DrB's posts
Habit reversal for atopic eczema
Our 12 year old patient was delighted when her previously troublesome chronic atopic eczema quickly cleared using habit reversal for habitual scratching using The Combined Approach. We asked her what part of the treatment …
Continue ReadingStress and atopic eczema
from AtopicSkinDisease.com When we ask someone in clinic what seems to bring on their eczema or make it worse, almost always stress is mentioned. This is can also be the case with the other two common skin diseases, acne …
Continue ReadingAtopic eczema and topical steroids: not too much, not too little
Being creatures of habit is usually useful, but nature can get the better of us. Anything that is done on a regular basis can become a habit. A habit is a behaviour that we lose conscious control over. Sometimes then …
Continue ReadingAlcohol and atopic eczema
Some trigger factors for acute atopic eczema flare-ups are easier to recognise than others. Those that are better known are stress, season, and allergies. Others include air-conditioning, sleep-overs, and drinking alcohol, for example. Alcoholic drinks like beer, spirits and wine …
Continue ReadingChronic atopic eczema in early childhood
Atopic eczema easily becomes chronic, or longstanding, in early childhood, partly because of inadequate use of conventional topical treatment, and partly because of habitual scratching. The skin becomes thickened, or lichenified. Chronic eczema is established. What to do about …
Continue ReadingAttitude and Atopic Eczema in the Elderly
At all ages the personal experience of chronic atopic eczema can lead to passive pessimism, a mindset that may need taking into account if treatment is going to be successful. Atopic eczema in the elderly has the added challenge of …
Continue ReadingFrom living with eczema to living without eczema
Learning how to live with eczema is important. Living with eczema means understanding what eczema is, and what needs to be done about it. Living with eczema also means discovering how to get on with life regardless, and not …
Continue ReadingEczema and Scratching
In 2013 NursingTimes.Net reported a survey that showed one in five eczema patients scratch “at least 10 times” a day, and of the 500 questioned, a third said they go to “extreme lengths” to hide their symptoms. Our experience …
Continue ReadingHabit scratching causes chronic atopic eczema
The itch-scratch cycle is familiar to everyone who knows about atopic eczema. When eczema flares up, it itches – a feeling, which leads to scratching – a behaviour. The scratching irritates the skin further, then there is more itching, …
Continue ReadingEczema warning: cold snap on the way!
My skin is like my piano: in cold weather it goes out-of-tune. The piano is an old upright: the strings are held tight by metal pegs that are fixed by brute force in a piece of wood, the soundboard. Wood …
Continue ReadingSwimming and eczema
Parents worry about taking a child with eczema to a swimming pool, but let’s face it swimming is fun and good exercise – it also saves lives! So I have checked this out, and the good news is swimming …
Continue ReadingTopical steroids for atopic eczema
Despite the revolutionary benefit of topical steroids in the treatment of atopic eczema, they are often feared, and may be avoided or used only cautiously. They seem to be seen more as terrorists than freedom fighters. Understanding how they …
Continue ReadingEctodermatology
Psychodermatology always gets a spell-check dotted red line under it on my laptop! The term has been around quite a while in various guises, including psychocutaneous (another dotted red line!) medicine and psychosomatic dermatology (that’s OK!). Part of psychological …
Continue ReadingStress and Life
“Stress is the spice of life” Hans Selye (1980) It was Walter Cannon (1871-1945) who first described the physiological fight-or-flight response to a threatening situation. The term stress was introduced by Hans Selye (1907-1982). Stress in small doses has an …
Continue ReadingWater dries skin
Understanding how moisturizers work means they can be used effectively. Last week there was a flurry of interest stirred up by the publication of the results of an experiment investigating the function of the “prune” effect on skin caused by …
Continue ReadingCrisis intervention and atopic eczema
Life transitions, like leaving high school and starting college, and transitions in t, like birthdays, and the start of a new year, are sometimes seen psychologically as “crises”. They are cross-roads, and can be times of heightened awareness, and …
Continue ReadingHabit reversal for passive pessimism
“Behaviour” commonly means what we see people doing. As a behaviour modification technique, habit reversal can be used to tackle nail biting, thumb sucking or scratching that have become troublesome habits. Habits start as conscious behaviours associated with specific triggers. …
Continue ReadingLichenification
The epidermal layer of skin reacts to repetitive mechanical trauma by thickening up (hypertrophy), with an accumulation (hyperkeratosis) of dead cells (keratinocytes) sticking to the skin surface. The appearance is called lichenification by dermatologists. The similarity to the bark of …
Continue ReadingThe skin as a battleground
Sometimes in clinic we talk about how the skin can become a battleground. Perhaps as a territory that is the boundary between ourselves and our surroundings, it is easy to see how this can be. The scratching, picking, rubbing, biting, …
Continue ReadingStressful Times?
Modern life is sometimes thought of as particularly stressful, compared with life in previous times. These days seem to have more pressure, more demands, and more complexity to contend with. Modern life is hectic, while perhaps previous times were at …
Continue ReadingChelsea Physic Garden
In deepest Chelsea, London UK, there is a gem often overlooked by international visitors. In the picture DrB stands between the Psychiatry and Dermatology beds in Chelsea Physic Garden. Containing almost 5000 plant species from all over the world, the …
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