What to do about excema/psoriasis?
February 21, 2007 10:45 AM   Subscribe

EmbarrassingSkinFilter: I get excema/psoriasis in the winters, usually on my arms and legs but now it seems to be spreading to my face. What do I do?!

I am in college. Three years ago (the year I that was living in the dorms instead of a house) I first got tiny bumps on my legs/arms. I had no idea what they were. This went on every winter since then. It starts on one patch on my arm and one patch on my leg and then gets all over my right forearm and then all over my calves.

One doctor said that they were "inflamed hair follicles," another doctor said that I was "using too much product in the bath" (I do not use any "product." I only use shampoo and conditioner on my hair, and then soap under the armpits). Another doctor told me I had excema or psoriasis. I then went to a dermatologist, he told me that it was a reaction probably to poison ivy but gave me no justification for his answer. (furthermore, whatever I have is not contagious - boyfriends have no gotten it and would I really get poison ivy in the SAME PLACE every year?) A biopsy that I requested came back with the result of "dermatitis" (which, to me, is completely vague and useless).

The doctor gave me a topical steroid (Clobetasol propionate 0.05% - the very potent kind) but it makes my skin splotchy so I decided to just wait it out like I have done the last two years (usually this goes away when summer comes ).

However, (as it slightly did last year) this weird bump thing is now slightly affecting my lips and even more slightly the area around them.

How do I stop this? Can I change my diet? I eat pretty healthy food but would cutting out ALL sugar/alcohol help? Should I go to a tanning salon? (this sort of helped once) Is there some sort of magic cure that will stop all of this?

What should I do? (I would move to a place with no winters but I need to finish university first!)
posted by anonymous to Health & Fitness (25 answers total) 7 users marked this as a favorite
Have you thought of making a pilgrimage to the Dead Sea? My friend went there with psoraisis and the symptoms went into remission for a year.

But you should be sure that it is excema and not an allergy. Have you had excema before? What did you take? Excema does not just show up once you are grown up, it's a whole-life thing. However, I get the same symptoms of excema whenever I get too much nickel in my bloodstream. You might look to see for other causes before considering having psoriasis.
posted by parmanparman at 11:01 AM on February 21, 2007

sounds like you might have some form of ichthyosis... that you suffer from a very common (1:250) skin malody that results in skin conditions that present in times of dryness.

Have you tried just using lots of moisturizer or say... vaseline? Topical steroids might help if it is an imflammatory reaction. I would try to see another dermatologist to get a second opinion for sure.

Changing your diet shoudn't have any effect on your skin in this instance. Alcohol and sugar would have nothing to do with it. Tanning might have worked since usually it is a more humid enviroment.

Question-Do you ever get it in the creases of your body, palms of your hands, armpits or the skin of your foot (considering you normally wear socks? If not, this could point the diagnosis more towards ichthyosis.
posted by cdcello at 11:02 AM on February 21, 2007

Small bumps? Consider whether it's Keratosis Pilaris. KP is a condition where your skin can't figure out what to do with certain proteins, and they build up under the skin.

A LOT of people have KP (maybe 50% or so?), but for a few of us, from somewhere around puberty to age 25 or so, it gets really bad and can be a source of extreme discomfort, mild to severe self-consciousness and body issues, and years of misdiagnosis. I was told it was "inflamed hair follicles" myself. I was told Felliculitis. I was given steroids etc. The good news is, it very often goes away or retreats significantly around age 25, so you won't have to deal with it as severely in the future.

The only reliable treatment that works for everyone with KP is sun. If it's KP, get out in the sun, go tanning if necessary. Also, find a topical moisturizing lotion that works for you. The fact that tanning helped you once tells me that you should really look into whether you have KP or not.

To see if it's KP do some research online. There's a good support community at http://www.keratosispilaris.org/ full of people who understand and with lots of ideas to try other than / in addition to sun exposure.
posted by lorrer at 11:04 AM on February 21, 2007

I have no idea if it helps or is a scam or what not, but I may just shoot my radio if I ever hear another ad for Skin Zinc, which is supposed to relieve psoriasis symptoms.
posted by cgg at 11:05 AM on February 21, 2007

You might need to describe your symptoms more clearly. Psoriasis is areas of thickened skin where overaccelerated skin cells have piled up faster than they can shed. They sometimes start out just red but usually end up flaky with a white "scale". They can be very itchy. It can run in families -- check with yours. It's also sometimes seen along with other autoimmune diseases like Irritable Bowel Syndrome. It's fairly typical to get lesions in the same general places, and the most common areas are the knees and elbows, the scalp, and places where your clothes rub like a bra strap area. This is because psoriasis in some people develops where there's any trauma to the skin, meaning a cat scratch or a mosquito bite can end up developing a patch. It's also common to get it along the "outsides" of the body -- outer thighs, outer calves, outer arms.

It is an incurable autoimmune disease. Common treatments are steroid creams/ointments; UVA or UVB therapy; chemotherapy drugs; and newer injected medicines called biologics which are essentially immunosuppressants.

First things first though -- you need a proper diagnosis and for that you need to see a dermatologist. Try one who has a light therapy area in his or her practice -- it means they deal with psoriasis. You have to get a firm diagnosis though. It could be so many things, including allergies, eczema, folliculitis, environmental sensitivities, extreme dry skin, etc etc. Be persistent and do your own research online to go in able to talk about the possibilities.
posted by loiseau at 11:25 AM on February 21, 2007

cgg: "I have no idea if it helps or is a scam or what not, but I may just shoot my radio if I ever hear another ad for Skin Zinc, which is supposed to relieve psoriasis symptoms."

It's not quackery -- zinc is used to treat psoriasis, though it's never been particularly helpful for me -- but it's best not to get roped into these kinds of products, which cost a tonne of money. You can get zinc cream in the baby aisle and tea tree oil in the first aid section in the drugstore for a couple of bucks each.
posted by loiseau at 11:27 AM on February 21, 2007

It sounds like psoriasis. Since the symptoms appear mostly in the winter, and the tanning salon helped, I would suggest you look into UVB light therapy.

For me, it worked very well. I had a weekly appointment at the hospital where I stood in a light box for 3 to 5 minutes. After 6 months the plague was mostly gone and has not reappeared in the year since.

Other treatment options include coal tar and similar ointments. Apply the coal tar sparingly to the affected areas and wash your hands well afterwards.

However, these options may increase the risk of getting some form of cancer.

On preview, what loiseau said
posted by angrybeaver at 11:29 AM on February 21, 2007

Sunlight. Less alcohol. More leafy greens. Cut out pork. Cut out cigarettes. Fresh air. Proper rest.
posted by jon_kill at 11:30 AM on February 21, 2007

Someone near and dear to me has eczema/psoriasis (been diagnosed as both) and here are a few things that have helped:
  • Bathing with bath salts such as these
  • Lots of vegetables and minimal sugar/alchohol
  • Be careful about anything you put on your skin, including lotions, soaps, perfumes, shampoo, etc. You can probably find support groups online where people recommend non-irritating products.

  • By the way, be very careful about topical steroids. Using them for a prolonged time, which can be tempting if they are one's only source of relief, can and does result in thin and highly sensitive skin which can make even incidental contact highly unpleasant.
    posted by harmfulray at 11:30 AM on February 21, 2007

    I've had a bad case of eczema for years and have been aggressively trying to get rid of it for almost two now. Along the way I've seen regular doctors, dermatologists, allergists, and a naturopath, and I've discovered that none of them really know much about it because individual cases are so highly variable. Here's what I can tell you about mine: Increasingly stronger topical steroids helped for a while but all eventually stopped working in the long term, at which point they're not good for you anyway. Going easy on soaps and shampoos and avoiding ones with harsh detergents definitely helps. Tepid showers help, but not enough to stop me from taking hot showers in the dead of winter. Stress makes it worse; if you have trouble with anxiety, it might help to work on that. Cutting a few common allergens out of my diet did not help - food allergies do give some people eczema, but not me. Strong moisturizers help: Vaseline, coconut oil, shea butter, vitamin E - but Aquaphor irritated my skin. Salt water soaks don't work for me and I never tried tanning beds, but I know they do help some people. Essential fatty acids, like from flax oil or fish oil, are good for skin and might help you if you're not already getting enough.

    I finally figured out on my own a while back that yeast triggers my eczema. After a few months on an anti-yeast diet, it's finally clearing up. I wrote off the yeast thing initially because crazy people on the Internet attribute every damn health problem to Candida yeast overgrowth, but it's seriously working for me.

    On preview, ditto loiseau - be persistent, do lots of research. It's taken me a ton of trial and error.
    posted by clavicle at 11:47 AM on February 21, 2007

    follow-up from the OP:

    My full list of symptoms:

    When this starts, a patch of skin about the size of a silver dollar appears bumpy and rough. It is on the bottom of my right forearm. Eventually I get some bumps elsewhere on the underside of my forearm closer to my wrist. If this area gets irritated it gets more itchy/red/patchy/flaky. This does not spread to upper arm or left arm. It is never scale-y. They never "weep" as eczema is supposed to.

    On my legs, I think it also starts with a small patch on my right shin. As winter progresses, my legs get covered with small red bumps that sort of look like pimples or tiny insect bites of something. This is more on my right leg than left. If they get irritated they itch. If not, they do not. (or maybe I have learned ot ignore this)

    Last year (and this year a day ago or so) this has also slightly affected my lips - a section of my lip looks like it has a patch of whatever is on my arm and then there are faux-pimples above my lip, as well.

    These are the only areas where this skin thing happens ever. The patch of my arm takes the longest to go away.

    This starts happening in the winter, when it gets cold and darker. I do not get it in the creases of my body. I did not have this or any other skin problem before three years ago. Last year I used moisturizer - the moisturizer did not make it go away but it did not itch as much.

    I went to a dermatologist. The biopsy he did said it was "dermatitis." He told me that to him it looked like a poison ivy allergy. (I think that the "poison ivy allergy" statement is bullshit.)

    I do not -know- that I have psoriasis or eczema but this is what a doctor told me so I just labelled it as such. My legs sort of look like the images of "Keratosis Pilaris" that google image search turned up.

    If I have an allergy to something, I have no idea what that something could be.
    posted by jessamyn at 12:01 PM on February 21, 2007

    This may be way off the mark, but are there any fibers in your winter clothes that aren't in your summer clothes? Do you wear more wool for instance?

    I was just thinking that if you spend a lot of time on the computer, (and what mefi-te doesn't?) the bottom of your right forearm may be rubbing against the fabric, making it a very likely place for a skin reaction that you may not encounter in the summer when wearing lighter clothes or different fabrics. Possibly the same with your shin depending on how you typically cross your legs when sitting.

    Total shot in the dark, but I thought I'd throw it out there!
    posted by platinum at 1:10 PM on February 21, 2007

    small bumps...like razor burn?
    during the winter my skin dries out ALOT and I get dry, bumpy patches on my arms and shoulders, sometimes face...i also get HORRIBLE razor burn when I shave my legs because they're so dry. If you haven't tried using a moisturizing cream on a regular basis, I'd try, just in case.

    I agree that it's probably not eczema, your symptoms don't sound like it, but take this for what it's worth: when I was younger I couldn't eat certain common foods without breaking out with an eczema reaction...the more of those foods that I ate, the worse the symptoms, and all of them were acidic foods. Is it possible that what you're experiencing is an allergic reaction to some kind of food that you eat more of during the winter?
    posted by azriel2257 at 1:42 PM on February 21, 2007

    ...It's also sometimes seen along with other autoimmune diseases like Irritable Bowel Syndrome

    Just as a clarification, Irritable Bowel Syndrome isn't an autoimmune disorder in any way and I think loiseau meant Inflammatory Bowel Disease. They're often mixed up because of the similar names. These kinds of inflammatory conditions (IBD, psoriasis, allergies) do tend to run in families so it's worth talking to your family members in case it gives you some clues, just make sure you're asking about the right diseases.
    posted by shelleycat at 2:37 PM on February 21, 2007

    Use this stuff,

    I swear this is like miracle skin cream for skin disorders..

    Google "Golden Salve" to find sellers.

    I am only a consumer of this product and am not selling it whatsoever.
    posted by Budge at 2:56 PM on February 21, 2007

    posted by Budge at 2:56 PM on February 21, 2007

    I'd second lorrer's suggestion that it sounds an awful lot like KP -- I've got a touch of it on my arms, much more noticeable when I was a child, that general practitioners had just called "dermatitis" or "acne" or "allergies" and suggested hydrocortisone for. (It didn't do a thing.) Have you been seeing dermatologists, or just a general primary care doctor? If you haven't seen a specialist yet, get thee to a good derm and make sure to tell them in detail about all the prior failed diagnoses/treatments, the reaction to sunlight, etc.

    If it is KP, it does indeed tend to get better with age -- although even in my 30s I still find it flares up a bit in the winter, between the lack of sunlight, skin dryness, and friction on clothes. In wintertime, I find what helps me to keep the little bumps minimized is gentle exfoliation in the bath/shower, keeping the skin moisturized, and occasional use of a salicylic acid acne treatment (no more than once or twice a week as that stuff can be drying).

    (If you do try that, there's no need to get fancy new exfoliating soaps/washes etc. -- most of them really aren't that effective in my experience. You can get better results by just using a slightly rough washcloth, loofah, or such with your regular soap. I like Japanese nylon bath towels -- they're inexpensive and last for ages.)
    posted by Smilla's Sense of Snark at 3:23 PM on February 21, 2007 [1 favorite]

    My legs get covered with small red bumps that sort of look like pimples or tiny insect bites of something. This is more on my right leg than left. If they get irritated they itch. If not, they do not.

    I have this on one of my forearms. Yeah, I know, one of my forearms. The whole thing is mysterious.

    What works for me is tretinoin (Retin-A). There are a lot of contraindictions you should check out, but the only side effect I've noticed is some peeling if I choose too high a strength. (I use 0.04% on my face, but can go to 0.1% elsewhere.)

    Tretinoin is also prescribed for KP (which I do have a mild case of, but which my dermatologist says my forearm-bumps are not). Assuming tretinoin could fit into your life now, see if you can cadge a few tiny sample tubes from a dermatologist -- they usually have plenty, and if it's going to work, you tend to see results fast enough for the samples to be helpful. You can try it on just a patch and see if a difference becomes visible.
    posted by booksandlibretti at 3:31 PM on February 21, 2007

    - small bumps
    - generalist doc can't identify
    - dermatologist says not psoriasis
    - no mention of scaly, silver-ish flakes large or small

    Well, one thing it's probably not is psoriasis.
    posted by mimi at 7:19 PM on February 21, 2007

    shelleycat: "...It's also sometimes seen along with other autoimmune diseases like Irritable Bowel Syndrome

    Just as a clarification, Irritable Bowel Syndrome isn't an autoimmune disorder in any way and I think loiseau meant Inflammatory Bowel Disease.

    Yes, sorry, I flip them in my head sometimes.
    posted by loiseau at 8:15 PM on February 21, 2007

    Yes, sorry, I flip them in my head sometimes.

    Don't worry, so do I and I have one and am studying the other.
    posted by shelleycat at 9:35 PM on February 21, 2007

    But you should be sure that it is excema and not an allergy. Have you had excema before? What did you take? Excema does not just show up once you are grown up, it's a whole-life thing.

    Just wanted to say that this is completely, completely, COMPLETELY wrong.

    My eczema arrived out of the blue as an adult in an initial alarming episode and has subsided (thank god) into annoying yet managable patches on my hands.

    Furthermore, eczema can be linked to allergies, not surprising to me since I've suffered from those all my life as well.

    Also, my tip (third time this past week sending this one on, lots of eczema posts lately on MeFi) is Cetaphil lotion in the tube - "Shea Butter" formula. It was recommended by my dermatologist and is the ONLY lotion that has ever helped my eczema. The other advice on here about tepid showers and keeping the skin moist is all good.

    Also, I'd try finding another dermatologist, if you can. They are worth their weight in gold when they take your misery seriously.
    posted by agregoli at 9:08 AM on February 22, 2007

    You don't get psoriasis on your face, and it doesn't sound like psoriasis, anyway (I have it).

    Yeah, see another dermatologist. You need a better diagnosis. Meanwhle, get some sun and use plenty of moisurizer. I like Cetaphil, too, both the soap and the lotion.
    posted by puddinghead at 10:18 PM on February 22, 2007

    puddinghead: "You don't get psoriasis on your face, and it doesn't sound like psoriasis, anyway (I have it). "

    Who told you that? Totally incorrect. You can get psoriasis anywhere there's skin. Many people including myself have had it on their face.
    posted by loiseau at 8:36 AM on February 23, 2007

    You're right, loiseau. My derm doc told me that, but the National Psoriasis Foundation website disagrees. I stand corrected.
    posted by puddinghead at 2:56 PM on February 23, 2007

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