How I finally eased eczema flare ups

Monday, November 9th, 2020 00:00 |

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For Florence Mukunya and Rachel Ogola’s children, the skin condition comes with management steps that have made life easier

Njeri Maina @Njerimainar

Florence Mukunya remembers having serious skin breakouts and noticing her skin looked different compared to other children’s at around age three.

“I am one of three children. I played all games my siblings played and did everything they did despite excessively itching at night after play and having seriously inflamed skin.

I remember when I was in Class Two and Three, my mum would apply ointment on me post play.

She would also give me antihistamines such as Piriton to help with inflammation,” Florence explains.

Living with the condition exposed Florence to discrimination, which was heavy on her then as a young mind.

The first incident happened when she was in Class Six in boarding school. Fellow students refused to shower with her or even sit next to her, claiming she had an infectious skin disease.

In Class Eight, after a trip to the Rift Valley where it was very hot, her best friend suffered heat rash.

Their classmates claimed Florence had infected her with her skin disease. Things did no change in high school either, especially since she loved to run and was active in sports. 

“I had to wear games kit that exposed my skin. At this point, it had dark spots  where the flare up had caused scarring.

Applying ointments to help deal with them also made me have light spots on normal skin. I overheard one of my classmates asking another why I had patches like a leopard,” she says.

She resorted to wearing long socks and long skirts even when short skirts were de rigueur to avoid scrutiny.

At that time, Florence had experimented with different soaps including medicated ones, which made the condition worse, and hydrating oils, which did not hydrate her skin enough. She chanced on glycerin and it turned out perfect for her skin. 

All this time, no one knew what she was reacting to. She only found out what her triggers were when her visiting auntie gifted her natural body products.

Using them resulted in a bad flare up, from which she deduced she was allergic to ingredients  (which ingredients?) and things with pollen or chlorophyll.

To make matters worse, she would later be diagnosed with asthma, something she manages by using an inhaler when she is exposed to dust. 

Immunity problem

Florence is among many Kenyans suffering from this little-known skin condition characterised with skin inflammations. 

“Eczema is not a skin disease. It is a skin condition where there is an immune system dysfunction in the skin, with the body overreacting to outside stimuli often referred as triggers.

These could be anything from own sweat and tears to dust, pollen, grass, emotional stress, and irritants such as harsh soaps and fabrics such as wool.

Eczema is not contagious; one cannot get it or give it to someone else. One either has it or doesn’t, as it is hereditary,” Dr Jacqueline Kavete a dermatologist explains.

It can also lead to skin scarring. Some people itch till they draw blood. The inflamed skin can form crusts or scabs as it heals.

This may leave a patient with patchy skin, where some parts are of normal colour and texture and others are darker and leathery. 

Dr Kavete says there is a marked correlation between incidence of asthma and eczema, as in most cases, patients tend to have both conditions.

Eczema can manifest at different stages in different people, with some showing symptoms early on and others much later. 

 “I had never heard of eczema untill my son was diagnosed with it at four weeks old.

I knew of allergens and associated allergic reaction, but not of eczema,” Rachel Ogola, a mother of two and the founder of Eczema Society of Kenya says.

When she took her son to hospital at six weeks old, and doctors prescribed steroids and emollients (substances that soften and moisturise the skin and decrease itching and flaking).

At the pharmacy to buy the prescribed medicines, the chemist told her the steroids were too harsh and strong for a baby that age. 

“That is when I started reading up on eczema and how to manage it. I got him off steroids, even though whenever we applied them on him, his skin cleared, and when we got him off them, his skin would worsen.

We got him completely off steroids at three years and gave him antihistamines to lessen the itch.

It was hard to send him to school as we had no control over what he came into contact with. But we are managing well; he is now nine years old.

It was easier with my second born, a five-year-old girl now, as we had information on the condition and how to manage it,” Rachel explains.

She found out her son’s triggers are cow milk, fish, juice with acid such as passion and red meat and for her daughters are fish and eggs.

“There is no cure for eczema. The trick is proper management alone. One should identify their trigger and avoid it.

They should also ensure they are not harsh with their skin, showering with lukewarm water and moisturising frequently,” advises Dr Kavete.

Rachel explains she had to start buying camel and goat milk as alternatives to cow milk. She also invested in cotton clothing for both her children and cotton beddings as they also react to materials such as fleece and wool.

Carpets and house mats had to go as they harbour dust, which is another common eczema trigger. Perfumes are also rarely used in the house.

Building self-esteem

“The often overlooked part in eczema management and care is the help, especially when dealing with young children.

Parents should ensure they train the nanny properly. Teach them to use lukewarm water and to pat the baby’s skin dry as rubbing might irritate it.

Tell them about the condition, so you do not leave them scrubbing down your child thinking that their patchy skin is either from dust or witchcraft.

Let them wear cotton since they will be making direct contact with the child.

Train them well so that when the child gets a swollen lip or eye when exposed to an allergen, they are prepared enough to call you calmly or even act independently,” Rachel insists.

For Florence, moisturising her skin regularly and hydrating has worked wonders for her.

She also avoids things she knows trigger her flare ups, for instance, wearing long sleeved jackets and long trousers when hiking to avoid contact with grass.

“Whatever works for someone may not work for you.  A mild soap for me may be harsh on your skin.

If I use Epimax  (an emollient cream), for instance, and you use it and it does not work for you, just move to something new.

Experiment untill you find something that works for you,” Florence advises.

Florence is also a firm believer in empowering those with eczema and nurturing their self-confidence.

“I was able to go through school largely unscathed because I had a high self-esteem, which I drew from education.

I would double down on my books and beat everyone in class, even those who made catty remarks about my skin.

Most bullies act from ignorance. It is, therefore, important that parents educate their children on this skin condition so they can better stand up for themselves and refute untruths.

I would also advise parents to support their children and help them get a hobby or an area where they channel their energies and help them cope with stress,” Florence says.

Rachel fully agrees. 

“Work on your child’s self-esteem starting with relatives, neighbours and teachers. Let the teacher know about your child’s allergen and condition.

You should also be very close to your children, empowering them and ensuring they decide what defines them and that their idea of who they are is not shaped by the outside world.

They should feel free to come to you with complaints or reports so that you can help them deal with anything the world might throw at them because of their skin condition,” she says.

There is little data to help gauge prevalence of eczema in Kenya save for a smattering of studies.

A 2002 study in Uasin Gishu county, showed a spike in diagnosed cases from 13.9 per cent in 1995 to 28.5 per cent in 2001.

Fortunately, sensitisation campaigns by people affected by the condition has seen an increase in awareness.

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