Patient's Query
Hello doctor,
My 23-year-old daughter has had eczema since she was a baby, but it has gotten much worse recently. She cannot sleep at night because the itching is so intense, and her skin looks very bad, red, cracked, and sometimes even bleeding. We have tried every cream available at the pharmacy, but nothing seems to help anymore.
For the past six months, she has also been having irregular menstrual periods, and we are wondering if there might be a connection between her skin condition and her hormone cycle. She feels very stressed because of her eczema, and it is starting to affect her mental health. She feels depressed and no longer wants to go out.
She works as a teacher, and her students keep asking questions about her skin, which makes her feel embarrassed and ashamed. We are also worried about possible skin infections because she scratches so much. Her boyfriend ended their relationship last month, and she believes it was because of how her skin looks.
Can you recommend a stronger treatment? We have heard about some new medicines called biologic treatments, but we do not know if health insurance covers them. Could her eczema be affecting her menstrual cycle? What are the best treatments for severe eczema? And are biologic medicines safe for young women who may want to have children in the future?
Kindly help.
Hello,
Welcome to icliniq.com.
I understand your concern.
Eczema is a condition where the skin becomes inflamed due to an overreaction of the immune system. This reaction may be triggered by genetic factors, environmental exposures, or a response to allergens. You should consult a dermatologist in person because "eczema" is a general term. The exact type of eczema needs to be identified through a physical examination or a skin biopsy so that the most suitable treatment can be given.
Eczema may worsen during menstruation due to hormonal changes. A drop in estrogen levels around that time can make the skin drier and more sensitive. However, eczema is very unlikely to be the direct cause of irregular periods. A gynecological evaluation is necessary to understand the reason for menstrual irregularities. Sometimes, conditions like polycystic ovary syndrome (PCOS) may occur alongside eczema.
There is a range of treatment options, starting from simple moisturizers to advanced medications like biologic immunomodulators. Treatment is chosen based on the severity and type of eczema in the individual. Some tests may be required, such as CBC (complete blood count), ESR (erythrocyte sedimentation rate), absolute eosinophil count, skin biopsy, and a USG (ultrasound scan) of the abdomen and pelvis.
Treatment may include moisturizers, emollients, and creams containing ceramides. It is important to avoid triggering factors such as harsh soaps, certain foods, allergens, or stress. Topical corticosteroids may be used to reduce skin inflammation. Antihistamines can help control itching. Oral corticosteroids may be needed during flare-ups. PUVA (Psoralen and Ultraviolet A) light therapy might be considered in some cases. In more severe cases, immunosuppressants or biologic medications may be used.
It is important to keep the skin moisturized, especially after a warm (not hot) bath. Drinking at least eight glasses of water every day helps to maintain skin hydration. Wearing loose-fitting clothing made from cotton or other natural fabrics is recommended. New clothes should be washed before wearing, and wool or synthetic fibers should be avoided. Using a humidifier can help if the air in the home is dry.
Managing emotional stress is also important, as it can worsen eczema. Encourage outdoor physical activity, yoga, or meditation for at least 30 minutes a day. If your daughter is experiencing symptoms of poor mental or emotional health, it is helpful to consult a psychiatrist for medication and a counselor or therapist for emotional support.
I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.
Thank you.
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Answered byDr. G. Harikaran
Medically reviewed byiCliniq medical review team
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