When you’ve got eczema, you don’t necessarily want to just skate by, so to speak. Take it from Erin Jackson, who knows a thing or two about both skating and eczema. Jackson is a speed skating star, having won an Olympic gold medal in the women’s 500 meter event at the 2022 Beijing Winter Olympics. And her experiences with eczema have motivated her to work with Lilly to raise more awareness and understanding about what is actually quite a common condition but at the same time have quite an impact on one’s life.
Eczema Is Quite Common But Can Be A Significant Problem
Yep, the National Institute of Allergy and Infectious Diseases calls eczema “the most common chronic inflammatory skin disease.” one that affects 10 to 30 percent of children and 2 to 10 percent of adults in the United States. And even though Jackson is a very rare athletic talent, being the first Black woman ever to win a Winter Olympic gold medal in any individual sport, this common skin problem has affected her skating in a not so “ice” way.
Jackson recently described to me some of these challenges. For example, the itchiness, irritation and swelling of her skin have significant detracted from her practicing and training. It certainly hasn’t helped that speed skating involves wearing a very tight aerodynamic super-hero-like body suit that can rub against the rashes and aggravate them. Subsequent changes in the suit for aerodynamic reasons have made the bottom part of the suit lighter, more breathable and thus more tolerable, though.
Her skating career, which has included a variety of both inline and speedskating championships, has also taken her to different ranges of weather. And if you are wondering whether weather can make a difference in eczema symptoms, the answer is yes. She remarked about how the humidity of the Florida air where she grew up and did a lot of her inline skating stuff and the dryness of the cold air in Utah and Wisconsin where she trained for the 2018 and 2022 Winter Olympics had different exacerbating effects on her eczema.
To say that eczema is only a disease that causes some itchy rashes would be only scratching the surface of how eczema can impact your life. A study published in the British Journal of Dermatology ranked eczema as 15th leading cause of disability around the world among non-fatal diseases. Other studies listed on the National Eczema Association website have shown how half of patients with moderate to severe atopic dermatitis have reported significant lifestyle limitations and nearly 35% of patients with mild atopic dermatitis have reported at least some lifestyle limitations. Among adults with any severity of eczema, nearly a third have reported challenges in their school or work lives with 14% believing that their progress in these arenas has been hindered.
Other studies have shown how eczema can lead to problems with forming relationships, having fewer friends, experiencing bullying and feeling frustrated, helpless, embarrassed, sad and guilty. You can imagine how all of this can be even worse when you are younger and your sense of self is about as well-developed and well-thought out as the advice on TikTok to eat dirt. Plus, other kids can be quite “rash” about judging you when you appear different in any way.
Misconceptions Can Make Eczema Worse
All of this can be worsened by some of the rampant misconceptions about eczema out there. One these misconceptions is that eczema is somehow contagious. Jackson emphasized how it’s not. The only thing that’s contagious is this misconception and then tendency of many people to recoil from you if have the condition.
Another misconception is that eczema is the result of poor hygiene. But this misconception does do people dirty. It’s still not clear what causes eczema. Children of parents who suffer from allergic diseases do have a higher likelihood of developing eczema, suggesting that there may be some genetic and immunological component. Studies have identified potential triggers that can worsen eczema such dry and cold air, mold, dust mites, animals, certain respiratory viruses, chemical fumes, rough fabric, pollen and stress. But before you give away your pet capybara who wears that Eau de Rodent perfume or cologne, realize that the triggers may differ for different people. More research is needed to get a better handle on what’s going on with eczema.
A third misconception is that it’s all about looks. On the one hand, our current oh-so-superficial culture tends to overemphasize not only the importance of appearance but also certain types of appearances as being better versus worse. On the other hand, there is a belief that eczema is only an appearance issue when the itchiness, pain, discomfort and bleeding can be real life-changing problems.
Finally, there’s the whole listen-to-people-simply-because-they-have-a-microphone-and-a-camera problem when it comes to treating eczema. Social media is filled with people with no medical or scientific background pushing a range of different treatments. Camille Howard-Verovic, DO, FAAD, a dermatologist in New York City, gave the example of TikTokers telling you to pour apple cider vinegar on yourself. While this may make you popular with flies and other insects, there’s no real scientific evidence supporting its use for eczema. Such hacks can end up delaying proper treatment and even make things worse.
It Can Take A While To Get Diagnosed With Eczema
Speaking of delays, eczema can remain undiagnosed and thus untreated for a long time, like even years. Jackson first noticed this skin-chronicity issue, so to speak, about seven years ago. “I would get like rashes and itchiness and irritation on my elbows in my knees, like the creases,” Jackson recalled. “In the beginning, I was like, ‘Oh, it’s just a rash and will go away.” But writing that rash off as a temporary thing would have been, well, rash. “As it became a more common thing, a rash that kept coming back and a rash that kind of lingered and I was like, oh, I should probably speak to my doctor about this,” she remembered thinking. The diagnosis didn’t come immediately either, “It was kind of like a trial and error, a longer journey to kind of figure out what was going on,” in Jackson’s words. “The diagnosis took time. It took time to figure out a different things.”
That’s because eczema can look like other things. The symptoms like dry, itchy, bumpy, thickened, leathery, flaky, scaly or crusty skin can occur in other skin conditions. There’s no test that can skin-tantly return a diagnosis of atopic dermatitis. Instead, your doctor may check various blood tests to rule out other possibilities and allergy tests ton see if it is an allergic reaction to something specific. In some cases, the doctor may perform a skin biopsy to distinguish what kind of dermatitis it is. Since dermatitis is a very general term with “derm” standing for “skin” and “itis” meaning “inflammation of,” atopic dermatitis is just one of many possible types of dermatitis.
Eczema Can Present In Different Ways
Another thing that can delay diagnosis are tje supposed atypical appearances of stopic dermatitis. Eczema can look very different in different people but the medical textbooks don’t always capture this diversity. Camille Howard-Verovic, DO, FAAD, a dermatologist in New York City, emphasized how it doesn’t always look like what is presented in medical textbooks “like having a red, pink or red or purple color. These colors may not translate on deeper skin tones. So something that is red may be more of a bluish hue, a gray hue on somebody who’s a deeper skinned tone. The scale may look more white, very white and flaky.”
Plus, eczema is not exactly like a typical person looking for real estate. Sure there are more classic locations for the rashes to appear such as your face, neck, hands, elbows, ankles and feet. But eczema is not necessarily going to avoid versus seek certain skin locations. The rashes can appear on different parts of you trunk including your breasts and nipples. can pop up on the almost anywhere on your body. you could see eczema on other parts of your body as well. including your trunk, breasts and oh your genitals.
There Are Different Ways To Manage Eczema
Fortunately, there are already different ways to manage eczema. One is to keep your skin appropriately moisturized. While you don’t have to keep your body moisturized to the point that you keep sliding out of your clothes and down the hallway, it can help to regularly apply gentle or sensitive skin moisturizers throughout the day and especially after anything that may further dry out your skin such as taking a bath, shower or a walk in a wind tunnel.
A second is to utilize anti-histamine and anti-inflammatory medications to help manage symptoms itchiness and swelling. This can not only reduce the resulting discomfort and impediments but also reduce responses such as scratching that could make things worse like cuasing bleeding and subsequent infections.
A third is avoiding anything else that may trigger your eczema to flare-up and worsen. This can include cleaning your mattresses to get rid of dust mites and reducing the amount of perfume, cologne and fragrances around you.
Another is the use of steroids, ranging from topical ones to oral ones. These can help reduce inflammation and any immune response. At the same time, overuse can end up thinning skin and messing around too much with your immune system. So, it’s important to have a medical doctor guiding their use.
Other immunosuppressant medications are available as well. Azathioprine, cyclosporine, methotrexate and mycophenolate mofetil are options for moderate-to-severe eczema. So are oral JAK inhibitors like Cibinqo and Rinvoq. Naturally, these should be used only with guidance from a medical doctor.
Then there are the newer biologics, antibodies that block various proteins involved in causing the inflammation seen in eczema. These include Ebglyss, the brand name for lebrikizumab, and Adbry (tralokinumab), which target and block interleukin-13, Dupixent (dupilumab), which targets both interleukin-4 and interleukin-13 and Nemluvio (nemolizumab), which targets interleukin-31. Both Jackson and Howard-Verovic are working with Lilly, the makers of Ebglyss, to increase the awareness of eczema and the possible treatments.
Finally, another treatment to shed light on is phototherapy, otherwise known as light therapy. This is when specific, safe wavelengths of ultraviolet light are used to ease eczema symptoms. It’s typically used with moderate to severe eczema that’s been unresponsive to topical treatments. If anyone recommends light therapy, you don’t want to be in the dark about their qualifications and experience.
With all of these various pieces, it can really help to have a care team guiding what you should do when with eczema. Jackson likened it to the team that she has for her speedskating. Without such a team, you could find yourself skating on thin ice.
