Postpartum eczema – diagnosis and treatment

The National Center for Biotechnology Information did a study in 2007 and estimated that 31.6 million people in the United States (and an estimated one third of the entire world population) experiences some kind of eczema.  It’s easy to see how the number could be even greater, because almost every time I try to explain to people what is going on with my hands, some form of the following conversation happens:

Me: “I developed severe eczema after my son was born.  It’s incredibly painful and affects every aspect of my life.”
Well intentioned person: “Oh, I had eczema too when I was a teenager.  It was so awful.  I used to get itchy hands and sometimes my fingers would get cracks in them.”
Me: “This goes way beyond that…”
Well intentioned person: “Have you tried using <<fill in the blank with some kind of over the counter eczema product that is loaded with perfume and packaging>>.”
Me: “That just makes it worse.”
Well intentioned person: “Maybe you should stop eating gluten.”
Me: “This is genetic, not gluten.”
Well intentioned person: “Bread is poison, you know.”

As you can see, there is no way for me to carry on this conversation without coming off as a total asshole.

Diagnosis and finding a treatment plan that was effective and proactive (but not too aggressive ) was a long and sometimes discouraging journey. After going through three frustrating experiences with “regular” dermatologists I eventually created a checklist of signs that a so-called dermatologist was not going to be able to help me – The Lobby Checklist.

The Lobby Checklist:

– Is the lobby recently remodeled?
– Is there a glass case containing product samples that the dermatologist will later attempt to convince you that you need?
– Are there more info pamphlets about laser hair removal than about legitimate skin conditions?
– Are the receptionists exceptionally young and attractive?

If I could answer yes to three of those questions then I knew I would encounter some kind of “doctor” whose eyes would glaze over when I described my symptoms and then prescribe a useless cream even after I already told him/her that I had already tried it.  I eventually sought out an allergist for a complete allergy workup.   My allergy tests showed no serious reactions, but the doctor was sympathetic and sent me home with 7 different steroid creams and 3 pages of notes. Time dragged on.  Eventually my hands and I settled into a mutually hostile routine – I would wash dishes in gloves, my hands would turn bright red, throb and itch, I would apply cream that didn’t alleviate my symptoms but I applied it anyways because I didn’t know what else to do.

Treatment

Eventually I started getting really sick.  It began with a sore throat, then I lost my voice for several weeks, then dry coughing and swollen lymph nodes.  Every two or three days I would develop a new cold sore on my mouth.  Cuts on my hands wouldn’t heal. My fibromyalgia went crazy.  I started sleeping all of the time, and on weekends I only got out of bed to eat a meal or two but otherwise slept whole days away.  I made an appointment to see a woman at the University of Washington who specializes in eczema.  She asked a lot of questions about my social life: do I ever get breaks from the baby?  Does anyone help me wash the dishes?  Do I have any hobbies?  I started crying so hard that I couldn’t even spit out a simple answer.

Although she was obviously disgusted with my lack of emotional maturity, she put me on a two-week course of antibiotics and heavy rounds of Clobetesol, a potent topical steroid.  In addition I had to soak my hands in bleach and water several times a week, take 2000 IU of vitamin D, take a daily Zyrtec plus a dose of Hydroxyzine for times when I really couldn’t control my flare ups.  I had to buy thin cotton gloves to wear underneath my latex-free regular gloves when doing dishes, and also at night.  She also told me to see a therapist and start having some fun.

Three weeks later I don’t even recognize my skin.  It looks pre-pregnancy clear.  Eczema sufferers are known to have more Staph. aureus on their skin and are frequently infected when the skin is broken from scratching or cracking.  I had a raging staph infection that had been going on for months.  Once the staph infection was under control my energy returned and my body could heal itself again.  Although I still have troublesome days and a few patches of rough skin, for now at least I don’t have to live in fear of any situation that involves washing my hands.  I’m even able to apply a little makeup now and then and I no longer look like I’ve been on a bender for three days straight. Right now things are good.

Just as bad as all of the physical discomforts of the last 18-months were two realizations that I had: first, that this is genetic and will never completely leave me (my aunt developed severe eczema after her first child was born 23 years ago and it has never left), and second is that it wasn’t a dirty hospital that infected my son with staph and nearly killed him, it was probably me.  For now I am trying not to dwell on those negative things and instead focus on the world that has reopened to me as an able-handed person: I can play the piano, sew, work in my garden and write in my blog again, although this time I will do those things without taking my body for granted. Skin, hands, and good health are never something anyone really thinks about until they are gone.

Advertisements

9 thoughts on “Postpartum eczema – diagnosis and treatment

  1. Thank you for this post. I completely relate and stumbled across your entry after googling “postpartum eczema”. I’ve always had eczema, but it would come and go… It flared up terribly after I had my daughter 6 months ago. My dermatologist, who sells a line of shampoo, 😉 recently completed a round of allergy testing with no significant results! I almost cried when they said “your back looks clear!” after the patch test. It’s so nice to see there are other people out there with the same frustrating problem!

    1. Alison, I’m so sorry that you are going though this…it is stressful and painful, unsightly and isolating 😦 Continue to seek help, if you can, and find out those doctors who will listen to you (for me that was my OB/GYN and the skin specialist at the UW). Most of all, be kind and gentle to yourself. It’s been 2 years since my son was born and my eczema still isn’t gone, but it is so much better! Now that I know how to manage it when I feel a flare coming on (bleach baths, healthy lifestyle, lots of sleep, and occasionally using the prescription steroid creams) the eczema and I have found a way to coexist. And remember that you’re not alone 🙂

      1. Thank you so much for the reply!
        I am thinking of doing my first bleach bath for my hands very soon. My derm has yet to diagnose me with eczema, but I’ve always said I’ve had it because I relate so much to everything I read. I’m already gluten free and I’m suspicious that sugar intake and stress really cause mine to flare up.
        I’m using a shampoo that my dermatologist formulated… It has 2% pyrithione zinc but I was surprised to read that it has sodium laurel sulfate in it. Do you have a problem with SLS? I’m debating whether or not I should get an SLS free shampoo.
        I think I’ll give my dermatologist one more shot. She has been trying to figure this out for me, but I think I’m still frustrated that it’s been 5 visits and we are no further along. She just keeps saying “continue using the Verdeso foam”, which doesn’t seem like a solution to me! (Especially since I can’t use the medication in large quantities because I’m breastfeeding…!)
        Ok- I’ll stop because I could rant about this forever! Thanks for listening!!!

      2. When I developed eczema around my mouth and eyes I tried using SLS-free toothpaste and washing my face in coconut oil. I really didn’t notice a huge difference, however. My eczema was very much triggered by stress and anxiety…however, everyone is different, and you could try asking your dermatologist about SLS and see what she says. I have been experiencing a flare up since starting my new job (12 to 14 hr work days, working weekends, etc) and I need to bleach my hands. I think I’ll write up a post about hand-bleaching technique it this week so other eczema sufferers don’t make some of the same bleachy mistakes that I did 🙂

  2. Homeopathy has been my only godsend. I’ve tried steroids and they worked for the first week but then made all if my symptoms come back tenfold. Homeopathy works on the whole being (physical and emotional). A lot of times my eczema flare up was from mounting stress in my life and the right remedy helped me to cope and therefore put my eczema at bay. If you find the right remedy for yourself, by choosing to go to a good homeopath or researching on your own, it can work miracles.

  3. I, too, have postpartum eczema. I’ve had moderate to severe eczema my entire life, but this is different. It came on when I was pregnant with my second and I’m covered from the chest down. I look like a leper.

    You mentioned Clobetasol… I’ve used it before but have been reluctant to use it while breastfeeding because it’s so strong. Did you use any of these treatments while nursing?

    1. I am so sorry that this has happened to you 😦 It’s been three years now and my eczema has finally started to return to “normal” pre-baby levels, whith occasional severe flareups in the winter and spring still, and I am glad I have super-drugs like Clobetasol as a last resort when I really need them. However…I’m no doctor, but my personal feelings about these intense topical creams that that it’s probably best not to use them when you are nursing a little one. I would look in to some other methods that won’t potentially come in contact with your baby, or get into your milk. Definitely find a good doctor who will listen to you and understand that many traditional creams for eczema (like Aquaphor or Eucerin) can burn and inflame the skin even more when you already have severe eczema. Ask your doctor to test you for staph, and remember to be kind to yourself. Stress and lack of sleep don’t help eczema, and if you have a new baby you’re probably dealing with those too. Good luck!

  4. my baby is six months now and my face has been covered in eczema for that long. everyone i come across ask me questions like: what are you using, what is this. its so embarrassing and weakens my self esteem. I wish there is something i can do. i have used a lot of creams to no effect. im so ashamed. its as if im putting on a large eczema mask.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s