Working With Eczema - the Silent Killer

I've been thinking a lot lately about what I can actually contribute to the world in terms of professional knowledge, and while there is plenty - enough to fill a small book, albeit a small book that is mainly filled with pictures and quips that only land about half the time - I've been wanting to write about something that affects me on a day-to-day basis.

My title probably seems like hyperbole, and that's because it is, but I've been seeing a few posts on websites for eczema enthusiasts regarding suicide lately. Some of these are factual news articles about people who straight up killed themselves and presumably attributed it to eczema, and some are just posts from people saying they can't go on, and feel constantly depressed because of what feels like endless misery.

This is not exactly unusual. In fact, around 30% of people with some form of 'Atopic dermatitis' were diagnosed with depression or anxiety (or both). In fact, eczema and depression are co-morbid. What's more, the inflammation and discomfort sends an immune response to the brain from all parts of affected skin; stress activates inflamatory pathways thus making both physical and mental health even worse in a co-morbid spiral of dead skin.

For me personally, eczema lands pretty low on my 'list of things that make me want to kill myself'. It sits somewhere below diabetes but above the endless vibrating buzz that comes from this goddamned computer even when it's turned off. Bad taste jokes about suicide aside, I thought I'd share a few anecdotes and perhaps a little advice on dealing with the ailment at work.

I first developed eczema when I was 11. At the time it was all up my arms and a bit on my face. I was bullied pretty hard - kids would pretend that I was some contagious disgusting monster. This was only half true - eczema is never contagious. It didn't really bother me back then. Sure, it sucked, but it was only some kids, and they weren't the kind you'd want to be friends with, they were the awful kind that dressed well and did cool stuff with all their money. I was also a christian at the time, and had a lot of faith that god was going to come and make it stop - I stopped waiting after a while, and now, 20 years later, I'm glad that I did.

Over the years I've come to realize that people don't really know how to deal with people with eczema. It's understandable, because it's such a 'meh' condition. It's not cancer, and it's not chronic cystitis caused by an impossibly tight foreskin that defies all medical reasoning (that's a post for another day). Truth is, if you don't live with it, you don't need to understand the extent to which it can be debilitating and straight up ruin your day/month/year/life.

A lot of friends tend to think that self-deprecation is the best remedy, only to forget the 'self' part. I've smiled through jokes about how I'm turning into dust. Most of them are also armchair doctors with incredible Piers Morgan-level insight into how moisturizer might help or how steroid cream 'just gets rid of it!' Most people don't take the time to consider that you may have perhaps tried every bloody cream under the sun. It's not their fault. They weren't there to see me as a kid with 25 different allergens strapped to my back in a grid looking like a wretched and defeated Teenage Mutant Ninja Turtle Skinacello.

_{Not me. Jan Polák}

This is a patch test to determine if the skin condition is based on allergens, rather than something genetic, and it includes 90% of the most likely offenders that trigger problems such as metal, leather, food & drink, medicine and beyond and is based on 'Type-4 hypersensitivity'. After 2-4 days, the results will be recorded according to a system of observable reactions, from negligible (-) to extreme (+++).

When I was 16 I flunked my GCSEs. I'd like to blame the eczema/circumcision, but really it's because I was a little shit. At that time I believed that I wanted nothing more than to be a chef, so I took my first job in a cafe. On my first day, I turned up 10 minutes early and ready to grill the world. The owner, impressed with my enthusiasm and vigor put me straight to work peeling eggs.

There was maybe 50 hard boiled eggs floating in a bowl. It wasn't glamorous, but Jamie Oliver wasn't remembered for his egg peeling skills. The first egg was easy. Actually it wasn't - peeling eggs isn't as easy as it looks - but in the grand scheme of my journey towards being a master chef, it was the easiest part. By the second egg, my hands had turned red, and bits of my skin were floating in the water. I tried to hide it from the owner, but by egg number five I was starting to resemble a Teenage Mutant Samurai Lobster.

His solution was latex gloves. I still remember the pain as the friction of the supposedly lubricated gloves scratched against my now fully red and bleeding claws. I tried, but eventually, would end up crying and saying 'I can't do this' over and over as the owner patted me on the back. He was a nice guy. Gave me a tenner and suggested "Maybe you should try a job in computers?" And that was the day my chef dreams died.

At my next job - a supermarket - sweet old ladies would tell me that I looked like I'd been in a fire. Joke's on them, I got fired for not handling their bread with enough care. I remember at my first serious job in a bar, a friend of mine who had some very visible psoriasis was told that he looked like he'd had a cherry Panda Pop chucked on his head. It was of course the manager saying that as people stood around and laughed. He smiled. I smiled. Sometimes keeping a job is more important than pride. I was forced to take two weeks off later in the year because my arms were oozing so bad that I was sticking to the counter.

If you've ever had eczema and worked in service, you've probably had somebody ask to be served by someone else. I've known eczema survivors to get quite upset and worked up by this, and while it does feel like getting your self-esteem kicked out of you, I also get it. I get why friends don't want me to put their sandwich together - nobody else should be eating my skin but me.

After I graduated I took a one year teaching position in China. Students here will say 'Wow your skin is very ugly' with the kind of innocent wonder that would be cute on a five year old, but feels a bit worn coming from the mouth of a 21 year old who is supposed to be going out into the world soon. Luckily teaching was very much not for me. but while living in China, I learned to deal with the horror of a whole new kind of eczema - the dyshydrotic kind.

Dyshydrotic eczema is a particularly fun brand of dry magic that causes small, gross, hard pustules to form usually on your hands, between your fingers, on your fingers, on your palms and anywhere else that will cause difficulty holding things.

It's one of the least understood of all these skin issues, but victims of seasonal allergies - like me - are more likely to develop it. Additionally, the most common positive results (19%) in the patch test is also a likely culprit; Nickel Sulfate - Nickel being something you can find in your keys, your phone, buttons and zippers, even chocolate and nuts - a low-nickel diet is an actual thing that can help.

In order to keep this post safe for work and work related and to avoid burning particularly rough vivid mental pictures into the back of your brain, I'll just list ways in which this unexpectedly affects work life. Here is a list of things that are difficult to hold when your hand is covered in blisters:

• pens
• pencils
• phones (mobile and desk)
• mouses
• keyboards (typing, not holding the keyboard like a phone)
• Office cats (We don't have one)

But the worst thing about it, and one of the more common things in the business world is shaking hands. The nervous feeling of meeting a new boss at a new job is already difficult to deal with. These people typically make judgements on a number of factors within a fraction of a second, and their minds rarely change.

But actually meeting them for the first time seems to run in slow motion. The slow motion feeling as someone puts their hand out to shake, as you awkwardly bring your hand to theirs gives just enough time for you to take in the dart of their eyes, as they realise they have locked into a silent contract with what might as well be a leper. You see the twitch of their hand as they instinctively try to move it away, all the time, questioning what kind of hazardous material they have introduced into their work place. As your hand connects, you feel your rough and yet explosive bubbles press up against their impossibly smooth palms.

You make a connection that you know you will never make again. They are wondering if you're contagious, and you're praying that their Dove hand model hands are somehow the cure. Both of us are wrong, and while they get to escape the moment, you realize that you're going to be going through it again with about 20 other people in the same day. You get home, and think 'I can't keep doing this' but you do. You have to, and you hope that one day it'll stop, and you'll start to feel human again.

Whew, got a little overly dramatic there! Like with everything, you look back and realize that in retrospect, it's not so bad. Perhaps nobody notices? I remember receiving a sex ed handbook when I was 10 that had a page titled 'But What About Wet Dreams and Embarrassing Erections? that page gave me advice about my eczema that I have since lived by - "Chances are nobody will even notice and you can go about your day as normal." Sadly, the book was very wrong about boners, but the philosophy has remained true for eczema - a lot of the time people don't notice, and if they do, they usually have the sense to keep their thoughts to themselves.

I realize that little wisdom has been imparted with regards to actually living and working with eczema, especially of the palmy variety, so I'll leave a couple of pointers for in the off chance that anyone didn't stop reading when I started talking about egg peeling:

• People are often dumb and thoughtless. The same kind of people that tell you you look terrible also tell adopted kids they're lucky their new parents saved them. Those people have little hope and are best ignored.

• Hand-related exercises and sports are basically off the table. Weight lifting will grind your hands to mince and good luck catching a football without fumbling it or regretting the save. I have found skateboarding, which is a godsend because it only really involves feet. My feet are now covered in eczema because god doesn't want me to do anything I enjoy, but at least that stays covered under my novelty coloured socks.

• Everybody is different, and different things work for different people. My experience is that any time a cream works, it will only work for a few weeks before my skin gains resistance. In fact, my skin is so good at adapting to different medicines, I wonder if I'm not a superhero with a particularly shitty power. Moisturizer does nothing for me, besides making my skin more susceptible to scratching.

• Wearing rubber gloves is like sticking your hands in their own personal sauna. The only plus side is is gives me a great excuse to not do washing up.

• The moment you come to understand that your condition is a part of you, the more at peace with it you will become. It took a lot of miserable years for me to come to terms with that.

• You know what else is a bastard? Pollen.

• If you've read this far you're just procrastinating. Get back to the job search/reading the top 10 reasons you deserve a raise

Source

References

Patch Test
Atopic/non-atopic
Murder-suicide
Emotional wellness of eczema
Psychoneuroimmunology of Psychological Stress and Atopic Dermatitis: Pathophysiologic and Therapeutic Updates
Topical Steroid List
Low-nickel diet
Likability Psychology

Other Image Sources:

Master Chef - Public Domain
Eggs - CC BY 2.0

_{Special thanks to @mobbs for introducing me to Steemit}