see details on page 11 of this magazine.

Please post or email us with your story, photos we can use for media attention or tips to help others.

Cheers, Cheryl Talent

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

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CONTENTS

05 EAA REPORT Do Newborns Need Moisturiser? Exposure to Sunlight offers Hope Taking too Many Antibiotics may be Harmful Eczema Treatment with Pregnancy Protein

08 CORPORATE NEWS Dr Fabrizio Spada – Ego Pharmaceuticals Research & Development Manager

09 Q&A What Type of Wet Wrap Should I Use? UV Therapy vs Sunbeds

14 PRODUCT NEWS17 COVER STORY Changing Times

19 CASE STUDY Clinical Research – What’s Involved

22 SUFFERER STORY Battling for Answers

24 EDUCATION Allergy-Proof Your Home Discoid Eczema

27 RECIPES Flourless Almond, Plum & Orange Blossom Loaf Peanut-free Satay Chicken Skewers


EAA REPORT

Reducing Risk for Atopic DermatitisAccording to two promising studies, parents whose newborns are at a high risk for developing atopic dermatitis could benefit the most from a gentle moisturizing product. Parents who have older children with eczema or other similar skin conditions might want to consider moisturising their newborn’s skin because atopic dermatitis has a genetic component and runs in families. The use of moisturiser beginning in the newborn stage may prevent development of eczema.

One study, originally published in the Journal of Allergy and Clinical Immunology, looked at 124 newborns who were considered to be at a high risk for atopic dermatitis. A randomized group of those newborns was chosen to use a daily moisturizer. Parents were able to choose from sunflower oil, Cetaphil cream or Aquaphor Healing Ointment. The remaining infants were not treated with moisturiser.

After six months, researchers found that using a moisturiser on newborns reduced the risk of developing eczema by 50 percent, compared to the control group.

Similarly, a second study also published in the Journal of Allergy and Clinical Immunology found that infants whose skin was treated daily with a moisturszing product had a 32 percent risk for developing eczema, whereas that risk remained 47 percent for the control group. (In other words, the group treated with moisturiser had 15 percent less eczema than the group that was not treated.)

Does Frequent Bathing Worsen Eczema?Prolonged water exposure can worsen eczema but this is usually not the culprit. It is more likely that soaps, shampoos, fragrances and not applying moisturizer after bathing are causing dry skin.

Actually, bathing infrequently could make matters worse. When dirt, debris and flaking skin build up on the surface, they can cause itchiness and irritation. Because of this, dermatologists generally

suggest that daily bathing is fine, as long as you’re using gentle products and moisturising frequently. Natural options include argan or safflower oils, which are high in linoleic acid. Oils and moisturisers should be used at least twice a day and applied every time the baby is bathed while the skin is still damp. Make sure that you pat the skin dry (do not rub) and use only towels that have been washed with a minimal amount of fragrance-free detergent such as Tide Free. Do not use organic detergents as they tend to irritate eczema- prone skin.

Skin care products to avoid if your child or infant suffers from eczema include:

Perfumed body moisturizers.

Johnson’s baby shampoo (it is very drying to the skin).

Alcohol and witch hazel.

Sodium lauryl sulfate in shampoos and body cleansers.

Any cleanser or bubble bath that foams or suds.

Dove Body Wash. There are multiple reports of skin allergy. Use the bar soap instead.

Fragranced laundry detergents.

Dryer sheets.

If you’re concerned about your baby’s risk of developing atopic dermatitis, or you’re struggling to manage your older child’s dry, itchy skin, talk to your paediatrician or dermatologist about the best treatment.

New data that show the “Allergic March” begins with eczema and progresses to food allergies then rhinitis (runny nose) and then asthma. These new studies suggest that daily moisturisation of newborns reduces the first step in the process, which may mean that it also decreases the development of food allergies and asthma.

Dr Leslie Baumann is a board-certified dermatologist, New York Times best-selling author and CEO of Baumann Cosmetic & Research Institute in Miami.http://www.miamiherald.com/living/health-fitness/skin-deep/

Do newborns need moisturiser? Current research suggests that using moisturiser can help prevent your newborn from developing atopic dermatitis, also known as eczema. This is especially important in newborns with a family history of eczema.

Take a look at what researchers are saying:

Exposure to sunlight offers hope for eczema sufferers

Exposure to sunlight releases a compound from the skin that can alleviate symptoms of eczema, research has found.The molecule, called nitric oxide, works by dampening inflammation, which causes itchy skin associated with the condition.Scientists say their findings pave the way for new therapies which mimic the effects of the sun’s rays and could help patients avoid light therapy, which can have damaging side-effects on the skin, such as raising the risk of cancer.Lead researcher Dr Anne Astier, of the Medical Research Council Centre for Inflammation Research at the University of Edinburgh, said: “Our findings suggest that nitric oxide has powerful anti-inflammatory

properties and could offer an alternative drug target for people with eczema.”Tests on healthy volunteers found that exposing a small patch of skin to UV light triggered a release of nitric oxide into the blood stream.Further studies found the chemical activated specialised immune cells called regulatory T cells, which act to dampen ongoing inflammation.The team found that patients saw their eczema improve as the number of these cells in their blood rose following light therapy.Researchers say their findings could lead to new therapies for the condition.

People with severe forms are often prescribed tanning lamps to help manage their symptoms, but these can cause skin burning, accelerated ageing and increased risk of cancer.Professor Richard Weller, senior lecturer in dermatology at the University of Edinburgh, said: “It is clear that the health benefits of sunlight stretch far beyond vitamin D and we are starting to fill in these blank spaces.”The study is published in the Journal of Allergy and Clinical Immunology.http://www.independent.ie/irish-news/health/exposure-to-sunlight-offers-hope-for-eczema-sufferers-35869082.html


Recently, dermatologists and medical students from across the nation attended the 37th Annual Advances in Dermatology meeting held at New York University. Dr Seth Orlow, chairman of the Department of Dermatology at New York University School of Medicine, presented on the connection between atopic dermatitis, more commonly known as eczema, and the skin’s complex microbiome.

One key aspect of Orlow’s presentation involved the often misunderstood relationship between eczema and a specific strain of bacteria called Staphylococcus aureus.

Cause or Effect?Numerous studies have found that people with eczema nearly always have a much higher concentration of S. aureus bacteria living on their skin than those without this common condition. In fact, the more severe the eczema, the greater the amount of S. aureus that seems to be present on the skin.

These findings lead many to believe that this bacteria causes eczema but this can lead to overuse of irritating antibacterial soaps and overuse of antibiotics. Orlow tells Dermatology Times that focusing on S. aureus as the sole cause of atopic

dermatitis is problematic, as the more likely scenario is that the underlying inflammation of this skin condition is what leads to an overabundance of S. aureus colonization on the skin.

As a result, treating eczema with aggressive rounds of oral or topical antibiotics to get rid of this bacteria could do more harm than good in the long run because these treatments are not generally effective and contribute to the growing problem of antibiotic resistance all over the country.

Probiotics and EczemaFortunately, research on the most effective medications for eczema continue to uncover potentially ground breaking possibilities for

future treatment methods. Current studies are examining the use of probiotics, or “good” bacteria, to

help diversify the skin’s microbiome in people with eczema, which helps protect the skin from pathogenic bacteria. The hope is that by normalizing the skin’s microbiome, probiotics

will help alleviate eczema symptoms and minimize the incidence of future flare-ups.

Dr Leslie Baumann is a board-certified dermatologist and CEO of Baumann Cosmetic & Research Institute in Miami.www.miamiherald.com/living/health-fitness/skin-deep/article165597567.html

EAA REPORT

Taking too many antibiotics to treat eczema may worsen your condition

Eczema could be treated with a pregnancy protein Atopic dermatitis, the most common form of eczema, could be treated with a protein known to protect the fetus against attack from the mother’s immune system during pregnancy, a new study suggests.Researchers from Japan found that the protein, called human leukocyte antigen-G1 (HLA-G1), significantly improved skin lesions in mice with atopic dermatitis.What is more, HLA-G1 was found to reduce immune system activity among rodents in response to dust mites, a common allergen for atopic dermatitis.Study co-author Prof Katsumi Maenaka, of the Faculty of Pharmaceutical Sciences at Hokkaido University in Japan, and colleagues recently reported their findings in the journal International Immunopharmacology.Atopic dermatitis is a chronic form of eczema, which is an inflammatory skin condition characterized by rashes - particularly on the face, hands, feet, and behind the elbows and knees - and dry, itchy skin.The symptoms of atopic dermatitis can be triggered by exposure to a number of irritants and allergens, including dust mites, pet dander, mould, pollen, cigarette smoke, and certain foods.According to the American Academy of Dermatology, atopic dermatitis is estimated

to affect at least 28 million people in the United States. The condition is most common among infants and children; around 90 percent of people with atopic dermatitis develop it before the age of 5 years.HLA-G1 REDUCED IMMUNE RESPONSE IN MICEThere is currently no cure for atopic dermatitis, but there are treatments to help manage the condition. These include medications such as corticosteroids, good skincare routines, and drugs that curb the immune system response.The new study from Prof Maenaka and team may have identified another strategy to help treat allergic responses in atopic dermatitis: topical administration of HLA-G1.HLA-G1 is a form of the HLA-G protein, which previous research has linked to foetal protection from maternal immune system attacks during pregnancy.To test whether HLA-G1 might help to dampen the immune response in atopic dermatitis, the researchers tested the protein on mice with the condition.To induce symptoms of atopic dermatitis in the mice, the researchers exposed them to dust mites for 15 days. This led to bleeding, dry skin, and scarring on the rodents’ ears.The researchers then treated some of the mice with HLA-G1 by applying the protein to

their ears every other day for a total of 20 days.The team found that mice treated with HLA-G1 not only showed a significant improvement in skin lesions, but blood samples from the rodents revealed that their immune responses had been reduced, compared with untreated mice.Unlike some current treatments for atopic dermatitis, the researchers note that HLA-G1 did not trigger weight loss.POSSIBLE TREATMENT FOR INFLAMMATORY DISEASESOverall, the results suggest that HLA-G1 may offer a safer, more effective treatment option for atopic dermatitis, and it may also lead to treatments for other inflammatory diseases.“Our study provides novel insights on the function of HLA-G proteins, which can provide clues on efficient therapeutic strategies for patients with atopic dermatitis, rheumatoid arthritis, and other related diseases.”Prof Katsumi Maenaka“Further investigation is needed to better understand HLA-G’s suppressive mechanism against excessive immune reactions,” he adds.

http://www.medicalnewstoday.com/articles/318842.php

Researchers have identified a protein that could help to treat atopic dermatitis


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CORPORATE NEWS

Ego Pharmaceuticals research and development manager Dr Fabrizio Spada has had a rich and varied career. His experience in the world of scientific research has led him from Italy to the US, and now Australia. Prior to his role at Ego, Dr Spada has seen his own studies published, been awarded patents for his work and even contributed products to NASA.Fabrizio is a highly qualified chemist, now responsible for the development and compliance of new dermatological products for one of Australia’s leading skincare specialist, about his years in the field and what’s in store for the future at Ego.

What is your main area of specialisation? I have had the fortune to work in different areas of scientific research, from synthetic chemistry to coating formulation to dermatology, to pharmaceuticals, so I like to think that I specialise in turning concepts into real products and technology through scientific experimentation.

Can you tell us about some of the companies/places where you have worked and the products you have produced?I have worked for Solvay in Italy and the US, then in Australia I enjoyed working for PZ Cussons, Stiefel (GSK), Natures Organics, and now Ego Pharmaceuticals. I have had the chance to develop a great range of products such as low friction coating for NASA components to be used for space satellites, unit dose detergents for auto-dishwashing, solid lipid nanoparticles for topical delivery of pharmaceutical actives, silicone free hair care range with sustainable natural ingredients, and now new cosmetic and therapeutic products for dermatology at Ego.

What is the most common skin issue that you hear about in Australia? Does this differ from elsewhere in the world? The main difference is predominantly in skin cancer prevention, as the Australian conditions are so extreme that the incidence of skin cancer is nowhere near as high anywhere else I have lived. This puts a lot of pressure on the scientists and manufacturers to develop the absolute best sun care products that we can make.

What is your main area of responsibility at Ego?At Ego Pharmaceuticals, I am responsible for the development of new cosmetic and therapeutic dermatological products, and their compliance with the current Australian and International laws and regulations in order to market the product in all the countries where Ego export.

What trends in skincare are you noticing that you can bring to the Ego product range? The main focus at Ego is really on the science behind the benefits of specific ingredients or active pharmaceutical entities, so perhaps our products do not look in line with the most recent “trends” in skin care, but our customers can be sure that the claims and benefits Ego promotes for our products are the results of science-based experimentation and testing.

What are you most looking forward to working on for Ego? I am looking forward to finding the next generation of technologies and solutions for skin conditions that can be supported by solid science and approved by the appropriate regulatory authorities so that our customers can be presented with and offered the best possible products for all their skin care needs.


Julie Van Onselen, Dermatology Nurse Adviser, says:I am sorry to hear your son is badly affected by itching. Itching and scratching are difficult symptoms in eczema. Scratching often leads to more damage and then more itching - the vicious itch-scratch cycle, which can cause restless nights. This leads to knock-on effects during the day, including tiredness and reduced concentration, with daytime itching and scratching also being a distraction at school.The best way to help reduce itching is to prevent dry skin and control eczema flares. It is really important to make sure your son has a good emollient routine - this means using medical emollients for washing, bathing and moisturizing (avoid all soap, bubble baths and cosmetic washes). Eczema flares need to be treated with topical corticosteroid in short bursts, as prescribed by your GP. If eczema is controlled, the itch will subside. However, many children with eczema are known to overheat, especially at night, and even scratch in their sleep, causing skin damage. This leads to dryness and skin irritation, setting off the itch scratch cycle.Wet or dry wrapping are methods (rather than treatments) that help to break this cycle by providing a protective layer that is comfortable and prevents damage from scratching. Dry wraps use one layer and wet wraps use a wet layer followed by a dry layer. Both types use viscose tubular bandages or specially designed garments (vests, leggings, socks and gloves).Wet wraps involve a large amount of emollient being applied to the skin, with a layer of garment or bandage that has been soaked in warm water put directly on top; a dry layer is then put on as a second layer. If your son will tolerate a wet layer, wet wrapping is worth trying at night because it has three specific actions to help with night-time itch: first, it causes evaporation, with a gradual drying out of the wet layer having a cooling effect on the skin; secondly, the large amount of emollient and occlusion helps to rehydrate the skin; and thirdly, the double layer absorbs the friction from scratching, thereby protecting the skin. However, wet wraps

are not practical during the day as the inner layer needs to be kept damp, though a dry layer could be used under uniform. Wet wraps are best used under the supervision of your healthcare professional as there are a couple of things you need to be careful about. First, they should not be used when the skin is infected.Secondly, topical corticosteroid absorption is increased under a wet layer, so check with your healthcare professional whether you should use emollient only or a lower potency topical corticosteroid plus emollients.Tubular bandages are available through your Pharmacy or hospital. Viscose garments are available through your Pharmacy or online. Remember, there are lots of triggers for children with eczema that will make the skin itch. One of the worst enemies for eczema is heat and changes in temperature, so keep your son cool, with light, cotton clothing during the day, and make sure his place in the classroom is not next to the heating. Use light bedding and keep the bedroom temperature low at night, ideally at 16-18C.

Q & A

What type of wrap should I use?My son is 8 and is very itchy both during the day at school and at night time. I am worried about his concentration in the classroom due to tiredness and the distraction when itching. We are keen to try wraps but there seem to be quite a few types to choose from. We are also wondering whether to use one layer or two and whether to opt for wet or dry. The worst time for him is at night and we would welcome some guidance on what wrapping method would be best for this situation and how we go about obtaining these from our GP.


Q&A

Donna Thompson, Consultant Dermatologist, says:Phototherapy or UV light therapy provided by dermatology departments can be a very useful treatment option for some patients with eczema.Other patients however may have their eczema aggravated by sunlight or light treatment, though it does sound like you have responded very well to this in the past, with improvements noticed within only a few days of sunlight exposure on holiday, and with your skin remaining clear for an extended period of time after phototherapy treatment received within the dermatology department.Narrow-band UVB, which is a limited wavelength of light between 311 and 313 nm, is the type of light treatment most commonly used to treat eczema, although other types of phototherapy may be used. This treatment is customized to each person and their condition and is closely monitored throughout the treatment period. Phototherapy in general is thought to work by reducing the overactive immune response in the skin and hence reducing the inflammation or eczema affecting the skin. It is not a cure for eczema and - although there may be good improvement for a period of time after phototherapy - the eczema can return. Further courses of phototherapy may be considered if there was a previous good response to treatment with minimal or no side effects.Phototherapy delivered by dermatology departments is not the same as using a sunbed in a tanning shop. In fact, it is recommended that people with eczema completely avoid the use of sunbeds as the dose of UV light is not controlled and cannot be customized for individual patients and t

their specific skin conditions, and there is no safe and effective monitoring of users.Exposure to phototherapy, natural sunlight, or UV radiation from sunbeds may all result in accelerated aging with increased freckling and wrinkling. There may also be an increased risk of developing skin cancer and - for this reason - only medically supervised phototherapy with dose monitoring is recommended.As your eczema is becoming more difficult to control, I would suggest that you discuss this with your GP, who may wish to refer you again to the dermatology department where further phototherapy or other treatment options can be discussed. Good luck.This information was obtained from Exchange Magazine published by the National Eczema Society

Dermatology department UV Therapy verses tanning shop sunbedsI have suffered with eczema most of my life, and I am now 23 years old. May skin is always better when I go on holiday to a sunny climate. It’s hard to know if it’s the sea water or the sun, but within a few days it gets much better and I am usually clear by the time I come home. A few years ago when I was studying for my A levels I had a course of UVB phototherapy treatment, which I responded well to and it kept me clear for several months. My eczema is now returning and I am struggling to control it with topical corticosteroids. At my local shops a new tanning shop has opened and the lady on reception says that they treat people with eczema. Is this the same as the treatment I received in hospital? Is it a safe option to try and would you recommend it?


If you find that your face feels sensitive, Ego Pharmaceuticals have created a new product designed to help your skin that needs a bit of extra care to calm & soothe discomfort. New QV Face Ultra Calming Moisturiser contains an oat kernel extract (Avemide 15TM), Vitamin E and glycerin to help leave your skin feeling fresh and hydrated for up to 24 hours.

Sensitive skin is defined by hypersensitivity to a range of stimuli, resulting in symptoms like itching, burning, stinging, tingling, tightness and skin discomfort, sometimes without any obvious physical signs to the skin.1 People with sensitive skin may have an impaired skin barrier, causing it to become more sensitive to external irritants or other stimuli.2 And further to this, symptoms of sensitive skin can worsen in dry or cold climates or with frequent or prolonged use of cosmetics containing common irritants such as soap and fragrance.

If it’s important to you to choose a product that helps soothe your sensitive skin and deliver moisturisation look for new QV Face Ultra Calming Moisturiser.

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STOP USING STEROIDS FOR ECZEMA AND START USING DERMAL THERAPYEveryone is familiar with eczema; it is a common medical condition in Australia, affecting at least 1 in 3 Australians. It is so common that either we suffer from it, or someone we love or care about such as, friends or family do. With that being said it means that hydrocortisone is the most commonly used medication within the eczema community. Hydrocortisone is an effective treatment for eczema and if doctors prescribe it, it should be used. But what if there was an alternative? Would you use it? Or would you let that said loved one know?LaCorium Health a company that is known for its innovation has created a treatment regimen for said sufferers of eczema. A treatment regimen that speaks volumes to those that have been looking for an effective treatment that is natural and STEROID FREE.

There are five products of Dermal Therapy that each sufferer of eczema should know about.1. Dermal Therapy Soap Free Wash a completely natural formula containing ingredients that are specifically known for their immediate hydrating ability. Created for use by the whole family it is free from SLS, petrochemicals, sulfates, parabens and fragrances. Therefore, allowing sufferers of eczema to bathe or shower with a wash that will not irritate their skin, but most of all it also moisturises the dry and irritated skin. 2. Dermal Therapy Eczema and Psoriasis Cream contains a balanced blend of natural ingredients as well as, herbal extracts and essential oils to treat dry and inflamed skin caused by eczema. This lavender scented cream is the perfect solution for eczema flare ups, providing relief when needed most. 3. Dermal Therapy Eczema Moisturising Lotion is an everyday moisturiser providing hydration for 24 hours. Formulated with a unique blend of ingredients, including colloidal oatmeal it alleviates discomfort and maintains the skins natural balance allowing for longer periods without flare ups. 4. Dermal Therapy Anti-Itch Soothing Cream is a wonder cream that has been proven to relieve itchy skin within minutes. With a balanced blend of Colloidal Oatmeal, Canadian Willowherb and Menthol it forms a unique 3 way action that calms, relieves and soothes. 5. Dermal Therapy Dry Skin Lotion is another everyday moisturiser that increases skin hydration by 50%. It can be used by the whole family and is perfect to use on a regular basis to keep the skin hydrated. www.dermaltherapy.com.au

By: Sandra Cobeta

These five products are the alternative to using steroids and are the answer to what we have been searching for.

PRODUCT NEWS


PRODUCT NEWS

BETTER WITH BIO-OILBio-Oil is a specialist skincare product formulated to help improve the appearance of scars, stretch marks and uneven skin tone. Its unique formulation, which contains the breakthrough ingredient PurCellin Oil™ is also highly effective for ageing and dehydrated skin. APPLICATION 1 For proven results it is recommended that Bio Oil be applied to the affected area twice daily for a minimum of three months. Bio Oil should be massaged in a circular motion on the face or body until fully absorbed.FORMULATION 2 The Bio-Oil formulation is a combination of plant extracts and vitamins suspended in an oil base. Oil, being oxygen-free, allows the plant extracts and vitamins to retain their potency. Bio-Oil contains the breakthrough ingredient PurCellin Oil™, which changes the formulation’s overall consistency, making it light and non-greasy. This ensures that the goodness contained in the vitamins and plant extracts is absorbed into the skin. USES 3 Bio-Oil has several key uses, and is effective at addressing a number of skincare concerns including:SCARS Helps improve the appearance of both new and old scars. STRETCH MARKS Helps reduce the possibility of stretch marks forming during pregnancy, teenage growth spurts and periods of rapid weight gain, and helps improve the appearance of existing stretch marks. UNEVEN SKIN TONE Helps improve the appearance of pigmentation marks and blemishes caused by hormonal fluctuations, skin lighteners or excessive sun exposure. AGEING SKIN Helps smooth and tone ageing and wrinkled skin on both the face and body. DEHYDRATED SKIN Helps supplement the skin’s natural oils, stripped away by factors such as extreme weather, water with a high chemical content, frequent bathing and the drying effects of central heating and air conditioning.

KEY INGREDIENTS 4 Bio-Oil is made up of a number of key ingredients, which include:VITAMIN A Vitamin A promotes the formation of new collagen and assists in skin renewal, helping to increase elasticity and improve the skin’s texture and tone.VITAMIN E The most widely used antioxidant in skincare products today, Vitamin E assists in the maintenance of healthy-looking skin, protecting it from the effects of free radicals which cause skin damage and premature ageing. Vitamin E also increases the moisture content of the epidermis, making the skin soft, smooth and supple. CALENDULA OIL Calendula Oil has cell regenerative effects and can be used to treat sensitive, damaged or sunburnt skin. It reduces inflammation and can be used to combat minor skin infections, rashes and superficial irritation. LAVENDER OIL Lavender Oil is known to have skin conditioning properties, it provides a calming and soothing benefit and is also a natural antiseptic. ROSEMARY OIL Rosemary Oil helps to invigorate and condition the skin, it also has soothing properties and mild antiseptic effects. CHAMOMILE OIL Chamomile Oil is an anti-inflammatory, providing soothing and calming benefits to the skin, and is particularly beneficial for sensitive skin. PURCELLIN OIL™ PurCellin Oil™ reduces the thickness of the formulation, improving its application and spreadability and making Bio-Oil readily absorbed by the skin. It also acts as an emollient, making the skin soft, smooth and supple.

Finding a solution to the irritating effects of eczema, psoriasis and other skin conditions is something only experienced by a few. Even when the symptoms are bought under control, it is always in the back of your mind that something that you come into contact with or put into your body will bring about the next flare up.When Naomi’s son started to suffer from the effects of eczema as an infant, she didn’t feel comfortable exposing him to some of the unnatural ingredients found in some medicated solutions. Instead, she wanted to explore a natural route that would have longer-lasting effect which would benefit the skin, and used an all-natural Shea Butter blend that her family had been making and using for years. Not only did her son’s skin clear up, but her friends that suffered similar conditions achieved similar results. Naomi saw an opportunity to help a wider audience and started up Shea Purity Products.A small business based now on the Mornington Peninsula, Shea Purity’s reputation is rapidly growing as a natural and organic eczema and psoriasis solution. The Shea Purity range consists of long-lasting Shea Butters (perfect for eczema), ultra-hydrating oils (for relieving psoriasis) and scented Shea-based soaps. To read more from other who have found their eczema and psoriasis solution in Shea Purity, simply visit their website at sheapurity.com.au and see the review section. The product range consists of various sizes, including a trial size which allows you to prove that the products work for your skin type.www.sheapurity.com.au

1 http://www.bio-oil.com/en-us/research/scar-study-2010. 2 Bio-Oil Product Information Booklet, p. 2. 3 Bio-Oil Product Information Booklet, p. 1. 4 Bio-Oil Product Information Booklet, p. 2-3.

SHEA PURITY


An organic, intensive healing balm to help soothe and repair dry, irritated and sensitive skin. Perfect for skin prone to eczema, psoriasis and dermatitis.Our award-winning* Kawakawa Balm is wild crafted from native New Zealand plants by embracing traditional Māori Rongoā techniques, and blended with pure organic oils.Frankie Kawakawa Balm is the only totally natural eczema relief product that contains no water. We choose not to add water to any of our products,

so you can rest easy knowing Kawakawa Balm is free from the irritating preservatives and stabilisers used in water-based formulations.Kawakawa is a native New Zealand plant with amazing healing properties for sensitive, irritated skin. It works by relieving the itch and creating a barrier on the skin, locking in moisture and supporting the active repair of the skin.

INGREDIENTS: Organic Beeswax, Organic Shea Butter, Organic Coconut Oil, Kawakawa Extract, Kawakawa Infused Oil, Calendula Extract, Olive Oil, Vitamin E. DIRECTIONS: Apply 2-3 times a day to irritated skin and then daily as skin begins to heal. * A top 10 Most Recommended Product in the 2016 OHbaby! Awards.For more information visit www.frankieapothecary.co.nz/product/kawakawa-balm

Being TGA Listed (Therapeutic Goods Administration) you know that the product works, it been tested and approved to provide relief from a variety of skin conditions and complaints, including:

Repair, moisturise and protect your skin today, with our Manuka honey enriched Therapeutic Skin Cream.“I cannot do without the Therapeutic Skin Cream for my eczema and dry skin. I apply it every day and the cream keeps my skin moisturised and itch free.” John, Qld

The products/treatments contained on these pages are for informational purposes only and are NOT ADVERTISEMENTS. These products may or may not have TGA Approval. This information is included by the EAA to keep its members up-to-date on product availability. Although the EAA conducts its own tests on the products, it is not responsible for any claims made by any company in regard to their product.

NATURE’S GOLD HAS THE PERFECT MIX OF INGREDIENTS TO BEAT YOUR ECZEMA

PRODUCT NEWS

Discover the healing and soothing qualities of our specially formulated Therapeutic Skin listed Skin Cream.

Contains:Australian Manuka Honey Medicinal strength

Macadamia Nut Oil Similar to the oil our skin produces – the production of which declines as we age

Safflower Oil Highly moisturising and protects the skin

Avocado Oil Penetrates the upper layers of skin very quickly, anti-oxidant and rich in Vitamins A, B, D and Lecithin

Rosehip Oil High in Linoleic and Linolenic fatty acids to help with eczema and dermatitis.

• Eczema• Dermatitis• Sun and wind burn• Insect bites and stings• Cracked heels• Cuts and scratches

• Minor burns and scalds• Dry and cracked skin• Nappy rash (honey should not be given or applied to the skin of babies under 12 months old)

Fortified with medicinal grade active Manuka honey this powerful skin cream makes the perfect treatment for eczema, dermatitis, dry skin, cracked heels, bruises, cuts and abrasions.

SPECIAL OFFER for Eczema Association members only:

15% DISCOUNT OFF Our TGA Therapeutic Skin Cream and Manuka

Power Concentrated Ointment.

Please enter code Eczema when ordering through our website.

www.naturesgold.com.au I 1300 309 128

KAWAKAWA BALM - DRY ITCHY Other uses of this multipurpose healing balm are: lip balm

hand cream

nappy rash/barrier balm

intensive dry face cream/eyebrow balm

cradle cap

irritated nipples

cuts and bruises

bug bites

HowtoregisterFormoreinformationortoregistersimply

gotowww.peekprogram.org/[email protected]

TheEczemaAssociationofAustralasiaandtheCentreforCommunity-DrivenResearcharepartneringonastudytobetterunderstandtheneedsofpeopleaffectedbyatopicdermatitis

(eczema).

Thisisanimportantstudythatgivespeoplethechancetotalkabouttheirexperienceandmostimportantly,givetheirviewsonthetypeoftreatment,care,informationandsupportthatthey

wouldliketoseeinthefuture.

Thestudyincludesanonlinequestionnairethatwilltakeabout10minutesandthenatelephoneinterviewthattakesabout30to40minutes.It’sagreatopportunitytohaveyourvoiceheardandto

helpinformthetypeofcareandsupportotherswillreceiveinthefuture.

Thestudyisopentopeopleover18yearsofage,livinginAustralia

whohavebeendiagnosedwithmildtomoderate,orsevereatopicdermatitis(eczema).


Kenkay Derma CHC advert update print.pdf 1 21/04/2017 12:51 pm


Changing Times

While there are specific steps you can take for each situation, your basic approach should consist of:

Preparation Do your homework! Identify the risks in advance and possible solutions.

Relaxation Stress is not your friend. Find time each day to do something that helps you unwind, whether it’s reading a book, going for a walk, cooking something new or simply being with friends.

Military Precision This is not the time to let your treatment

regimen slide. More than ever you need to be completely on top of applying your emollient and other topical treatments, taking any oral medication you require and avoiding your known triggers. Even if your skin is ‘behaving’, extra vigilance will minimise the risk of a relapse.

Support As well as asking your friends and family for their help during a potentially tricky period, be sure to alert your healthcare team well in advance of forthcoming event rather than waiting for a problem to arise. They will plenty of experience to draw on, having supported other patients through similar situations.

ExamsAs far as internal school exams are concerned, if you think that eczema might impact negatively on performance, it’s important to alert teachers and the school that your child has eczema and explain the impact that it can potentially have. Do this when your child first joins the school and at the start of each school year. Be prepared to provide relevant evidence, including correspondence from your GP or dermatology team. If you are concerned about conditions on the day of exam (eg not wanting your child to be seated in direct sunlight or next to a radiator), make sure that these concerns are raised as part of this process. Likewise, if It is likely that hand eczema might prevent your child from being able to write or will slow writing down, explore the possibility of extra time or perhaps typing.

For public examinations there may be less scope for adjustments and it is worth bearing this in mind so that any tougher regime doesn’t come as a shock at such an important time. There are some special arrangements for public exams though that – with support of the school, as they make the relevant applications – you may find useful to explore, especially if your child has more severe eczema. You might find assistance in

the ‘special considerations’ provisions that every examination board is required to have. There are two types of special consideration:

• Adjustments, to maximum of 5%, to marks for candidates who were present for an assessment but disadvantaged due to temporary injury, illness, indisposition or other unforeseen incident immediately before or during the assessment. (An example cited is that hay fever on the day of the exam could result in a 2% adjustment.)

• Procedures for making a qualification award where a candidate has covered the course but is unable, through temporary illness, injury or indisposition, to be present for part of the assessment and therefore unable to fulfil all the usual assessment requirements.

The board are also required to have ‘reasonable’ access adjustments but these are far less likely to apply to eczema. Universities and other tertiary education providers will have their own regulations regarding exams and you would need to take up concerns with them directly.

Job interview / starting a new jobChoose your ‘first impressions’ outfit carefully. Avoid anything warm or itchy and try not to wear garments you haven’t tried and tested as being eczema-friendly. If a flare-up means you can’t wear a tie, as the interviewer might expect, or you struggled to make your hair and face ‘polished’ as you might like explain at the start of the interview that you have eczema and that your skin is going through a bad patch.

If the person isn’t familiar with condition, have a 60-second overview prepared that you can deliver in a confident, matter-of-fact manner. You can also use it when meeting new colleagues for the first time to avoid any awkwardness. While people don’t need to know the full ins and outs of your condition, having a basic understanding will help.

Be upfront about any specific requirements when you start your new job. For example, if your desk can’t be under the air-conditioning unit, say so immediately rather than struggling on in a bid to ‘fit in’. Equally, if you need to reapply cream during the day, explain the situation so that people don’t think that you’re simply doing a disappearing act whenever you want a break.

Claire Moulds looks at how to tackle the major milestones on life’s journey when eczema is your ever-present travelling companion.A landmark event can often be the catalyst for a major-flare-up, a change in symptoms or an array of new triggers. So how can you best prepare?

COVER STORY


On the moveA new home represents a fresh start and potentially fresh set of challenges as you move to a different environment.

Things to consider include:

• Are you moving to a warmer or cooler climate? How does your skin normally react to changes in temperature?

• Are you moving from a soft-water area to a hard-water one? While for some a change in water leads to no ill-effects, others will note that the water ‘doesn’t suit them as well”.

• While we all have our own aesthetic preferences when it comes to our homes, the period versus modern property debate has additional implications for those with eczema. Damp and mould could be an issue in the former while over-heating due to high levels of insulation can be a problem in the latter.

• Did the previous owners or tenants have pets or smoke? Can you afford to completely strip or deep-clean the property to remove any residual triggers?

• Town versus countryside is another key consideration, especially if you’re moving from one to the other. Traffic fumes and pollution can be a problem in the city and exposure to different pollens and agricultural chemicals and issue in a more rural setting.

• Will you have access to the type of medical care you are used to?

• If you’re moving abroad, will the medical care and medication that you currently have be available, of the same standard and free of charge?

WeddingInform the wedding co-ordinator at your venue of potential issues (e.g. temperature) and – if you’re not staying at the venue – ask if there is a room where you can freshen up and apply your medication in private if you need a ‘top up’ over the course of the day.

Talk to your photographer about any concerns. If facial eczema is particular issue, you may prefer to avoid close-up shots. If you are conscious of eczema on your limbs, the photographer will be able to advise you how to pose to ensure that the eye is drawn to other areas of your body. A pre-wedding photo shoot is a great way to explore different approaches and to help build your confidence.

When trying on dresses, focus on how they move with you when you walk, dance and sit, so that you can identify any seams, edges or detailing that might catch your skin.

If there’s a problem, but you love the dress, ask the shop if they can make alterations. Alternatively, consider wearing a soft T-shirt or eczema garment underneath. A veil or bolero jacket can help with temperature control and manage how much of your skin is on display.

Meanwhile, men might find a bow tie less irritating than a cravat and might also want to consider wearing just a waistcoat and shirt rather than a jacket, to avoid the risk of overheating.

Having a babyIf a woman has severe eczema and has been taking immunosuppressant tablets (azathioprine, cyclosporine, methotrexate) or has had a recent course of oral steroids, it is important that her medication is reviewed by the GP or dermatologist before she tries to conceive, as the medication may need to be changed when she becomes pregnant. If she has been taking alitretinoin, she will have been advised that it must be stopped at least 5 weeks prior to conception – this is vital as there is a known risk to the foetus when women are taking this medication.

The huge physical, hormonal and emotional changes you go through during pregnancy can impact on your skin. While some might see an improvement, for other eczema can get worse. Keep communicating with your midwife, GP and dermatology team so that they can respond to any changes in your eczema. It is safe to use emollients during pregnancy. Mild and moderate topical steroids are licensed to be used for flares during pregnancy. However, potent steroids and above (and also Protopic and Elidel) have not been trialled extensively during pregnancy and should therefore only be used under the guidance of dermatologist.

Breastfeeding can sometimes be challenging, as irritant dermatitis of the nipple can occur. Try to prevent this by applying emollients, leaving a gap of 30 minutes before feeding. There is no need to wash nipples prior to feeding – any extra washing may provoke irritation.

Landmark birthday or anniversaryWhether you’re turning 18 or 21, 40 or 50 or celebrating your silver or golden wedding anniversary, chances are a special celebration or trip is planned to mark the occasion. Naturally, you will want to look and feel your best so that you are able to enjoy the moment with friends and family, so be sure to make plans well in advance.

If you suspect that a ‘surprise party’ might be in the offing and don’t want to be caught

unawares, discreetly ask someone for a ‘heads up’. Equally, if you are fearful that the organisers might overlook something crucial, give the same trusted friends a list of ‘must haves’ and ‘must avoids’.

If you feel the urge to try something new in terms of make-up, a hair restyle or perfume/aftershave to mark the occasion, experiment several months before the big day to avoid an unexpected reaction overshadowing the celebrations.

RetirementMany of us associate the workplace with eczema triggers, but the home or other environments can be just as problematic. Therefore, think carefully before you embark on a new hobby – eg gardening may bring you into contact with plants that can produce irritant or allergic reactions, redecorating projects may expose you to chemicals, or the trip of a lifetime may result in the local flora or climate sending your eczema into overdrive.

While most people look forward to unwinding when they retire and the chance to pursue their interests and hobbies without work getting in the way, the truth is that many aspects of our working day can actually help those with eczema. For example, being in a temperature-controlled office environment can be beneficial for those who don’t like to be too warm or to cold and who might subsequently struggle to recreate the same consistency struggle to recreate the same consistency in their own home. Equally, being engrossed in the challenges of work or discussions with colleagues can act as a distraction from the dreaded itch. In a more relaxed peaceful post-retirement environment, the same people could find they are more aware of the urge to scratch and are more likely to act on it.

Before you come to the end of your career, take the opportunity to observer the aspects of your working day and environments that are most beneficial to your eczema and identify ways to recreate them when you’re at home.

Undoubtedly, when life changes in a significant way, there’s a good chance that your eczema will formulate its own unique response to new circumstances or surrounding. Nobody can predict in advance what the exact outcome will be but – by taking the steps outlined above – you can ensure that you’re in the best possible position to manage the situation and to help your skin to adjust.

This article was obtained from Exchange Magazine published by the NES

COVER STORY


CASE STUDY

What types of clinical research are there?The validity and robustness of clinical research can be mapped out broadly according to the image opposite, starting with the groundswell of expert opinion at the bottom of the pyramid. Anecdotal reports (eg ‘9 out of 10 people prefer X to Y’) are not included since, by definition, there is no scientific evidence and no controls or base-line-checks – not that this prevents some less reputable companies marketing their product based on anecdote! Remember, too that the size of a trial is important – the more people who are tested, the more robust the evidence. EXPERT OPINIONThis is the lowest level of acceptable evidence. It refers to opinions of respected authorities and is based on clinical experience descriptive studies or reports by expert’s committees. CASE-CONTROL STUDIESA case – control study is an observational study (rather than intervention-based with testing of drugs and treatments) which recruits a group of individuals with the health issue under investigation (cases) and a group of individuals without this particular health issue (controls). The prevalence of past exposure to potential risk factors for developing the health issue are then compared between the cases and the controls. If the prevalence of past exposure is found to be more common among cases than controls, then exposure may be a risk factor for the health issue under investigation. COHORTWLike case-control studies, Cohort studies are implemented to cause of disease, and observer how participants react under set conditions in order to establish link between risks and health outcomes. However, they look at much larger numbers of people than case-control studies and often take places over a long period of time.Cohort studies are useful for investigating the relationships between health and environmental factors such as chemicals in the air, water and food and are therefore often used by the world health organization (WHO).Cohort studies are most commonly ‘prospective’ i.e. they are forward-looking, planned in advance and carried out over a future period of time.‘Retrospective’ cohort studies instead focus on past data to from

conclusions. This means that any gaps or limitations in the collection of data cannot be filled in after the fact. RANDOMISED CONTROL TRIALSThe randomised controlled trial (RCT) is the accepted gold standard for scientific testing of any new medical interventions. This is the route all pharmaceutical companies must take to prove the safety and efficacy of a product before it can become routinely available.Typically, in RCTs each person recruited to take part in the study is randomly assigned to one of two groups: one groups receive the treatment that is under investigation while the other (the control group) receives a ‘placebo’ (a fake version of the treatment). Participants do not know which group they have been assigned to and other variables are kept constant. This enables researchers to evaluate the effects of the treatment compared with any effects experienced by participants taking the placebo who may believe they have received the ‘real thing’.Sometimes a second treatment is added to the mix, so the comparison is between the new treatment, the second treatment and the placebo. Alternatively, RCT can just test the new treatment against a second treatment, with no placebo involved. Further trials can sometimes even be initiated after a treatment has been in existence for many years –for example, two existing treatment option might be compared.Randomisation reduces potential bias and everyone stands the same chance of having access to the medication.Trials may also be ‘double blind’. This means that neither patients nor researchers and healthcare professionals know who is in which group, to ensure there is no risk of influencing the results.Cross-sectional studies make comparison at a single point in time, whereasLongitudinal studies make comparisons over timeCritically appraised articles and topicsConclusions formed from evidence-based scientific literature remains a key component to ascertain how useful and credible clinical research has been by filtering the column of articles and reports published annually. The way this is done is through a system of ‘critical appraisal’ to pull apart the way research has been carried out and scrutinise how the process was designed to answer the particular question posed.

The world of clinical research data and medical trials is complex. John Fuller explains the different types of research, trial phases, the independence of trials, the recruitment process, and how you can get involved.

What is involved?

Clinical Research


CASE STUDYOther aspects of detective work include investigating the methods used to conduct the research, what the interpretation of results was and any conflicts of interest that might dilute the accuracy of the findings.A critically appraised article is a professional summary of single study and helps clinicians decide whether the results are valid and can help in patient care. A critically appraised topic is like a shorter and less rigorous version of a systematic review (see below), summarising the best available research evidence on a topic. SYSTEMATIC REVIEWSSystematic reviews are the pinnacle of clinical research and offer a highly respected stance on the effectiveness of interventions. A systematic review attempts to summaries and appraise all existing clinical evidence that meets specific eligibility criteria to answer a given research question. It is a very methodical process in which the authors pool numerical data about the effects of, say, treatment (through a process known as meta-analysis), and assess empirical evidence for the benefits and harm of that treatment in order to inform clinical decision making.The Cochrane Library host the Cochrane Database of Systematic of research in healthcare and health policy. Cochrane Reviews take into account all the primary research on a topic that exists up to that point and are themselves ‘peer-reviewed’, which means the scholarly material has been examined by other experts to make it as definitive and respected as possible. A patient is also included in the review panel. What are clinical trial phases?Clinical trials go through a number of steps, called phases, to determine whether the drug or treatment is safe and has the expected and desired effect on a condition. Before tests are conducted on humans, extensive laboratory work will have taken place.PHASE 1 involves testing with human volunteers for the first time. The group consists of a small number of individuals (say 20 – 100 people) who do not have the condition under investigation. Any side effects are monitored and – provided that there are no serious, adverse reactions – the dose is increased incrementally in order to determine the safe dosage range.PHASE 2 is an expanded trial that includes a larger group of people with conditions to be addressed by treatment under investigation to calculate short-term benefits and to further ascertain safety PHASE 3 is an even larger study for those drug or treatments that have passed Phases 1 and 2. Often thousands of patients with the condition are recruited and trial may take over a year to complete. The key difference between this and previous trials is that in Phase 3 there is a placebo group or other medicine for 3 comparison of effectiveness and any side effects. Trials involving drugs will typically be tested on adults first and then on children. It is rare for such trials to take place on under-2s.If a trial is connected to obtaining or changing a licence, application will be made at the end of this phase to the relevant regulatory body, such as the European Medicines Agency (EMA) or Food and Drug Administration (FDA).PHASE 4 trials are done after the treatment has been approved by regulatory body, is marketed and available to the public. The effects on populations are studied in other to understand the effects of long-term use.

How independent are trials?Clinical trials are researched and funded by pharmaceutical companies, medical research agencies, charities or governments. Interested parties may have a breadth of objectives, including financial gain, cost-effectiveness, the mechanics of manufacturing a safe and effective drug, and wider concern around public health policy. Details of who has funded what be found in peer-reviewed articles - for example, under grant/funding information or clinician conflict declaration.In the UK before a clinical trial can begin, it must be reviewed and passed by a government agency called the Medicines and Healthcare Products Regulatory Agency (MHRA) who inspect trial sites to ensure that they conform to current clinical practices. The protocols (procedures) of clinical trials are also subjected to intense scrutiny by the MHRA.Equally a trial cannot start until it has been approved by an independent research ethic committee whose role is to safeguard the right of those taking part in the trial. These committees are overseen by the Health Research Authority (HRA), who co-ordinate and standardise practices relating to regulation.

How can you get involved in a clinical trial and should you do it?You could ask your GP or dermatologist about any research and trials going on nationally or in your area of the country. Alternatively, the UK Clinical Trial Gateway (UKCTG) website (see ‘Useful resource’ below) aggregates the latest clinical trials and research from a number of UK registers. It is run by the National Institute for Health Research (NIHR) and they have plenty of sound of advice around the process of finding out about trials and making an informed decision on whether to participate.More than half a million people enrol themselves in clinical trials every year across the UK to play a pro-active role in their own care, access the latest treatments and be part of a broader movement to improve the nation’s health. You may receive money when you take part in a trial to cover your expenses, your loss of earnings or your time.Although there is due diligence around professionalism, safety and the impact for patients, taking part in clinical trials is not without risk and you need to give it careful thought before volunteering.Typically, taking part in a trial necessitates stopping all (or almost all) treatments. In the case of eczema, you would continue to use emollients but, if you are currently taking systemic, you would need a systemic-free period (sometimes lasting many weeks) before using the treatment under investigation.Obviously, coming off such treatment could have an adverse effect on your skin. For peace of mind, it’s worth remembering that you can withdraw from a trail at any time but for both yourself and those organising the trial, it makes most sense to know what you’re getting into. Ask lots of questions of those running it –for example, what are the aims of the trial, how long will it last, who is funding it, what will it involve and what kind of commitment will be required from you? Be very clear about this last point and the impact it may have on your life – for example, will you need time off work, what are the potential side effects of medication, is there a ‘placebo’ group? (if there is a placebo group, that means you may not get any medication/treatment at all.)

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



SUFFERER STORY

Our lovely, artistic daughter Yaritza wasn’t born with eczema. In the fact, our eczema journey started when she was diagnosed with contact dermatitis, which she developed on her thighs at 3 months old at the site of her first 5 in 1 vaccination. At subsequent jabs, she reacted again and at 6 months old was diagnosed by the GP with atopic eczema – in addition to the contact dermatitis – and given Oilatum and 1% hydrocortisone cream. Unfortunately, the latter only seemed to make the eczema worse.At 8 months old, following an immediate reaction to Nana’s scrambled eggs, Yaritza was rushed to hospital where subsequent allergy test showed a positive reaction to egg (angioedema) and sesame (urticarial) but negative milk, so we could now add food allergies to her atopic story.While we wanted Yaritza to be immunised like other children, and understand that most children with atopic eczema do not respond the way Yaritza does, we were also conscious of the fact that I had ended up in A&E myself a few years previously following up a compulsory routine vaccine at 13 months. Our GP at the time completely understood our decision, especially given my medical history (food intolerances, penicillin allergy, sinusitis and angioedema following a diphtheria and tetanus vaccine) and my husband’s (penicillin allergy, allergic rhinitis and shrimp allergy).As Yaritza continued to be introduced to new solid foods I noticed further reaction (swollen lips, rashes, itchy throat and inner ear, etc) to tomatoes, oranges, chicken and all types of nut. Despite this we came under intense pressure to complete the childhood vaccination programme from health visitors, doctors and nursery managers and were strongly advised to give her the pneumococcal booster vaccine in 2007, which led to us rushing her to the out of hours GP clinic as she fitted for almost 2 hours and had large red blotches all over her body.Further on in our eczema journey a RAST test would go on to identify her as ‘highly allergic’ but we were never supplied with a breakdown of what she is actually allergic to. We only became aware of this oversight when Yaritza was hospitalised and we spoke to another family who had also had RAST test but who had been given a comprehensive list to refer to.I do feel that we have been badly let down by the medical profession, not only with promises that she would ‘grow out of it’ but also because they don’t seem to understand that her allergic nature

means she doesn’t respond as well to their creams and medicines as other patients might, and some of the ingredients that they contain only serve to irritate her skin further.It is soul destroying watching someone you love in such incessant discomfort and being unable to take away their pain while being constantly prescribed creams that only make her worse. My daughter has been labelled ‘non-compliant’, which infuriated me as we have always tried to work with whatever we’ve been given, while I feel like I’m viewed as an over-anxious, steroid-phobic mother just because we don’t fit into the medical profession’s view that if we keep trying creams eventually we’ll find the one that works for us. The truth is, we’re all working with only a partial picture of everything that Yaritza is allergic to and that makes it very difficult to treat her effectively.The devastation Yaritza feels when something doesn’t improve her skin- when we’ve been assured that it will – is then made 10 times worse when we find that the new medication is itself causing a reaction to develop. It’s just so frustrating to have the very thing that’s supposed to help you actually cause you more problems and the fact that those caring for her don’t always seem to recognise this. I appreciate that Yaritza’s reactions to her treatments are not typical of all other children with atopic eczema, but none of us can change that and we have to find a way to move forward.When we were first referred to a dermatologist he did several skin swabs and blood tests, which showed Yaritza had very low iron levels. Since then, we have used a high does multivitamin B complex and magnesium to help with stress. The same doctor also suggested we take her away for 3 months to somewhere sunny to help to heal her skin but, when asked, refused to put it in writing as a potential solution.At its worst the eczema impacts Yaritza’s sleep and self-esteem with a vengeance. She has slept through the night only five times in her life and most nights only gets a few hours at most, waking up to 30 times a night due to an itching bout that might last anywhere from a few seconds to a few hours.I hate waking her up for school in the morning and she desperately pleads for me to let her go back to sleep. People just don’t understand and you feel guilty for whining about eczema because it’s not life threatening. However, the demanding nature of the condition – morning, noon and night – has a severe impact on everyone’s quality of life.

Battling for answersMum Christine Delgado shares her experience

of caring for a child with chronic eczema.


Love and distraction seem to be the only things that work but the itch (or an allergic reaction) always taints each and every day so, as a family, we are constantly experiencing swings of emotion.As parents we don’t cope, we just get through the day. We have no choice, no respite, no sleep and no help and have been to hell and back over the years. While I find writing poems and songs helps me to release some of the frustration I feel, my husband is a drummer and ‘bangs the hell out of them’ to release his.Having a positive outlook is the only way to survive the hell of eczema. It would be so easy for us to completely fall apart, but we can’t as she need us. Physically I may be ready for knacker’s yard but, mentally, dealing with severe eczema has made me even more determined to give Yaritza the happiness she so deserves.Moving out of the city and by sea in 2015 has definitely helped Yaritza as impact of the pollution and concreate dust on her allergies is immense. Since the move her asthma and hay fever have nearly disappeared, although we still have to be careful around building works as her contact dermatitis means she’s allergic to potassium chromate, which is found in concrete.Meanwhile, school remains a major issue for us all.Year 2 was good because her class teacher also had eczema so she kept the room cool and they used to put their creams on together. Year 3 and 4 were difficult and her attendance was less than 70%. Year 5 was great thanks to a really supportive teacher who came up with some great techniques to help her cope in class. She didn’t tolerate any bullying and understood if she was late in. She also recognised that when Yaritza flares up there is little point continuing with school work as it can make her more stressed if she is struggling/too tired to concentrate.Year 6 attendance is 55% to date, not helped by a group of ‘catty’ girls who have been making her life hell. Unfortunately, as she reveals here in her own words her concerns were dismissed as ‘petty’. At the start of this year we were also pressured to get her into school on time regardless as they thought it was because she was trying to avoid maths first thing, which isn’t one of her strongest subjects as she has missed so much school. They completely disregarded the fact that she was extremely sleep deprived and uncomfortable so doesn’t want to get up to do anything.I am currently considering home schooling while investigating special/holistic schools that she may better suited to. When the Head Teacher initiated a meeting to ‘ensure a smooth transition to High School’ I discussed her needs at length with teachers and the school nurse suggested that a ‘named’ support person would be helpful. We have waited over a year for a child psychologist who seems determined to help if he can and who will support her through High School and try to ensure a smooth transition. He has eczema himself

and is also a neuropsychologist, so we are hopeful that he can provide habit-reversal techniques and help with stress management, anxiety, anger and deep sadness.As of March she also has a new Consultant Dermatologist. Our first meeting with him saw prescribe Cephalexin to clear her infected skin. She had not tried this antibiotic before and initially it seemed to be working well, which was great for Yaritza as at last we had a treatment that visibly improved her skin. We had been assured that they had no previous patients who also had penicillin allergies

react to it but after 4 days of taking it Yaritza started to exhibit some worrying side effects including very itchy skin, uncontrollable shaking and increased anxiety – the following evening this turned into a rash, bright red spots on her face and severe hallucinations. We were eventually taken in an ambulance to emergency where she was given Prednisolone and Piriton. Needless to say, she was extremely upset at having yet another reaction to her medication and her trust in doctors was once more destroyed.We still hope that fresh input into her care will see things move forward though and she is now due to have a 4-day stay at our local hospital for intensive topical treatment, and we have agreed that we may use cyclosporine in the future as we’ve not yet explored the systemic treatment route.We have spent years trying to find Yaritza a friend with eczema only to discover Bella out of the blue at an art festival last year. Even from a distance we could tell she had the same sore skin and within seconds of spotting one another the two were holding hands in pure empathy, joy and relief. It was a powerful moment and it has been a privilege to watch their friendship grow.

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


EDUCATION

Those of us living with Allergies are well used to the runny nose, itchy skin, scratchy eyes, wheezing and sneezing that signal an over-zealous immune system. Completely eliminating allergy triggers from your life might be impossible but there are ways to minimise the misery. Here, we discover what you need to know and provide a room-by-room plan to detox your home of the major causes of allergy.Clinical Immunologist and allergy specialist Dr Raymond Mullins from allergycapital.com.au say there are three major indoor allergy culprits in Australia:1. Dust mites. These eight-legged creatures live off the dead skin we all shed every day. You’re not allergic to the dust mite itself but rather the protein in tiny particles of dust mite dropping that get into your nose, eyes or lungs.Dust mites are everywhere, so it’s a waste of time and money trying to completely eradicate them from your life. It is, however, possible to minimise your exposure to minimise your exposure enough to reduce your allergy symptoms.2. Mould. Mould is a fungus that helps rotting vegetation turn into compost and also grows in areas exposed to damp. Think bathroom, kitchen, laundry, pot plants and garden mulch. It reproduces by releasing spores, which becomes airborne and can trigger asthma or allergy symptoms.Visible mould often looks like a black, white or green ‘fuzz’ and may produce a musty smell. It’s almost impossible to keep mould spores out of your house, so the trick is to prevent mould from taking hold by removing it wherever it’s found and making sure your home is well ventilated and dry.3. Family Pets. Allergy specialists used to advise people prone to allergy to ban pets from the family home altogether. But research shows exposure to domestic animals can actually reduce the overall risk

of developing an allergy, so now it’s recommended you only avoid animals if you’re already allergic to them. And it seems it’s actually the proteins in the skin oils and saliva of household pets you’re reacting to, not the dog or cat hair.“Although the amount of allergenic protein can vary between breeds, there is no such thing as a hypo-allergenic pet,” says Dr Mullins. “If you’re sensitive to animal dander, even a bald animal can trigger a reaction.”

Your Home Detox Action plan THE BEDROOMDe-Clutter. Banish dust magnets including too many cushions or soft furnishing. If stuffed toys are a must, regularly pop them into the freezer for 24 hours to kill dust mites before washing them to remove allergens.Choose hard floors whenever possible. Carpet is a haven for dust mites, so opt for washable floor rugs, or air them in the sun to kill off dust mites if they can’t be washed easily.Use dust mite covers for mattresses, doonas and pillows. They trap dust mite dropping inside while allowing air to circulate.Create a no-go zone for pets. A study of cat owners shows if you ban your feline friends from the bedroom it significantly reduces your risk of developing a cat allergy.Avoid sheepskin or woollen underlays because dust mites love them. Feather doonas aren’t as bad as once thought, as long as they can be cleaned regularly.Wash pillowcases and sheets weekly in hot water (55ºC), or mix 100ml of eucalyptus oil into 25ml of dishwashing liquid and add to pre-wash, Soak for 30 minutes before cold washing. Note: eucalyptus is not suitable for sensitive skin or eczema or for those who react to strong smells.

Suffer from watery eyes or itchy skin? There are steps you can take to make your home an allergy-free zone

Good Health - Allergy Proof Your Home


What is discoid eczema? Discoid eczema is a common type of eczema or dermatitis with coin-shaped areas of inflammation on the limbs or torso. It is usually very itchy.What causes discoid eczema? The cause of discoid eczema is unknown. Some people have conditions related to eczema such as hay fever or asthma. Dry skin may aggravate or predispose a person to developing discoid eczema and the rash may be worse in winter. Less commonly, certain medications, or contact with a chemical in the person’s environment, may play a role.What does discoid eczema look like? Discoid eczema occurs in both adults and children. Initially, the coin-shaped areas may be pink and relatively flat with some scaling but other changes may occur such as thickening of the skin, oozing, crusting and severe itch. As the rash improves, some brownish or pale discolouration may occur which gradually disappears over months.

In some cases, the rash may become more widespread. Secondary infection may occur with significant oozing of fluid and crusting.Discoid eczema may recur or become chronic. It responds to treatment more slowly than other types of eczema.How is discoid eczema diagnosed? A dermatologist usually makes a diagnosis of discoid eczema, based on the person’s medical history and by examining the skin.If there is doubt about the diagnosis or it

does not have a classical appearance, a skin biopsy may be needed. A swab may be needed to determine if a bacterial or viral infection is also present. Patch testing for dermatitis may be needed if a person’s history suggests that they are in contact with a material that may be causing the condition. There are no routine blood tests. This information has been written by Dr Sara Tritton 2017 © Australasian College of Dermatologists

Discoid Eczema

General measures include: • Wearing cotton clothing • Avoiding overheating• Avoiding irritating products• Using soap substitutes such as sorbolene and glycerine or other products your dermatologist may recommend• Using moisturisers (such as sorbolene and glycerine or other products your dermatologist may recommend) at least after bathing and ideally twice daily

Specific treatments include:• Oral antibiotics, may be prescribed if infection is present• Topical steroid (anti–inflammatory) ointments or creams may be prescribed by your dermatologist• Antihistamines may be helpful for some peopleIf discoid eczema becomes more chronic, or does not respond well to these measures, your dermatologist will discuss other treatment options with you.

How is discoid eczema treated?

Also known as discoid dermatitis

THE KITCHEN• Use extractor fan above the stove to reduce humidity in the kitchen.• Check for water leaks around the dishwasher or under the kitchen sink.• Empty and clean drip trays under the fridge regularly.• Remove rubbish daily and was the bin regularly to reduce mould and dust.

THE BATHROOMYour bathroom is a prime spot for mould, so ventilation is important. Allergy specialist Dr Kathryn Patchett advises using your bathroom extractor fan and opening a window or wiping down the walls to remove condensation after your shower.Fix dripping tap. A faulty seal or leaking pipe behind the toilet or under the sink can create mould that you may not notice until it irritates your airways and makes allergy symptoms worse.Glass shower screens are easier to keep clean and dry but if you do have a shower curtain, Dr Patchett says it’s best to get one that can be regularly cleaned in the washing machine and dried in the sunshine or clothes dryer.Most commercial mould-killers contain bleach and produce fumes that can cause irritation to sensitive airwaves. A microfiber cloth and household cleaning vinegar is a good alternative to remove mould and prevent regrowth.

LIVING AREAS• Fabric holds moisture and attracts dust mites, so when it’s time to replace your lounge furniture, opt for easy-to-clean surfaces like leather, or removable fabric covers so they can be washed.• Dust weekly using a damp or microfiber cloth to remove allergens rather than flicking them around with dry duster, advises Dr Patchett.• Avoid too many scatter cushions and make sure to wash covers regularly.• Ditch plug-in room deodorisers or automatic-release insect sprats – they emit volatile organic compounds (VOCs) and can sometimes irritate sensitive noses.• Air-conditioning can increase airborne mould so natural ventilation is best on days when the outdoors allergen count is relatively low.• For window coverings, choose roller blinds or washable curtains over venetian blinds or heavy drapes – these attract more dust.• If you have indoor plants, dust them regularly and remove any dead vegetation that may harbour mould.

This article was written by Larraine Sathicq from Good Health Magazine



Flourless Almond, Plum & Orange Blossom Loaf This divine almond, plum and orange blossom loaf is made without flour to produce a lighter, gluten-free alternative to many traditional fruit loaves. It is packed full of flavour and is gorgeous served warm with a pot of tea.

INGREDIENTS

2 medium green apples (300g), grated coarsely

2 free-range eggs, beaten lightly

1/4 cup (60ml) unsweetened almond milk

2 tbsp honey or pure maple syrup

2 tsp vanilla extract

1 tsp orange blossom water

2 cups (240g) ground almonds

2 tsp gluten-free baking powder

5 small plums (375g), halved

2 tsp honey or pure maple syrup, extra

2 tbsp flaked coconut, toasted

METHOD• Preheat oven to 160°C. Lightly grease a 10.5cm x 21cm x 6cm (base measurement) loaf pan; line base and long sides with baking paper.• Combine apple, egg, milk, honey, extract and orange blossom water in a large bowl. Add ground almonds and baking powder; stir until just combined.• Spread mixture into pan, level top; top with plums, cut-side up, pressing them slightly into the batter. Drizzle with extra honey.• Bake for 1 3/4 hours or until a skewer inserted into the centre comes out clean. Sprinkle with coconut and serve warm.

TIPS:• You can also make this loaf with other stone fruit such as small peaches or apricots.• You may need to cover the loaf loosely with baking paper during the last 10 minutes of baking to prevent over-browning.• For paleo and dairy-free diets, serve with coconut yoghurt. Recipe by The Australian Women’s Weekly

Peanut-free Satay Chicken Skewers You no longer have to miss out on the utterly delicious flavour of satay chicken just because you have a nut-allergy. These brilliant skewers are free of peanuts, perfect for a family lunch or dinner or a barbecue with friends.

INGREDIENTS

1/3 cup nut-free butter

270ml canned coconut milk

2 tbsp tamari

2 tbsp sweet chilli sauce

2 tbsp lime juice

2 tbsp tamari, extra

1 tsp sweet chilli sauce, extra

12 chicken tenderloins (640g)

200g snow peas, trimmed, sliced

2 cups (300g) cooked jasmine rice

2 tbsp fresh coriander leaves

METHOD• Heat a small heavy-based saucepan over medium heat; cook nut-free butter and coconut milk, without boiling, stirring until smooth. Stir in tamari, sweet chilli sauce and juice; cook, stirring for 1 minute or until hot.• Combine extra tamari and extra sweet chilli sauce in a small bowl. Thread chicken onto 12 skewers; season. Cook chicken on a heated, oiled grill pan (or barbecue or grill) for about 2 minutes each side or until cooked through; brush with half the tamari mixture in the final minute of cooking.• Meanwhile, boil, steam or microwave snow peas until just tender. Combine snow peas with remaining tamari mixture until coated.• Serve chicken on rice with snow peas and satay sauce; sprinkle with coriander.

TIPS:• Serve with stir-fried asian greens.• You need to cook ⅔ cup jasmine rice for the amount of cooked rice needed.• We used a peanut-butter-style, nut-free butter made from roasted sunflower seeds; available smooth and crunchy, from health food stores, some larger supermarkets and online. Recipe by The Australian Women’s Weekly

RECIPES


Documents

Eczema Association of Australasia Inc - Changing Times€¦ · 4 Eczema Quarterly Spring 2017 The ECZEMA ASSOCIATION OF AUSTRALASIA INC relies on volunteers and part time staff. Donations