A thick skin from scratching

An elephant skin due to eczema.

When my son Armaan started scratching, the first thing I always said to him was: 'don't scratch'. Some days I repeated this all day long. But when he kept scratching, until open wounds appeared and started bleeding, I sometimes even got angry with him. The feeling of helplessness and not knowing what to do came up more and more often, with emotions that fluctuated between anger and despair.

For many people, eczema is more than just a skin problem; it is a constant battle between the unbearable itch and the will not to scratch. The urge to scratch can be so intense that it can be almost impossible to resist. In addition to the visible effects, such as skin damage, scarring and infections, eczema also has a deep emotional impact. It requires not only a literal 'thick skin', but also a figurative one, because the battle is both physically and mentally tough.

The literal fat point
People with eczema know it all too well: that endless cycle of itching and scratching. This is not just a matter of discomfort, but a physical response of the body that can lead to thickened skin – a condition called lichenification. The constant scratching damages the skin, causing it to develop a rough, leathery texture. A literal ‘elephant skin’. This is the skin’s way of trying to protect itself, but eventually it gets stuck in a vicious cycle of inflammation and irritation.

Armaan had been suffering from this thickened elephant skin for years, especially behind and on his knees and in his neck. In addition to the painful cracks that formed and burned in the thick skin, it also looked unpleasant.

How does thickened skin develop?
With eczema, the skin barrier is already weakened, causing moisture to evaporate more quickly and allergens or irritants to enter more easily. This triggers an inflammatory response that causes even more itching. Scratching irritates the skin further, leading to more inflammation and eventually a thickening of the skin. Although the skin tries to adapt to this constant stress, it actually becomes more sensitive and vulnerable.

In addition to discomfort and pain, thickened skin can also affect your appearance and self-confidence. You become aware of the visible areas, especially if the thickening is on prominent parts of the body, such as the arms, neck or face.

Children increasingly asked my son why he looked different. "He looks like a grandpa," was said. He was only 3 years old then...

The figurative thick skin
In addition to the physical changes that eczema causes, the condition also brings emotional challenges. People with eczema, especially those who have had it since childhood, often learn from an early age to deal with comments, stares and the feeling of being ‘different’. This causes them to develop not only a literal thick skin, but also a figurative one – as a protection against the emotional impact of these reactions.

The Emotional Toll of Eczema
Living with eczema can be a daily test of patience and endurance. In addition to the physical itching and pain, there is the mental strain: the fear of new flare-ups, worry about the appearance of your skin, and the frustration of finding the right treatment can take a heavy emotional toll. Many people with eczema experience feelings of shame, insecurity, frustration, and sometimes even social isolation.

When Armaan's resistance is lower and the first signs of a flare-up are visible on his skin, the itching often starts at night. We then plan an extra siesta during the day, because rest often has a healing effect on him. Although we try to explain this to Armaan as best we can, it is difficult for a toddler to understand. He often does not want to sleep during the day and starts the discussion with: 'But my friends are playing outside and I am not allowed to join in now.'

Yet eczema can also give strength. Over the years, people with eczema often build emotional resilience. They learn to deal with setbacks and find ways to protect themselves from negative energy from outside – whether that is physical itching or nasty comments.

If I have a cut on my finger, I’m quick to complain that it burns in the shower. But Armaan, with all the damage and open wounds on his skin, has developed an extremely high pain threshold. People often comment on how painful his skin looks, but he doesn’t feel that pain anymore because he’s used to so much worse.

How do you repair thick skin?
A good skincare routine is essential to soothe and nourish the skin, especially for people with eczema. A greasy protective layer is essential, but how greasy it should be varies from person to person. After all, eczema and its triggers are different for everyone. Between flare-ups, Rivaana’s daily maintenance cream is usually enough to nourish the skin and form a light, occlusive protective layer. If the skin feels too dry, an extra greasy cream can be a good addition for extra protection. Vaseline or cooling ointment are often recommended, but at Rivaana we recommend a natural greasy ointment, such as a cooling ointment based on beeswax.

Rivaana's daily maintenance cream also contains natural ingredients that help restore thickened skin. This recovery process is initially recognizable by the thickened skin peeling, creating space for new skin. During this peeling process, it is important to regularly replenish the skin, either with the maintenance cream alone or in combination with a greasy ointment.

Do you also have experience with an 'elephant skin'? Share your story, because you are not alone. Recognition and understanding from others with eczema can offer a lot of peace and support.

-Anisha Biharie, Founder Rivana.