Himesh

Himesh was diagnosed with eczema when he was 10/11 years old during a stay in hospital with a serious skin infection. He has since been attending a children’s dermatology clinic and, over the years, has used a number of different creams and other medications.

Himesh was first told that he had eczema after he was admitted to hospital with a serious skin infection around age 10 or 11. This came as a shock as Himesh had not had any major problems with his skin before and because eczema more commonly develops in younger children. Himesh has since been attending a children’s dermatology clinic which has been really helpful, especially the nurses who offer new treatments and spend time explaining them to him. He will shortly be moving to an adult dermatology clinic and worries that there will be less support in helping him manage his eczema.

Having had eczema for 6 years, Himesh is confident that he knows how to manage his skin condition well. He has experience of a number of different creams, emollients, bath oils and tablets as well as of night clothes made from a special fabric. The routine for managing his eczema is very time consuming as it involves lots of activities and different medicated products such soap substitutes. He is dedicated to the routine but does not like that the treatments make his skin feel heated up and uncomfortable.

Eczema interferes in various ways with Himesh’s home life, education, social activities and confidence. For example, he previously enjoyed playing football but recently took up tennis instead because it does not require him to be in contact with grass. Himesh dislikes that his eczema makes it especially difficult to keep up with school work; he sometimes needs time off for dermatology and GP appointments, for stays in hospital with infections and because he needs to reapply creams in between classes. He also finds it disappointing that he cannot wear the kinds of fashionable clothes that he likes because the fabrics can flare up’ his eczema and he also misses using regular’ hair styling products.

Himesh hopes that his skin will continue to improve and that he might eventually grow out of it. He was aware that the emollients and ointments he currently uses may not always be effective and that he may have to try others. He feels that he has learnt a great deal through his experiences of having eczema and he is keen to help others by sharing this knowledge.

Himesh describes a special medical/welfare room at school where he goes to use his emollients.

Age at interview 17

Gender Male

Age at diagnosis 10

It’s just a room basically and like it’s got frosted windows so obviously no one will be able to see. And like it’s, in our school it’s a place called the Student Services so you just go to there and get and they would keep all your creams and like the big tubs but I would carry my own well now I carry like my little tub because I can’t be bothered sometimes to go all the way down to that place and then go back to lessons so I just used my cream and top it up when I need to in lessons, because I only do it less anyway now, so yeh. But yeh that room I’ll just go into that room and just apply my creams I guess there and then give the creams or medications back to the person at Student Services.

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Himesh has needed time off school and sixth form to attend medical appointments but tries not to let it affect his education.

Age at interview 17

Gender Male

Age at diagnosis 10

I would probably say like when I had one of my infections and had to have like, go to like dermatologists appointments, allergy appointments, general appointments it kind of took a lot of time off school which was a bit annoying cos I could have done better if that makes sense, but due to that little bit that I missed I kind of have to catch up, you know, get back to the position where everyone else is, but yeh that’s it really. But yeh I wish I didn’t have all the infections and time off school but you can’t help it really but yeh. I did try my best in school to be honest, so yeh. But I never let like eczema stop me from doing most of my education. It did kind of stop me from doing my sports and that but I tried, I tried to not let it stop me from doing my education.

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The impact of eczema on Himesh’s confidence stopped him from playing sports for a while.

Age at interview 17

Gender Male

Age at diagnosis 10

When I started secondary school I was obviously, I was quite into my sports and obviously around that time in year 7, 6 I started having eczema and then it kind of stopped me from doing some sports I love, like I used to I used to do football and all day every day basically, used to be quite good. And then I kind of stopped because my confidence kind of just went downhill because of my eczema, I didn’t like paying on grass. And plus like obviously people, other people that came from different schools were kind of [inaudible speech] and my confidence went right down, so I kind of stopped doing more sports. But as from, currently I’ve started to do more sports or more stuff that I didn’t use to if that makes sense.

So is that different sports?

Yeh so like as I avoid grass sometimes cos it kind of does make my skin bad and at one point I was allergic to it, I do more tennis now and I kind of I do that every Sundays, so yeh I find I feel good doing it if that makes sense and I know I’ve got eczema and sometimes it is bad to like sweat and stuff like that but I do feel uncomfortable at times sweating but I’m at this point where I can control it so it’s kind of good that I do play tennis and I do love my sports so I don’t really want to stop it to be honest. But sometimes I don’t go if my skin is bad but that’s only when the season changes or when I’m unwell I don’t go either.

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Others’ comments and behaviours sometimes make Himesh feel self-conscious at school.

Age at interview 17

Gender Male

Age at diagnosis 10

You get like the younger groups that would like probably just say, would probably look at you and you know, whisper to their friends or I don’t know say eee’ or something like that, I know that they don’t know what I’ve got but it kind of makes me feel like if they’re seeing it like that what are other people seeing, if that makes sense so I would force myself to cover up, force myself to put more moisturiser I guess just to make sure that my skin is better. And like but sometimes again like when people don’t understand when you put the creams they’ll say stuff like oh he’s got cream on his face, shiny face or whatnot you know what I mean, so yeh. But obviously those people don’t understand what I was going through.

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Himesh’s confidence dropped after being diagnosed with eczema during secondary school.

Age at interview 17

Gender Male

Age at diagnosis 10

I think during like the first couple of years of, of secondary school I used to be really confident like I could talk, present work if I wanted to in front of the class even though my eczema was really bad at that time. But as I grew up I kind of got more wary of what people think, I know you really shouldn’t, you really shouldn’t do that because you shouldn’t really but yeh I really got wary of like what people think of me how they might think of me and stuff like that so then my confidence just went down to be honest and I really find it hard to talk in classes especially when the teacher picks you as well, it’s really annoying but you have to do it. But yeh I just kind of like get really shaky and panicky and kind of get to a point where I don’t know what to do but you have to do it so, so yeh it kind of does affect me.

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Himesh talks about one of his eczema infections. He had to stay in hospital for antibiotic treatment.

Age at interview 17

Gender Male

Age at diagnosis 10

One of the worst ones were Bullous Impetigo because I got referred to the hospital because obviously I had infection but at that point I didn’t know it was Bullous Impetigo I think they said it was some type of herpes virus. So they were giving me medicine through the veins for the wrong treatment which made my energy levels go down and were thinking why is this happening I should be getting better if that makes sense. And like for a good, I think four or five days they were treating me with this through the veins and it wasn’t helping at all and I think a derma- specialist, a dermatologist nurse, no doctor came in and said You’re treating the patient with the wrong medicine, he hasn’t got, I think it was herpes virus at that point, he’s got Bullous Impetigo. And then once I got the right treatment my energy levels you could see was going up, so yeh I spent a good two weeks probably in the hospital.

It kind of wasted my time I think most of my infections were at school time so I think this was Year 6, 7 something like that, it really affected my school time cos obviously Year 6 last year of primary school and stuff like that but SATS as well I think it was but yeh still it just affected valuable time as well because I could have been out of the hospital much quicker than two weeks if they had treated me with the right medicine, but yeh.

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Putting on emollients makes Himesh’s skin feel too warm and uncomfortable.

Age at interview 17

Gender Male

Age at diagnosis 10

When I’m applying a cream I feel really like heated up so then obviously then I would have to wait until it soaks in and then put my clothes on and I remember when I used to do it about probably about two years ago, usually put it, no yeh two years ago, used to our it day and night when I wake up and like I would get heated up especially when it was school time I would have to put my cream on and then put my clothes on and I feel really uncomfortable especially when you have to wear a shirt, blazer, tie all day, so yeh I’d feel uncomfortable basically.

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Himesh used to take antihistamines to help him sleep, but began to worry about this.

Age at interview 17

Gender Male

Age at diagnosis 10

I used to take a lot of Piriton back then, I’d probably say I was addicted to Piriton at one point because I couldn’t sleep, I know it sounds bad but I couldn’t sleep and I thought Piriton was there for me to put me to sleep, if that makes sense, but as I’ve gotten older I realise not to take as much so I only take it when I need to take it. Because I know that one of my doctors said that if you use too much of a drug it could stop working for you, if that makes sense, so yeh. So now I control myself when I want to use Piriton, I don’t use it that much now.

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Himesh was offered light treatment but decided not to try it.

Age at interview 17

Gender Male

Age at diagnosis 10

I was offered it and I think I said not to do it because I think like my dad had the laser treatment as well, well similar kind of laser treatment and it didn’t help him at all it made it worse. But yeh I didn’t want to do it as I think as well it took a lot of time off school to do the treatment so yeh I decided not to do it and just manage the skin how I was doing basically, so yeh.

And was that through your dermatologist?

Yeh, definitely yeh through the dermatologist always suggesting me things to try out so yeh.

And were they sort of quite happy with your decision not to go for the sort of light therapy?

Yeh definitely yeh, they don’t mind they just basically offer you like new treatments or new ways of going about with your eczema and then you can decide to either take it on or not basically, so yeh. So that’s what I like about it to be honest, you always get like suggestions and trying out new stuff to try and make your skin better I guess so yeh.

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Himesh is age 17 and will soon be moving from paediatric dermatology to adult dermatology. He is unsure about what to expect from this change.

Age at interview 17

Gender Male

Age at diagnosis 10

So at the moment you’re at a children’s dermatology unit, is that right?

Yeh.

And will you be moving onto an adult, adult clinic at a later date?

Yeh unfortunately I have to, they told me this last time I went, I think a month ago, cos I’m coming to that age I will have to get referred to an adult clinic. But I’m not really looking forward to that because apparently there’s a huge difference because like they don’t tell you what to do apparently in the adult clinic whereas in the children’s clinic I guess they go more in-depth if that makes sense. But you have to be by yourself in the adult clinic so you have to, I guess pay more attention and they’re not going to help me out as much as the children’s nurse would.

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Himesh talks to his uncle (a pharmacist) to get information and advice on eczema treatments like Protopic.

Age at interview 17

Gender Male

Age at diagnosis 10

Oh yeh like every now and again the dermatologist nurse would offer me like this new treatment, new creams or, or some sort of surgery or treatment kind of thing. So I’ll obviously go back to my uncle and he will explain to me properly what, what the ups and downs are what the, stuff like that basically, and so yeh. So he is quite handy I guess if I missed out any key information I guess on the day, so yeh.

Could you give me an example of the sorts of things, conversations you’ve had with your uncle where he’s been sort of able to fill you in on some of that information?

Okay so recently I had a conversation with him regarding this new cream that’s called Protopic that was offered by my dermatologist nurse, she said it would probably improve the redness of your skin. And it was different because I thought it was, I thought it was a steroid but my uncle explained it’s not a steroid so you can use as much, as much of it as you want, but yeh. So I started using it basically and sort of kind of, I kind of saw improvements in places but before I try creams or any new treatment I kind of test it out on my skin first so I’d put a bit of it, I’ll apply a bit of it on my arm for a day or so and see how it goes and then use it or not use it after that, so yeh.

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Himesh stopped eating cheese for a while because it triggered his eczema. He’s now re-introducing it to his diet with antihistamines.

Age at interview 17

Gender Male

Age at diagnosis 10

I’m not allergic to the food as such but I would avoid some of the foods like cheese I would avoid but recently I’ve been trying to have like a slice of cheese a week just to see how it is, I used to love cheese let’s just put it that way I used to eat it a lot but then obviously when I had eczema it wasn’t good for my skin.

The cheese, I only had a slice a week as I said but it’s been alright to be honest and I’ve started to eat pizzas as I used to love pizza as well but I’ve started to eat pizza again but still I have that feeling that my skins going to get bad if that makes sense so I force myself once I’ve finished eating it to have Piriton so nothing gets bad, but yeh I’m not 100% sure if it’s a good, like if it’s a good thing to have pizza or cheese because I do tend to have Piriton afterwards. Not for the cheese if I’m having a slice but if I’m having quite a lot of something then I would have the Prirton afterwards.

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Himesh talks about seasons and weather flaring up his eczema.

Age at interview 17

Gender Male

Age at diagnosis 10

Do you get sort of a sense that a flare up is on its way or does it just come out of the blue?

Well now I can tell like, when like seasons change and weather changes I can tell that my skins going to be bad but I can control it now cos I’m at that age where I can understand how to control it. So it’ll probably flare up for a week or just go bad for a week because of the weather change or season change then after that it’s alright, so yeh.

What kind of weather or season change?

Oh all sorts like if it went from really cold to really hot all of a sudden my skin would have to adjust to an extent so it would have to flare up, not too much anymore, but you would still change and go bad for around a week and then once its controlled it will be alright, back to normal if that makes sense, so yeh.

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One of Himesh’s teachers has talked about techniques for coping with stress.

Age at interview 17

Gender Male

Age at diagnosis 10

Yeh, yeh stress definitely sorry. it would definitely flare my skin up cos I’m at that point where I’m panicking I guess and I can’t control myself so I don’t know what to do so then my skin will get bad and that will lead to me itching even more and then you’re getting even more frustrated and putting more stress on me basically so it’s not a good time to be honest when I’m stressed. But I do, I’m trying to control it better now but I could still do with improvement if that makes sense so yeh.

So is that some of the techniques that your drama teacher taught you?

Yeh definitely like I think one of them was to like breath in and out until ten, slowly like cross your fingers and just like tense your whole body so you feel calm afterwards once you’ve tensed it for a couple of seconds and stuff like that so yeh. I do try to do that more often now if I get stressed but I haven’t been stressed lately so yeh.

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Himesh talks about the frustration of eczema flare-ups’ and undoing all the work he’d put into looking after his skin.

Age at interview 17

Gender Male

Age at diagnosis 10

Could you tell me a bit about what it’s like when your skin does flare up?

Yeh it’s a bit annoying cos I get to a stage where my skins at a good point which I see as a good point basically and then all of a sudden I’ll have this infection which just makes everything pointless, I have to start again, if that makes sense. Yeh it’s not really good having infections for people with eczema it’s just really annoying cos you have to start again. Once you’re at a good point of your skin, you have to, you know, it goes to waste in a way, so yeh.

Do you get sort of a sense that a flare up is on its way or does it just come out of the blue?

Well now I can tell like, when like seasons change and weather changes I can tell that my skins going to be bad but I can control it now cos I’m at that age where I can understand how to control it. So it’ll probably flare up for a week or just go bad for a week because of the weather change or season change then after that it’s alright, so yeh.

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Eczema has developed on different parts of the body for Himesh. He feels most concerned about areas that other people can see.

Age at interview 17

Gender Male

Age at diagnosis 10

Are there sort of some parts of your body where you feel more self-conscious about?

Probably the ones that are more shown, in show sorry like my face and sometimes my arms but definitely my face and my hair definitely yeh because otherwise everything else that’s covered I don’t really, not care about but like I don’t really see the point of caring about if no one can see it or can’t see it at the moment if that makes sense but yeh the face definitely and my arms, hands. Used to be hands a lot because my hands used to be really bad and my face you could really see it in the face. But those are really the places that are worse than other places on your body because I think it’s more exposed to the air and stuff like that, that’s why it gets bad but yeh that’s really why.

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Himesh learnt that he had eczema when he was admitted to hospital for an infection at age 10/11.

Age at interview 17

Gender Male

Age at diagnosis 10

I think I had an infection first so I ended up in the hospital and one of the doctors said, I think they said This is due to your eczema and I was, obviously I, I didn’t know I had eczema at that time until the doctor said, so yeh I think that’s when it started.

Hmm. How did you feel when the doctor said that?

I didn’t know how to feel because I think at that point I didn’t know what eczema was, if that makes sense, so yeh.

And what happened next, did the doctor explain a little bit about it?

Yeh explained like you have a skin condition for it, you’ll have to put creams and stuff, which I didn’t mind at the time because I thought that’s alright, if that makes sense, but as you, you know, get used to, to the routine and stuff it gets kind of annoying I guess cos it take up a lot of time, so yeh.

Hmm. Hmm. So what did you think the symptoms might have been because you said you had an infection, was that a skin infection?

Yeh it was I think because I probably scratched myself that’s why something probably went into my immune system and then it triggered an infection which was really bad because I had to stay overnight in the hospital. I think that infection I had to have medicine through my veins I think it was, so yeh it was pretty bad as I’d never experienced anything like that, I used to be a really healthy kid really so yeh.

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