How I'm Using Protopic / Tacrolimus While on Dupixent and Avoiding Withdrawals

I made a decision last month to use Tacrolimus (generic version of Protopic ointment) while on Dupixent (a biologic eczema medication). Not one time, but in an ongoing manner. It was not an easy decision to make - considering the many fellow eczema fighters that have ended up in withdrawal from Tacrolimus.

What is Tacrolimus Withdrawal?

The eczema community says it’s just like Topical Steroid Withdrawal (TSW), which I went through during my first pregnancy. It’s what can happen when you overuse the Tacrolimus ointment on your body to combat flareups. The ointment stops working (or you may suddenly stop using it after overusing it) and then withdrawal symptoms take over. It’s a new world beyond eczema, with burning, redness, fierce itching, flaking, swelling, oozing, and crustiness. It has its own timeline - I was lucky to have TSW for only a year. Many folks suffer years in withdrawal. It’s a debilitating, life altering struggle and I wouldn’t wish it on my worst enemy (not that I have any).

Why I Chose To Use Tacrolimus?

Ironically, Protopic / Tacrolimus (along with Dupixent) helped save me towards the end of my topical steroid withdrawal in 2017. I stopped Dupixent in 2018 to get pregnant for my second child. I continued using Protopic until late 2022. Well, 2023 was not good. I tried for a solid year to avoid my allergens and triggers, but the bubble I must live in doesn’t exist.

I decided to restart Dupixent in late 2023 and, to my surprise, I was flaring up from the Dupixent itself - apparently, it often causes fungal infections and flareups around the mouth and neck. My new derm immediately recommended I use Protopic / Tacrolimus. I said “absolutely not!” But I started reconsidering a few weeks later and decided to restart Tacrolimus while on Dupixent. I needed to be safe about it, though, and needed to trust my derm that they could help protect me from withdrawal symptoms.

How I’m Avoiding Protopic Withdrawal

I’ve got serious trust issues when it comes to dermatologists and tend to believe that most of the medical industry is pretty unaware of withdrawal consequences from the use of eczema ointments. I had a new derm and needed to feel confident that they understood not only about withdrawals, but also how to avoid it. After building trust with my derm, we discussed my treatment plan: use Protopic as sparingly as possible, but also as needed. And we’ll monitor if it becomes less effective, because that would be a big red flag.

Because I’m on Dupixent, my flareups are more contained and occur less often. So, I won’t need Protopic as often as I did pre-Dupixent. But Dupixent causes flareups soon after my injection - and it also doesn’t contain my eczema 100%. I’m fine to use Protopic sparingly to combat my mild to moderate flareups, whenever I do have them.

Specifically, my derm advised me to use Protopic / Tacrolimus once or twice a day on the affected areas, for a few days every two weeks, which is how often I have my injection and about how often I get flareups nowadays. This treatment plan works perfectly for me now.

How Will I Know if I’m At Risk for Tacrolimus Withdrawal?

According to my derm, we will monitor how my skin is reacting to the protopic / tacrolimus. If the ointment starts to be less effective, it’s a sign that my body is headed towards Tacrolimus withdrawal. The key is to identify this sign early on and not once I’m deep in withdrawal, which is how I ended up with TSW. Fingers crossed that I never see this sign, but if I do, I’ll work with my derm for a safe way to taper off Tacrolimus or switch to something else. What I won’t do is what I did last time: be blind to the possibility of withdrawals and lather my body with topical steroids until I wake up one day and look at my deeply wounded body wondering if it’s being attacked by eczema or something else.

How I am Doing while on Tacrolimus and Dupixent

I’m doing great! I feel so much better than last month, when I was dealing with breakouts while on Dupixent. And I feel way better than 5 months ago when I restarted Dupixent and had little control over my flareups.

My flareups still happen, but they’re contained. As I sit writing this, I’ve got a small flareup on my neck (still from that jacket I wore last week - thanks dust mite allergy!) and on my arm (same spot I’ve had for years, just not as bad) and a little around my mouth (probably from my Dupixent injection a few days ago). I’ll use Protopic on my flareups today and will be grateful that there’s a treatment that I’m confident will work, and that I’m monitoring for safe use.

And, as I often feel when my skin is healthyish, I feel beautiful again!

Restarting Tacrolimus While on Dupixent

I got back on Dupixent 3 months ago, and I didn’t clear up and have perfect skin like I expected. Like I thought happened last time. It didn’t. I still had mild to moderate flareups, according to my own blog, which I had to re-read to find out.

But I didn’t remember needing Tacrolimus. I did. It helped save me a few times, including while I was in Dupixent.

But people scared me off Tacrolimus (the generic version of Protopic). I worried I’d go through withdrawals again. And I’ll do anything to not go through TSW again. So, I stopped it.

I focused on my skin allergies and avoiding triggers. And it worked for a bit. But, it turns out that the bubble I must live in doesn’t exist. My skin allergens are impossible to manage. And I tried hard.

Fast forward, and I reached the moderate to severe chronic eczema threshold I always said would trigger my restarting Dupixent. But now Dupixent is turning on me. Giving me terrible facial and neck flareups. My FACE!

I don’t remember this from last time.

But I had Tacrlimlus last time.

Fungal infection it turns out - and it’s pretty common with Dupixent users. Anti-fungal ointment and nightly Benadryl helped this last week, but only to a certain point. Then it started spreading again, even though it was not as severe anymore.

And it kept spreading.

My next Dupixent shot is due soon. And I have an onsite leadership meeting with my job in 1.5 weeks. I can’t keep hiding by backing away from my zoom camera at work. And I really don’t want to wear my eczema fight on my face with my work colleagues.

I’m also so tired and thirsty. I swear, when I have bad flareups, it seems that it zaps all the moisture and energy out of me. I end up looking and feeling like a dehydrated zombie.

Well, I caved tonight. I used Tacrolimus again, after working hard to stop a year ago.

Well, what’s the point of stopping something because it may do what it has proven to help stop?

Anyway, that’s how I feel about it today. I reserve the right to think differently tomorrow or in a month or in a year, because that’s the way it goes in this lovely game of eczema life.

Now I just hope Tacrolimus helps the way I remember it helping …

3 months of Dupixent (again) and still flaring

Here I am with a flare-up “beard” 2.5 months after my restarting Dupixent (after a 5 year break). It’s been spreading and it’s still spreading. And on my face; the forbidden area! It’s on my arm too. My skin hasn’t been in clear mode at all since I restarted Dupixent. It got better, but has progressively gotten worse.

I’m trying to figure out if it’s better right after my Dupixent injection and then gets worse again after a few days.

Sigh. I guess overall it’d be worse without Dupixent at all. Damn silver lining.

I’ve said for years that Dupixent helped finish clearing me from my Topical Steroid Withdrawal (TSW) and then kept me totally clear until I got off it (to get pregnant). But now I’m realizing I was using Protopic at the same time time as Dupixent. What if the combination of Protopic and Dupixent is what cleared me? I finally stopped Protopic last year - I was hoping to keep it that way.

Maybe my going out of town in three days for the holidays will help with my flare up. Ha! Travel has only ever triggered terrible flareups. Unless there’s a Christmas miracle this year! Ho, ho, ho.

Why I Got Back on Dupixent 5 Years Later

Why I Started Dupixent 5 Years Ago

I've had eczema for decades now, from mild to moderate to severe. During my first pregnancy it became insufferable, because I went through Topical Steroid Withdrawal (TSW). I wouldn't wish TSW on my worst enemy (not that I have them!). I'm grateful that my TSW improved after my pregnancy, but my system was still out of whack. At the time, Dupixent had just been approved by the FDA and I was lucky to be able to access the medication. I got on Dupixent on May 2017 and it quickly helped, ultimately clearing me completely.

Why I Stopped Dupixent After Nearly 1 Year

But then I wanted to get pregnant again. At the time, no human testing had been done to determine if it was safe to be on Dupixent while pregnant. My allergist determined, through animal testing reports, that I shouldn't be on it and we figured out how many months prior to getting pregnant I should be off Dupixent. So, I got off Dupixent on February 2018, 9 months after starting it, to get pregnant again. And, yes, I was pretty scared about what would happen. Would I go through TSW again? Would my eczema come back with a vengeance?

5 Years Post Dupixent

For awhile, I was mostly fine after getting off Dupixent. I was ecstatic. I'd still get flareups, but they weren't too bad - I was mild to moderate for a few years, which I found acceptable. I told myself I would only get back on Dupixent if my eczema became moderate to severe consistently.

Well, my eczema has been progressively getting worse these last few years. My flareups started lasting longer and became more severe. I thought I could treat it by getting off all medications and just avoiding my allergens. I got off Protopic (i.e., Tacrolimus) … finally. I got yet another allergy patch test and discovered new serious skin allergies. I became obsessed with avoiding my allergens, and it seemed to be working for some time.

But I lost control. Or maybe I never actually had control. My flareups were getting really bad, spreading and lasting months. In fact, they were never fully going away, just spreading and receding, like a tide. An eczema tide. And they ranged from being an angry flareup to a moderate flareup and, if lucky, to a mild flareup. Like a burning light inside me that got brighter or less bright, but always lit. An eczema light burning inside me. Tide … light … whichever eczema analogy I use doesn't matter - it was terrible and I needed help.

I Lost Hope with my Skin Allergies

I moved to Austin almost 2 years ago and hadn't gotten a new allergist or dermatologist yet. So I went on the hunt for an allergist. I saw two allergists and both gave me conflicting info (0f course!), but both said one thing in common: I was severely under-treated.

I considered going back on allergy shots, something I've tried twice before but gave up on both times, because I never saw results. Maybe I had given up too soon both times. The second Austin allergist, Dr. John Villacis, (whom I've chosen as my ongoing allergist), however, explained that allergy shots only work about 50% of the time. And they should start helping within 6 months. Since I've tried them before (and at least for 6 months each time), we decided the problem wasn't that I had given up on them before, but that I was probably in the group of the 50% that doesn’t get help from allergy injections. My system would always overreact. Both allergists highly recommended Dupixent - I had already tried it before and it significantly helped me last time. Plus, it has helped so many people since I first tried it back in 2017.

Deciding to Start Dupixent Again

My eczema is closely related to my many and ridiculous skin allergies. I've decided that the bubble my body needs to live in to avoid these allergens does not exist. Benadryl is the only thing slightly helping at this point, but I can’t be on Benadryl 24/7 and live my life asleep or groggy constantly. It is time to get back on Dupixent. I feel hope again.

Double Benadryl Night

It’s a double Benadryl night

It’s been awhile, thought I could cope

But this year has been rough

And this flareup won’t stop

No lotions or ointments;

They don’t work anyway

I’m to avoid my triggers, ha.

I’ve said it before and I’ll say it again,

The bubble I must live in

Doesn’t exist.

Maybe it’s time to do real meds again.

For tonight, it’s two Benadryl.

Tomorrow is another day

(And I’m sure I’ll be drowsy.)

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Eczema and Skin Allergy Rant

Why?!

Is it my house? Is it my intense dust mite allergy?

Or my ridiculous colophony allergy?

Or is it my high work stress?

Is it because I got stuck at an airport hotel a few nights ago without my checked luggage, which ironically held my packed dust mite allergy mattress/pillow covers?

Whatever it is, I don’t even care at this point. It’s impossible to avoid my dust mites and colophony allergens. I remember the good ol’ days where I was just worried about my fragrance allergy. That’s such an easy one at this point.

I can’t live in a bubble and I can’t throw enough money at these allergies.

My flare up is bad right now. My arm flare up started weeping today during my work zoom call with a vendor. And it’s spreading. I’m feeling it start on my right thigh, spreading on my neck, starting on my left arm, and, damnit, my face is getting itchy. It’s going to be a bad one. It’s already a bad one. And I can’t pump enough antihistamines into me to stop it (within the recommended limit).

I need to talk to an allergist again. Maybe it’s time to get on real meds again. (NOT topical steroids or protopic/tacrolimus!)

Today, I feel defeated by my ridiculous skin allergies that trigger my eczema flare ups. Tomorrow is a new day, and will probably involve my finding a new allergist (since moving to a new city last year). Tomorrow is a new day. But tonight, I pout.

I’ll Put a Spell On It

There’s a scene in 90s movie The Craft where a young lady is full of burn scars and suddenly (through witch craft!) her damaged skin starts to wipe off to reveal perfect, healthy skin. I watched this scene 20+ years ago and it’s just as powerful for me now as it was back then - even more powerful, probably! At the time, I didn’t yet know the feeling of being trapped by your skin.

Right now, I’m lying awake in the middle of the night because my neck is doing that thing where it is so itchy that it burns. What is that sensation called? It’s not just an itch and not just a burning feeling. A burning itch … an itchy burn … whatever it is, I need it to stop.

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This flare up has escalated throughout the last 6 months and is now spreading and is angrier than ever. Innocent me (how can I still be eczema innocent?!) thought proudly that I had figured it out last year. Well, it has now gotten my full attention - I’m back at hypotheses and testing.

I long to wipe this flare up off me - tell me what Wiccan spell must I do to make it happen!

From Eczema Shame to Eczema Confidence

Published on WebMD blog.

My eczema flare-ups have two main stages: the worsening, which leads to peak flare-up, and then the recovery, which leads to clear skin. In the past, the two phases together have lasted a few days, a few weeks, or, terribly, a few months.

Not long ago, I was in the recovery phase of a bad flare-up on my hamstrings. They were no longer burning or unbearably itchy. But the skin was still swollen and dry. I completely forgot about my thighs, though, when my sister invited me to the spa for a massage. I would’ve never gotten a massage if my skin was actively flared up – massage oil on a hot flare-up would’ve been a terrible idea. But I should’ve waited a few more weeks to go get a massage.

I realized my oversight as soon as the masseuse put her hands on my bare skin. I was undressed, lying on my stomach, covered by a white blanket. And I felt so exposed. Eczema exposed. “Oh no, my legs!” I thought, “Oh no, oh noooo!”

She started on my shoulders and moved down to my back. Then she was massaging my waist. I was everything but relaxed. I felt so much anxiety – a surprising amount of it. And I felt shame about my skin. I felt guilty that I put my masseuse in a situation where she’d have to touch my flared-up skin. Would she be disgusted? Would she want to stop? Even worse, would she turn on the lights and stop the massage? Would she think it’s contagious? People still think that, right?

At this point, the masseuse finished massaging my arms and covered up my back. She repositioned the blanket and pulled out one of my legs. This was it. It all built up to this moment … and nothing happened. The masseuse massaged my legs like nothing was wrong. I assumed she was being very professional about it. I still felt bad for putting her in this situation.

Finally, the massage ended. She left the room and I got up to get dressed. There was a full-length mirror in the corner. I sped to it and looked at the back of my legs. And they looked completely normal. The room was dim enough that my flare-up didn’t stand out. I stood in front of the mirror and saw more than my reflection. I recognized my eczema shame. Until that moment, I hadn’t realized I felt shame regarding my eczema. I’d felt obsession, anger, frustration, and even pity. But shame? I was too confident to feel shame! But the last hour couldn’t be ignored.

“No,” I told myself. “Not OK.” I didn’t choose to have eczema and I’m not a bad person or less than anyone else for having it. I will not feel shame. I will be confident about how I handle it. I will have eczema confidence.

And, I will lower my skin expectations. Perfect skin is not necessary. Most people have blemished skin – and they get massages. Looking in the mirror of the massage room, I saw myself as I was – perfectly fine and appropriate for a massage.

ChatGPT Poem About Eczema

I asked ChatGPT to write a poem about eczema and it did not disappoint:

Eczema, oh how you itch and you burn
A constant reminder, my skin takes its turn
Red and inflamed, it never seems to rest
A daily battle, one I cannot best

Dry and scaly, a constant state
My skin's own war, one I cannot escape
Creams and ointments, a daily routine
But still the itch, the urge is so keen

A constant companion, always there
Eczema, my burden, my cross to bear
But I will not let it defeat me
I will fight, with all my energy

For though my skin may be flawed
I am more than a rash, more than a scab
Eczema may mark me, but it does not define
I am strong, I am bold, I am one of a kind

So I'll keep on fighting, with all of my might
Eczema, you may mark my skin,
but you will not win this fight.

Contact Dermatitis to Leather & Wood

The Discovery

The discovery of a severe skin allergy is bitter sweet. That moment of discovery sounds like waves crashing and the sky thundering. Stars align and you quickly go through all the moments you missed in your head. The flare-ups that caused confusion and misery. They make sense now. And they were avoidable.

That’s the silver lining. Now I know what to avoid. But it’s not so simple. Skin allergies never are simple.

My Allergic Reaction to Leather & Wood Products (Sometimes)

As always, it stars with an itch. It progresses to little red bumps that themselves get bigger, redder and itchier. The bumps spread. It gets to the point where a large area of skin is thick, inflamed, red, and itchy to an unimaginable point. Like one big, furious welt. It’ll start oozing after a week if the skin continues to be in contact with the allergen.

The Leather & Wood Products I Can’t Touch with my Bare Skin

My skin does not flareup from all leather and wood, but a few leather and wood items in my life consistently cause flareups. I’ve discovered and confirmed this in the last half year. Because I have a serious dust mite allergy, I surround myself with mainly leather and wood - no upholstered furniture.

One of my leather couches causes contact dermatitis. And, of course, it’s my Chesterfield couch from Restoration Hardware and not my sectional from Costco! The fake leather upholstered seats from my dining set also causes problems. As does my wooden desk in my work-from-home office. My desk! And my leather desk chair. And the leather on my car seats! My beautiful camel colored leather. What a shame.

And the list will probably keep growing as I touch new things.

How I Avoid My New Contact Dermatitis Allergies

Pop quiz: how does one avoid contact dermatitis? Ya don’t touch it! It turns out that it’s that simple. I still use all these items that cause allergic skin reactions, but I use a barrier so my skin doesn’t have direct contact with the culprit. I have a towel under my laptop, so my forearms touch the desk instead of my desk. I avoid using shorts, so my pants are a barrier between my legs and dangerous seats. I cocoon myself in a washable and clean blanket on my Chesterfield couch. And I avoid short dresses, skirts and shorts when I go out to avoid sitting on furniture that could cause a reaction. And by short, I mean anything that is above my knee, because the point is for there to be no bare skin touching a seat.

Why Am I Allergic to Some Wood and Leather products?

I think I’m allergic to some (not all) wood and leather products because of my contact allergy to colophony, which is also known as rosin. It is an ingredient in many products, from makeup to topical medication, furniture … even asphalt! It is also found in lubricants, polishes, lacquers and varnishes.

How I Treat My Skin’s Allergic Reactions

I sure did learn the hard way that the best way to treat my eczema (assuming it’s caused by a skin allergy) is to LET IT BE. Most importantly, I stop exposing my skin to my allergen when it starts and before it gets terrible. If it gets out of hand and gets terrible, I ride it out. No steroids, no non-steroid topicals like Elidel or Protopic … not even moisturizer. I do wash the flared area with CLn Bodywash and use antihistamines like Claritin and Zyrtec daily, both of which I think helps.

And it works! If contact with the allergen is stopped, within one week my skin turns itself around and starts improving. Often, within two weeks, it’s healed almost completely or is at least going through the shedding process and headed towards complete healing.

I feel so liberated from not using eczema medication anymore. I now tackle the root of my eczema problem - the triggers. Though, my triggers are so widespread and ridiculous that I feel shackled by them some days. But, hey, one win at a time!

Affirmations for Taking a Shower with Intense Eczema Flareups

1. I can do this.

2. It’ll be fast - just in and out.

3. Flared-up skin needs cleaning also.

4. I can control the water temperature.

5. Close my eyes and think about something else during the shower.

6. Cleaning flareups is important to avoid skin infections, which makes it worse.

7. Do it now so I don’t have to think about doing it the rest of the day.

8. Go now!

Okay, no more pacing in the bathroom while the water runs. I’m going in!

What Is Topical Steroid Withdrawal Syndrome (TSW)?

Published on the WebMD blog.

Topical Steroid Withdrawal (TSW) is hard for me to write about. I went through it 6 years ago and it was one of the worst experiences of my life. I didn’t know I was going through it at the time, and even today there’s still much I don’t know about it. What I do know is that I would never wish TSW on anyone.

What Is TSW?

Topical Steroid Withdrawal (TSW) syndrome is torture. It’s also known as the Red Syndrome because your skin looks and feels like it’s in flames from head to toe -- deep red, and so hot. It’s the result of your body’s reaction to stopping the use of topical steroid creams and ointments. And, although we’re accustomed to body reactions lasting just a few hours or days, TSW syndrome (TSWS) takes months and even years for some to overcome. I went through it while I was pregnant with my first child -- I stopped using topical steroids because of my pregnancy.

What Does TSW Feel and Look Like?

TSW is well known at this point, so a formal list of symptoms and photos are easily accessible. Here’s what it looked like for me, which I’ve also seen in others with TSW:

• Statue-like skin: My skin was so dry, thick, and hardened that it felt like I had a statue for a body. Sometimes I couldn’t smile and at times it was hard for me to turn my neck when I drove.

• Oozing skin: It’s as unpleasant as it sounds.

• Flaky skin: Ever felt like eczema flaky skin looks like snow? With TSW, it felt like a snow blizzard. It was more of a complete shedding of my skin as if I were a reptile.

• Edema: I learned about edema when I woke up with my eyes so swollen and oozy that I couldn’t open them.

• Unbearable itch: The itch was constant and to the extreme. I didn’t sleep for days at a time. The lack of sleep (while pregnant) was one of the hardest parts of TSW for me.

• Hot, hot skin: The heat was so uncomfortable. It was hot to the touch. It was red and hot; it felt like I was burning.

• Adverse to everything: I couldn’t put anything on my skin, including water. Everything burned – especially non-steroid ointments and creams. But I still had to wash my skin, because of a potential infection. My husband would help slather my skin at night after a painful shower and I would pace around my room, muttering a mantra until the burning calmed down.

• Swollen and aged looking: TSW changed the skin on my face and body. I didn’t look like myself. I was swollen and had lines on my skin everywhere. I looked 20 years older and as if I wasn’t aging gracefully. I didn’t like how I looked when I went through TSW.

Getting a TSW Diagnosis

Here’s the kicker: Doctors may often overlook TSW. I believe it’s becoming more recognized and accepted by the medical industry nowadays, but not nearly enough yet. Six years ago, when I went through TSW, I had been dealing with moderate to severe eczema for a decade already, but my condition was so severe that I questioned whether it was even eczema. I went to see a dermatologist and she said, “Yes, it’s eczema, and it could be worse.”. But that doctor was wrong! It wasn’t eczema, it was TSW syndrome.

A fellow eczema fighter on social media let me know that I had gone through TSW after she saw my blog.

TSW typically occurs in people because you are usually prescribed topical steroids. But TSW is not technically eczema -- it’s like the monster sibling to the eczema beast. They are closely related but are technically different. I didn’t realize this for a long time.

The TSW Cure

There’s one thing that helps: time. I was lucky that my TSW symptoms calmed down toward the end of my pregnancy. Even luckier, I was able to get on a biologic medication after I gave birth and it cleared up the rest of my TSW symptoms. But these medications aren’t without side effects. Many people with TSW are adamant about just waiting it out, though it could be years.

Surviving TSW

Though there’s no easy cure for TSW syndrome, there are things that helped me get through my TSW.

• Ice/cool packs. These were especially necessary at night to help with the heat of my body while on my mattress and bedsheets.

• Acupuncture. This helped me, I believe. My acupuncturist was so caring that she even came to my house for my treatment once or twice.

• Family and friend support. TSW was hard on my mental health; the support from my friends and family was essential.

• Journaling. At the time, I didn’t know I was going through TSW, so I was all alone in my journey. I wrote in my journal and my Itchy Pineapple blog to get through it.

• Meditation. I had mantras and was doing breathing exercises to deal with the torture of TSW.

• Hand vacuum. I used this on my bed when I woke up or in the middle of the night to deal with the many skin flakes. It was hard to lay on dirty, flaky sheets.

• Social media groups for TSW. I engaged in eczema groups while I went through TSW but didn’t join TSW groups until afterward. Nothing (except for a cure!) beats being connected to people with the same condition. There are TSW groups on Reddit, Instagram, and Facebook – all are active and supportive.

I am a silver-lining type of person, so here’s the silver lining to TSW: Every day that I don’t have TSW is a wonderful gift. I’ve been TSW-free for 5 years now and my worst eczema days do not compare by even a sliver to my worst TSW days.

To my eczema-fighting peers, if you think you may have TSW syndrome, research it online, connect with TSW groups and talk to others with TSW. Consider all your options and stay strong. You’re not alone.

Itchy, weepy and crusty

I sat somewhere bad

and probably had on shorts

Now my thighs are raging,

hot, itchy and weepy,

leaving my pants sticky and crusty

Spread to my face

and some on my neck

and now my inner elbows too

Is this going to stop soon?

Where did I sit?

Was it the fabric couch in the waiting room?

Or my leather couch that somehow still makes me itchy? or the leather seats in my car?

maybe it was somewhere dirty - is this the dust mites allergy or one of my many other allergies?

Does it even matter? No. Maybe. Who cares.

Stop soon, body.

Merry, merry, itch, itch

’Twas the night before Christmas and all through the night,
not a creature was stirring, not even a mouse.

Wait, what’s that?
It’s me scratching
my itch, itch, itch.
On my forehead, that’s new.
near my hairline, how odd.

Ah, I remember!
An elf costume I wore
for my two little kiddos.
A hat on my head for just one hour
Ho, ho, ho
Itch, itch, itch

Dust mite allergies are relentless,
the worst Christmas grinch.
But an itch is okay
it’s family and cheer that matter.

Merry Christmas to all, and to all a good night!

I'm Allergic to Old Books

I started a new book two nights ago and I’m convinced that I’m allergic to it. It’s super old and the pages are brown. For years now, I’ve mostly consumed books digitally or audibly. I was excited to read a physical book and smell the old pages as I read.

I’ve been itchy most of this year, but I can confidently say that my itchiness level went up significantly as I was reading the book. To the point that I noticed it. I realized I was reading an old book and remembered that dust mites liked things like books, records, newspapers, knick knacks, etc. The book! I was reacting to the book!

This year, I’ve realized the severity of my dust mite allergy, because I started a dust mite allergy immunotherapy treatment called Odactra. It’s a tablet of dust mite extract that I keep under my tongue for two minutes. My body has had obvious adverse reactions to the tablet and I’ve had to cut down on the dosage in order to control my reaction to it.

Clothes, shoes, blankets, books … I’ve reacted with rashes and itchiness to all these things this year. It’s been a hard year with my dust mite allergy. Or, maybe it’s been a good year, because I’ve learned the intensity of my dust mite allergy.

Well, I’m going back to digital books. Who needs the clutter of books anyway. I’m just glad to know enough to avoid the trigger.

Scratching Bliss or Itching Torture?

It was date night and a delicious red snapper dish was in front of me. I was distracted, though, because my flared-up ankles were screaming with itchiness. I started scratching … and then kept scratching - the kind of scratching that takes over your senses. After about ten seconds, I stopped and paid attention to my surroundings again. I almost felt awkward about it!

“Isn’t it crazy how I can have orgasmic-like scratching at a public restaurant?” I asked my husband? He didn’t understand what I meant and I explained that scratching a really itchy spot felt incredible for me.

“No - I think that’s just you. Or at least not most people,” he told me.

“What?! How does scratching feel for you?” I asked him, surprised.

“It feels like something awful ending,” he said. Well, that’s a negative take on the situation, I thought. Itching does feel like torture and I am glad when it ends, but I can’t ignore how good scratching feels.

So, the question stands - is scratching blissful or just the end of torturous itching?

Drawing my Eczema

I’ve drawn my current eczema flareups the way I did years ago when my eczema was uncontrolled and I journaled my eczema and food intake daily. I’m at the point where my eczema is intolerable more often than it is tolerable. I’m too itchy, my blood is getting on things, and my flared skin is hot to the touch. BUT my face has been fine, so I am over-the-moon grateful.

Last weekend, as I sat at a park chair on a hot summer day, watching my kiddos play, my skin hurt a lot, all over. I was losing my stamina for dealing with it. At that moment, I started considering Dupixent again. It made me sad that my mind went to Dupixent - because I wasn’t going to consider taking it again unless my eczema was chronically moderate-to-severe. I’m not ready yet. I’m grateful to have Dupixent as an option, but the long-term side effects worry me a bit. For example, my face still flushes sometimes when I drink alcohol (a Dupixent reaction), even though I stopped taking the medication three years ago.

Last week, I finally started my dust mite allergy treatment. Today, I started a new homeopathic treatment recommended by my acupuncturist, whom I started seeing again last month. I will try these things and if my eczema doesn’t improve, I will consider Dupixent again. It helped me once and I trust it will help me again.

Eczema on the back of my thighs

Owie, breathe, stay calm.
But the burning, oh so hot.
Ignore it. Just sleep.

What It's Like to Live With Eczema and Skin Allergies

Published on WebMD blog.

Eczema isn’t as simple as it seems. The symptoms, severity, and flare triggers can range widely from one eczema warrior to another. I think, though, that I can confidently say eczema is a skin condition that causes dry, itchy skin.

That doesn’t sound very confident, does it? I’ve had eczema for much of my life and have talked to many doctors, but I still have many questions about it. Is eczema the condition that causes the symptoms, or are the symptoms eczema itself? Eczema equals rashes, but rashes don't always equal eczema, right? Does it stop being eczema when the symptoms become super severe, even though eczema led to that severity level?

Before you conclude that I’m completely unqualified to write about eczema, I’ll share what eczema means to me and how it’s affected my body.

What Is Eczema?

Eczema is dermatitis -- they’re interchangeable words that describe a chronic condition with inflamed, dry, itchy skin. There are different types of dermatitis conditions, like atopic, contact, nummular, stasis, and seborrheic. I’ve dealt with atopic, contact, and seborrheic dermatitis. My current struggle is contact dermatitis, which is closely related to my many skin allergies.

How Do Skin Allergies Cause Eczema?

Triggers cause eczema flare-ups and can be related to things like stress or allergens. Allergens that come into contact with your skin cause a reaction. Poison ivy is a good example. Most people are allergic to poison ivy and they react with a rash.

Different people have different allergies. I have many skin allergies, and that makes it more likely for my body to come into contact with an allergen and have a reaction (i.e. an eczema flare-up).

My Skin Allergy and Eczema Life

My lifelong eczema journey is marked by milestones and revelations related to allergens that I discover are causing reactions. Fragrance was my first allergy revelation, then dust mites, and, as of last year, colophony (which is rosin made from pine, fir, cedar, and similar trees).

It seems the older I get, the more all-encompassing my allergens become. Lately, it’s to the point where my clothes are triggering flare-ups.

Example 1: I put on a sweater that triggered hives on my arms that kept spreading, improving, then worsening for weeks with no end in sight. It’s inflamed and itchy as I write these words.


Example 2: I wore sweatpants or sat on a fabric couch and the backs of my thighs broke out in painful, burning hives.

Example 3: I wore the same cloth face mask a few times and suddenly it triggered eczema on my face, in the areas under the mask.

These real-life examples are all recent, and they’re confusing -- not all sweaters, face masks, and sweatpants trigger reactions. I assume they need to be freshly washed or they can gather dust mites, triggering a flare-up. I have many more examples: reactions from metal jewelry, cosmetic products, rugs, deodorants, soaps, etc. Skin allergies are especially difficult because of their mysterious nature.

How I’ve Dealt With My Eczema and Allergies

I’ve been very thorough with my eczema treatments and have tried most options, from over-the-counter eczema creams to oral steroids and traditional Chinese medicine (like herbal pills and acupuncture, which worked well!). I used topical steroids to the point that I went through topical steroid withdrawal -- the most severe, debilitating skin condition imaginable. I’ll never use topical steroids ever again.

My treatments have varied throughout my life and have been based on the severity of my eczema, which has ranged between mild, moderate, and severe. Nowadays, I’m trying to manage my eczema by avoiding my allergens altogether and using a nonsteroidal prescription ointment when my eczema gets out of hand. I’m considering traditional Chinese medicine again because my mild-to-moderate eczema has been on the moderate side for much of this year and I don’t seem to be doing a good enough job at avoiding my many allergens.

It’s an Itchy Life

Although everyone’s eczema journey and eczema types are different, chronic eczema fighters have many things in common: consistently dealing with itchy skin, at different severity levels, resulting from different triggers throughout our lives. It’s an itchy life, and we all have that in common. It’s good to know I’m not alone in my itchiness.

The Right Clothes and Accessories Help Me Avoid Flare-ups

Published on WebMD blog.

It may surprise people to learn that clothing and accessories can actually cause eczema flare-ups. I often get contact dermatitis, a type of rash that results from my skin coming into contact with an irritant. There are two main types of contact dermatitis:

Irritant contact dermatitis is the most common and isn’t caused by an immune system reaction. Instead, the irritant directly damages skin tissue.

Allergic contact dermatitis occurs when your immune system has a delayed reaction to an irritant that touches the skin, like how people typically react to poison ivy.

For me, contact dermatitis occurs when I use or wear a product or item that has one of my many allergens. This includes ingredients that are in makeup and body cleansing products, but also in clothes and accessories.

Dust Mites: The Invisible Allergens on Clothing and Accessories

My dust mite allergy is consistent and life altering. I do all the typical things to handle the allergy: my mattress and pillows are enclosed, my house has no carpet, there are no curtains in my bedroom, my couch is leather, etc. I take it even further, though, because I know that dust mites can be on my clothing.

When I wear a sweater that I haven’t washed recently, for example, it might give me a rash -- and after I wash it, it no longer makes me itchy. Coats, scarves, and hats that aren’t enclosed will gather dust and cause flare-ups, too. Sometimes, if I wear a new garment and don’t wash it first, it makes me itchy. I’ve concluded it’s because it was likely in a dusty warehouse.

I also use HEPA-filtered vacuums and steamers to clean my coats and hats, I wash my sweaters often, and I keep my hats and accessories enclosed. This helps minimize clothing flare-ups caused by my dust mite allergy.

Metal Allergies Limit Jewelry Options

Everyone reacts to metal jewelry differently. I have family members that can’t wear gold below 18 karats, for example. I myself get a rash when I wear copper jewelry or fake-gold jewelry (which I assume is because it probably includes copper). I can sometimes wear sterling silver, but not any gold (regardless of karat), except for my gold wedding ring. I’ve been patch tested by an allergist to determine my metal allergies. Results showed I have none, even though I’m at the point where I can really only wear plastic, non-metallic jewelry.

It doesn’t make sense, and I wish I knew exactly which metals my body rejects so I could purchase the right jewelry for me. I have tried to wear enough metal jewelry, though, to know I should avoid it. So I shop for wooden or plastic items with no metal clasps. It’s not easy, but it makes my pieces even more special once I find them.

Wearing the Best Materials

Even if you don’t have allergies that cause contact dermatitis, wearing the right clothing can improve or worsen flare-ups of atopic dermatitis, the most common form of eczema. Loose-fitting cotton clothing that lets your skin breathe is best. On the contrary, polyester clothing will overheat you, causing sweat and irritating eczema. I’ve read that superfine wool can be good for people with eczema, but I haven’t tried that type of wool clothing. However, the wool sweaters I have tried were a terrible idea -- in general, itchy people should probably avoid wool clothing.

Cleaning Clothing

The cleaning process can turn a non-triggering clothing item into an allergen if it’s cleaned with triggering materials. Keep your skin allergies in mind when cleaning your clothes. For example, I have many allergens that are in cleaning products, including the fragrance. So I’m careful with the fabric detergent, stain cleaners, odor eliminators, fabric softener, dryer sheets, and dry-cleaning services I use to clean my clothing. In general, I use the fewest products possible.

Clothing Can Carry Allergens

An article of clothing may be fine for your skin, but if it’s been in contact with an external allergen, it may still cause a reaction. Picture this: Your partner goes on a walk wearing a sweatshirt and is amongst plants and pollen that you avoid due to allergies. If you wear this sweatshirt before it’s washed, those allergens could still be on it and could cause a reaction. It’s safe to always keep in mind where your clothing has been before putting it on your body.

The Known Unknowns

Be aware of how your body reacts to your clothing and look for patterns. Are you always itchy when you wear a certain item? Even if you don’t know why an item is causing a reaction, avoid it altogether to be safe. I recently realized that my new Teva sandals were causing my ankles to flare up where the straps touch my skin. Sandals! I would probably not have made the allergy connection 10 years ago, but now, nothing surprises me and I do my best to listen to my body. I don’t know why my Teva sandals cause a rash on my ankles, but I avoid them, nonetheless.

Pay Attention and Act Quickly

Most importantly, pay attention to your body. An eczema flare-up starts with a small itch. Have you noticed you’ve scratched a little, for just a few times, but in the same spot where a new article of clothing or accessory touches your skin? Notice any little bumps? Take it off or change your clothes before it gets worse!

The best thing you can do for your eczema is to control your flare-up when it’s in the early stage, before the area starts spreading and you are red, inflamed, and unbearably itchy. This leads to uncontrolled scratching, bleeding, and likely scarring. No article of clothing or accessory is worth an eczema flare-up!