Managing symptoms, treatments and triggers at school/university
- symptoms, such as itching, or side effects from treatments making it hard to concentrate or take part in classes
- finding opportunities to use treatments, such as emollients, whilst at school or in lectures
- coping with triggers related to school, including stress about exams
- taking time off for going to GP or dermatology appointments
Symptoms of eczema, such as itchy and sore skin, can draw unwanted attention from others and make it difficult to focus in class. Aadam worried that other children thought he had fleas when he scratched his skin. Shams felt self-conscious when he had blood on his white shirts. George finds it hard sitting still for a long time, especially in warm classrooms. Molly also found her skin became itchy when she walked in the cold and then sat in a hot lecture theatre. Itchiness makes Himesh fidget more. Laura’s teachers would check she wasn’t scratching. Shams found it painful to move and, as an “interactive learner”, this made it difficult to engage with other people.
Being kept awake because of itchiness or discomfort has a knock-on effect the next day too (see also section on sleep). Himesh, Evie, Shams and Katie-Lauren sometimes found it hard to wake up in the mornings and could be late for school, college or university. Katie-Lauren has slept through alarms before and says she’s slower getting ready after a bad night’s sleep. Himesh has “nodded off” in classes because the antihistamines he used to take made him drowsy. Writing can be painful if eczema is on the hands or arm joints. Ele remembers her knuckles splitting open once when she picked up a pen. George didn’t tell his teachers that eczema between his fingers was making writing painful. Evie and Lizzie both found typing on their laptops was easier for taking notes, but wrote by hand in exams.
Eczema treatments and school/university
Putting on treatments, such as emollients and steroid creams, can be time-consuming. It can be inconvenient in the mornings, especially when in a rush to get to school or lectures. Shams tries to get up early to give him time for putting on his creams.
Side effects and the appearance of treatments can make people feel self-conscious. This can include the look as well as smell of emollients and sunburn from phototherapy. Aadam felt embarrassed when Protopic (tacrolimus) left a bruise-like rash on his face. Anissa’s wet wraps at school drew attention from others who would ask questions and sometimes make unkind comments.
It was tricky to find a suitable time and place to put on emollients in school, whereas sixth form/college and university usually had shorter days or more breaks between lessons. Evie remembers having to ask teachers permission to go put on her creams during classes. Himesh’s school had a special medical/welfare room where he could leave his emollients and top-up throughout the day. This meant he had to be quick though, even during break times, and he worried about missing out on learning. George never takes emollients to school (or on school trips) as he doesn’t want his peers to know he has eczema. Alice and Evie were happy to put on creams during university lectures, but others weren’t. Anissa and Katie-Lauren found it difficult putting on creams in public/shared toilets, especially for areas of eczema under clothes. Using emollients before or during classes and at work can mean slippery hands, making it difficult to hold a pen or pencil. Aadam had grips for pencils which helped but he found it embarrassing asking other people to sharpen pencils for him. Katie-Lauren and Ele also found that the paper would become greasy and left moisturiser streaks on the page which ink couldn’t write over.
Triggers and school/university
Stress related to studies (especially homework, assignment deadlines and exams) is a major trigger for many people’s eczema. Georgia took some time out from her studies when it became too much to cope with eczema on top of her A-levels and a part-time job. She noticed her eczema became more irritated when she was applying for university too. Aman pointed out that summertime exams mean stress and high pollen counts, both of which trigger his eczema. Cat found university more stressful than her current job, as she said she used to be constantly thinking about her studies. She says she had less of a structured routine then so would often stay up late and her skin would get itchy. Physical Education (PE) was talked about by a lot of people. There were lots of reasons why sport was avoided or limited by young people with eczema. Himesh and Laura both have pollen as triggers for their eczema, so have to limit contact with grass. Swimming was often avoided because chlorine and being in water for a long time can trigger eczema. Heating up and sweating can irritate, sting and dry out the skin, and there may not be showers provided or enough time after class to re-apply emollients. Evie couldn’t take part in PE when she had an allergy patch test. Some people didn’t want to take part in sport because they felt self-conscious. Wearing a PE kit or a swimming costume meant that usually covered parts of the body were seen by others. Abid wore a vest and shorts for swimming and felt very self-conscious in the changing rooms. A few people had requested not to take part in PE or had been advised by their doctors to not avoid it. Naomi’s teacher was understanding the few times she asked to be excused because of eczema. Anissa’s PE teachers didn’t believe that eczema was a good enough reason not to take part.
School uniforms could trigger and worsen eczema symptoms. Himesh didn’t like putting on his school uniform after applying emollients because he would feel uncomfortable all day. Alice had to wear tights at school and this made her skin itchy. School jumpers can also be itchy and Naomi was allowed to wear long-sleeved cotton tops underneath hers. Aadam preferred wearing his school jumper, rather than have the eczema on his arms visible with just a polo shirt. He felt “ashamed” to show his skin and, in the summer months, often crossed his arms so others couldn’t see. Schools had different policies on things like wearing make-up and facial hair, which some people talked about in relation to their eczema. Other triggers associated with living away at university include: drinking alcohol; socialising (including nightlife); stress (from studies and assignments but also other stresses from living away from the family home) allergens (such as dust and mould) in university accommodation; shared accommodation, with impacts on cleanliness and products (washing-up liquid, laundry detergent); changed diet; and different water hardness qualities. Another factor mentioned by some which added to the difficulties of looking after eczema was a lack of routine (such as with putting on emollients). Time-off from school/university
Getting medical help can mean missing out on school, sixth form/college or university. This includes repeat visits to GPs and dermatologists, going for treatments and waiting for infections to clear. Himesh wishes his doctors had given him the right diagnosis and medicine for an infection when he had to stay in hospital, as he could have been back at school sooner. Jessica’s appointments were split between her home and university cities, meaning she had to travel and plan between the two. Appointments were sometimes scheduled so that the young person didn’t miss out on school/university. This was especially important for phototherapy treatments because sessions are usually frequent (2-3 times a week). Himesh decided not to try phototherapy treatment because he didn’t want to miss any lessons. Vicky could easily walk to her phototherapy sessions and they were scheduled for after school. Cat fitted her appointments around her university lectures and it wasn’t much of a detour from her usual route home. Shams’ phototherapy sessions were scheduled for after school but it still meant he had to rush home and quickly have some dinner before travelling to the hospital.