Skin Deep

I’m twenty-one years old and I suffer from eczema. It's thought of as a simply irritating rash, causing some redness and itching, most commonly experienced by children; a phase they grow out of eventually. I suffered from the skin condition for all of my childhood. I was relentlessly teased for being scabby. That experience gave me a thicker skin, an ironic side effect whilst I was plastering my flesh with steroids. I grew out of it when I was thirteen. On the cusp of adolescence, I finally became normal. Now, in what should be the heyday of the young adult existence, the condition that plagued my childhood has returned with a vengeance.

Like every human being on the planet, the representation of myself both in person and online presents me to be a carefree, confident, and outgoing person. You can’t tell that I can be extremely anxious, a part of myself that I had mostly under control until recently when it manifested itself in an angry rash.

My love life is something of a comical disaster; you laugh, because if you don’t it's just plain depressing. Yet recently, it's become less funny. The men I choose to let into my life and care for have not only caused me pain but also managed to rip apart any shred of self-esteem that I had. I won’t bore you with the details because the ‘sad girl chooses bad boys’ storyline is played out, but the more I was hurt by others, the more I scratched and the worse my skin got.

A sense of self-confidence in my physical appearance is something I’ve always lacked. I’ve put myself on various calorie-restricted diets for over half my life; the first one being when I was nine years old. My mother, who I adore endlessly and who I idolised when growing up, always disliked the way she looked. How was I supposed to love myself when I watched my perfect mother pinch and prod at the same curves that I have? She would sigh when she put on anything that hugged her figure, and talk about her ‘muffin-top tummy’ or her ‘dimpled thighs’.

I would sit on her bed and watch her try on dresses that she’d ordered from folded-over pages of the Next Directory. She would grab at her stomach, holding a pinch of fat between trembling fingers, rage consuming her as another dress failed to meet her expectations. “It's a size 14, so why won’t it fit over my arse?”. Her hands kneading her tummy like a soft dough as if it were the same bread that she was denying herself to eat. I’ve always thought she was beautiful, but if she felt like that about herself, how could I be beautiful? I thought it was normal to hate what you looked like if you looked like me.

In recent years, my mother has gone through somewhat of a transformation. She’s grown in confidence which she exudes through I glow I’m deeply envious of. It fills my heart with adoration to look at her in a statement dress, with killer heels and the attitude to match. She’s grown to own her body, the curves and the flaws are a part of her natural beauty; something to be admired and not hidden under oversized clothing. I only wish I could go through the same transformation.

In the last six months, my skin has slowly been completely ravaged by eczema sparing only my face in it's domination. This rash has taken on a life of its own; in fact, it seems to be sentient at this point. I imagine that it has its own voice and it's own set of ideals, with its only focus being to rip me apart; scratch by scratch, pick by pick. Think of me as Jenifer Aniston and my eczema The Leprechaun in the 1993 cult classic. I’m quietly walking around trying not to summon the evil force, shotgun in hand and tie-dye bicycle shorts on. It appears whenever I reach for the gold, the treasure being any sense of self-confidence I can muster. I can hear it, in that ominous Irish grumble of The Leprechaun, saying “Oh! You want to wear a dress today! Those are my legs now. You can’t have them back!”

I’ve been treated for eczema in various different ways since I first developed the rash when I was four. Normally I was given corticosteroids; a brutal cocktail designed to obliterate the rash with a comically long list of unfortunate side effects. Effective treatment but unsustainable. I’ve had doctors recommend oven mitts to combat the itching. Oven mitts. As if my skin condition could be cured if I baked myself at 180 degrees for 12 minutes. But my favourite treatment, purely because it was so bizarre, was the ‘clicker’ experiment of 2009. When I was ten years old, I went with my mother to a dermatologist in hopes of vanquishing the scratchy devil that was tormenting me. Instead, they provided me with a clicker - one of those counting devices that you press the top of and the number rolls over to increase with each click. It was suggested that this would be helpful for my pre-pubescent self to count how many times in a day I felt the urge to scratch myself, then record the total number in hopes of becoming more self-aware of the issue. Spoiler alert- sending a child to school with a clicking device was a bad idea. I suddenly became the fledgling bouncer of my year six classroom, standing at the door counting all of my classmates as I permitted them entry. Hi Lauren, thanks for sharing your sarnie with me at breaktime. Come on in! Click. Hi Tom, catch you at the park later? Click. Jenny, I’m sorry but we’re at capacity. No click for you.

Another interesting side effect of this skin condition is the unwanted diagnoses from people who aren’t doctors. It's a truly fascinating symptom of my eczema, that seems to encourage men to approach me and point out the thing I’m most insecure about. It's truly bizarre, seeing as you wouldn’t want to approach anyone and point out a giant pustule on the centre of their face, yet my broken skin seems to call out to the average Joe in the smoking area of any nightclub, or the amateur GP stood outside the Tesco Express. “You’ve got eczema”. Why thank you, stranger! I hadn’t even noticed.

When comparing notes with one of my closest friends and fellow eczema sufferers, we both shared very similar experiences with the phenomenon that is the male commentary. Maybe it's a symptom of the patriarchy, and if I was a man they probably wouldn’t comment. Maybe, it's the worst opening line of all time. Either way, it's a side effect of this rash that needs to be silenced.

A recent survey by the National Eczema Association revealed that more than 30% of adults with eczema were diagnosed with depression and/or anxiety. It's important to recognise this information, as eczema in adults is frequently ignored or dismissed. Often, it’s eczema in children that is paid the most significant attention. This could be a result of the ‘taboo’ culture that we live in; talking about the uglier issues of adulthood can be more difficult, as we wipe away the shiny veneer of femininity in this discussion. Being scabby isn’t comfortable to talk about, but isn’t comfortable to live with either.

Dr Daniel Wallach, a senior lecturer in the Department of Dermatology of the NB Hôpital Tarnier in Paris, is renowned for his experience with patients suffering from Atopic Dermatitis. He explains that ‘Atopic dermatitis in adults is often a serious condition. It involves chronic, red, thick, lichenified plaques, sometimes with isolated pruritic papules. Pruritus, commonly known as the ‘itch’, is always intense, with knock-on effects on daily life, morale, sleep and activity.’

With this in mind, it's easy to see how the urge to scratch could consume your entire life, occupying every thought and fracturing a person’s ‘morale’. Like many others who suffer from eczema, my skin gets worse in times of stress or upset, which is unfortunate given my poor life choices in recent history. But whilst I’m writing this, I know that I’m only making things worse for my skin and my mental health. I’m breaking that cycle, or at least I’m trying my best to.

It's easy to dismiss surface-deep issues, like eczema or acne, as unimportant or somewhat inconsequential. A recent study published in The Journal of Allergy and Clinical Immunology in Practice found that individuals affected with Atopic Eczema are 14% more likely to develop new depression and 17% more likely to develop new anxiety. The term ‘new’ in these conclusions is deeply relevant to my own experience, as it refers to a recent and different development of a mental health issue experienced as a direct result of the skin condition, and not a pre-existing issue. The same study concluded that ‘individuals with atopic eczema may be more likely to experience depression and anxiety through the effects of itch and discomfort, disfigurement, and perceived social stigmatisation. In addition, poor sleep related to atopic eczema may increase the risk of mental illness.

My own skin causes me to feel anxious, self-conscious and generally fragile for 90% of my day. Even writing this now, I can feel my skin begging to be scratched. Seeing these statistics not only validates my own struggle with my mental health as a direct effect of my skin condition, but it validates an entire silenced group of individuals who suffer from skin abnormalities that have been dismissed over time.

Part of the personal healing I’m trying to encourage comes with accepting the facts and coming to terms with what I look like. There are many chapters of my existence that I can file under the ‘love life blunder’ section, but there's only one that matters: mine. I don’t love myself, or the skin I’m in, and it makes it worse. People say you should love the skin you’re in because it's yours. Even when I didn’t have eczema, I still never liked myself, but this fiery skin demon is giving me another reason to hate it. So this is for anyone who suffers from what other people consider to be issues that are only skin deep: it's okay to not feel okay. You’re normal, you’re valid, and you’re just like me.