As a community pharmacist with over 17 years of experience, I've encountered numerous cases of eczema and dermatitis. In recent years, I've also observed an increase in customers experiencing Topical Steroid Withdrawal (TSW) symptoms, which presents a unique set of challenges. 

Managing eczema isn't solely about alleviating physical discomfort; it encompasses the emotional strain individuals endure.

The relentless quest for remedies, the anticipation of relief, and the subsequent disappointment when treatments fall short can be emotionally taxing.

While medications and ointments are fundamental in eczema management, there's a broader perspective to consider.

Through my daily interactions and discussions with fellow health practitioners, I've accumulated insights that extend beyond the conventional pharmacy approach.

Outlined below are straightforward, daily modifications that can profoundly impact eczema management, enhancing the overall quality of life.

1. Environmental Factors:

Maintaining a Comfortable Ambiance:

The environment we live in significantly influences our skin's health. Fluctuations in temperature, be it the chilling winds of winter or the intense heat of summer, can intensify eczema symptoms. Thus, it's crucial to regulate the temperature of your living space.

In seasons with low humidity, think about incorporating a humidifier. This device adds moisture back into the air, helping to prevent skin dryness.

Laundry Considerations: 

A task as mundane as laundering can unexpectedly trigger skin issues. The usual suspects? The aggressive chemicals and fragrances present in many laundry detergents. While they might impart a pleasant scent to our garments, they can be detrimental to those with sensitive skin.

My Recommendation: 

Shift to hypoallergenic and unscented detergents. This minor change can have a substantial positive impact on your skin.

Dressing with Comfort in Mind:

The apparel we choose can either soothe or aggravate our skin. Constricting, man-made materials can trap perspiration and warmth, escalating itching and unease. Preferably, select relaxed attire crafted from organic materials like cotton, which permits your skin to respire, minimising potential irritation.

Fabric Suggestion: 

Bamboo: This material is gaining traction, especially among those with sensitive skin or eczema. Brands such as Bamboo Bubby and Bamboo Body specialise in bamboo-based attire, celebrated for its plushness, airiness, and eco-friendliness. Bamboo fabric, softer and more breathable than cotton, also boasts of its ability to wick moisture and its antibacterial attributes, making it ideal for those prone to skin issues.

Allergy-Conscious Choices:

For individuals with allergies or particular skin ailments, it's paramount to opt for attire that doesn't exacerbate the skin. The Allergy Shop offers an assortment tailored for those with allergies and eczema, guaranteeing both comfort and minimised irritation.

The essence lies in selecting attire that ensures comfort, facilitates skin respiration, and is crafted from natural, hypoallergenic materials. Such choices not only mitigate skin irritation but also foster overall skin well-being.

2. Nutrition and Foods to Avoid:

In the realm of healthcare, we often hear the adage, "You a re what you eat." As a pharmacist, I've come to realise the profound truth behind this statement, especially when it comes to conditions like eczema. 

While medications and creams are vital, the foods we consume play an equally significant role in either alleviating or exacerbating symptoms.

From my interactions with the community and the stories shared, here are some nutritional insights that can make a tangible difference in your battle against eczema:

Know Your Triggers: 

Just as we have individual tastes, our bodies react differently to various foods. For some, dairy might be the culprit, while for others, it could be nuts or wheat. It's essential to identify and steer clear of these triggers. 

A practical approach? Maintain a food diary. By jotting down what you eat and observing any subsequent flare-ups, you can pinpoint potential triggers. And always, before making any drastic dietary changes, consult with a healthcare professional or nutritionist. They can provide personalised guidance tailored to your needs.

Embrace Anti-inflammatory Foods: Inflammation is a key player in eczema flare-ups. But did you know that certain foods can combat inflammation from within? 

Omega-3 fatty acids are your allies in this fight. Incorporate fatty fish like salmon, mackerel, and sardines into your diet. If you're vegetarian or vegan, chia seeds and flaxseeds are excellent alternatives. 

These foods not only soothe inflammation but also nourish your skin from the inside out.

Hydration is Key: Water is the elixir of life, and for a good reason. Staying well-hydrated ensures that your skin remains supple and reduces the risk of dryness and itchiness, common eczema symptoms. 

So, make it a habit to drink plenty of water throughout the day. Your skin will thank you for it!

Watch Out for Additives: In today's world of processed foods, it's easy to overlook the myriad of additives that find their way into our meals. Some of these, like artificial flavours, colorings, and preservatives, can be potential eczema triggers. 

My advice? Become an informed consumer. Read food labels diligently and opt for products that are as natural and additive-free as possible.

Cut out or reduce as much as you can foods that cause more inflammation in the body.

Refined sugar and carbohydrates tend to cause a flare up in two ways.

Directly triggering the immune response and secondly, by disrupting the balance of good bacteria in our gut. 

The gut flora or gut microbiome consists of trillions of beneficial bacteria with various functions, such as helping to digest food, supporting the immune system and even influencing our mood. 

Recent studies show that a high intake of refined sugars leads to an overgrowth of certain types of bacteria in the gut (Proteobacteria) while decreasing the type of good bacteria ( Bacteroidetes) which reinforce the gut barrier function and minimise the effect of toxins.

Cutting back on those jam donuts and sugary treats can make a difference to the underlying inflammation in your body. It might just be the factor that reduces symptom severity from a 6 to a level 1-2 which is easier to manage. 

3. Emotional Well-being and Support:

Battling persistent eczema or dermatitis symptoms can often lead to feelings of anxiety, low mood, and even stress, which can further exacerbate flare-ups.

Engaging in calming activities, such as exercise, swimming, or yoga, can be instrumental in resetting the nervous system, shifting it away from a constant state of alertness. Connecting with a support group or collaborating with an empathetic healthcare professional can be transformative in your journey towards better skin health.

4. Consider Diagnostic Tests

If conventional methods prove ineffective, it might be beneficial to undergo comprehensive allergy testing or bloodwork. This can help identify specific allergens triggering your immune reactions. From my dialogues with holistic health experts, a review of your medical history, combined with allergy tests and a structured protocol to exclude inflammatory foods and introduce gut-healing supplements, can be enlightening. It's worth noting that a significant portion (around 80%) of our immune responses is rooted in our gut.

Holistic Approach to Eczema Management:

Addressing eczema requires a comprehensive approach. It's about making enlightened decisions, not solely at the pharmacy but also in your kitchen and living environment. As we navigate this path, know that I'm here, armed with the collective wisdom of our community, to guide and support you every step of the way.

For recommendations on holistic practitioners, please refer to:

• Everything Eczema (Kishok Satkunarajah, Certified Nutritional Practitioner)
• Steroid Free Skin (Dr. Kayla Clarke, Naturopathic Doctor)
• Rener Health Clinic (Mike Reid, Naturopathic Practitioner)
• Perth Allergy Clinic