Eczema (young people)
Emotions and having eczema
Skin conditions like eczema can have emotional impacts. Some said that having eczema had big emotional impacts for them, but others said they weren’t affected that much by this. Having eczema was often described as “frustrating” and “annoying”, and can impact on confidence and self-esteem. Many thought young people, especially teenagers, are especially worried about body image. George says he became more self-conscious as a teenager and thinks it’s an age when people are most judgemental. Eczema and scarring can add worry to other insecurities, like body size/weight and facial hair. Ele thinks that hormone changes in puberty added to feeling angry about eczema. Overall, people in their early twenties said they now worry less and feel more positive, but that there can be occasional ‘bad days’. Others, though, felt quite fed-up with having eczema and resigned to having it.
Well, as a kid emotionally – mm, you'd feel not…well as a kid you didn’t feel normal, you didn’t know it was normal. I was the only person in my class that had eczema, so people really didn’t understand it. And I used to be teased for it as well cos I was different.
And I was also…I was also, I think…no I wasn’t, there was another person, but there was only two people that were my skin tone as well back then. So, I was bullied for my hair, my skin, everything and it…and as a kid, you know you don’t feel…I never had that much friends, that’s why that friend I've known for thirteen years was the only one I had during that time. So, yeah that, as a kid, I can't really say cos you don’t…you're just a child, you don’t understand feelings that well, you just sort of know, you know you feel sad. I remember refusing to go to school cos I didn’t want people to stare at me and stuff like that. So, it would get quite psychological.
It's been hard, it's not easy; really isn't easy to have eczema cos it's a mixture of being physically in pain and emotionally in pain you know? You could have it severely and it not bother you in the, that much; you could have it a teeny bit and it completely destroy the way you think, the way…like your life, you might not want to leave the house cos you might have a massive scar on your face cos you’ve had eczema there or something you know. I just…I reckon doctors and GPs should…I mean a lot of them are very understanding, but they tell you the same thing; I want to hear something different that isn't going to be, "Oh I'll just give you these…this cream," and it's like, well I don’t need anything from that, it's just me paying for more stuff, like it probably won't even work. They should do like trials and they give you like a free sample and try it for like a week I reckon. Cos that would be…that might be more successful than giving them medication that would flare it up without them.
People thought that others might not think of eczema as a ‘serious’ condition. There is not a straightforward relationship between severity (how much eczema a person has or how strong their symptoms are, like itching and pain) and emotional impacts. Some people had fairly mild eczema but found it very upsetting. Others had severe eczema but didn’t find it had much of an emotional impact on them. Eczema severity and other things, like the affected body location, can be factors shaping feelings – but they do not guarantee that the person will feel a particular way.
Feelings about eczema related to:
There was one year when my eczema was really bad and then it scarred that summer and then the following summer I was so nervous about getting tanned and had made such a conscious effort all year not to scratch because it was almost like because you couldn’t see the eczema, the scars were really horrible because no one, everyone, I kind of felt like everyone would’ve been guessing what they were because they were literally just blotchy skin. And I hated it, I was, that was as, I was as insecure about the scars as I was when the eczema was visible. and the scars have gone, so now I do get scars here [points off screen] but like I’ve always, always, always had scars there so I’m used to that and that’s never, I’ve kind of grown like to kind of be unfazed by that. But the scars on my face and my chest I hated, but I don’t get those anymore.
I think during like the first couple of years of, of secondary school I used to be really confident like I could talk, present work if I wanted to in front of the class even though my eczema was really bad at that time. But as I grew up I kind of got more wary of what people think, I know you really shouldn’t, you really shouldn’t do that because you shouldn’t really but yeh I really got wary of like what people think of me how they might think of me and stuff like that so then my confidence just went down to be honest and I really find it hard to talk in classes especially when the teacher picks you as well, it’s really annoying but you have to do it. But yeh I just kind of like get really shaky and panicky and kind of get to a point where I don’t know what to do but you have to do it so, so yeh it kind of does affect me.
I was really happy cos, it took me a while to get hold of all the prescriptions cos there were so many. But once I started taking them, it really started to turn round and my face was clear and my skin was smooth. I wasn’t red. It was really nice to feel comfortable in my own skin again. I didn’t, I couldn’t, didn’t have to go out and feel like everybody was looking at me because my skin was so, so red and horrible. And I could wear things that I wanted to wear. I could get my arms and my legs out. And I could wear like a, like a loose neck instead of having to keep it covered up cos my neck was so sore. It was just nice to be able to get back to what normal would have been if my skin wasn’t so bad. So I could dress like everybody else, do what everybody else is doing. And I felt comfortable sort of seeing people, being out and about.
The ‘vicious cycle’ of stress and eczema
Stress was a major trigger for many people’s eczema. Others, such as Jessica, weren’t sure if this was the case for them and Gary found only certain kinds of stress made a difference. Some people described their skin as ‘showing’ or ‘reflecting’ their feelings through flare-ups. Abid says anxiety and sadness “physically manifest” on his skin.
Having eczema can be a source of stress. Other reasons for feeling stressed include studying (especially exams) and arguments with friends, partners or family. Stress and eczema can fuel one another in a ‘vicious cycle’: stress leads to itching which makes the eczema worse and causes more stress. Being unable to sleep enough can add to this problem.
Stress is really bad for it.
OK
But not every kind of stress because stress at work, it doesn’t affect it. Friends – not really, only family, and I just, I just told you about, I just thought about it with my mother when I was home a couple of weeks ago that I'm kinda like-, I like to dictate and I like to be the ruler. I like to tell people what to do and I don’t really like when they tell me. And at work when they try to push me down.
I always go like, “Yeah OK,” I just let them. I smile at them and I ask like, “Yeah OK, it's alright,” and when they calm down and then I give everything back.
[Laughs]
But I cannot do this one with my parents because I love my family and they stress me a lot and my brother as well. And my brother is like the closest person for me in the world but he can stress me in such a bad way [laughs]. No-one can make me feel as stressed as him.
If I'm sad it doesn’t trigger the eczema, if I'm only sad. Only the stress and only this kind of emotional stress – everyday, driving a car; someone comes in front of me; I get angry, I push the horn – it doesn’t change my skin. Work or other stuff. It's mostly emotional, only my ex-girlfriends could trigger it, and then my family. Yeah.
Because those are the kind of relationships that I cannot push down in how I would like to. Because at work it's easy because if, even if it's my boss and tells me something really bad, I can still punch him. They're going to fire me – who cares, I'll find another job, but I cannot do this with my father or my mother [laughs], so that’s kind of really bad because I have all this pressure inside me and I just think can't get it out. And then my mother comes to me and, “Hey, talk about it.” I don’t want to talk about it because I talk about it and then I get angry again [laughs] and it makes no sense. For me.
See, I don’t know, just like everyone’s always like ‘oh, is it cos you’re really stressed?’ But I don’t actually notice it that much. And I feel like if no one had ever told me that like it’s quite a common thing, ‘oh, stress is a trigger for acne, stress is a trigger for eczema’. But if no one had said it to me I probably wouldn't have even noticed. Yeah, I’m pretty sure that the like, it’s self-perpetuating because of, the vulvar eczema thing stresses me out. And then that’s sort of like, is stressful. But like yeah, I can’t think of a specific. I don’t, I don’t think it gets worse near exam time or anything. So I can’t really think of any specific time.
Yeh, yeh stress definitely sorry. it would definitely flare my skin up ‘cos I’m at that point where I’m panicking I guess and I can’t control myself so I don’t know what to do so then my skin will get bad and that will lead to me itching even more and then you’re getting even more frustrated and putting more stress on me basically so it’s not a good time to be honest when I’m stressed. But I do, I’m trying to control it better now but I could still do with improvement if that makes sense so yeh.
So is that some of the techniques that your drama teacher taught you?
Yeh definitely like I think one of them was to like breath in and out until ten, slowly like cross your fingers and just like tense your whole body so you feel calm afterwards once you’ve tensed it for a couple of seconds and stuff like that so yeh. I do try to do that more often now if I get stressed but I haven’t been stressed lately so yeh.
Mental health and eczema
Some people had mental health issues, such as depression and social anxiety, which they felt their eczema contributed to. A few people had been to counselling offered by their school/college or referred to by their doctor. Katie-Lauren found it helped to speak to a counsellor at college as she says it gave her a different view on things.
Depression sort of came about from the sort of other circumstances but it somehow seemed to also have a, a sort of relative influence on my eczema. So, when my eczema was worse I'd feel sad, and you know in turn probably being sad or stressed out would make my eczema worse, and they'd both conflict, make it even worse. And maybe some occasions, or many occasions where I've been down and depressed cos of my eczema, especially when it does flare up, and I have to wait for an appointment cos some…I have, in previous times, made emergency appointments where doctors have turned me away citing that this is not considered a emergency situation, so you have to just go back home, make an appointment as everyone else, and it has frustrated me, stressed me out; in turn led to depression that causes more… well more flared up eczema. They both kind of worsen each other out.
It’s something that my GP arranged. Cos I’d been speaking about it with my boyfriend and he’d noticed how, how much it had been affecting me. I mean I wouldn’t go out, and I’d cry because I couldn’t go out cos I felt horrible. Or we’d, I’d planned to go out and my skin wouldn’t be to the level I’d like it to be so I’d be upset. Or my skin would hurt that much that I’d be upset. And, and I wasn’t coping with it how I should have been. Cos I didn’t have a positive mental outlook. I was just down in the dumps and feeling sorry for myself. And he just told me that if I didn’t sort it out, then it was just gonna carry on being like this and I was just gonna stay stuck in this rut. So we spoke about it and I did agree with him that it was having a big impact on how I was spending my life. Cos I was spending a lot of time inside. I wouldn’t go out with my friends. So we, we went to the GP. And she understood that it was having an effect on my life and that I didn’t, wasn’t enjoying the things that I used to enjoy or enjoy going out with my friends.
I've only ever had those suicidal thoughts only a few times. But I remember at the time I knew I'd never do it, but it's just something, and you think, 'Mm could I?' and I thought, 'No don’t be so stupid, you know you can sort your life out,' you know, 'get yourself, you know get some, you know…' I've got tremendous help here so, I know for a fact they're not going to make me suffer.
If you are feeling suicidal, you know or you're feeling low, really low, tell somebody. Like I got the courage to tell my mum that I had, I might have anxiety. I went…I had a depression when I was thirteen so that doesn’t help. But that’s over now. But I think out of that I've got anxiety problems so, now everyone…now wherever a job I get next or, even if I make a new friend, I tell them.
Yeah
So that they can understand I'm not going to…I'm not saying I'm suicidal because I want attention, it's cos it's generally you think that. I mean I've never…I would never, ever have the guts to do it, I don’t know how people can do it, it's so…it frightens me to think about it. But when you're in that time and place, when you're sat there itching or you're thinking about…you're relapsing back your life going, 'My life's been crap with this skin, I haven’t been able to have fun, haven’t been able to do this.' That’s when you just think, 'Uh, if I just ended it now would it be over?' and then, at that time you…like my mind just sort of flips and thinks, 'Hang on, look at the positives, you're life aint all negative. You’ve still got all your family – there's people out there that haven’t got parents you know - don’t be moaning about your skin, you know it will go away.' If you take care of it, it will either clear up a bit or could completely go away.
It was kind of annoying when I had this one and my brother started pushing me that it must be emotional because he just, he just started seeing a, a therapist and started reading about it and he was like, “Yeah, it's something so deep inside of you,” and I was like, “Yes, this moment that you're pushing me and you're stressing me [laughs], this triggers my eczema.” But he doesn’t-, he still thinks that I have something, unsolved problem inside of me and that’s why I have it. I don’t find it this way.
I went and I was like really feeling fine at the therapist and I was like, actually after a while I haven’t really seen any point about talking because actually I was, I was really, I was so alright emotionally; inside everything was alright except my eczema. When I had my sk-, when my skin was bad I was like so nervous and anxious, but then I know that I don’t need a therapist for that one to tell me I'm anxious because of my skin – I know that one, everybody know that one.
But this kind of emotion-, because my brother always pushed me and that, “Yeah it must be something emotional,” and then I was like yeah, but so many bad things happen with me, so many times I had a bad mood, but still it didn’t affect my skin. And then I think two-, like in the last two years I figured this one out, or the last one year that it's actually my family which occurs it.
Confidence and self-esteem
Eczema can make people feel less confident. Jessica said that vulval eczema caused mostly practical difficulties but it also negatively impacted her self-esteem. Having eczema didn’t affect Abid’s confidence too much but he knew that other people struggled with this.
Some remembered when other people had done or said things which made them self-conscious about their skins. They didn’t always use the word ‘bullying’, but examples included nasty comments and being physically forced to show their eczema. There was often the fear that something could be said unexpectedly at any moment. Sometimes the things that people did or said weren’t meant to cause upset, but still did out of ignorance. Even comments meant to be helpful caused people to feel awkward as it drew attention to the eczema. Vicky doesn’t like it when people look at her skin for too long. Gary doesn’t like it when people “pity” him.
I mean with meeting new friends and stuff you don’t normally shake hands with them or anything like that like if you’re meeting a mate of a mate but there’s sort of the worry of oh are they grossed out by my skin like do I mention it like they might not have noticed it at all they could be just, you know, but a couple of times I have noticed people staring at it and that gets a bit like having sort of social anxiety as well then most people will just be like oh it’s just eczema but they think like I’m disgusting oh my God they’re judging me, they’re judging me, everyone hates me [laughter] it just, just turns into sort of like an internal three act play and even though I can sort of play it off externally on the inside it’s just like I’ve just made someone feel sick.
You get like the younger groups that would like probably just say, would probably look at you and you know, whisper to their friends or I don’t know say ‘eee’ or something like that, I know that they don’t know what I’ve got but it kind of makes me feel like if they’re seeing it like that what are other people seeing, if that makes sense so I would force myself to cover up, force myself to put more moisturiser I guess just to make sure that my skin is better. And like but sometimes again like when people don’t understand when you put the creams they’ll say stuff like oh he’s got cream on his face, shiny face or whatnot you know what I mean, so yeh. But obviously those people don’t understand what I was going through.
It cleared up all the eczema itself but then I was obviously left with all the marks that the eczema had made, been there, because they'd been there for years and obviously I'd sort of scratched and rubbed and it had made itself sort of just scarred up my face really bad. And so then I just… even though it went away I still had these really big dark circles around my eyes from where the eczema used to be and in the corners of my mouth from where the eczema used to be in the corner of my mouth as well. And it was just sort of… even though it had gone I felt like it was still there in a way. I mean, obviously yeh, I mean the itchiness and the flakiness of it all, the just, the sort of terribleness that comes with the condition wasn’t there but sort of the aftermath was still there, if it makes sense.
Negative feelings about eczema can be ‘internalised’ – this is when the person thinks nasty things about themselves, even if nobody else believes or suggests these things. Feeling self-conscious can have very real effects and in many aspects of young people’s lives, such as: school, college, university and studies; social life and hobbies; friendships and romantic relationships; work life; and relationships with family members.
People had different strategies for managing times when they might feel less confident about eczema. Often this involved hiding eczema with clothing or hair styling, though this is difficult for visible parts such as the face and hands. Young women sometimes used make-up but this could be a trigger for some. Others, like Molly, found it highlighted the dryness of the skin. Some people cancelled plans when they felt bad about their skins (their eczema, treatments and/or scarring). Katie-Lauren wears bracelets as a distraction so that “people look at the bracelets rather than my skin”. Shams often makes up other excuses to tell people, such as that he accidentally scraped his skin on a wall. Some people used steroid treatments more than they thought they should in the hope that their eczema would clear up sooner, but also worried about side effects from doing this.
I use make-up all the time. I’m awful. And when I wash it off my skin is blotchy and red and sore and I think to myself, ‘I shouldn’t have wore make-up’. But yeah, because I feel there’s a pressure to. Even though I try to make sure that I don’t, I try to make sure that I’m not doing it for other people. But I can’t escape that this is the society we live in. So, even though I’m okay with my skin, I don’t think I am okay with not wearing make-up or presenting myself in a certain way. So, but I’ve heard about eczema make-up and I’ve, but I’ve never been told about it by my doctors even though I have described the problem of wearing foundation and all they say is, “Don’t wear foundation. Don’t wear make-up.” But really I think they understand what society we live in, so maybe they should be a little bit more helpful. But I have heard that it does exist. But I have tried gentle make-ups which are claimed to be for sensitive skin and in reality it’s, it’s not.
I just wanted to do what everyone else was doing cos I was that age when it was like everyone wore the same clothes, awful clothes, and everyone was like trying make-up for the first time and everyone was kissing boys for the first time and I just wanted to be doing all of that and because I couldn’t do the make-up thing then I felt like I've been robbed of everything because obviously the make-up thing was so like linked like kissing your first boy and like going to parties and being this confident, beautiful girl. Like I felt like all of that was because of the lack of make-up and therefore the double lack of confidence, it all kind of started to kind of knock on to all the other stuff.
Growing in confidence
People said they’d become more accepting and confident with time. Often they thought that getting a bit older helped. Abid regrets worrying about what others thought of his eczema because it put a lot of “mental restrictions” on his life. Hazel and Sarah say they often think their eczema is more noticeable than it is to other people. Counselling had helped some to think in a different, more positive way about themselves. There may be occasional times when having eczema knocks their confidence again, but many tried to enjoy life and find things which made them happy. Gary feels better when he does a lot of walking and it helps relieve stress which, in turn, calms down his eczema.
I think in a weird way it’s actually made me like more confident. Because, since it’s got better, I’ve now been like ‘two fingers to you, eczema’ and [laughs] like taking back my life. and it kind of doubly doesn’t faze me and I’m almost proud of my eczema to be like “What’s wrong with it, like if you’ve got a problem with it – I don’t really want to hang out with you”, not that I’ve ever had that confrontation with someone [laughs]. But yeh no I think actually now it’s better, it’s only had positive impacts. Obviously like if I hadn’t had it in the first place I'd be, I actually think I’d be such a different person today if I hadn’t had it in the first place, which I’ve never really thought about [laughs].
In what sort of ways do you think you’d be different?
I think I’d have never had, I actually potentially might not, might not have been as confident as I am now – just because I’d never of had the wobble to kind of teach, like pick myself up from and kind of fight against. And I think, I don’t know, yeh, that’s probably like the key one I think – my confidence is probably actually up on the fact that I’ve suffered eczema in a really weird way, I don’t know.
From the whole way through my teens, the whole way through secondary school, I did taekwondo, and that’s indoor, but it's a lot of like movement with your hand and things so, I think you just overcome it; like any discomfort or any embarrassment or anything you just gradually overcome it by, you know, being, doing sport and things like that. So, it's probably quite a good thing for, you know, encouraging and making people more confident with the condition.
So I think like, well I guess with taekwondo, for example, it's a, taekwondo like it is about obviously kicking, but also punching a lot and using your hands a lot. So you sort of… without realising, it probably like really helped me because, obviously I can't just like not use my hands in a sport, in the classes. So, I think it sort of confronts it in a way; like you have to use it, like, you know you're putting your hand to people's faces; a lot of contact. Whereas, you know some people, it could have easily been the other way round – I could have like, over my teens, just become sort of very like, you know covered up, not wanting people to touch me, my hands and things like that. Whereas, like the taekwondo with the tactile side to it makes it a lot more just like, becomes the norm I think.
Some people felt strongly that eczema is not something to be embarrassed about. They talked about pressures on appearance and body image which can make people feel bad about themselves. Many thought this had a negative impact on women especially, but that men are affected too. Some felt that ‘beauty ideals’ excluded lots of people, such as those with visible differences as well as skin conditions like eczema. Aisha and Hazel talked about the role of the media and Photoshopping models in advertisements. They challenged these expectations about appearance as unrealistic and unfair.
Cos I have my big sister who’s, who’s always been really supportive and just been like, “If anyone cares about what you look like, that has no bearing on you, it’s just them.” But also, when it was getting bad, I just felt like, ‘Oh, I can’t leave the house. What am I going to do?’ And I wanted to leave the house. I didn’t want to stay in and it just made me feel like, ‘Well what am I going to do?’ So I, it started slowly. I didn’t like wake up one day and say, “I love my skin. Screw you.”
[Laughs]
I started slowly and then I realised no ones’ going to say anything and if they do, everyone else in this place is going to look at them like they’re arseholes, because they are. And then I started thinking, ‘Well, if no one’s going to say anything, are they even noticing?’ Like when it was massive, like really bad and spread over big parts of my skin, I’d be like, ‘yes they can notice. I bet they think that it’s disgusting. I bet that I’m putting them off their food or something’. And slowly I’d go out and probably sit in a café and I’d be like quite, and I’d notice that no one, no one was looking. No one thought anything of it. They did not care. Occasionally you’d probably got someone look at your arm and then walk off. And I realised that they may think like, ‘Oh, look at her skin,’ for five seconds and then they’ll never think about it again. Or even pass through their mind at all after that one second of them going, ‘Oh, look at her skin.’ And that doesn’t even, just because they looked it doesn’t mean that they’re hating like on your skin.
Scarring was also talked about. Aman says he’s no longer concerned with scarring as he’s just happy when his eczema is not too uncomfortable. Anissa used to feel uncomfortable about the scarring on her arms from eczema patches. She doesn’t think “everyone’s going to love” their scars, but she now likes hers because they’re “unusual” “like a leopard” print. Some people felt there were positives that came from having eczema – such as becoming a kinder and more understanding person. Many wanted to help others who are going through the same experiences as they had/have. Talking to others, including those who have eczema themselves, was seen as a good thing (see also ‘Sources of information and support about eczema' and ‘Friendships, intimate relationships and eczema’). Sarah finds there is a “funny side” to having eczema too, which she jokes about with friends who also have it and can relate to her experiences.
I remember one mother was even saying to me that she gets the book out whenever her child scratches. It makes me feel good. I mean, one of the aims for this book, a more personal aim was something, like eczema is something that has severely affected my childhood. And rather than looking at it so negatively I wanted something positive to come out of it. And although like it’s still like quite a hard time to talk about it’s not so difficult now that I’ve done something good about it.
Naomi felt like she stood out at school because of her eczema and skin tone.
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And I was also…I was also, I think…no I wasn’t, there was another person, but there was only two people that were my skin tone as well back then. So, I was bullied for my hair, my skin, everything and it…and as a kid, you know you don’t feel…I never had that much friends, that’s why that friend I've known for thirteen years was the only one I had during that time. So, yeah that, as a kid, I can't really say cos you don’t…you're just a child, you don’t understand feelings that well, you just sort of know, you know you feel sad. I remember refusing to go to school cos I didn’t want people to stare at me and stuff like that. So, it would get quite psychological.
Naomi explains about emotions and eczema.
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Feelings about eczema related to:
- symptoms like skin redness, flaking, and scarring. Some worried about what other people think (about the sight of eczema or whether they could ‘catch’ it). Alice worried people might think she had lice or scabies and was ‘dirty’. Itchiness can be frustrating and trying not to scratch can feel like a “battle” of willpower. Flare-ups can be frustrating as it can feel like all the ‘good work’ put into skin care is undone. Shams found it upsetting when his eczema cleared up but then “slowly and surely it comes back again”. The uncertainty of what the future might hold in terms of eczema was a concern for some people. Some felt it was “unfair” that they had eczema, especially when they knew others had ‘grown out’ of it.
- getting a diagnosis made some people feel shocked, frightened, confused, angry and lonely. People who had eczema all their lives said it had become ‘normal’. Others, such as Jessica, felt relieved to finally have an explanation for their symptoms and were hopeful about treatments.
- seeing medical professionals involved: frustration with repeat appointments and no improvements (especially if they feel their eczema isn’t being taken seriously); annoyance when appointments don’t run on time; feeling blamed and nagged by health professionals; hopefulness about referrals (such as to dermatologists); and disappointment when healthcare professionals didn’t ask about or offer suitable support with confidence/esteem problems. It was important for many that their health professionals understood there can be an emotional side of having eczema. Some people felt comfortable with health professionals they had met many times and trusted them to help. Others felt intimidated and nervous, especially when meeting a new doctor or nurse for the first time. Health professionals sometimes did or said things which made the young person uncomfortable.
Molly worried about what others would think if they saw the marks visible on her skin after tanning a few summers ago.
Molly worried about what others would think if they saw the marks visible on her skin after tanning a few summers ago.
Himesh’s confidence dropped after being diagnosed with eczema during secondary school.
Himesh’s confidence dropped after being diagnosed with eczema during secondary school.
Georgia felt positive and hopeful after her first dermatology appointment.
Georgia felt positive and hopeful after her first dermatology appointment.
- avoiding triggers can mean missing out on the things that other people do. Naomi says it “puts me on a downer” when her friends talk about using bath products that she can’t. Some people worried about coming across a new trigger unexpectedly or being in a contact with a trigger without realising. It can also be hard to identify these. Abid enjoys cooking and would find it difficult to limit his diet in an attempt to work out possible triggers. Some said they would rather do particular activities, rather than avoid them, even if it meant being in contact with triggers.
- using treatments (like emollients, steroid creams, phototherapy) and their side effects or discomforts. This can include: the ‘unpleasant’ feel, look and smell of some treatments which can attract attention from others; annoyance about carrying the items around; embarrassment at others seeing the bottles; fears about over-using steroids; frustration when treatments don’t help or irritate the skin; and worries about treatment costs/money.
The ‘vicious cycle’ of stress and eczema
Stress was a major trigger for many people’s eczema. Others, such as Jessica, weren’t sure if this was the case for them and Gary found only certain kinds of stress made a difference. Some people described their skin as ‘showing’ or ‘reflecting’ their feelings through flare-ups. Abid says anxiety and sadness “physically manifest” on his skin.
Having eczema can be a source of stress. Other reasons for feeling stressed include studying (especially exams) and arguments with friends, partners or family. Stress and eczema can fuel one another in a ‘vicious cycle’: stress leads to itching which makes the eczema worse and causes more stress. Being unable to sleep enough can add to this problem.
Gary says that stress, with his family and romantic relationships, is a key trigger for his eczema.
Gary says that stress, with his family and romantic relationships, is a key trigger for his eczema.
OK
But not every kind of stress because stress at work, it doesn’t affect it. Friends – not really, only family, and I just, I just told you about, I just thought about it with my mother when I was home a couple of weeks ago that I'm kinda like-, I like to dictate and I like to be the ruler. I like to tell people what to do and I don’t really like when they tell me. And at work when they try to push me down.
I always go like, “Yeah OK,” I just let them. I smile at them and I ask like, “Yeah OK, it's alright,” and when they calm down and then I give everything back.
[Laughs]
But I cannot do this one with my parents because I love my family and they stress me a lot and my brother as well. And my brother is like the closest person for me in the world but he can stress me in such a bad way [laughs]. No-one can make me feel as stressed as him.
If I'm sad it doesn’t trigger the eczema, if I'm only sad. Only the stress and only this kind of emotional stress – everyday, driving a car; someone comes in front of me; I get angry, I push the horn – it doesn’t change my skin. Work or other stuff. It's mostly emotional, only my ex-girlfriends could trigger it, and then my family. Yeah.
Because those are the kind of relationships that I cannot push down in how I would like to. Because at work it's easy because if, even if it's my boss and tells me something really bad, I can still punch him. They're going to fire me – who cares, I'll find another job, but I cannot do this with my father or my mother [laughs], so that’s kind of really bad because I have all this pressure inside me and I just think can't get it out. And then my mother comes to me and, “Hey, talk about it.” I don’t want to talk about it because I talk about it and then I get angry again [laughs] and it makes no sense. For me.
Jessica is unsure whether stress is a trigger for her eczema.
Jessica is unsure whether stress is a trigger for her eczema.
One of Himesh’s teachers has talked about techniques for coping with stress.
One of Himesh’s teachers has talked about techniques for coping with stress.
So is that some of the techniques that your drama teacher taught you?
Yeh definitely like I think one of them was to like breath in and out until ten, slowly like cross your fingers and just like tense your whole body so you feel calm afterwards once you’ve tensed it for a couple of seconds and stuff like that so yeh. I do try to do that more often now if I get stressed but I haven’t been stressed lately so yeh.
Some people had mental health issues, such as depression and social anxiety, which they felt their eczema contributed to. A few people had been to counselling offered by their school/college or referred to by their doctor. Katie-Lauren found it helped to speak to a counsellor at college as she says it gave her a different view on things.
Shams’ depression and eczema link together.
Shams’ depression and eczema link together.
Georgia was referred to see a counsellor to talk about her low self-esteem.
Georgia was referred to see a counsellor to talk about her low self-esteem.
There have been times when Naomi’s felt suicidal about her eczema.
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There have been times when Naomi’s felt suicidal about her eczema.
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If you are feeling suicidal, you know or you're feeling low, really low, tell somebody. Like I got the courage to tell my mum that I had, I might have anxiety. I went…I had a depression when I was thirteen so that doesn’t help. But that’s over now. But I think out of that I've got anxiety problems so, now everyone…now wherever a job I get next or, even if I make a new friend, I tell them.
Yeah
So that they can understand I'm not going to…I'm not saying I'm suicidal because I want attention, it's cos it's generally you think that. I mean I've never…I would never, ever have the guts to do it, I don’t know how people can do it, it's so…it frightens me to think about it. But when you're in that time and place, when you're sat there itching or you're thinking about…you're relapsing back your life going, 'My life's been crap with this skin, I haven’t been able to have fun, haven’t been able to do this.' That’s when you just think, 'Uh, if I just ended it now would it be over?' and then, at that time you…like my mind just sort of flips and thinks, 'Hang on, look at the positives, you're life aint all negative. You’ve still got all your family – there's people out there that haven’t got parents you know - don’t be moaning about your skin, you know it will go away.' If you take care of it, it will either clear up a bit or could completely go away.
Gary was encouraged to see a counsellor by his family but he didn’t find it helpful.
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Gary was encouraged to see a counsellor by his family but he didn’t find it helpful.
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I went and I was like really feeling fine at the therapist and I was like, actually after a while I haven’t really seen any point about talking because actually I was, I was really, I was so alright emotionally; inside everything was alright except my eczema. When I had my sk-, when my skin was bad I was like so nervous and anxious, but then I know that I don’t need a therapist for that one to tell me I'm anxious because of my skin – I know that one, everybody know that one.
But this kind of emotion-, because my brother always pushed me and that, “Yeah it must be something emotional,” and then I was like yeah, but so many bad things happen with me, so many times I had a bad mood, but still it didn’t affect my skin. And then I think two-, like in the last two years I figured this one out, or the last one year that it's actually my family which occurs it.
Eczema can make people feel less confident. Jessica said that vulval eczema caused mostly practical difficulties but it also negatively impacted her self-esteem. Having eczema didn’t affect Abid’s confidence too much but he knew that other people struggled with this.
Some remembered when other people had done or said things which made them self-conscious about their skins. They didn’t always use the word ‘bullying’, but examples included nasty comments and being physically forced to show their eczema. There was often the fear that something could be said unexpectedly at any moment. Sometimes the things that people did or said weren’t meant to cause upset, but still did out of ignorance. Even comments meant to be helpful caused people to feel awkward as it drew attention to the eczema. Vicky doesn’t like it when people look at her skin for too long. Gary doesn’t like it when people “pity” him.
Ele worries that others will judge her negatively for having eczema on her hands.
Ele worries that others will judge her negatively for having eczema on her hands.
Others' comments and behaviours sometimes make Himesh feel self-conscious at school.
Others' comments and behaviours sometimes make Himesh feel self-conscious at school.
Aisha describes the changes left to her skin even after her eczema cleared.
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Aisha describes the changes left to her skin even after her eczema cleared.
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People had different strategies for managing times when they might feel less confident about eczema. Often this involved hiding eczema with clothing or hair styling, though this is difficult for visible parts such as the face and hands. Young women sometimes used make-up but this could be a trigger for some. Others, like Molly, found it highlighted the dryness of the skin. Some people cancelled plans when they felt bad about their skins (their eczema, treatments and/or scarring). Katie-Lauren wears bracelets as a distraction so that “people look at the bracelets rather than my skin”. Shams often makes up other excuses to tell people, such as that he accidentally scraped his skin on a wall. Some people used steroid treatments more than they thought they should in the hope that their eczema would clear up sooner, but also worried about side effects from doing this.
Anissa thinks doctors should be aware of the pressure on females to wear make-up.
Anissa thinks doctors should be aware of the pressure on females to wear make-up.
Molly was upset that couldn’t wear make-up like her friends when she was younger.
Molly was upset that couldn’t wear make-up like her friends when she was younger.
People said they’d become more accepting and confident with time. Often they thought that getting a bit older helped. Abid regrets worrying about what others thought of his eczema because it put a lot of “mental restrictions” on his life. Hazel and Sarah say they often think their eczema is more noticeable than it is to other people. Counselling had helped some to think in a different, more positive way about themselves. There may be occasional times when having eczema knocks their confidence again, but many tried to enjoy life and find things which made them happy. Gary feels better when he does a lot of walking and it helps relieve stress which, in turn, calms down his eczema.
Molly felt very self-conscious as a teenager but feels she’s more confident for having got through it.
Molly felt very self-conscious as a teenager but feels she’s more confident for having got through it.
In what sort of ways do you think you’d be different?
I think I’d have never had, I actually potentially might not, might not have been as confident as I am now – just because I’d never of had the wobble to kind of teach, like pick myself up from and kind of fight against. And I think, I don’t know, yeh, that’s probably like the key one I think – my confidence is probably actually up on the fact that I’ve suffered eczema in a really weird way, I don’t know.
Laura has eczema on her hands and found that doing taekwondo has made her more confident about using them.
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Laura has eczema on her hands and found that doing taekwondo has made her more confident about using them.
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So I think like, well I guess with taekwondo, for example, it's a, taekwondo like it is about obviously kicking, but also punching a lot and using your hands a lot. So you sort of… without realising, it probably like really helped me because, obviously I can't just like not use my hands in a sport, in the classes. So, I think it sort of confronts it in a way; like you have to use it, like, you know you're putting your hand to people's faces; a lot of contact. Whereas, you know some people, it could have easily been the other way round – I could have like, over my teens, just become sort of very like, you know covered up, not wanting people to touch me, my hands and things like that. Whereas, like the taekwondo with the tactile side to it makes it a lot more just like, becomes the norm I think.
Anissa challenges the idea that eczema is something to feel insecure about.
Anissa challenges the idea that eczema is something to feel insecure about.
[Laughs]
I started slowly and then I realised no ones’ going to say anything and if they do, everyone else in this place is going to look at them like they’re arseholes, because they are. And then I started thinking, ‘Well, if no one’s going to say anything, are they even noticing?’ Like when it was massive, like really bad and spread over big parts of my skin, I’d be like, ‘yes they can notice. I bet they think that it’s disgusting. I bet that I’m putting them off their food or something’. And slowly I’d go out and probably sit in a café and I’d be like quite, and I’d notice that no one, no one was looking. No one thought anything of it. They did not care. Occasionally you’d probably got someone look at your arm and then walk off. And I realised that they may think like, ‘Oh, look at her skin,’ for five seconds and then they’ll never think about it again. Or even pass through their mind at all after that one second of them going, ‘Oh, look at her skin.’ And that doesn’t even, just because they looked it doesn’t mean that they’re hating like on your skin.
With the help of Fixers (charity), Aadam wrote a children’s book based on his experiences to help others with eczema.
With the help of Fixers (charity), Aadam wrote a children’s book based on his experiences to help others with eczema.
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