Do you want to hear something really sad? This is what one woman told an All Party Parliamentary Group looking into the effects of skin disease on a person’s physical and psychological well-being – “I feel like I am disgusting. I feel unattractive and I have such little confidence in myself as a result of how I look. People stare at my face and it makes me feel completely worthless.” This was a woman with severe acne, but anyone who has suffered from facial eczema will know exactly what she’s talking about.
Getting eczema on your face is awful. It’s sore, it itches, it can make you feel truly terrible. But, I’ve had bad patches on the backs of my knees which have been far worse than the flare-ups on my face and they haven’t made me feel nearly as unhappy as when it’s up there for the world to see.
It’s obvious of course, we all want to look nice, presentable, attractive even. But, why should simply not looking nice lead to feelings of worthlessness? In fact, the situation is so much worse than you would imagine.
In April 2013 an All Party Parliamentary Group on Skin published a report on the effects of skin disease on a person’s physical and psychological well-being. Apparently, they wanted to get in there before the massive NHS overhaul and make sure that dermatology isn’t conveniently swept under the carpet.
If you suffer from eczema, like I have done for the last 40 years, the findings in the report will come as no surprise. Eczema makes you feel bad and feeling bad makes your eczema worse. How’s about that for catch-22?
But, the report also tells us that skin disease can adversely affect almost every aspect of a person’s life and in some extreme cases can ultimately lead to thoughts of suicide. “Common psychological problems associated with skin disease include feelings of stress, anxiety, anger, depression, shame, social isolation, low self-esteem and embarrassment.” And, to top it all, the report is pretty conclusive in its findings that general health practitioners not only do not prioritise the treatment of skin disease but actively trivialise it. Apparently, dermatology is not considered a core module in university medical and nursing courses and as a result, according to the report, there is a severe shortage of dermatologists in the UK. The report goes on, “Until dermatology has been recognised as one of the core fields of primary care, variation in the standard of provision is only likely to get worse.”
I very much doubt that a low-key cross-party report is going to make significant waves any time soon, if at all. So, if we’re being realistic, we’re on our own. Like anyone else who suffers from eczema, I must have tried and tested every cream, emollient, moisturiser and food supplement going. And I still do – I never give up on the holy grail quest for the miracle cream or magic pill. In fact, sometimes I believe I’ve found it – but then the old flare-ups come back and I’m back to square one. Topical treatments are all well and good, but if you’re like most eczema sufferers you’ll probably end up reacting to them in the end.
When I went for allergy testing it turned out that one of the strongest substance reactions was to hydrocortisone cream, something I had been prescribed by my doctor to treat my eczema for decades.
So, the upshot is – we’d better get a bit better at dealing with the reality of living with the disease.
The incredibly unhelpful and damaging link between ‘looking good’ and ‘feeling good’ is as good a place to start as any. Facial eczema sufferers can feel handicapped by an inability to improve their appearance. Make-up is a no, no for many – the only thing that you can slap on your face is a handful of anodyne grease prescribed by a GP – so when you simply CAN’T look good, what do you do?
Well, the report tells us that people are hiding in their homes because of the state of their skin, retreating from the world. At a basic level, they are failing to contribute to conversations and on a larger scale, they are denying themselves the opportunity to be in a relationship (worthless and disgusting remember?) and damaging their professional lives by not putting themselves forward for job interviews. I can absolutely sympathise with this – I have done my fair share of creeping around the edges of life, hiding in the shadows, not drawing attention to myself for fear of anyone looking directly at my face.
But, while I know that the psychological effects of looking awful are to be taken very seriously, let’s face it, this problem is something we have totally invented for ourselves as a society. I have never really been able to wear make-up because of my facial eczema, which actually suits me fine because I’m a bit lazy and I’m not sure I could be bothered with the rigmarole of it all. But, I’m certain that being completely cut out of that cosmetics merry-go-round has done me no harm at all and, perhaps, puts me in a better position to say this.
It takes a lot of effort to be confident. Lots of talking to yourself into things that you find uncomfortable. But, take it from me, the pay-off is huge. I don’t know what my face will look like when I wake up in the morning, some days it’s fine but some days it looks like I’ve been stung by a swarm of bees and been given a chemical peel during the course of the night. But, one thing I can guarantee is that at least one day out of seven, I’m not going to look good. So, after decades of hiding I have taken a very large and sharp machete to that link between looking/feeling good. In fact, in true blog style here’s a couple of ‘before and after’ shots:
AFTER. Believe it or not, my skin was terrible when this photo was taken. Itching madly, skin around my eyes puffing up like a balloon and generally flaky and sore. Very nearly as bad as it was in the before photo. The difference is – I genuinely don’t feel bad about it.
Melanie Reid broke her neck and back falling off a horse and writes a column for The Times about her experiences. “There are some things you don’t learn until it’s too late. One is that a woman’s relationship with her own body image is a totally unnecessary war. If I could reclaim even half of [my time], how much better I would have spent it – dancing, running, travelling, kissing, talking, laughing, reading, playing sport.”
So, taking the risk of being horribly trite – ask yourself this. Does your facial eczema prevent you physically from doing a single one of the things on that list? No? Then what the hell are you waiting for?