TORONTO - Preet Bhogal still remembers being taunted in school for his inflamed skin. The Nova Scotia native would always wear long-sleeved shirts to cover his arms and tried to shrug off jeers about the flare-ups on his hands, but the words still hurt.
"My eczema covered just about my whole body," says the 33-year-old, who has lived with the skin condition since he was a baby.
"It definitely affected my self image, self esteem, mental health."
While the physical severity of Bhogal's eczema improved with a combination of age and a strict care regime, its emotional impact continued to be felt in subtle ways. He didn't wear short-sleeved T-shirts until he was in his 20s, doesn't know how to swim because his eczema was exacerbated by pool water and vividly recalls how concerned some of his peers were about catching the skin condition that isn't contagious.
"There's almost a barrier around you. Because I had visible eczema, people were afraid to get close," he says.
While Bhogal's case was an extreme one, the challenges he faced are encountered by many living with eczema today.
As the rates of those who experience the condition appear to be on the rise, Bhogal and advocates for those with skin disease hope having conversations about eczema will help demystify the condition and make it easier to deal with.
"There's often a lack of awareness of the issues that it causes and the amount of stress in the way that skin disease really affects someone’s life," says Bhogal, who is now a board member with the Canadian Skin Patient Alliance.
"I would like for people to just know that it exists and for people to not be afraid to talk about it."
While official annual statistics are hard to come by, a number of doctors and patient support groups estimate about 20 per cent of Canadians will experience eczema at some point in their lives.
"When you talk about 20 per cent, that's huge," says Dr. Catherine McCuaig, a pediatric dermatologist at the Sainte-Justine children’s hospital in Montreal.
"It's a very common condition."
Eczema exists in different forms and is most often experienced in childhood. One of the most common forms is atopic dermatitis, a hereditary condition which results in red, itchy and swollen skin which can have fluid-filled bumps that ooze and crust.
Another common form is contact dermatitis — where skin is inflamed from contact with an allergen, like poison ivy, or repeated exposure to an irritant. Other versions of eczema include a form associated with varicose veins and another related to dry skin.
According to McCuaig, who also teaches dermatology and pediatrics at the University of Montreal, while the rates of eczema appear to be on the rise, the severity of the condition could be increasing as well.
There are theories that a combination of genetics, environmental factors and poor immune systems in children brought up in over-sterile environment could all be factors in the rise of the condition, says McCuaig.
One of the priorities for dermatologists now is ensuring that those with the skin condition get the physical and mental care that they need.
"Most people get the diagnosis however they may not have adequate treatment," says McCuaig, adding that her hospital's skin treatment team includes a psychologist and a social worker.
According to McCuaig, increased physician and patient education on eczema would help raise the profile of the condition and how it is dealt with.
That's where organizations like the Eczema Society of Canada come in. The advocacy group not only offers support to those with the condition, but also works towards explaining eczema to those unfamiliar with it.
"I think we often minimize or don't understand how it can feel to live with an itchy, burning skin rash on your skin most of the time," says society president Amanda Cresswell-Melville, whose own son had severe eczema as an infant.
As part of their efforts, the society is producing its first guide for schools and daycares to help educators better understand the condition and the needs of students who deal with it.
Some of the recommendations in the publication slated for release in November include special soaps in washrooms, special consideration for those with eczema during craft time and field trips, and pointers for teachers who may confuse behaviour related to eczema — jittery kids who have trouble concentrating due to their itchy skin — with other conditions like attention deficit disorder or hyperactivity.
"A lot of teachers don't even know about eczema," says Cresswell-Melville. "We're really trying to bridge that gap between school and home."
Ultimately, support and understanding are key to helping someone with eczema deal with their condition without suffering deep emotional scars.
"Part of what we always try to emphasize is that it is a struggle and it is difficult, and patients living with this really are living with quite a challenge," Cresswell-Melville said. "Working through that is really important."
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