Dermatologist Reacts

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DR. SERRAO: Terrible, right? I mean, I have eczema and that sounds absolutely terrible.

VOICEOVER: Dr. Rocco Serrao is a dermatologist and lifelong eczema sufferer. He’s here to give Eczema HQ his honest—and expert—opinion on real-life eczema experiences. This is Derm Reacts.

SUPER: Derm Reacts

DR. SERRAO: Okay. Let's do this.

SUPER: How would you describe your eczema flare-ups?

SUPER: Sophie, real eczema patient

SOPHIE: When you go outside…and you come home and you’re just, like, itchy all over, and you can rinse it off and, like, you can move on, that is a feeling that I feel just from my own skin during really bad flare-ups. Like, I can’t wash away that feeling.

DR. SERRAO: So, flares really define AD overall.

SUPER: AD = atopic dermatitis, the most common type of eczema

DR. SERRAO: When a patient’s going through a flare, it’s pure misery that they just can’t escape, and that’s what we heard here. Eliminating flares would be ideal, but if we’re going to have them, let’s have them less frequently and let’s have them be less intense.

SUPER: Christina, real eczema patient

CHRISTINA: You try to avoid any type of allergens. You try to avoid certain foods and stuff like that, but it happens anyway.

DR. SERRAO: So, if we say “avoid triggers”…

SUPER: A trigger can set off an immune response and worsen symptoms—but it’s NOT the cause of eczema

DR. SERRAO: …there’s two things that are tough there. One, you may not be able to identify your trigger. Two, it may not be practical to avoid the trigger. Saying “avoid the trigger” is not sufficient to control atopic dermatitis.

CHRISTINA: I’ve noticed that any time I get stressed out just in general, I will get just super itchy. I don’t know why.

DR. SERRAO: Right. So, emotional stress, physical stress can both trigger itch, right? I'll say it jokingly to patients, “Well, we can probably get your disease under control if you eliminate all stress from your life,” and they’ll laugh because it’s impossible, right?

SUPER: Jane, real eczema patient

JANE: I’ve been wearing cotton gloves on my hands, and that helps to minimize the scratching and the breaking of the skin.

SUPER: Bonus tip: Try pinching or patting the itchy skin

DR. SERRAO: We’ve got to minimize the damage that’s going to happen from scratching and that can be wearing a cotton glove. There’s a prime example.

CHRISTINA: Why is it so itchy? Why can’t I stop scratching?

DR. SERRAO: I think it’s absurd to tell a patient with eczema not to scratch.

SOPHIE: When I was really little, people would always say, “Oh don’t worry, you’ll grow out of it.” But here I am 20 years later, and I haven’t grown out of it.

DR. SERRAO: Atopic dermatitis is a disease that can manifest in so many ways. So, one thing we have to be careful not to do is give the false hope of growing out of something. If anything, I edge on the side of saying this may persist. Let’s be prepared to battle this condition lifelong.

SUPER: How has eczema impacted your everyday life?

CHRISTINA: When I was fresh out of high school, I wanted to go to the military. Guess what you can’t do! You can’t join if you have eczema.

SUPER: Not-so-fun fact: In one study, 14% of adults believed eczema held back their career

CHRISTINA: And looking back, that probably was for the best choice, like, I couldn’t do my job right if I was always scratching and itching.

DR. SERRAO: I mean that, that makes my heart sink. So, instead of you controlling your disease, here eczema’s controlling these patients, right? And eczema’s controlled me at times too.

SOPHIE: It’s normal to me to have to wake up in the middle of the night to get in the bathtub because there’s nothing else I can do.

DR. SERRAO: I mean, who wants to get up in the middle of the night and take a bath? I mean, that sounds terrible, right? I mean, I have eczema and that sounds absolutely terrible.

JANE: There was a period where I wasn’t sleeping because I was so itchy at night, so it definitely impacted my daily work schedule.

SUPER: Not-so-fun fact: Approximately 30% of adults with eczema struggle with sleep

DR. SERRAO: So, there again, sleep disturbance, and we know eczema affects sleep. So, don’t get a restful night of sleep. How do you perform at school the next day? How do you perform at work the next day? Is there absenteeism? Is there presenteeism?

CHRISTINA: Um, my sleep, previously in the past…

DR. SERRAO: There’s sleep again.

CHRISTINA: …it had impacted my sleep tremendously, like I had sleep deprivation. I was barely sleeping because I was always scratching.

SUPER: How do you collaborate with your eczema doctor?

JANE: When I’m going to the doctor, I really don’t prepare at all.

CHRISTINA: I always come prepared with some question so far as, you know, “Hey, have you found out any new treatments that could help eczema?”

DR. SERRAO: So, preparing for the visit, right.

SUPER: Good news! Today there are more eczema treatments than ever

DR. SERRAO: These visits can be frustrating because it would be a very similar routine.

SOPHIE: If my skin is really bad prior, or there’s something I’m worried about, I’ll take a picture on my phone and I’ll either email it or I’ll just show her in clinic.

DR. SERRAO: Again, when a patient’s going to a dermatologist or going to their doctor, it is a single snapshot in time. And if you hit the dermatologist on a day when you’re doing well, they’re going to have no clue how severe your disease was. So, photos are wonderful. It’s good to capture the moment when you’re having a flare-up.

CHRISTINA: A good visit is having an actual solution to whatever issue and leaving the office and, hey, I’m going to get better.

DR. SERRAO: So, what struck me here was what is a patient trying to accomplish…

SUPER: Bonus tip: Be a team player—set clear goals with your doctor

DR. SERRAO: …when they visit the doctor with their eczema. And it sounds like what they want leaving is hope.

SOPHIE: You leave with a plan of things that you feel like could potentially help you. Things that your dermatologist is confident that will help you, and it just is such an empowering feeling, and it’s such a hopeful feeling, and it’s just great to, like, have a plan for a way to try to attack the same thing that’s trying to attack and take over your skin.

DR. SERRAO: Having a structured plan and a plan that can offer hope are essential and that takes time. So, I mean, my heart goes out to these people.

SUPER: Make the most of your visit with our Doctor Discussion Guide. Get started at

DR. SERRAO: There’s a disease controlling people’s lives, which is why there’s a huge need to help the people that we’re seeing here.

SUPER: A big thank you to Dr. Serrao, Jane, Christina, and Sophie for sharing your eczema experiences.

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