This is kinda long so I appreciate anyone who might take the time to read this!
I’ve had eczema my whole life (mostly atopic dermatitis, some dyshidrotic eczema especially in high school). Environmental allergies: pretty much everything but horses and pine trees. Other allergies: penicillin, some nuts (mostly due to my severe birch allergy per my allergist), and oats. I’ve been really struggling lately. Normally I would go through a worse flare every year or so and I’d deal with it and it would ease up after a while, but it seems like as an adult (28y/o) it’s just gotten worse. I have been dealing with a flare for the past year and a half.
Treatments:
- Steroid shots: as a child when the flares got severe
- Medrol dose packs: occasionally was prescribed for flares as an adult
- Triamcinolone: very sparingly as I’m terrified of TSW
- Eucrisa: didn’t really work for me
- Opzelura: worked well for a while, the dermatologist I was seeing at the time gave me basically no information on it and while I should have done more research myself it kinda just stopped working after a while.
- Vtama: last year, kinda worked? But it wasn’t life changing.
- Mupirocin: for a recent infection
- Doxycycline: for a recent infection
- Zoyrve: currently on this medication and waiting for it to work.
- Impoyz: a 3 day course for acute inflammation
- I won’t get into every OTC thing but starting in September I started being more consistent in taking Vitamin D3+K2, omega 3s, and Zyrtec. I’ve now been on all daily for 5 weeks. Go back and forth usually between Zyrtec and Claritin for my usual allergies and Benadryl around cats and dogs or severe environmental stuff.
Last summer it got to where it was almost over my entire body. I had bleeding and was bruised all over from scratching. My SO would drive me around in the car and have me sit on my hands to distract me and keep from scratching uncontrollably. Sleeping was so difficult. I did allergy testing at my allergist, my dermatologist got referred to another dermatologist to talk about phototherapy, and did an elimination diet for almost two months where I broke out in whole body hives after eating oats. The information from my allergy testing was semi helpful but I wasn’t using anything that I testing positive to. The flare kinda calmed down after a while and it got to the point where I felt like I could live normally again. My skin didn’t look fantastic but it wasn’t spread over my whole body anymore.
I basically use the most plain skincare ever to help keep my skin calm but nothing really helps. I use Vanicream everything, some Cerave (not recently though as it’s been making irritation worse), and Vaseline.
Fast forward to June of this year, I’d had some flaring on my neck and face and the other usual spots (back of knees, elbows, hands) on and off in the spring but nothing terribly unusual. In May a spot on my chin started getting worse. I was doing all my usual things to help soothe and manage but it kept staying red and irritated with relief every once in a while. In June I thought I for sure had an infection over a weekend I was out of town but I was able to get a telehealth appointment and they prescribed some Mupirocin for a week. It seemed to help that spot some. During July things were okay but not great. I went to the beach and maybe my skin loves the sun bc it cleared up a lot. At the time I was also using a sample of Zoryve my derm had given me earlier in the year (unfortunately the sample was the 0.05 and not the 0.15 but I guess it was something). I was using that and it seemed to help some but then the end of July/beginning of August things just went downhill.
I get redness in my philtrum and the eczema on my chin progressively got worse and worse and opened up. It started as such a small spot (and now it’s about the size of a quarter or maybe a silver dollar on my chin). I did another elimination to see if maybe my body just needed a bit of a reset. I could never tell if it ever really got better at times or if it was just in my head. I wasn’t sleeping. I was doing anything and everything to try and stop the cycle of scratching. My SO would wake up and grab my hands while I slept because sometimes I would scratch so violently it would wake them up.
By September I was worried about infection again and came to terms with I just can’t live like this anymore and nothing is helping. I love my dermatologist but maybe you guys understand the hesitation of going back again and again when it feels like a lot of times there’s nothing they can do. My chin especially was crusting and weeping and getting worse and my whole body was getting worse as well so I went back to my derm and she put me on two weeks of doxycycline, a medrol dose back, Triamcinolone twice a day for my hands, elbows, and knees, and Zoryve (now the adult dose - 0.15) for my neck, eyelids, philtrum, and chin (once it healed enough to apply it - was about a week before the skin was intact enough). She told me to basically just use Vaseline and Vanicream moisturizer if I tolerate it and she said if I still had the mupirocin I could put that on my chin as well. I started the doxycycline, Triamcinolone, and Zoryve that night and the medrol dose pack the next morning. Even after just one night I could tell a huge difference in my itching. The next two weeks I experienced more relief than I had in months. I was sleeping soundly. I was so thankful.
Behind my knees has stayed flare free, my elbows and hands have either been clear or like 80-90% clear, my eyelid has been clear, however, my neck, above my lip, and that spot on my chin will not quit. I went back to my derm AGAIN last week because my face and neck (especially my chin) got SUPER inflamed and cracked and was bleeding again and I didn’t know what to do. He told me to use a very thin layer of impoyz (clobetasol propionate) on the spots on my face and neck once a day for three days and then switch back to the Zoryve. I did that - a thin layer on Thursday, Friday, and Saturday, and then switched back to Zoryve on Sunday. It worked fantastically- and even on all the other meds I’d had over the last month my face was clearer and less red than it’s been in a long, long time. However, starting yesterday redness and inflammation on my chin started coming back… I can’t use that impoyz again for a long while since it’s a steroid… whomp whomp :(
Called my derm asking about maybe trying something else that’s stronger or a different mechanism and then switch back to Zoryve once the deep skin barrier has had more time to heal and he basically said give the Zoryve more time… I started on most spots on my face September 9th and when my chin was intact enough to start it I only stopped on my chin for those 3 days I used the impoyz so it’s been a good 4 weeks I’ve been using it but I supposed it could take longer.
I am just so frustrated and tired and I don’t know what to do. I’ve considered phototherapy but it would be hard with my work schedule. I’m really hesitant to try dupixant since it hasn’t been on the market for long and I have turned the idea of trying it over and over but I am just not comfortable. I’d also be really worried about rebound flares. Allergy shots are so expensive and they’d probably make my eczema worse to start out anyway. The Zoryve has definitely helped some with the itching sensation which I’m very grateful for but the redness and swelling and such is still very present and with the worst of it being on my face right now I guess I’m just really impatient for something to work better.
I’m tired dawg.
I know eczema is so different for every person, and I am truly grateful that my really persistent patches of eczema aren’t covering my whole body or anything, but if anyone has any thoughts, advice, or just some hopeful stories I’d love to hear. Anyone think somehow fitting phototherapy in would be worth it? Anyone have any other recs?? Thanks for reading if you made it to the end!