Sarah
Sarah has had eczema all her life. Her skin cleared up during her teenage years but the eczema returned whilst she was at university. She has seen many GPs and finds it frustrating that she tends to be offered only a limited number of treatment options.
Sarah has had eczema since she was born, continuing through to her childhood to her early teens when it cleared up almost entirely. However, when Sarah moved away to university, her eczema returned severely. She had eczema on her face for first time; the skin was very red, flaky and she had swelling around her eyes. She did not have the right medications for her skin and she was not yet registered with a GP in her university city when this big flare-up happened. She thinks her eczema came back because of all the changes that were happening, including moving to a new place (with a different water type and low quality university accommodation) and increased alcohol consumption. The GP she saw prescribed an emollient and steroid cream which started to help almost instantly. She continues to manage her eczema with moisturisers and occasionally steroids. Sarah’s eczema has become infected before, including developing sebaceous cysts and impetigo which required several courses of antibiotics.
Sarah has had mixed experiences with GPs, including receiving contradictory advice on using steroids on the face. She has asked for a dermatology referral but was told that she must first try all the treatment options. This is frustrating because the GPs she has seen tend to offer only a couple of moisturisers, for example. However, when Sarah asks for a particular moisturiser by name, she finds that GPs are usually willing to prescribe it. Sarah now tries to limit her use of steroids out of concern that these might become less effective and cause long-term damage to her skin. She once stopped using steroids altogether but this became very difficult at such a stressful time during the exam period. She has looked on some forums about steroid withdrawal and likes to read beauty blogs about products suitable for people with eczema. The cost of treatments for eczema was a big concern when Sarah had an unreliable income with a part-time job. She finds it frustrating that both prescribed medications and shop-bought products often do not offer samples, making the process of trialing different things for her skin very expensive.
Sarah has found it very hard having eczema on the face, such as on the eyelids, around her chin, behind her ear, on the back of her neck. She has combination skin which makes it difficult to manage eczema alongside acne breakouts. She finds that thick moisturisers can cause blocked pores, leading to spots on her face and ingrown hairs on her legs. Sarah has tried lots of different cosmetic and hair styling products, eliminating those which aggravate her skin; this includes products which aren’t directly applied to the skin but disperse, like hairspray, shampoo and spray deodorant. Sarah would like to have an allergy test to help her avoid triggers but her GPs have not been supportive about this. Sarah knows of some triggers already for her eczema, including stress, a lack of sleep, dehydration, sports, tight clothes, biological washing powder, fabric conditioner, season changes, dust and animal fur. Some alcohol and sugary drinks, such as cider, also make her skin worse but she’s not sure about other food triggers for her eczema. Eczema also limits the clothes that Sarah can wear, making it difficult to dress smartly when she wants to. She tries to limit the amount of make-up she wears she worried that it would make her feel self-conscious but she has instead found it liberating.
Sarah’s advice is to young people is to talk to others about their eczema, as she says that this will help them feel more comfortable. Many of her friends also have eczema and she finds that talking with them helps her see the funny side of the condition that people without eczema wouldn’t really know about. Sarah would also like for doctors to offer more of a range of treatments, for example different kinds of moisturisers, and to recognise how committed many of their patients are to managing their eczema well.