So the most common type of eczema we see in children and young adults is something called atopic eczema. And that’s often something which starts in babies, and it’s a very complex disease, but it’s mostly to do with a problem initially probably in the barrier of the skin. So, how kind of intact the skin is. And then because of the skin being kind of leaky it loses water, so you can get quite dry skin, and it also means you can develop further problems such as allergy in some cases. So that’s by far the most common sort of eczema, which is called atopic eczema. There’s a few other types, which some people, you know, can have problems with. So there’s one called contact eczema, which is when you’re kind of actually allergic to something that goes on the skin. And we tend to see that, sometimes it can be alongside atopic eczema but it can be also in older people or different types. Some certain jobs are at high risk, for example hairdressers, people that are in contact with certain things. And there’s two types of contact eczema. One’s irritant, where you’re just being, you know, exposed to things that irritate the skin. And one’s an actual allergy. But they all look very similar, they can all look very similar kind of clinically in terms of the skin being red and dry. And then the other kind of big group of eczema is something called seborrheic eczema. And that’s one which really tends to affect the face. So the seborrheic areas are where you produce more sebum, so it tends to the places where you’d otherwise get acne. So forehead, eyebrows, round the nose, and sometimes scalp and back. And that’s a different type of eczema which seems to have a kind of yeast, which is on the face and scalp, which can cause a particular type of eczema. Sometimes you see that in babies, but you can also see it in adults. So it’s quite common. It’s actually, you know, cradle cap that we see in babies is a form of seborrheic eczema as well.

And one thing I found especially was with the GPs they’re not always as knowledgeable as you think they are. So, growing up, you just kind of take it as a given that your GP knows everything about every condition. And then, kind of come 14, 15 you start realising well, they’re just prescribing me the same thing over and over again and seemingly expecting a different response. So, if I was going to give any advice that I’d say, go and talk to a dermatologist, because they’ll know exactly what your skin needs and the different types of eczema and will have different types of treatment for it. Whereas, a doctor might only recommend hydrocortisone or one specific treatment. And, so the times when I’ve been to a dermatologist they’ve really kind of [laughs] I’ve said, Well you know, the doctor told me to use this, and they’ve basically turned around and said, Well, you know, that’s not really going to affect it because you’ve got this type of eczema or It’s a bit too bad for that kind of cream. It’s not really gonna have an effect.

So this is something that we know quite a bit more about in the last ten years, really understanding eczema, is- you know, it’s a complex condition which is a mixture of your immune response and your skin barrier. So it’s both things going on. And we know that in quite a lot of people they have-, they’re born with a slight difference in their skin barrier function, and there’s a protein called filaggrin, which is quite an important genetic association. If you have mutations in filaggrin, your skin is- your skin barrier function is not the same as someone that doesn’t have. So, right from birth you have a slightly leakier skin. So that means two things, that you have this dry skin but it also means that you have this barrier dysfunction. So that means the allergies can- things can enter through the skin and cause problems. So that’s, we think now there’s a sort of sequential called an atopic march, where you start off with this barrier problem with the eczema. And then due partly to the eczema, you then get exposed to certain things in the environment such as grass, pollens. And that leads to sort of development of hay fever. And in some cases then again, this sort of exposure-, this exposure to allergens through the skin, can then lead to the development of things like asthmas as well. So that’s why some of them it’s to do with your immune response being overactive, and some of it’s to do with your skin barrier being suboptimal. So it’s those two things working together which mean you get this whole complex process.

And that’s why some of it runs in families. So atopy we know is partly genetic, and some of it is to do with how well you manage your eczema, probably when you’re small, and that can reduce your risk we think of going down this pathway.

And there’s been an increase in eczema and other allergies over the past few decades, which is more than you would expect if this was just a genetic condition. So we know that it’s not just people’s genetics, it’s a combination of environmental exposure, the way we manage eczema, the way we manage these other allergic conditions alongside, you know, the way your skin is when you’re born.

As I’ve been growing up I have begun to sort of see what I am allergic to. And it’s not just eczema that like I have allergies with. Like, it bringsit worsens my eczema but it, also I have allergies like mouth reactions and things like that with other food types. So, things like, anything related to sheep so lanolin, wool and things like that – I know to avoid. And so it’s one of those things as a kid you just get told, “Don’t sort of stroke any animals; don’t stroke sheep especially; don’t wear things that are wool; don’t eat lamb,” things like that. And also food groups such as like tomatoes and oranges I wouldn’t eat. Dairy, so when I was younger you sort of just know not to, and I guess also your my Mum was sort of checking whether I was eating things.

Is there anything else to do with sort of shared accommodation whilst you’ve been at University and like, since you’ve graduated?

I lived in like a really mouldy room two years ago which wasn’t great, and I noticed that that did have quite a big impact on like how everything was with sort of particularly like my hands and my elbows, that was quite severe. But, it got better after I moved out which was good [laughs].

So, have you ever done any allergy tests at all?

No, I haven’t actually. I would be interested in doing that just to know if there’s anything that like I’ve never know if I’m allergic to pets, but I’ve never had a reaction around pets so I don’t know. Or, like I’ve never had hay fever or anything like that but I would be interested to know if it’s something specific, like dust or mites or something like that, but yeah.