Book Review: The Eczema Solution

The Eczema Solution, by Sue Armstrong-Brown, outlines a program to stop scratching and thus heal the skin of chronic atopic eczema sufferers. The approach was developed at the Chelsea and Westminster Hospital. The underlying principle is that if patients can stop scratching, they can reduce their itching, as discussed in an earlier post, and reduce the rash, since this is triggered by the scratch. Severe eczema patients can tell you that even though a good scratch is satisfying in the moment, it simply leads to even more intense itching and much more severe rashing and inflammation of the skin. While this is known in theory, the trick is being able to actually keep your nails off your skin in the face of intense itching.

That's where this book comes in. The author notes that chronic eczema suffers have developed a habit of scratching, even when when they are completely unconscious of the behaivor. This continuous scratching is very damaging to the skin and prevents healing, exacerbating the condition. Each chapter in the book presents exercises that the reader does before moving on to the next chapter. The exercises are designed to break the habit of scratching. At the same time, you continue to use emollients and steroids to treat flare-ups (indeed, the author argues for using steroids for some period even after the skin looks healed.)

Breaking the habit of scratching begins with logging every time you scratch with a hand tally counter. This sounds a bit crazy--and it is. For weeks, I walked around with a little clicker that I had to press each time my hands moved to my skin. This is a truly eye-opening experience. I was scratching hundreds of times a day. The counting exercise really did make me aware of all the unconscious scratching. Once aware of it, you can being to slowly reduce the amount you scratch using some habit-changing exercises presented in the book.

The book is written by someone who has suffered from atopic eczema her entire life: she has coped with the itching, been hopitalized for her eczema more than once, and tried every treatment available. It is comforting to read a book about severe eczema that is written by someone who completely gets it. The one downside is that I personally found that the book over-promises the level of relief to expect from the program. This may be because I had already learned not to scratch hard at the itchy spots or else I'd have to face worse symptoms and devastatingly ugly flare-ups! I think this book could be more profound for those who are not yet able to stop scratching at any level. Learning to control the scratch reflex can improve the look of your skin (and therefore reduce anxiety) and does, to some extent, reduce itching. It does not, however, "cure" the eczema or completely eliminate itching and sleepless nights, as the author promised. But it does help some and is worth a try, at the very least for the awareness it brings about your own unconscious habits.