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Eczema understood.

Eczema is a chronic itchy skin condition that also goes by the name of Atopic Dermatitis. Most commonly effected are children but it is not uncommon to present at any age.

An individual can suffer from eczema due to many different causes or influences but understanding the condition gives us more tools to be able to eliminate or relieve symptoms.

I have a personal interest in digging deeper into the details of this skin condition and how i can find relief as both my children suffer from this condition, i would love to be able to help others look outside the box of traditional treatments and to provide information about Eczema.

Of course, this blog is written by me and is my opinion, i am not claiming to be a doctor or dermatologist but this is my understanding of the skin and this skin condition.

Lets start by looking at Filaggrin, now i hear you ask, what is Filaggrin?

Filaggrin is a filament associated protein that is essential for skin cells to be able to go through differentiation and mature correctly into tough, resilient corneocytes that make up the outer layers of our skin - the ones you look at everyday in the mirror (i'd like you to imagine a grain of rice) it also plays a really important role in providing the skin with hydration, protection and plays a role in how your skin responds to stress.

Filaggrin is formed from the breakdown of profilaggrin within the layers of our epidermis.

If you have ever had a skin consult with me you will be very familiar with my 'roof' analogy and the importance of healthy barrier function, if not hit pause on this blog and check out my previous blogs to learn a little more, it will help all of this make a lot more sense.

So very basically, compromised filaggrin formation results in our skin cells being unable to develop correctly which in turn leaves our skins barrier function impaired or the "roof of our house" with holes (now id like to you image a rice bubble)

Why am i getting you to visualise rice and rice bubbles? these two represent skin cells, a healthy skin cell being the grain of rice - strong, water resistant cells which allow for fully functioning innate immune and barrier defense systems. The rice bubble represents sick skin cells, which are brittle with holes resulting in a compromised barrier defense system, increased trans-epidermal water loss (evaporation of water from within the skin) and in turn decreased enzyme activity.

A compromised skin barrier function allows for easier entry of allergens, triggering inflammatory and allergic immune responses amongst many other things.

Filaggrin has a monumental job to do! So what happens if we are lacking in filaggrin? We have a dry, flaky, barren skin cell that provides no hydration, holds no hydration within the skin and cannot form a solid roof structure allowing pathogens and allergens directly into the skin - as well as skin cells that are unable to compact neatly to form a protective layer over our bodies. When we think about what eczema actually looks like you can see all of this happening, the skin is red and inflamed, dry and flaky. This tell us that the skin cells are unable to attach nicely to each other (incomplete cell compaction) so we are getting that dry flaking, which means the barrier is impaired and the skin cells and systems underneath are stressed hence the redness and inflammation and the itching that is associated with eczema comes from the disruption of our immune system and the histamine response.

So who decides if we are blessed with filaggrin or not? Your dear mother and father. We are made up of thousands of different pairs of genes from our parents and they kindly gift us a set each. Around 1 in 10 of the population have reduced amount of filaggrin because they have inherited a faulty copy from one of their parents, this is called Filaggrin Gene Deficiency.

If you are passed on this deficiency from one parent you will have 50% loss of function, if both parents have passed it on you will have no filaggrin and will very likely present with atopic dermatitis, eczema, psoriasis, dry or barrier impaired skin at some point in your life. It is important to ask your parents if they too have ever suffered from any of these condition, even having lipid dry skin can be an indication of a filaggrin gene deficiency. With all of that in mind, its important to remember that every skin is different and unique, just because mum has or has had eczema doesn't mean that she is going to pass on eczema to her children.

Sadly there is currently no test i can pass on to determine if you have this genetic deficiency or not but having a comprehensive skin consult can help to establish if this is something that could be a contributing factor if you are suffering from dry, itchy, sensitized skin.

Knowing that you may or may not suffer from eczema can be determined before you are even born does give us an indication of how we can help to treat or relieve the symptoms that are associated with the condition.

Our skin type, is the type of skin we are born with and the type of skin we will live with for the rest of our lives. I like to explain it as, if you are born with dry skin you will always have dry skin, we can do things to help improve the amount of lipids our body produces and apply hydration to our skin topically but the moment we stop doing those things, our skin returns to being dry. Its much the same with eczema when there is a filaggrin gene deficiency, if you are born with this, you can help to reduce the impact this has but that underlying genetic make up will always be with you, this is really important to keep in mind when seeking treatment.

It is also really important to think about the long term repercussions of any treatment you are thinking of having and what impact it will have on the skin, how is this treatment plan going to serve you and your skin for the long haul?

When we understand how the skin functions and what it requires to function helps to establish a treatment plan that is sustainable and going to work in harmony with the skin to maintain its integrity, without that we are back where we started.

I can say from experience, when treating eczema in my children, because we are unable to change what is driving the skin condition (in most cases being filaggrin gene deficiency) the condition does seem to come and go and the severity is influenced by many factors, but i do believe as our children grow, their systems develop and they do slowly grow out of the severity of eczema if consideration is taken to what influences a flare. I also believe there is great value in seeking the help from a Naturopath who can guide you in finding these influences and finding ways to avoid them and work towards building resilience.

I can tell you i have tried every product you can think of to try and provide relief but if eczema was as simple as treating it topically i would certainly have "cured" it by now but it is much much deeper and multifaceted than that, until i truly understood the intricacies of the condition i couldn't understand how to treat it successfully and more importantly how to manage a flare. I don't believe if you have a filaggrin gene deficiency you will ever be cured of eczema, its all about management.

There are many influences that can have a negative impact on the skin and cause a flare for example, washing powders, soaps and topical products applied, certain foods causing inflammatory responses or intolerances (this is very individualised) and environmental factors such as pollens and seasonal changes. There also needs to be considerations for internal health - gut health, diet, nutrient deficiencies, medications, stress and histamine levels.

When looking at eczema in adults all of the above are important factors, our skin is a site of response so if eczema is something that has appeared in adulthood a great place to start is looking at what is happening on the inside, what has changed or is it an accumulation of things that have built up to cause an inflammatory response within the skin and now you have broken out in an itchy rash.

I am going to say that topical steriods, where they do sometimes have their place, can do more harm then good when used for long periods of time and without great thought given to all considerations of a condition such as eczema. Topical Steriod Withdrawal should also be in the back of mind when using such treatment protocols. I have seen first hand on multiple occasions the damage this can do to the physical and mental state of people even after long periods of discontinued use. Again this is only my opinion but i feel it is important to raise awareness around the subject.

Like any other skin condition, when we respect the skin and work with it, homeostasis can be achieved and our skin is allowed the opportunity to function as nature intended. If you haven't read my blog about Corneotherapy now would be a fantastic time to do so. I recommend a corneotheraputic approach to treating all skin not just eczema. In my mind it makes perfect sense, if we work alongside our skin and supports its natural function its going to be able to do its job much easier than having to fight everything that is introduced to it and create stress within the skin. Maintaining the integrity of the outer layers of skin by not over exfoliating, having ablative treatments and eliminating ingredients from topical products such as fragrance, emulsifiers, preservatives, mineral oils to name only a few will be hugely beneficial to relieving symptoms when treating eczema.

As i mentioned earlier there is no miracle product that is going to cure your eczema, its all about finding the cause, eliminating triggers and supporting the skin.

If you are suffering from eczema and would like to have a chat, please do reach out, it would be my pleasure to help you find some answers.

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