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If you’ve ever wanted a sneak peek behind some of the eczema cases that I work on, I’m sharing a fascinating healing journey of a client with severe eczema on feet + her body!
This client was excited to be a part of this new case study series I’m bringing to the podcast to help inspire other eczema warriors out there.
It’s easy to give up especially if you start to feel like there are no answers or causes of eczema – that it’s just a mystery! But I hope that this journey for my real-life client dealing with eczema on feet + her body will remind you that you just have to keep digging!
And that healing can take time – sometimes more than you’d prefer to give it.
This journey for my client has spanned two years (not like the quick fixes claimed online).
She had A LOT to deal with in stages so that she could still be a functioning human being who showed up at her job ready to work.
I plan to share more of these types of case studies soon on other skin conditions so stay tuned!
In the meantime, let’s dive into this eczema on feet + full body case…
Or, listen on your favorite app: iTunes (Apple Podcasts) | Spotify | Stitcher | TuneIn | Subscribe on Android
In This Episode:
- Severe eczema on feet + body case study (with my own client!)
- What her eczema journey was like before we started working together
- Assessments I used to uncover hidden root causes of eczema on feet + body
- Key clinical findings of her severe eczema case
- What’s a realistic timeline for severe eczema spanning decades?
- Where my client is on her eczema-healing journey
Quotes
“After consistently working on root causes, this summer was the first time that she could wear shorts in the past 6 years.”
“Depending on your case’s complexity, your timeline may be longer than what you expect – especially with issues present for many years if not decades.”
Links
Apply to work with my virtual clinic HERE
Healthy Skin Show ep. 109: Eczema Triggered By Hidden Infections [CASE REPORT]
Healthy Skin Show ep. 257: Itchiness + Histamine Intolerance – Why Am I Itchy?
328: Client Case Study: Severe Eczema On Feet + Body {FULL TRANSCRIPT}
Welcome back to episode 328 of the Healthy Skin Show! In today’s episode, I’m going to share with you a case study of a client with severe eczema whom I’ve been working with in my clinical practice. If you didn’t know – my clinic works vitually with clients struggling with chronic skin issues who live all over the world where we consult in varying capacities.
Over the past few months, listeners have asked me to share client case studies here on the show. Partly because client case studies not only present an opportunity for inspiration, but also a significant reminder that healing is possible, even when the case is severe.
That said, depending on the severity of your case, your timeline may not be what you expect – especially when the issues have been going on for many years if not decades.
I say this because it’s all too common to see what seem like “overnight” transformations online leading you to think that if you just push through for a month or maybe even six months at most, you should be miraculously better. That’s often NOT the case – as some clients with severe cases have taken 12 to 24 or more months to slowly unravel and address underlying issues so that they don’t just come back.
I want you to know what is realistic… and unfortunately, a realistic timeline for healing isn’t what people share online. But it’s important for you to know, no matter what skin issue you’re dealing with.
This is why I’m excited to share this client’s journey with you today!
In case you’re wondering, my client has given me permission to share details of her case, as she too wants people to know that healing can happen, but your timeline may not be what you expect – especially when your case is severe and has been going on for decades.
So let’s dive in!
Severe Eczema On Feet + Body Case Details
When my client with eczema on feet + her body contacted my clinical practice, we started by collecting a lot of crucial information about her case.
She shared with me that her eczema had started in elementary school and resulted in her using topical steroids for 30-35 years. Ultimately the medication use culminated with her developing topical steroid withdrawal syndrome in 2016.
Between 2017 and 2021, she worked with 2 different functional practitioners who were not very helpful with her constipation issues or with her skin.
The more recent provider recommended a low histamine diet for 3 months. When that didn’t improve anything, she asked her to remove more foods which my client found very alarming and unsustainable.
At this point in early 2022, she began looking for someone else who wasn’t just going to put her on an elimination diet for her skin and found me – originally joining my Skin Rash Rebuild program, but then decided due to the severity of her case that she wanted private support as well.
My client’s complaints included severe eczema with extremely swollen feet that were peeling and crusted. Her hands were also swollen and she experienced quite a lot of itchiness.
Her sleep was pretty poor, while other skin complaints of cracked, dry, hyper-pigmented (inflamed) skin were notable.
She struggled with recurrent staph infections especially on the feet as that was the most severe area of eczema.
And she shared that at this point, she felt that she had fully transitioned through TSW and was now back to having eczema again.
My client noted that she had previously tried…
- vegan diet (which made her tired)
- low histamine diet (which didn’t stop her itchiness)
- removing gluten, dairy, red meat, shellfish and nuts – none of which made an improvement in her skin.
She also tried UVA and UVB phototherapy, Chinese herbs and acupuncture and moisture withdrawal without much improvement.
She also struggled with gas and a tendency towards constipation. She noted that she’d previously had painful indigestion about 2 months prior.
As I said, her feet were by far the worst with severe inflammation manifesting as a near-purple tone to her skin with crusting and plaques, peeling and itchiness.
Her hands were cracked, dry, and itchy with occasional pustules on palms and fingers.
She also had rashes behind the knees, on the inner thighs, inside of the elbows + forearms, upper chest and lower torso as well as on the neck.
What We Assessed For
Because skin is connected to other parts of the body, I always want to assess overall health function including getting a detailed case history, family health history, environmental exposures, medication history, current diet (as well as previous diet history), sleep, gut function, travel history, previous infection history, exercise and movement, traumas and significant stressors, allergies or sensitivities, and hormone status (ranging from sex hormones and menstrual cycle information to blood sugar regulation).
I also like to review historical labs (typically going back at least 2-3 years if possible) to see if we can spot trends that help us pinpoint issues that could be overlooked without that information.
So in this client with severe eczema on feet + her body, her diet assessment revealed…
- Failure with all dietary changes (highlighting that itchiness should not be blamed on excess histamine).
- Increasing diet restriction made her feel physically worse (ie. vegan diet increased fatigue potentially pointing to already suboptimal nutrient stores that are known to end up deficient on a vegan diet without appropriate supplementation).
- Concern over her frequent consumption of sushi with raw fish – a potential avenue for parasitic infections.
- Low protein intake since only 1 meal/day had any substantial protein in it – everything else was mostly starch-based.
When I assessed her gut function, I found that…
- Increased fiber and water intake wasn’t helping her constipation so continuing to only increase those intakes wasn’t addressing a fundamental underlying problem. She was reliant on magnesium citrate and prune juice to help have 1-3 healthy bowel movements daily.
- Her recent history of painful indigestion made me wonder if there was gastritis or pylori present in the stomach that could be degrading the mucosal lining.
- The severe bout of diarrhea after returning home from India a decade prior curious – did she pick something up there, and if so, what?
We discussed her medication history since this can impact a variety of factors, and I noted that she had…
- Low exposure to antibiotics during her life
- Long-term use of topical steroids for approximately 30-35 years
- 10-year use of oral birth control which is known to deplete important key nutrients
And lastly, in terms of testing, I initially recommended…
- GI Map (functional stool test evaluating for commensal + pathogenic organisms in the large intestine as well as some important gut function markers)
- A panel of conventional blood labs that her GP ran based on the concerns + historical data we collected
- Skin culture of the eczema on feet due to concerning symptoms
Severe Eczema on Feet + Body Case – What We Uncovered
Once all of the information returned, she and I went over her labs so that I was able to help her understand what we found in terms of not just having eczema – but also, for her specific case!
Here’s a quick rundown of some of the significant findings…
- Foot culture revealed THREE different pathogens requiring treatment by her doctor
- Suboptimal nutrients – specifically Vitamin B12 + Vitamin D
- High Eosinophils (on her CBC panel) and a VERY High Total IgE marker
- Her stool test revealed H.pylori in the stomach, an imbalance of gut commensals, a whole bunch of inflammatory opportunistic bacteria including some that are considered possible triggers of autoimmunity AND the presence of candida species. Her one gut function marker – secretory IgA was also low which may have been the result of already low protein intake combined with H.pylori that lowers stomach acid and also impairs protein digestion (and absorption).
Critical Details For Severe Eczema on Feet + Body Case
As I reflect back on her case of severe eczema on feet + body, there were some critical details of this severe eczema on feet + body case that I thought I’d highlight for you.
First of all, it was very clear from her history working with the functional providers that diet wasn’t going to do much to improve her eczema or other symptoms. That’s why I recommended reintroducing all foods that she had been told to remove except gluten.
There was clearly no histamine intolerance here as had previously been suspected by other functional practitioners. They likely assumed from her extreme itchiness that THAT was the problem, but there are so many other factors that drive itch which is why it’s so important to work with a practitioner who is VERY skin literate – not just focusing on autoimmunity or gut problems.
I also asked her to increase her protein intake to 80-100 grams daily (an average of 25 to 35g/meal) since damaged skin requires higher protein needs to support the process of healing.
Secondly, her high Eosinophil and Total IgE picture didn’t make sense given that she really didn’t have any significant allergies that she was exposed to regularly. Her Total IgE specifically was through the roof which increased my already present suspicions that parasites could be hiding in her system. I was already suspicious due to her frequently eating sushi as well as developing GI issues after visiting India as well as other countries that we, unfortunately, find in people returning with parasitic infections after their trip.
As a result, we eventually did another stool test using a microscopic inspection of the sample that’s more specific to parasites which uncovered a helminth (worm) infection as well as more Candida.
Lastly, she had significant gut microbiome imbalances that were inflammatory. That’s important to note since cytokines (aka. Inflammatory messengers) can originate elsewhere in the body, but end up on the skin exacerbating skin conditions. This mess required A LOT of work over many months as well as focused support for phase 2 liver detox so that she wouldn’t flare up with the use of herbs to help rebalance the microbiome.
Where My Client Is Now
Currently, my client + I have been working together for about two years now. We have passed beyond the need to put out huge fires (thankfully!) as we continue to refine the smaller issues that still linger.
Remember – she had eczema since she was a young girl.
She recently shared with me that her hands are soft without any need to moisturize them. There are a few little cuts on her hands, but she used to get 10-20 cuts at a time, especially on her knuckles which left her wearing bandaids on every finger. She was happy to report that she hasn't had to wear bandaids in months — and it’s the first winter she hasn't had to wear any bandaids!
There’s a bit of hypopigmentation on her skin in a few spots, but most areas of her formerly rashed skin are much better.
Her feet are still having a few lingering issues that we’re working on, but NOTHING like what she was experiencing before.
Now she doesn’t even need to moisturize daily!
This past summer, my client reflected that her full body rash was gone and her feet no longer hurt.
And there were several important firsts for her – it was the first time that she could wear shorts in the past 6 years. AND it was also the first time in years that her skin was healed enough that she was able to enjoy swimming in a lake.
She also noted that when she saw her dermatologist recently, they were very puzzled about what she’d done to dramatically improve her skin because of how severe her case was.
In case you’re wondering, my client isn’t using any topical medications, immunosuppressants, or biologic drugs. The only medications she’s used during this journey have been antibiotics or antifungal medications that were prescribed by her doctor based on her skin cultures and issues we found on the stool testing that they felt comfortable treating.
In terms of her diet, the only food she still avoids is gluten – nothing more and is very happy with her diet and ability to eat foods that she enjoys rather than being as restricted as she was before we started.
I have to acknowledge that it’s an honor to support this client on her road to remission and I’m grateful to her that she allowed me to share a piece of her healing journey with you.
It’s important for me to mention that the critical issues and problems will vary from case to case, which is why getting an in-depth case history is as essential as the labs. Knowing the case helps you know what to look for.
That said, please don’t assume that my client’s issues and imbalances are yours.
I share this information to demonstrate how much can be going on under the surface and the massive possibilities of uncovering other imbalances that can be presented when you look beyond the skin.
AND I also want to remind you that healing takes time. It’s not always the fast process that people claim on the internet. Certainly, not all cases that I’ve worked on take this long, but I feel that sharing this hopefully gives you more clarity about a realistic timeline rather than a quick fix.
If you’re looking for help with your eczema case, we consult with adult clients all over the world virtually, so there’s no need to travel to see us in person.
>> CLICK HERE TO WORK WITH US!
We have a process to assess your case, provide you next steps + see if you’re a good fit to work with my team so you can get the help that you need!
If you’ve got any questions or thoughts to share about this, leave a comment below so I can address them.
Thank you so much for tuning in and I look forward to digging deeper with you in the next episode!
