Habit reversal for eczema

This fall I stumbled upon the book Eczema Solution by Sue Armstrong-Brown. The book promises to be “a revolutionary programme that really works” for chronic eczema. It is based on premise that while the tendency to flare will not go anywhere in eczema sufferer’s life and while flare-ups will probably always come and go, chronic eczema is often a result from a scratching habit and if that habit can be changed, also chronic eczema will heal.

Online, there are few helpful blog posts and articles about habit reversal/combined approach for people who are curious to know more:

… just to mention a few. These sites explain the combined approach more than I will, but the method can be summarized to include three levels of treatment:

  1. Frequent moisturizing, because dry skin feels itchier than moisturized.
  2. Prescription creams from your dermatologist to control inflammation. These need to be strong enough and used long enough.
  3. Habit reversal training. In this, one uses a clicker counter to record scratching episodes while working on reducing their frequency by rehearsing new behavior that is incompatible with old one.

Now, the book is targeting people who suffer from long-term eczema and who might have somewhat of a scratching habit. I read from somewhere that people with eczema scratch harder and longer than people without it, and as the book suggests, they also scratch when they are not itchy due to having a longstanding skin condition. Scratching is a habit for them. (It’s noteworthy that the combined approach would probably be less applicable if you have a completely new eczema and no real scratching habit.)

So I started tracking my scratching as the book instructs and oh boy do I have a scratching habit: I scratch when I’m itchy, I scratch when I’m thinking, I scratch when I’m bored or tired or stressed out, and so on and so on. Using the clicker counter, I found out that I was scratching over 200 times a day (and I can still consider myself lucky since some people report 1,000 episodes a day). Naturally, my skin can’t be fine with all that scratching and after the initial baseline tracking week, I started on cortisone creams and a crazy involved moisturizing scheme to help heal my skin while at the same time practicing behaviors to replace the scratching, like clenching fists that has become my sacred mudra of healing, and simply noticing that actually, sometimes, I’m not really itchy and that I do not need to scratch. Also, as the book promised, simply pressing nails on the real itch, or pinching the skin until the urge is gone is very helpful.

I’m glad to report that after 3 weeks of doing the program almost to the T, my scratching is down to a little bit over 100 episodes a day and that despite of my desperate post from yesterday, after doing a 2-week review, I feel much better about my skin and the program itself. Progress is especially noticeable on my hands that have almost completely healed because controlling hand scratching and skin piking seems to be easier for me than controlling scratching on other body parts.

Also, I’ve been under INTENSE stress from life and universe and everything which has slowed my progress. For future weeks, I probably need to address the stress in order to facilitate bigger success with the program. I mean, it’s just way too hard to not have a good old scratchy time that feels soooo satisfying and rewarding when you are mentally run down and done for. But more on that later. This is a process.


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