ADULT ECZEMA

 

 

Atopic dermatitis also affects adults…

Children suffer more from this particular form of eczema. But they’re not the only ones. It’s estimated that in industrialised countries, about 10% of adults also have it. Some have had to live with it throughout childhood and adolescence. For others, atopic eczema appears for the first time when they are adults. This chronic skin disease can appear at any age. It’s initially caused by an epidermis that is excessively porous, often a hereditary feature. People with eczema have skin that is very dry and that poorly fulfils its barrier function of blocking irritants from the surrounding environment.

To know more about childhood eczema, discover our article here: "Childhood eczema"

"I was born with atopic dermatitis. I came out of my mum’s tummy completely red with eczema. It never went away."
Elisa, 26 years old

"In my family, there are a lot of people who have atopic eczema. So there’s a genetic element to it. It popped out on me when I was only a few weeks old. I’ve never known life otherwise."
Aurélie, 26 years old

"I’m the only one in my family who has atopic eczema. Flare-ups started when I was quite young. My first memories are when I was 6 or 7 years old."
Jules, 22 years old

Good to know

• Atopic eczema goes through cycles of flare-ups and calm periods. People with atopic skin have a genetic predisposition which makes their skin more porous. It lets allergens penetrate the skin. An eczema flare-up can be brought on by all sorts of triggering or aggravating factors: poorly chosen toiletry products, diet, stress, cold, pollen, pollution, clothing that rubs…
• As an adult, red eczema patches are primarily located on the face (eyelids, ears, neck…), as well as on hands and arms, legs and the stomach.
• Patches can be intensely itchy, which has a direct impact on sleep and the quality of social relations with family and friends and at work…

"Generally, my patches are nice and red, the skin may even be split, and it oozes. I mostly get them on my hands, on the back of my knees and inside my elbows, on my heels, ankles and the front part of my feet."
Elisa, 26 years old

"Eczema flare-ups can be short, lasting for a few weeks, or long, up to five months. It depends on what’s going on. My whole body gets red patches on it. I have them on my face, arms and legs, and the skin is very dry and intensely itchy."
Aurélie, 26 years old

"My atopic eczema isn’t too serious. It comes and goes. I get red patches, especially in my elbow and knee creases, and on my neck, that are itchy."
Jules, 22 years old

“Adults are less ashamed of their skin compared to adolescents: they have left the safety of the family and have moved into sexuality, professional life and a social environment. They are aware of their problem. Certain events in the past may have left “scars”, so it can still be important to reassure them about how their skin works and about living a healthy lifestyle.”

Dr Magali Bourrel-Bouttaz, Dermatologist.

“Atopic skin can arrive at any age. The skin anomaly is often there from the beginning, but there is huge variety in the epigenetics. About 100 genes are involved in atopic eczema. Much depends on the triggering factor.”

Dr Magali Bourrel-Bouttaz, Dermatologist.

Eczema and hygiene measures

If you have atopic eczema, the current health situation that is the result of Covid-19 has probably not made things any better. Repeatedly washing hands and disinfecting with hydroalcoholic gel are not the best recipe for a skin barrier that is already fragile. Essential hygiene measures dry out atopic skin even more and can make hands feel painful.

What solutions exist that cure eczema?

Adults have often tried different strategies to definitively cure their atopic eczema, from the most rational to the most fantasy-inspired. The only treatment that is effective during flare-ups is applying topical corticosteroids, prescribed by a doctor. At the same time, skin should be cared for on a daily basis using dedicated toiletry products for atopic skin, including the shower oil + emollient balm duo.

"I’ve seen so many different doctors, dermatologists and allergists. I even went to see a witch, a hypnotiser… I’ve put so many things on my hands in the hopes that they would make it go away, even milk. I’ve tried everything. But the only thing that really reduces the flare-ups is to be committed to daily hygiene and skincare that are adapted to my skin’s needs. If I go anywhere, I bring all my products with me, even for a weekend away. Same for my topical corticosteroids."
Elisa, 26 years old

“There is no miracle treatment. Patients need to take charge of their disease. That means they need to understand their skin to really understand why a specific product or treatment is useful. That’s the best way for patients to faithfully follow their recommended treatment, and in the end to take control of their eczema normal and not let it overtake their life.”

Dr Magali Bourrel-Bouttaz, Dermatologist.

« Complementary techniques? Sure, why not? It’s important to recognise everyone’s beliefs. They should nonetheless always be in addition to medical treatment.”

Joël Pacoret, Psychologist.

Good to know

Discovering the mysteries of your atopic eczema can often resemble an investigation! Everyone reacts differently to triggering and aggravating factors. Hot, cold, sweet foods, fabrics, toiletry products… Pay attention and notice how you react. (No need to make it an obsession, either!)

"There are so many things during daily life that can cause a flare-up: specific soaps and detergents, dust, stress, spring pollen, heat, cold. Pollution also plays a role, I think. My atopic eczema started on my face when I moved to a big city six years ago."
Aurélie, 26 years old

"I’m a fairly relaxed person in general, so I don’t think stress really impacts me. Instead I try to look for causes among pollen, dust, dust mites… Those things often trigger a flare-up. Water hardness can also have an effect on my skin."
Jules, 22 years old

The psychological impact of eczema as an adult

82% of French people² think that atopic eczema is related to stress. It’s true that stress can be an aggravating factor, but it’s not the initial cause. Eczema is not a psychosomatic disease, although it does impact a person’s psychological state. Between itching that can quickly become an obsession to constant uncomfortable sensations and fear of how others see you, atopic eczema can affect your mood. Skin and touching are an essential part of our social relations. Having red eczema patches may make certain people who don’t have atopic dermatitis feel apprehensive. Others may be worried that it’s contagious, or an indication of poor hygiene. Vague ideas and feelings like this can affect both professional and personal life.

² Les Français et l’eczéma – IFOP Sanofi Genzyme - November 2019

"No one really understands what it’s like. People often don’t really know what to say to make you feel better."
Elisa, 26 years old

"Thanks to my atopic skin, I feel a bit ashamed. Everyone can see it. I don’t feel as comfortable, as attractive as I could… Very often I just feel embarrassed. Whenever anyone talks to me about it, I answer, “Yes, I know”. It may look like I’m not bothered by it, but I am. It’s a way of stopping that topic of conversation. No one likes talking about a subject that annoys them – especially with someone who doesn’t know anything about it!"
Aurélie, 26 years old

Three ways in which atopic dermatitis can affect working life
 

1. Loss of self-confidence

People who suffer from eczema may often be reserved, due to a lack of self-esteem. Physically, they frequently try to camouflage all parts of the body that have eczema on them. Psychologically, they can also have difficulty asserting themselves in their role at work, even if they have the skills. And then there are the unpleasant comments from people who don’t know anything about atopic eczema…

"My hands give me a complex because people can see my eczema and it embarrasses me. Especially on my hands. I never want to show them. When I have to show something with my finger, I always use a pen instead. I wear nail polish and rings to camouflage a bit. I wear gloves in the winter. And I love working from home!"
Elisa, 26 years old

"The first thing I do in the morning? I check in the mirror. Eczema creates a complex. You don’t feel comfortable in your body : skin is tight, it itches and flakes. It’s not feminine. I always feel like other people look at me differently because of what my skin looks like. I often wonder what they’re thinking to themselves and saying."
Aurélie, 26 years old

“Any adult patient is so much more than just their atopic eczema. It’s important to remind them that they have many other valuable qualities and skills, and talent for activities that they enjoy. Psychological help from a health professional may be necessary. Don’t hesitate to contact a specialist if needed.”

Joël Pacoret, Psychologist.

2. Stress

Sleeping problems that are tied to itching create chronic fatigue, making atopic eczema sufferers less resistant to daily stress. A vicious cycle can develop: professional stress, eczema flare-up, stress about the red patches, and so on.

"Itching really perturbs my sleep. I sleep poorly because I’m afraid of scratching and of waking up with dry skin. And when I do sleep, I wake up because I am scratching. It’s kind of a downward spiral. But when my skin is fine, I sleep well."
Aurélie, 26 years old

"When my eczema flares up, the itching wakes me up at night. I sometimes scratch until I draw blood."
Jules, 22 years old

3. Avoidance strategies

In extreme cases, some patients prefer changing the type of work they do, or even accepting the night shift to avoid seeing people look at them.

“Two things are important here. First, a treatment’s objective is to allow a patient to get back to a normal life. Healthcare professionals’ duty is to help patients in this way. Second, patients shouldn’t hesitate to talk at work about their disease, symptoms and any possible impact they may have, while reassuring about their quality of work. This type of attitude requires courage as well as having accepted the disease and being open about it.”

Dr Magali Bourrel-Bouttaz, Dermatologist.

Three pieces of advice from a psychologist to feel more comfortable at work

1. Don’t hesitate to talk about your disease. Organise a moment with your manager or a colleague. That way you can speak about it openly start a peaceful relationship.
2. If your working environment isn’t adapted, you might be able to contact an occupational physician. They can help you set up favourable working conditions with your employer so that you continue to grow professionally.
    
3. "For patients who have decided to do a professional reconversion, it’s important to support and value this change. How other people look at you can become too stressful. If this is a solution that helps you live better and more fully on a daily basis, and you feel more balanced, then your decision should be respected and supported."
   
   Joël Pacoret, Psychologist (France)

Two consequences of atopic eczema on social and love life
 

1. Self-Image problems

Atopic eczema is a visible skin disease that few people are really familiar with. When people see red patches that may be thick and flaking, they can mistake them for a hygiene problem or fear that they are contagious. Some people with eczema accept it without any trouble and have learned to live with it. Others can be ashamed of their skin. They use their imagination to find the best ways to hide their eczema, and it can become a real complex for them.

"When I was a child, I was often told that I had witch hands because they looked so wrinkly. I would hide away. I think I was really hurt by that comment, and that is why I hide my hands as much as I can today. Now I get the question, “What’s wrong with your hands?” I laugh, explain that it’s eczema. That’s life!"
Elisa, 26 years old

"When you’re little, you hold hands and stand in line together. My classmates never wanted to hold mine because they were always really dry. I think they thought my hands were dirty. Even my teachers commented on them! “You can’t stay like that! You’re all red! Stop scratching.” Comments like those stay with you, especially when you’re a child."
Aurélie, 26 years old

• For almost 70% of patients¹, atopic eczema has a negative impact on their mood and self-confidence.

•  

Adults with atopic skin are often sensitive about how other people look at them. Meditation, yoga and recentring techniques focused on well-being can be useful. They make it possible to see that we’re not what others say about us or see about us. We’re much more than that.

Dr Magali Bourrel-Bouttaz, Dermatologist.

2. Social Relations

Feeling uncomfortable about themselves and their skin means that some adults may sometimes be deeply affected. They may exclude themselves on purpose from certain activities or relationships, for fear of showing their skin or their pain. Generally, however, most adults with atopic skin develop resilience and strength that help them keep a sense of proportion.

• 52% of people with eczema² choose to opt out of social activities, 37% avoid sunbathing and salt water, 33% avoid sleeping with a sexual partner.

"During summer holidays last year, I had a big flare-up. There was eczema all over my hands, with split skin and pus everywhere. I couldn’t do anything myself because my hands hurt as soon as I touched something. I felt so ugly. But I also took a step back, told myself to follow my treatment and that everything would be better in a few days. And after it’s over, it’s true – it’s not serious and only temporary."
"Due to the flare-up, I couldn’t go diving with my friends. I knew that if I went in the water, the salt would make my hands hurt too much. I didn’t see it as giving up. That’s just the way it is. I do what I need to for my skin. I don’t even really realise anymore how it can get in the way."
Elisa, 26 years old
 

Toiletry products, make-up, perfume, clothing: some products are not at all good for atopic skin. It can be hard to give up products that others use or that you particularly enjoy or appreciate, but eczema flare-ups can be just around the corner.

"I’m careful about what I put on my skin: I avoid using perfumed or plant-based products in the shower. With clothing, I avoid buying certain types of fabric, since I know they don’t let skin breathe and will make me itch and scratch."
Elisa, 26 years old

"I have to be careful all the time about what I put on my skin. My dermatologist even said I shouldn’t wear make-up, and foundation in particular, since it dries out my skin too much. But it’s still the only thing I can use to hide the red patches I have on my face."
Aurélie, 26 years old

"I pay attention with laundry. I make sure to choose the right detergent, and don’t use fabric softener. I’ve noticed that some of these products caused flare-ups. It’s better being careful."
Jules, 22 years old

“Adult patients are often more open to the necessity of buying specific products. They’re aware that they need quality products, designed specifically for them, adapted to their skin’s needs.”

Joël Pacoret, Psychologist.

“To care for themselves, some patients have to change their habits. It can be difficult for them to find the motivation. They need a bit of time to adjust their daily life, and this disease impacts daily life. Having an objective, even a small one, is a good way to gently develop new habits. It might be wearing tights again, or a ring. Taking care of skin for the sake of it has little meaning for patients, and is therefore not very effective. If care and treatment are there for a reason, they will be more effective.”

Dr Magali Bourrel-Bouttaz, Dermatologist.

¹ IFOP Study – Sanofi Genzyme – January 2020

² Les Français et l’eczéma – IFOP Sanofi Genzyme – November 2019

 

Five keys to living better with eczema
 

1. Learn about your disease and get professional help

Too many patients don’t know enough about atopic dermatitis and start to believe misconceptions: It’s from stress, just got to let it out, can’t do anything about it, it’s an allergic reaction’ and other wrong ideas. Some dermatologists are very good at managing this special disease and can create an atopic dermatitis treatment for adults. The treatment will help to improve your daily comfort and space out the flare-ups. Even as an adult, even if you have suffered for many years, you should get professional help, including from a psychologist if you think you need it.

2. Learn the right reflexes

Finding the right shower oil for washing, applying an emollient cream everyday that will really help to spread out flare-ups, adjusting your diet… Your doctor and pharmacist can provide a number of tips to help you care for your skin on a daily basis. There are also very active atopic eczema associations for patients, and it can be worth your while to get in touch with one or two.

 

Discover our article: "Solutions that make living with atopic eczema easier"

"I can thank my parents for how I’m able to manage my eczema today. They have always been there for me and taught me the right things to do, including the importance of applying cream everyday. I quickly became independent in taking care of my skin. Today it’s simply second nature. I always apply cream right after getting out of the shower. I always have hand cream in my bag and topical steroid cream for when I have red patches."
Elisa, 26 years old

"I put cream on everyday to moisturise my skin after showering. I don’t see it as annoying. It’s just a habit, and it brings only benefits. It’s so essential when it comes to keeping itching away. So I just do it, always."
Jules, 22 years old

“It could be worthwhile to visit forums, join patient associations or other types of support groups to share your experience with others who also have it. That way it becomes easier to develop perspective and get some support.”
Joël Pacoret, Psychologist.

3. Talk about your skin and explain it

Instead of hiding your skin and avoiding other people, talk openly about your eczema. Explain what happens when you have a flare-up and remind everyone that it’s not a contagious disease. Ignorance and fear don’t help anyone.

"When people ask me, I tell them the eczema comes out as itchy red patches on my skin. I stay simple."
Jules, 22 years old

4. Get better at handling fatigue

When you’re having a flare-up, topical corticosteroids are always necessary. Follow the doctor’s prescription to apply them, so that you sleep better and stay in good shape. Frequent physical activity helps to regulate sleep and get rid of stress. Breathing, meditation and cardiac coherence exercises can also be helpful. Different complementary medicines can soothe further still.

5. Work on your self-esteem

Gain some perspective on your eczema. It doesn’t define you as a person. It is obviously a part of you, and has helped you develop very positive human qualities that help you succeed, such as resilience and tolerance. Thanks to your disease, you’ve been able to develop your personality. But don’t give it any more space than it deserves. Do find other centres of interest that can help divert your attention, including from your itching. Don’t hesitate to be with other people, to be part of a group through sports or artistic activities, or an association. Develop your talents. Your skin is no reason for you not to succeed, as so many others have, despite their atopic eczema.

"Eczema is something you have to live with. It’s not a big deal. It doesn’t prevent you from having a normal life: a boyfriend, friends, laughing, finding a job. There is no reason why this skin disease should make us feel different or bad. It’s even quite common and is not in the least serious. There is nothing life-threatening about it, even if it’s not always comfortable."
Elisa, 26 years old

"Eczema is annoying, but there are diseases that are a lot worse. And it’s true that some people never even notice that you have it. It’s actually more about how we see ourselves than how others see us."
Aurélie, 26 years old

"My eczema really doesn’t trouble me. I’m used to it, and my family is too. There are solutions for soothing skin. And it’s not all the time. It comes and goes."
Jules, 22 years old

“You already have the solution inside you. Everyone has their own, whatever their age.”
Dr Magali Bourrel-Bouttaz, Dermatologist.

“In any situation, however difficult, there is always something positive. Living with eczema can help patients develop skills and qualities that others may never have.”
Joël Pacoret, Psychologist.