So today’s topic is all about periorbital eczema, so that’s eczema around the eyes. So it tends to happen on the eyelids and underneath the eyes. I’ve got multiple videos on eczema for the face, body, and for children. So you can watch those for those specific situations. But this one really is for around the eye area. Often for skin of color, any form of inflammation does lead to pigmentation. So at the hyperpigmentation clinic, that’s my clinic, I see a lot of cases of periorbital pigmentation that have happened after eczema because that constant rubbing irritation and inflammation triggers the melanocytes, the cells that produce the pigment melanin. Those cells then become hyperactive. They’re clustered around the eyeball and you see it as dark circles.
So really what we want to do with periorbital eczema is to break the vicious cycle and try and nip it in the bud as early as possible so that you don’t end up then with pigmentation. Because once you get pigmentation, it’s actually very difficult to treat in someone with eczema because the skin barrier is damaged. So then how many actives can you really put on that skin to try and treat the pigmentation? So we just don’t even want to get to that point if we can avoid it. So if that sounds good to you, please give me a thumbs up. Let’s dive right in.
So often the complaint is that the skin feels dry, flaky, irritated. The skin can often feel thickened. It can sting whenever you put anything on it, or even just when you’ve not put anything on it. Sometimes the skin can bleed, and it just feels uncomfortable and swollen. So it’s frustrating because it’s around the eye area, it’s right at the center of your face. It’s not something that you can hide or that is under your clothes. And so people really do feel very self-conscious about it. It also means that you can’t do your normal things like wear makeup, for example, to cover it up because it literally makes the situation 10 times worse.
So first of all, you really need to look at the triggers. So the classic triggers are dry weather. Often this happens in the winter when you have central heating on or it can happen in the summer when you have air conditioning on. Both those situations are going to dry the air and can be triggers for periorbital eczema.
The next classic trigger is stress. So stress really affects the water-holding capabilities of the epidermis, the top layer of skin. And so then you get more transepidermal water loss, so more water evaporation from the skin, and then guess what happens. Your epidermis is now dry and you are now in that vicious cycle of getting eczema. So stress is something that also really does need to be managed.
The third is contact dermatitis. So this is really any cosmetics. This includes creams, washes, makeup, moisturizers that contained things like denatured alcohol, which can dry the skin, fragrance, which can irritate the skin as well, essential oils, which is a skin sensitizer. These things really should not be worn on eczema prone skin or a damaged skin barrier. So really please have a look at your makeup. Have a look at the ingredients. It’s very likely that a lot of these ingredients are actually in those cosmetics and in those creams.
The next common causes is atopic dermatitis, which tends to take place under five years old and affects about 20% of children. So a lot of people will grow out of eczema as children, or it just becomes more mild as we get older so that’s something else. But also the other triggers are things like pollution or smoking. Other ones would be dust, chlorine. So if you swim a lot, and also some sunscreens can irritate the skin, a lot of them will have denatured alcohol in them.
So for example, I’m manufacturing sunscreen at the moment. And sunscreen is a very difficult one to manufacture, the reason being that it can feel very oily. And so the instinct of any cosmetic formulator is to put in an alcohol that is quick drying, that evaporates immediately, and gives you that nonsticky feeling. It was extremely hard for me to formulate our SPF50 zinc oxide, SPF50 physical mineral sunscreen without alcohol. And that actually took a lot longer to achieve because it’s very, very difficult to do and it’s not something that a majority of manufacturers are going to do. So really have a look at the back of the packaging and just see which ingredients are in there.
So how do we treat it? So, first of all, we have to stop the triggers. This could be your makeup, it could be pollution. Whatever it is, you need to stop the trigger. It could be stress. The next thing you need to do often your GP or your doctor may give you a steroid cream if it’s quite severe. It’s a circuit breaker in this vicious cycle because eczema equals dry skin, equals not a healing environment for the skin, equals more transepidermal water loss, equals more dry skin. And it literally is this vicious cycle. So really want to stop the inflammation, calm the skin down, create that healing environment for the skin, allow the skin to recover.
Unless you do that circuit break, it’s extremely difficult, no matter how much you’re hydrating the skin, no matter how many occlusives you’re putting on the skin, if the skin is inflamed it’s just going to carry on drying out. So it is a necessary step. It is something that a lot of people don’t want to do because of the fear of thinning skin. But that really does happen with higher steroids over a longer period of time, not 1% hydrocortisone for a couple of weeks is really not going to have that thinning skin effect that can happen.
Next I want you to wear a thick, fatty, delicious moisturizer with no fragrance, no essential oils, no denatured alcohol, nothing that’s going to irritate your skin. I’ve written down a full list for you. So the products that I love and I’d recommend are Bioderma intensive eye cream. I like Vanicream moisturizing ointment because it’s thicker and that really is going to trap water in the skin. Aveeno eczema therapy itch relief balm, again is very occlusive, very thick. QV intensive ointment. And that is for our Australian family, our New Zealand family who have access to QV.
So everybody who’s watching this channel should be able to get access to one of these products. I really put a lot of effort to making sure that the products that I’m recommending are global products that my whole family around the world has access to. There’s no point in me doing a video where it’s only products that you can find in the UK, that really isn’t going to help everybody. So I do try and make a conscious effort to do that. So please buy one of those products. As you know, none of my videos have ever been sponsored, they’ll never be sponsored. This is purely based on what’s in your best interest.
I may even go one step further and cover the area on top with Vaseline. So the non-fragranced Vaseline, just to really occlude the area, especially at night time. At nighttime I’d also use a humidifier because water has to come from somewhere and either the water is evaporating or the water is being locked into your skin. And there really is a process of diffusion. So really you want the air around you at relatively higher water content and not a drying environment because obviously water’s just going to evaporate. We do not want that. We want to create that healing environment. So please buy yourself a humidifier and put it on at nighttime. And please don’t have any AC or central heating on at nighttime, if you can avoid it. I know obviously if you’re in a really hot country and you’re going to not be able to survive without AC, I fully understand, but just know what’s going on and just know how important it is for you to purchase a humidifier as well.
When you wash your face, please don’t put it under a hot shower. So when you have your normal shower, as it is, please, I don’t want any of you using a hot shower anyway. It’s so bad for our skin but if you can’t survive without your hot shower, I do understand. Try and make it lukewarm if you can but don’t put your face under it. I want your face to be washed with relatively cool water, not cold water, but cool water and use micellar gel wash if the skin is actually dirty. It’s probably one of the most gentle things that you can use on your skin, where your skin still feels hydrated after you’ve washed it. You do not want your skin feeling squeaky, or dry, or tight, it’s absolutely the enemy for all our skin but especially eczema prone skin.
It’s also essential to reduce stress. I know it’s really easy to say. I’m literally the most stressed person. I’m the worst person to give you advice on stress. But when you’re in times of difficulty and this covid has just been a nightmare for so many people. So many of us know people who have had covid, who passed away with covid, and we’ve all gone through a lot of grief, I’d say in the last 12 months. I think this has really impacted everything around us, but it has also impacted our body, it has impacted our skin. And if you have been eczema prone, you’re probably likely to have had a flare up, to be honest, in the last 12 months, just because of the amount of stress we’re all under.
So it’s easy for me to say, “Oh, de-stress your life.” But obviously life isn’t quite like that. And what I would say is try and manage your stress as best you can, and just know that holding stress in, I used to do this, hold stress in, and it would just affect every part of me. And I don’t want that for you. So I would invest in learning how to manage stress because life is stressful. Just even the thought of what may or may not happen is stressful. That’s something I really had to learn this year, honestly. I’ve learned a lot this year but one thing that does really does stand out in my mind is learning to take care of my mental health and stress levels.
Now, as I mentioned at the beginning that you can’t get periorbital pigmentation that happens with eczema around the eye area. And so what I would say is do not put on any actives on the skin. This includes my dark circles kit, please do not wear this if your skin barrier is broken because it’s only going to irritate your skin further. You have to repair the skin barrier before you can do anything about the pigmentation. I would say make sure you’re really good with your SPF50. I do prefer physical because of the anti-inflammatory effects of zinc oxide. Make sure there’s no alcohol in it or any fragrance in it. That’s really essential for a compromised skin barrier.