Wednesday, March 16, 2016

Hives/Urticaria and Eczema/Atopic Dermatitis—A Lifetime of Causes and Cures

First of all, let me say that I am not a doctor, and I am not qualified to give medical advice.  I am simply someone who has suffered from both chronic eczema and hives at different periods throughout the last twenty-five years, and who has elicited the help of "professionals" practicing Eastern medicine, Western medicine, and a few off-the-compass therapies, as well as doing quite a bit of my own research along the way.

Second of all, my eczema and hives are not your eczema and hives, or anyone else's for that matter.  Out of five things that I find helpful, you may find that one is effective for you, while the other four have no effect, or worse, aggravate your condition.  Always tread with caution when experimenting with any new treatment. 

I am someone who distrusts most prescription medications and prefers to look for natural treatments.  But if I have learned anything from going that route, it is that natural treatments are not to be trifled with.  Don't believe that just because someone recommended it and you found it in the vitamin section at Whole Foods, it's fine for you to start popping it without another thought.  Some of those supplements are just as powerful as any prescription and can cause imbalances in your body that are just as bad as any side effect.

With all of that said, in my experience both eczema and hives (which is technically an autoimmune disorder) have three main causes: Stress, Hormones and Allergies.  That sounds rather simplistic, but if you start to research it and think about it, you will discover that it is almost infinitely complex and custom tailored to each individual's body.  Which is why I believe medical professionals have had so little success in treating these conditions—there is no one answer that works for everyone, or even for most people.

My purpose in writing this is to share my experiences and hopefully help others who suffer from similar conditions.  I don't promise to offer solutions, but I hope to give others food for thought about what may be triggering their skin issues, thereby giving them ideas for remedies that might work in their case.

My eczema began when I was seventeen years old and I started taking birth control pills.  I did not identify "the pill" as the trigger until later.  I was heading off to college, covered in that confounded itchy rash, and my mom took me to the dermatologist where I was given a cortisone shot.  If I remember correctly, it worked for about a week, and then I was back to full-on misery.

I went to FSU and suffered with my eczema for a year before I transferred to FAU and moved back home.  My mom watching me suffer up close that second year was what sparked the real treatment experimentation.  But I'll get back to that.

During the day, my eczema was uncomfortable but tolerable, though sweating definitely made it worse.  The body releases toxins through sweat, and your skin is your largest toxin-releasing organ.  But it was at night that it became utterly unbearable, leading to little if any sleep, missing class, and me being fired from a job for the first and only mortifying time in my life. 

I have read many other accounts of people saying their skin conditions are worse at night.  Why is this?  I have also read that cortisol (the "stress hormone") and blood sugar can both rise at night.  I believe the increased itchiness at night may be connected to one or both of these factors.  I haven't discovered the solution, but I believe if you can identify causes, it can at least take you in the right direction as you look for treatments.

I did many things while I was away at college that year that probably contributed to my worsening eczema.  Those things included drinking too much alcohol, which not only introduces a toxin that your body has to shed, but also increases insulin secretion, especially if you're drinking lots of sugary mixers.  And insulin is a type of hormone that is connected to other hormone levels in the body, such as estrogen and testosterone.

But drunk or sober, I was miserable.  I coated myself from head to toe in OTC cortisone cream at least once a day before bed, and often before leaving in the morning as well.  I covered my limbs in white pajama pants and long sleeves every night in an effort not to scratch myself bloody, and because I couldn't stand colored thread getting stuck in those weeping rashes and sores that I scratched open.  Sometimes I wore socks or cloth gloves to keep my fingernails and toenails from tearing at my skin, but I usually ended up pulling them off in the middle of the night, or rubbing myself raw even if they stayed on.

I always scratched myself bloody at some point during the night, despite my attempts at full body armor.  And there are two problems with this, other than the obvious unpleasantry of the image itself.  One is that I always bleached my white pajamas and my white sheets to get out the blood.  In my experience, bleach is not eczema's friend.  Neither are most chemical laundry detergents.  I recommend the mildest fragrance free detergent you can find, and personally I could never use Tide when my skin was acting up, "Free" or otherwise.

The second problem is the cortisone cream.  Not only is cortisone a steroid, which suppresses the immune system and mimics certain hormones, but it also spreads infection, perhaps due to its immune suppression qualities.  So here I am, scratching bloody furrows in my already weepy rashes, and then spreading massive quantities of cortisone cream on it twice a day.  I am fairly certain this resulted in me carrying a low grade infection around in my body for about two years, which must have played havoc with my immune system, amongst other things.

Like many of us, I had very little money in college.  Most of the time I lived off ramen noodles (with that packet of MSG flavoring) and whatever bag of fruit was on sale that week.  MSG is a neurotoxin/excitotoxin, a type of chemical that can cause damage or death to nerve cells.  The hypothalamus is our master hormone regulator and its nerve cells are some of the most susceptible to damage.  Incidentally, some sugar substitutes fall within the same chemical family, and over time the use of these chemicals can result in hormonal imbalances that cause all sorts of issues, skin and otherwise.

And for me, when that sale bag of fruit was oranges or grapefruits, my citrus allergy was exacerbated, which undoubtedly made my eczema worse.  I knew my fingers sometimes got rashy from touching citrus, and now it seems obvious that if I couldn't touch it, I shouldn't have eaten it.  But at the time I never made the connection.  I was probably drinking orange juice regularly too, which is way more concentrated than eating a single orange.  Those are the sort of "Face Palm" realizations that I look for now as I search out solutions, and that I hope reading this will make you think about too, as you look to solve your own skin issues.

I don't remember exactly when I stopped taking the birth control.  I do remember that it took another year after I quit for my body to balance itself out and my eczema to disappear.  And that was the year I moved home and my mom was hell bent on curing me.  We tried so many things, I couldn't honestly tell you what worked and what didn't.  I'll tell you a little bit about it, but my reigning opinion after twenty-five years of chronic skin issues is that the only true cure is taking care of yourself, avoiding the things that you come to realize make you worse, and giving your body time to balance itself out again.

In addition to the prescription ointments and antihistamines I got from the doctors, we tried Zinc (both topical cream and ingested capsule), Sulfur powder ingested because it is an old folk remedy for skin problems, your usual OTC remedies like calamine/Aveeno/aloe, acupuncture, chiropractic, energy balancing with light therapy and past life regression mixed in, and scream therapy.

All I can say about that last one is I used to drive forty-five minutes once a week to this woman who practiced out of her sixth floor condo by the beach.  And I have no idea how her neighbors didn't put a stop to it, because no matter how loud I screamed, it was never loud enough for her.

I am certain I am forgetting some things we tried, but you get the picture.  There have been some studies suggesting that people who've suffered sexual abuse are prone to skin conditions.  And that children who've suffered this trauma often draw pictures of themselves covered in dark clothing from head to toe, revealing very little skin.  I have had some personal experience with sexual abuse, though I cannot say if it had anything to do with my skin conditions.  But it's food for thought, and certainly a good reason to explore therapy.

When I still had the eczema after all of this, my mom scraped together enough money to take me to the Nevada Clinic.  She had almost died from pesticide poisoning years before, and swore they saved her life when nothing else worked.  What I remember of the trip is that I had never been to Las Vegas, and we had fun walking the strip and visiting the famous hotels.  And also that they said my autoimmune system was out of whack and it was like I was living in a constant state of "fight or flight" mode.  They gave me biofeedback cassette tapes to take home and listen to.  They probably gave me other things too, but it's those tapes I remember.

All I know is that about a year after I stopped the birth control pills, the eczema was gone.  I don't know if it was the estrogen, progesterone, or both, that triggered it to begin with.  And when I decided to try what my gyno assured me were "low dose" birth control pills again about two years later, the eczema came back immediately and took another frakking year to go away, even though I quit the pills tout suite.  Just thinking about it makes me want to revisit scream therapy.

Older, wiser, and determined to never try birth control pills again, my eczema came back in patches over the years, but was never as bad as it was during those two previous bouts.  Things that I recall triggering it were stress, citrus, dust (possibly dust mites) and cleaning chemicals.  If you haven't figured it out for yourself yet, eczema prone people have to be extremely careful with soaps, lotions and perfumes.  Even strong incense and scented candles could make me itchy if I was in eczema mode.

My mom was worried about my immune system being compromised, and that low grade infection I'd been carrying around for so long.  There were a couple of years in my twenties when I kept getting staph infections on my fingers, usually at the sites where I got those eczema rashes from touching citrus or cleaning supplies.  I would try to cure them myself by switching between antibiotic ointment and peroxide, but inevitably I'd end up on oral antibiotics. 

Mom reminded me that I'd had impetigo as a child, which is a form of staph.  She blamed herself for not breast feeding me and giving me all the natural immunities that come with breast milk.  And she worried about my overuse of antibiotics and antibiotic resistant strains of bacteria.  She started sending me a mix of Chinese herbs that was supposed to boost my immune system, and I dutifully took them for years whenever she sent me a new bottle.  It had several ingredients, but the only one I remember is Astragalus.

In my thirties I started to have digestive issues, which ended up leading to my first bout with hives.  I developed terrible heartburn and acid reflux, as well as a really unattractive belching problem, especially at night.  I had been drinking a tablespoon of apple cider vinegar a day for several years because I'd read about all of its health benefits.  Personally I believe I overdid it and this contributed to an imbalance in my body's stomach acid production.  People who swear by apple cider vinegar will undoubtedly disagree.  But here's where my belief comes in that natural supplements can be just as damaging as prescription drugs when you use them incorrectly.

I eliminated onions and peppers from my diet because I noticed that they aggravated the issue.  I avoided fried foods for the same reason.  Tums and chalky chews didn't work unless I popped them constantly.  Alka Selzter, Pepto and Zantac gave varying relief, but the heartburn usually came back later in the form of painful bubbles that seemed to migrate around my chest and back.  I understood why some people mistook heartburn for a heart attack.  Not to mention I started to get leg cramps at night, which led me to read about how certain acid reducers deplete minerals like calcium, potassium and magnesium in your body. 

I also read that drugs like Zantac are actually antihistamines, which I find super interesting, because it suggests that heartburn is really a type of allergic reaction.

The bottom line is that acid reducers create an imbalance in your body's natural ability to produce stomach acid, so they are never the long term answer.  I read about natural digestive enzymes and bought a bottle from the health food store.  I felt like it was helping, so I finished my month's supply and bought more.  Unfortunately it contained bromelain, which comes from pineapples.  I am allergic to pineapples—not fatally, but the more I eat, the more my mouth itches and burns.  I knew that, but just like with the bag of fruit of the week, I failed to make the connection until after the damage was done.

After a month and a half of bombarding my system with concentrated bromelain, my body said F.U. and I broke out in itchy welts from head to toe.  This was a different beast entirely from the eczema I knew and hated.  I went to a dermatologist, who drew a circle around a red patch on my stomach with a pen, and told me if it "migrated" it was hives.  It did.  I was prescribed the requisite ointment and antihistamine, which were just as useless as they had been for the eczema.  The hives got worse.

I went to an allergist.  He did blood tests to find out what I was allergic to, but they came back showing I was allergic to everything.  He told me that my immune system was stronger than any he'd ever seen, and he'd be surprised if I ever got sick.  That part was great, because it allayed my long time fears about my immune system being compromised.  Was it those Chinese herbs my mom kept sending me—who knows?

Unfortunately he also said that my rock-hard immune system was in overdrive, and treating everything like a histamine that needed to be attacked.  (Sounds similar to the Nevada Clinic's pronouncement that my eczema was due to my autoimmune system being in a constant state of "fight or flight", no?)  He said I could experiment with OTC antihistamines, but that the only real cure was time and avoiding the things that set me off.  So even though he couldn't help my symptoms, he gave me a reasonable explanation.  And I found that far more helpful than the dermatologist's one-size-fits-none pills and ointment.

My hives reacted to weird things.  You'd think processed foods and the usual allergens like soy, eggs, dairy, etc. would have been the likely triggers.  But my triggers were fruits, vegetables and herbs.  Cucumbers made my lips blow up like a collagen injection gone horribly wrong.  I'd never had a reaction to cucumbers in my life.  Can you think of anything more mild than a cucumber?

If you're like me, you waste the odd hour here or there watching cat videos online.  Maybe you've seen the one that's just clips of different cats freaking out and jumping straight up in the air when they realize there's a cucumber behind them.  Google's pretty funny.  The point is, perhaps those cats know something we don't.

Seedy underbelly of cucumbers aside (I apologize, sometimes I can't resist a pun), I had to cut out half my vegetable repertoire, most fruits, and herbs.  White starches like potatoes and rice seemed to be good, though orange veggies like sweet potatoes and carrots were not.  Fortunately I seemed okay with dairy, since I'm not sure life is worth living without cheese, but bleu cheese was definitely out.  I have trolled many a message board populated by hive sufferers, and I remember more than one person commenting that their diet was reduced to solely rice when their hives were bad.

My husband and I began cooking with butter and salt as our only seasonings.  I think I even cut out olive oil for a while, though it never bothered me before or since.  There are things that we are willing to do, and things that we are not willing to do, and those lines can change depending on what we are going through at the time.  There are people who swear by this or that strict exclusionary diet to heal any bodily ill.  I was willing to cut the things I cut from my diet, and no more.

And of course I sought the relief of those OTC antihistamines.  Benadryl was marginally helpful.  If my face blew up like the Elephant Man's and my eyes were swelling shut, it made it go back down.  But it made me sleepy and was only intermittently effective against the itching.  Claritin didn't do much for me.  When I tried Zyrtec, however, I wanted to jump up and down and shout with joy.  It stopped the itching!  Oh, that god-awful itching, that makes you want to scream and cry and crawl out of your skin.

But the temporary relief of Zyrtec, for me and many others on those hives message boards, conceals an awful truth.  It can actually make your hives worse.  And I'm talking not only more welts, but if a portion of your welts only looked like a deadly contagion before and didn't constantly they ALL Itch, All The Time.  My skin became so sensitive that my hair started driving me crazy.  I wanted to chop it all off because every time it brushed against my shoulder or arm, it felt like bugs were crawling all over me.

Of course, this reaction happens when you try to stop taking it, so I suppose if you are willing to continue taking it forever maybe it would keep working for you.  I am not willing to do that.  Long term antihistamine use causes all sorts of health issues, and I don't need any new issues thank you very much...better the devil you know, and all that.  

Throughout the years I have experimented with various supplements that I read were good for skin conditions.  I can't remember them all.  And I can't tell you if any one of them really helped.  Since my bromelain pills triggered my hive outbreak in the first place, I have tried to be very careful about what supplements I choose.  Though I am still adamant about finding natural cures and only taking steroids or prescription meds as a last resort if your life is hanging in the balance.

The natural cure, if you can find it, will always be the best and longest lasting cure.  Finding it requires patience.  Many supplements require at least a month of committed use before you begin to see results.  A lot of people give up on them before they have a chance to work.  But the other side of the coin is that you may not realize a supplement is causing you harm until your system is thoroughly saturated with it. 

I believe supplements should be approached with respect and caution, especially during a hive outbreak when your system is rejecting so many things and your face could literally blow up at any moment.  I'm not discouraging their use by any means—I'm still experimenting with them myself.  I'm merely advising caution.

At the end of my first six month hive outbreak, after cutting all of the things from my diet that made my face blow up, I got pregnant.  My husband and I had stopped using birth control five years prior.  We weren't sure if we wanted kids and we weren't really trying, but since that's what normal people did, we decided to take an "if it happens, it happens" approach.  I had begun to believe we were safe without birth control, and that the kid thing just wasn't going to happen for us. 

I have read about diet affecting fertility.  Since allergies are an immune system response, and about 1/5 of infertility cases are thought to be related to immune issues, it makes sense to me.  Maybe all those things I cut from my diet that I had never reacted to before had actually been causing minute allergic reactions in my body all along.  By that token, maybe I'd be a healthier person if I never ate any of those things again, hives or not.  But like I said, there are things we are willing to do, and things we are not.

My doctor prescribed progesterone pills to strengthen my uterine lining and said I might lose the pregnancy if I didn't take them.  As you can imagine, I was torn.  I was terrified that the hormones would kick off a year long bout with eczema like the birth control pills had.  And now that hives were in the picture, what if I spent my pregnancy suffering not only the normal discomforts and sleeplessness, but also scratching myself bloody with some horrible eczema/hive hybrid, unable to allow myself even the intermittent relief of antihistamines?  I wasn't sure I was willing to do that for a pregnancy that I had my doubts about to begin with.

I had an appointment a couple of weeks later, and the decision had already been made for me.  I miscarried.  And it sucked, both physically and emotionally.  I had just started to talk myself into wanting the baby.  But although it was terrible, it helped me realize once and for all that I did not want children.  I'm still a little sad thinking about it now, but in the end, my relief outweighed my grief.

I have had three bouts of hives since then, all lasting four to six months.  My current bout began in December, when I was travelling for the holidays and super stressed out, and I am now about three months in.  I still had Zyrtec in my medicine cabinet from last time, and somehow I forgot about how awful its backlash was.  I only remembered that it stopped the itching, and I was desperate. 

I took it.  It worked (temporarily.)  And it was a mistake.  How did I forget?  I suppose that hives are so horrible, and I'm so relieved every time they go away, that I just put them out of my mind and try to act as if they never existed.  Maybe I believe if I do a good enough job of forgetting about them, they will forget about me and never come back.

I also believe that the stress of dealing with hives is a vicious circle in itself that just keeps perpetuating them.  If you can find a routine that works for you and keeps you comfortable most of the time, if you can just calm down and try to forget about them while doing whatever you can to take care of yourself, I think it helps them to eventually go away.

I allow myself the Benadryl, and taking it regularly makes me immune to the sleepiness.  A month ago I was taking up to six a day.  Now I'm down to two, one just before dinner and one around midnight.  There is still itching, and if I deviate from my schedule or diet, I have to take more to remain sane.  I also take more during my period because the hives are worse and the pain meds I take for cramps (usually Aleve) make my face blow up.  I have cut out my sugary afternoon coffee, which was one of the things I was unwilling to give up before, but I've come around to it with this bout of hives.  I have insomnia anyway, so I sleep better without the caffeine and extra sugar.

I have also cut out the three-quarters of a bottle of wine I was drinking almost every night.  I watched my mom pass away from lung cancer a year and a half ago, despite her lifetime of alternative therapies and organic eating, and it just absolutely wrecked me.  I'm much better now, but my eyes still tear up thinking about it.  I was unwilling to give up the wine at that point, although I knew it was making it harder to get up in the morning, on top of the depression that made it a struggle to get out of bed to begin with.  I was willing to make myself go to the gym, because I recognized that I had to do something to keep myself going, and I was so messed up mentally that a physical cure was all I could manage.  But you'd have had to pry the wine from my cold, dead fingers.

I believe that everything we do to take care of ourselves contributes to our systems rebalancing themselves and our skin conditions eventually receding.  I am trying probiotics this time around.  I have taken them before, but never drew any correlation with my skin issues.  I only started two weeks ago, so I couldn't tell you if it's helping.  I don't believe it's hurting.  I also read something about vitamin B6 being helpful, so I just started taking that again.

I read several comments from people about turmeric curing their hives.  I want to try it, but I am leery of my sensitivity to herbs, so I want to be very careful.  I think I should try the fresh root with no antihistamine in my system and see if I have any reaction, rather than roll the dice and jump right into the concentrated capsules.  Turmeric also has anti-inflammatory properties, and is considered both a weak phytoestrogen and an immunomodulator.  All of these things recommend it to me as a strong candidate for my hive treatment arsenal...assuming I am not allergic.

My friend gave me a medical marijuana edible to try, and my hives were so clear all day, I was certain it was a miracle and they were gone for good.  It also shot me so far into space, I'm convinced I had a conversation with my mother's spirit.  That's not a sustainable treatment.  I've tried a little of the vapor since, and it's super mellow and seemed to make my hives subside, but it doesn't last long.  THC has been found to regulate the immune system and is being researched in applications to treat auto-immune diseases like arthritis, diabetes and M.S.  I've read anecdotes about people taking different immune suppressing drugs for other issues, and seeing the side effect of their hives being cured from it.  But as with many treatments, THC has dangers to consider, such as the possible suppression of a gene that can help prevent breast cancer.

There are countless things we are exposed to, both intentionally and not, that affect our hormone levels—from the prescriptions we take, to the supplements we choose, to the food we eat, to the pesticides on that food and in our yards, to the plastics our food and drink are stored in.  Our hormones affect our immune system, and remember that hives is an autoimmune disorder.  I've read accounts of women getting hives during menopause, or after a hysterectomy.  It seems clear to me that the trigger in these cases is hormones, and for me they have been a huge trigger for skin issues throughout my life.

I mentioned the "stress hormone" cortisol, and how both it and blood sugar levels can increase during the night, possibly causing skin condition sufferers to itch more.  As the "stress hormone", it is also one of the major players in our "fight or flight" response, which results in biochemical and hormonal imbalances, including flooding the body with glucose and inhibiting insulin production.  Am I beginning to make sense when I say that stress and hormones are two of the major contributing factors to chronic skin conditions like eczema and hives?

But balancing hormones is a tricky business.  Many substances that mimic natural hormones in our bodies are not treated the same way by our bodies' hormone receptors and do not perform the same functions as natural hormones.  In some instances this is good, in others bad.  Furthermore, too much exposure to such substances can disrupt our bodies' ability to produce natural hormones.  It is much the same with some sugar substitutes that our bodies neither recognize nor react to in the same way that they react to sugar.  This can be good in the short term, but can cause all sorts of long term issues.

I believe our best chances for discovering both our triggers and treatments rely on us recognizing how things we don't normally think about are truly affecting us, both short and long term.

Chronic skin conditions are traumatic, not only physically, but mentally and emotionally.  The itching can drive you out of your mind.  But welts and rashes all over your body are also ugly to look at.  Seeing them makes other people wince and feel sorry for you, but it also makes them not want to touch you, because you look contagious.  Friends and family ask how your hives are doing, or suggest things for you to try.  And you know they mean well, but it just makes you want to scream because you're already trying everything you know to try, and your hives aren't any better than the last time they asked.

When I was in college, my best friend and I used to hang out with three guys who were roommates.  She went on to marry (and painfully divorce) one of them.  I remember they had a friend who used to come over and drink with us sometimes.  He had the worst case of psoriasis I've ever seen.  Just red, crusty rashes over every exposed inch of his body.  

I don't remember his name, but I clearly remember the last time we said goodbye.  He was moving away, or I was, and I hugged him.  He held onto me so tight, he was almost shaking.  And I remember getting the sense that he was profoundly grateful I'd reached out and hugged him, because he probably wasn't used to people ever touching him.  I empathized strongly with him, having battled eczema myself, and I knew very well that you couldn't catch psoriasis.  But his was so bad that even I had to suppress my instinct not to touch something that looked so horribly contagious.

I feel for every single one of you with these terrible chronic skin issues.  And if you've made it this far, I thank you for taking the time to read my story.  I hope it will help you to have one of those "Face Palm" moments that leads you to stop doing something that's inadvertently making your symptoms worse, thereby making your life a little more bearable.  I offer no magic bullet.  Only the belief that we CAN get better, we just have to approach our condition and our treatment from a thoughtful perspective.

And we must be patient and not give up, which might be the most difficult prescription of all.