The eight stages of a flare-up: a few words on a face full of eczema

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1. Failure 

When my face reacts to something I’ve touched, something I’ve eaten or just something floating around in the air my first feeling is failure. My failure. I’ve let my guard down, I’ve forgotten to be vigilant. Or I haven’t been clever enough to identify the thing that has caused my skin to bubble and itch and burn today. What’s happened?, people ask. I don’t know, I never know.

2. Anger

Why today? Every day is a bad day for an inflamed face. Every day that I have a reaction I need to face the world, go to a meeting, present to a room full of people, go on camera, stand in a playground full of mums. So rarely do they happen on a day where I’m free to hide under the duvet.

3. Frustration

There’s nothing I can do now. The rot has set in. The bubbling and boiling is already underway, my system is attacking itself and the battle is in full swing. There is no cream or lotion that will bring this swiftly to an end.

4. Feeling overwhelmed

I feel like my brain is boiling. The intense itch and the popping of little hives all over my face is taking over every thought in my head. Every ounce of my will power is being diverted to not scratching the intense itch that is spreading over every inch of my face, even though I will inevitably give in and scrape my nails backwards and forwards across the burning itch. Which takes me back to failure.

5. Depression

It might only be brief, but my all consuming self interest has taken over. Nothing else matters, no-one else matters.

6. Acceptance

I try to calm my brain and hands while the equivalent of a wild bush fire is spreading across my face. I remind myself that it’s not my fault, that there is nothing to be ashamed of. I am clean and I have cared for myself as best I could. This is not my fault. It’s not my fault.

7. Courage

I have to face the world, I have no choice, there are other people to care about, there are things that need to get done. Besides which, hiding away means I’m more likely to scratch and become more self obsessed. More staring in the mirror, more self loathing, more missing out. I go out to work, pick the children up from school. I talk to people, laugh, forget about my skin for a few seconds at a time.

8. Coping

A few seconds become minutes and I find I can cope. I feel the eczema and do it anyway. My mood is lifted by beating the obsession, going about normal daily business – in spite of the wild fire – and I kick this burning skin to the back of my mind.

Until the next time.

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Make your own quick and easy goats milk kefir probiotic for eczema

I’ve been a little preoccupied with goats over the last few weeks. Ever since hearing Shann Jones of the Chuckling Goat on Steve Wright on Radio 2 a few weeks back talking a great show about the benefits of goats milk probiotic for eczema, I’ve been borderline obsessive about these gorgeous little creatures and their health giving properties. I have just finished a 21 day course of kefir, a probiotic drink made from raw goats milk, produced on Shann’s idyllic farm in West Wales and I believe I’m starting to see the benefits. (I won’t repeat everything I’ve already written about probiotics and allergies/eczema – you can read all about it here).

My final week of taking the 21-day course of kefir saw my skin feeling supple, clear and strong. I do seem to have had fewer allergic reactions on my face and I feel pretty perky too. But these phases come and go naturally anyway so I would need to give it much much longer to give the results a proper road test.

I would dearly love to order the magical kefir from Chuckling Goat each 21 days and continue where I left off, but my bank account would bleat loudly at that idea. So that left me with the DIY option. Now, in my wildest dreams of course, I am shepherding a herd of goats on a Greek island soaking up the freshly pressed olive oil and Mediterranean sun and warmth …

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… but a screech back to reality sent me off to our amazing local farm shop where I managed to stock up on some raw goats milk from a small farm in Kent. For the kefir starter there was a choice to be made – live kefir grains (the best and would provide an indefinite supply of kefir for generations of little Beczemas to come) or kefir direct-set powder (a slightly less risky option for the novice kefir brewer – will provide 4-5 weeks of repeated brewing). I went for the direct-set option simply because it is my first attempt.

So here’s the kit:

  • 1 litre of raw goats milk
  • 1 litre kilner jar (run through the hottest setting on the dishwasher)
  • 1 packet of direct set-kefir powder
  • Stirring spoon (also washed in hot dishwasher)

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Raw goats milk from Ellie’s Dairy in neighbouring Kent:

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Kefir Direct-set Powder Starter Culture from Natural Probiotic Selection

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Step One: Pour your powder into the (clean!) kilner jar

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Step Two: Pour milk into jar (warmed to around 30-35 degrees is advised – I warmed it until it just took away the chill and felt like room temperature)

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Step Three: Stir with (extremely clean!) spoon

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Step Four: Secure a muslin cloth over the top to keep the nasties out and let the whole thing breathe as it ferments and turn into your little magical pot of eczema warriors that you can send into your gut to fight your atopic fight for you. Somewhere that will be warm (20 degrees or so) and not in direct sunlight. I’ve put mine on my kitchen counter top.

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Step Five: After 48 hours – and after the milk has set to a thick, but still drinkable consistency, remove three tablespoons of the kefir into another (scrupulously clean!) kilner jar and pour on as much raw goats milk as you like (to a maximum of 1 litre) to start the whole process again – this time leaving only for 24 hours. Give your kefir a shake and chill it in the fridge for a couple of hours, shake again before you drink it and hey presto – Kefir for eczema.

You can carry on doing this for about 4-5 weeks apparently with the direct-set powder starter. With the live grains on the other hand, you can just strain out the grains (with a plastic sieve – metal sends it into a spiral of kefir hysterics so I’m told)  and then pour on the new milk to keep the live grains fed and happy. In fact the grains multiply so fast that kefir brewers pass them on to friends and likeminded people with a desire for a healthy gut.

So, there it is – quick and easy kefir. Of course, the easy peasiness of the whole exercise has come with a wee compromise – I’ve got to confess that, so far, the direct set stuff is not a patch on the taste of the kefir from Chuckling Goat, which has a beautiful fizzy and sour kick to it, so I’m going to switch to live grains as soon as I can in the hope that the taste improves. But I’m going to keep on keeping on with this stuff because my skin has never felt so healthy, supple and strong. I’d love to hear from anyone else who is having a go themselves – and, well, if any kefir brewers want to share some live grains, you know where I am. Wishing everyone happy skin :)

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Eczema, the tabloids and me

I’ve noticed something lately. Eczema has slowly and creepingly become regular fodder for the tabloids. They appear to love nothing better than to reel off stories of how something as simple as household porridge oats have ‘cured’ someone’s otherwise stubborn and angry eczema (accompanied by equally sensational pictures of horrific looking skin) or how someone’s child screamed the house down and ripped themselves raw before finding a miracle new cream.

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When in fact, as most of us know, the boring truth of the route to good skin is careful daily management with the occasional and timely application of prescription creams from the GP. And sadly there is no cure. Well, not yet (I’m always hoping).

Which is why I was so surprised that, when I spoke to a tabloid journalist – banging my skin-mind drum and soapboxing about body confidence and self-esteem issues, that I was represented fairly, the condition was treated with respect and some very sensible advice was offered – without resorting to sensational miracle cures.

Read the article online here.

The whole thing came about when I was approached by the British Skin Foundation (a charitable organisation which does amazing work for people with skin conditions in the UK) to become a media case study. I have written so much about the lack of real pictures of real people with eczema in the media, that I decided to put my money where my mouth was and throw my hat into the ring.

Mirror journalist, Rosie Hopegood, called me up one afternoon and we had a jolly nice chat about eczema and how I have managed it over the years – she even allowed me to waffle on about the importance of addressing the psychological issues attached to skin conditions (for probably a *little* too long). We said our farewells and I thought little about it.

The only moment I felt slightly uncomfortable was when she asked whether my eczema had ever affected my personal relationships, I dodged it quickly and evasively – in truth it has affected them a great deal – especially when I suffered from eczema all over my body (it’s confined mostly to my face these days) – but I was surprised by how panicked the question made me feel. That aside though, and in spite of nestling next to a headline on the cover which profiled a story about how an animal ate a girl’s nose (!), the results of the interview and the contents of the article were really quite encouraging.

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The article focused on the need to break the itch/scratch/itch cycle – which, as everyone who has eczema knows, would be the key to a lifetime of eczema happiness IF ONLY IT WERE POSSIBLE!

It offered general nutritional advice, explained what eczema is, accurately and sensitively, and even printed two pictures of eczema skin, neither of which were sensational – just honest to goodness eczema.

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Only one slightly melodramatic quote ‘I’ve taught myself to smile through the pain’ (cringe) – while of course I do try and put my best foot forward – if it really does hurt, I’m afraid I’m frowning with the rest of you!

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But in fact, Rosie summarised the whole of my eczema blog so succinctly and pretty accurately into this tiny little box – in this newspaper which I haven’t read since I used to visit my long gone Grandparents decades ago in a small East Midlands industrial town – that I think I’ll get me coat…

Well done the Sunday People!

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Feeling hopeful: Kefir for Eczema Diary Week Two

After hearing Shann Jones of the Chuckling Goat, a farm in Wales offering goat products that claim to help with eczema and allergies (read all about it here), on the radio talking persuasively about the benefits of kefir (a probiotic drink made from raw goat’s milk) I decided to take the plunge and order their 21-day course.

In a nutshell here is the theory behind kefir for eczema. If you suffer from eczema – a condition that has recently been added to the list of autoimmune diseases – it’s likely that your gut needs replenishing with some good bacteria which, according to Chuckling Goat, can help prevent your immune system from turning on itself and attacking healthy tissue – think Raquel Welch in the Fantastic Voyage. Read more here.

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There is currently a 4 week-long waiting list for their course of Kefir following all the media interest, but I must have got in there just before the rush as my box of bottles arrived in good time, beautifully packaged and insulated with a cold pack so they were perfectly chilled during an unseasonable period of very hot weather. I transferred them straight to the fridge and got quite excited about unleashing all these little bacteria warriors into my gut.

Chuckling Goat recommend that you keep a diary as you work through the course of probiotics to gain an understanding of how it’s all working, and I’m told if your gut’s in pretty bad shape you can expect a tough first few days – so here goes:

Read Week One here

Day 6-8

After hitting rock-bottom at the beginning of the first week of taking the 21 day course of kefir for eczema I am happy to report that I am feeling much perkier. My skin has calmed down, it’s gone from the burning and itching to the drying and cracking stage, sounds bad but is in fact much more manageable. I’m feeling more energised with no headache or stomach complaints. I’m not feeling entirely on top of things but so SO much better than at day 4! I have been sleeping extremely well and I’m waking feeling, not exactly refreshed, but well rested.

Days 9-11

So, two bottles down four to go. Sun is shining today and when I took the dog for a walk – I didn’t have to drag my leaden limbs across the fields like I did on day 4. I have even been looking forward to my little glass of fizzy magic each morning. But my skin is still pretty awful – dry, irritated and itchy – so, I have given in and have applied my prescription cream to my face, (I was planning on avoiding it to give the kefir a real run for its money but I just couldn’t take it any longer!).

Days 12–15

Once the prescription cream had worked its magic I started to feel a lot better. My skin is improving – comfortable and supple, but I can’t say I’m feeling much improved from when I first started the course of kefir. And I can tell my skin is on the edge its seat just waiting to spring into life and react to all those menacing spring pollens floating about in the air. I’m keeping it in check, I think, with all my creams and potions but I can’t see any major change.

Days 16-18

I always have a few zits knocking around on my face, probably because of all the creams I have to slather on – clogging my pores. It’s a choice sometimes – shall I have eczema or acne today? Mostly I choose acne, because the eczema is so damned uncomfortable and the acne I can cover up if necessary – there’s no hiding the porridge face. But, now, this may be my imagination but I think the spots are slightly less angry and deeply embedded. They usually feel like the tip of an iceburg – what the rest of the world sees is nothing compared to the massive volcano like structure sitting just beneath the surface of my skin. Since the kefir, they are here today, gone tomorrow as opposed to before when they would be here today, much worse tomorrow and positively Vesuvial the day after!

My skin is starting to feel much more supple and elastic and I am sleeping the sleep of the dead – in a good way. I have one bottle left and am really hoping this is the start of something good.

Day 18

Suddenly, my skin feels amazing. It’s days since I have put any prescription cream on my face and my skin feels supple, elastic with not a hint of irritation. It does look a bit blotchy and I have a few surface spots, but I actually really don’t care how it looks because it rarely feels this good. I can do anything, smile, yawn, frown and nothing hurts. I have been through patches like this before, so who knows if it’s the kefir – but with three days left, I’ll keep on trucking and let you know.

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Is eczema an election issue? NHS privatisation and the British dermatology crisis

A week before the country goes to the polls, dermatology provision in the UK is teetering on the brink of a major crisis. A report issued this week from an independent health think tank reveals the desperate lack of training for GPs in skin conditions and their treatment. But the most alarming news comes in the shape of the dismantling of existing dermatological services and the resulting ‘mass exodus’ of NHS dermatology consultants in its wake, leaving eczema patients with nowhere to go.

If you suffer from eczema or other skin conditions you will already know how woeful and under resourced the level dermatology care that your local GP is able to provide. Which is desperately ironic as skin issues make up a massive percentage of visits to GPs, in fact 24% of the population will make a visit to their GP each year with a skin complaint.

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24% of the population will visit their GP each year with a skin condition yet GPs receive just six days dermatology training

A report on the state of the country’s dermatology provision from health think tank, the Kings Fund this week lays the facts bare. “GP dermatology teaching averages approximately only six days and most GP training schemes have no dermatology attachment,” says the report. “Dermatology undergraduate training averages a couple of weeks at most, is variable in terms of quality as well as syllabus, and it is not compulsory.”

And for the 13 million GP consultations for skin conditions each year there are just 650 skin specialists across the whole of the country to advise GPs and provide specialist care.

The psychological affects of skin conditions have been highlighted again and again, from cross-party reports from MPs to actions groups such as Changing Faces, yet these needs remain tragically unmet by GPs who are poorly equipped to meet the needs of their patients due to the low priority of skin disease and its impact on quality of life in medical training.

But most worrying of all, as people with skin issues are predominantly treated as outpatients, dermatology provision – even in its specialist capacity – has been extremely vulnerable to quiet and swift privatisation. Dr. David Eedy, President of the British Association of Dermatologists (BAD) believes that dermatology has been seen as an easy service for NHS commissioners to shift ‘into the community’ due to a widely held but mistaken view that skin diseases are minor ailments and can be easily identified and treated locally, reducing the burden on hospitals.

“The drive to shift treatment into the community leads to decommissioning of Dermatology hospital services,” says Dr Eedy. “Another concern is the practice of ‘cherry-picking’ by private healthcare providers who are more likely to take on relatively easy, high volume, lucrative work in the interests of profit. The upshot of this is that the local NHS hospital department is left to pick up the more difficult and expensive work while saddled with increased financial pressures.”

Dr Eedy goes on to explain that there have even been cases of independent providers tendering for dermatology services without even having dermatologists or other appropriately trained staff in post. This could be explained by the commercial confidentiality clauses that can, according to Dr Eedy, “stifle transparency,” when private companies are involved in bidding to provide healthcare services. “This makes it hard for external bodies to scrutinize whether the new service is compliant with national guidelines,” he says.

One particular case very close to my heart is the closure of the acute dermatological services at Nottingham University Hospital (NUH) Trust earlier this year. Long upheld as a centre of excellence in dermatology – and in fact my first ever visit to a sympathetic specialist dermatologist when I was in my teens. The reason for the closure? Six of its eight consultants walked out after refusing to work for a private subcontractor, which had been awarded the contract to provide the majority of local dermatology services in the area.

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Nottingham University Hospital, which closed its acute adult dermatology service earlier this year

But the news gets worse. The subcontractor awarded the contract was Circle, you may remember the private health care company from the news earlier this year. Circle became the first private company to run an NHS hospital when it took operational control of Hinchingbrooke Health Care NHS Trust in February 2012.

In January 2015, Circle announced its intension to withdraw from the contract, just three years into the 10-year agreement, following a damning review of its services from a health care quality watchdog, leaving the taxpayer to pick up a massive bill for its lack of understanding of the actual costs of running a hospital.

“We expressed concerns that Circle’s bid to run Hinchingbrooke had not been properly risk assessed and was based on overly optimistic and unachievable savings projections,” said Margaret Hodge speaking at a parliamentary committee reporting on Circle’s failure to deliver.

Private health care provider, Circle - famous for its failure to run Hinchingbrooke Hospital, has taken over dermatology service in Nottingham.

Private health care provider, Circle – famous for its failure to run Hinchingbrooke Hospital, has taken over dermatology service in Nottingham.

It has been reported that the senior dermatology consultants at Nottingham refused to join the private contractor largely due to lack of opportunities for proper academic research and training under Circle’s management.

“Nobody has thought through the implications for teaching, training and research – the whole future of British dermatology,” said Dr Eedy commenting on the closure of NUH’s dermatology services. “Nottingham is just one example of the many fires we are fighting across the UK to try to keep dermatology services open in the face of poorly thought-out commissioning decisions and the Government’s lack of understanding of the implications of pushing NHS services into unsustainable models provided by commercially driven private providers or enterprises.”

Labour’s shadow Health Secretary, Andy Burnham believes that the Nottingham dermatology crisis has revealed that the true ‘ideological intent’ of the Government’s NHS plans is becoming clearer by the day. “They ploughed on with this privatisation even though doctors said they would leave,” he said. “It shows competition lawyers, not consultants, calling the shots in the Coalition NHS. Labour will scrap the competition culture and put the right values at the heart of the NHS.”

While NHS dermatology provision is far from adequate, if academic research and training provision is at greater risk under private management and rare centres of excellence are closing their doors – privatisation of dermatology, its lack of accountability and questionable track record in proper financial management could be the final nail in the coffin for the kind of improvements that are desperately required for patients with skin conditions in urgent need of better specialist care.

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Goats milk kefir probiotic for eczema and allergies: A Fantastic Voyage

Picture Raquel Welch in a skintight diving suit being attacked by evil green slimy antibodies in the classic 1960s sci-fi movie, Fantastic Voyage and you’ve pretty much got the latest major breakthrough in eczema and allergy research.

Fantastic Voyage who wants a leg

In January this year researchers in the US added atopic dermatitis (aka eczema) to the growing list of autoimmune diseases. Automimmune diseases develop when your immune system decides that some of your healthy cells are foreign and launch a deadly attack – among the diseases already included on the list are Multiple Sclerosis, arthritis and irritable bowel syndrome.

The discovery was made in the US during research into a new drug called dupilumab, a ‘monoclonal antibody’ which, according to a report in the Journal of Allergy and Clinical Immunology , “can reverse the immune response that causes atopic dermatitis skin lesions.”

Dupilumab acts to turn off the responses of two very specific proteins that are responsible for the immune system turning on itself causing flare-ups of eczema.

Great news, but this stuff is likely to take a number of years to get through trials and turn up on your GP’s radar so what can we do with this information right now?

Shann Jones director of The Chuckling Goat, believes that goats milk kefir, an Eastern European probiotic drink, can help to alter the response of the immune system and reduce allergic inflammation.

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“Kefir modulates the immune system,” says the Chuckling Goat website. “Certain compounds in kefir may play a role in regulating immune function, allergic response, and inflammation. One study found that kefiran, a sugar by product of the kefir culture, may reduce allergic inflammation by suppressing mast cell degranulation and cytokine production. Another study found that certain bacteria in the kefir culture inhibited IgE production, helping to moderate the body’s allergic response.”

The Chuckling Goat offers a 21-day course of their probiotic goat’s milk kefir with the claim that it will permanently repopulate your gut with the good bacteria that effectively helps the immune system work out who are the goodies and baddies when it comes to fighting off infections and foreign bodies.

I heard Shann being interviewed on the radio a few weeks back and was persuaded to give the kefir a whirl – could this really be a natural, drug-free alternative to dealing with the evil antibodies who have simply chosen to fight for the wrong side?

My bottles arrived this week (beautifully packaged and nicely chilled). So, I’ve zipped up my jumpsuit and I’m diving in. As recommended by the Chuckling Goat, I’m keeping a diary of how I feel as the days go by and I’ll share my fantastic voyage with you as I progress through the course. Wish me luck!

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Queasy and cheesy: Kefir for Eczema Diary Week One

After hearing Shann Jones of the Chuckling Goat, a farm in Wales offering goat products that claim to help with eczema and allergies (read all about it here), on the radio talking persuasively about the benefits of kefir (a probiotic drink made from raw goat’s milk) I decided to take the plunge and order their 21-day course.

In a nutshell here is the theory behind kefir for eczema. If you suffer from eczema – a condition that has recently been added to the list of autoimmune diseases – it’s likely that your gut needs replenishing with some good bacteria which, according to Chuckling Goat, can help prevent your immune system from turning on itself and attacking healthy tissue – think Raquel Welch in the Fantastic Voyage. Read more here.

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There is currently a 4 week-long waiting list for their course of Kefir following all the media interest, but I must have got in there just before the rush as my box of bottles arrived last week, beautifully packaged and insulated with a cold pack so they were perfectly chilled during an unseasonable period of very hot weather. I transferred them straight to the fridge and got quite excited about unleashing all these little bacteria warriors into my gut.

Chuckling Goat recommend that you keep a diary as you work through the course of probiotics to gain an understanding of how it’s all working, and I’m told if your gut’s in pretty bad shape you can expect a tough first few days – so here goes:

Day One

Woke up very excited to get started. As instructed, I poured myself out one third of a pint into a glass, looked at it, had a sniff and suddenly didn’t feel so excited any longer. The words Shann used to describe the kefir on the radio echoed around my head, “it tastes NASTY, I’ve got to tell you, it’s horrible stuff.” So, I held my nose and went for it – and, in fact, it wasn’t nearly as bad as I was expecting. It tastes like slightly sour, fizzy, natural yoghurt but obviously thinner and drinkable.

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Chuckling Goat also recommend using their moisturising cream alongside the 21-day course of kefir, but sadly it contains hazelnut oil which I’m allergic to, so that was out for me. I have read in other studies that applying the probiotic directly to the skin can have benefits – so this might sound completely disgusting but I just poured the remaining drops out of the glass and slapped them onto my face. Later on that day I did feel a little bit queasy (and possibly so did everyone else with me wandering around smelling nicely cheesy!) but that was about it for day one.

Day Two/Three

My husband woke me up on day two and day three by bringing me a freshly brewed coffee in bed – ah, bliss – but, just before I took my first sip I remembered I had to go downstairs and drink a third of a pint of fizzy yoghurt. So off I trundled and again, it really wasn’t that bad. In fact I think I’m starting to like this little fizzy and sour wake-up call.

As for the state of my health, things were starting to take a turn for the worse. I was starting to feel slightly headachey and the skin on my face was feeling puffy and very itchy, the first signs of an eczema flare-up. Although this is not uncommon – I often have these reactions on my face – I have been having a really good run lately, my skin has been behaving itself and has been clear for a couple of weeks now. But I could tell that something was irritating me.

Day Four

Today was a bad day. I felt completely exhausted and in a very low mood. I had a crushing headache. The skin on my face was horrible and the allergic reaction was getting worse, I had hives on my eyelids and my skin was sore and incredibly itchy. I felt like I just wanted to sleep all the time.

Hoping for a better day tomorrow.

Day Five

Feeling a little brighter today. The headache has gone and I’m feeling more positive with a bit more energy. The skin on my face is calming down a little, but is still sore and itchy. Still feeling tired but hoping for a good night’s sleep.

With any luck, that’s the beginning of the end of a tough battle inside my gut and I can start reaping the benefits of furnishing my insides with these good bacteria.

Watch this space for the next five days.

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