Skin Status: 3 Months Post Baby

My baby boy was born 3 months ago. I had a skin-healthy pregnancy with mild-to-moderate eczema. Since giving birth, my eczema has stayed in the mild to moderate range, leaning more on the moderate range.

Possible Protopic Withdrawal Effects

I wonder if my worsened skin is a reaction to my hormone changes or my having to back off a bit from using Protopic. I still used Protopic the last three months, but was low on it for about 2-3 weeks. I’ve since gone back to liberally using Protopic and my skin has been improving. I’ve heard Protopic causes withdrawal effects; it’s something that makes me nervous.

Skin Condition

In the last two months, I’ve been flared up on my forearms, triceps, elbows, shoulder blades, lower back, hips, hamstrings, calves and ankles. There’s bleeding, painful showers and through-the-night scratching, but my face has stayed healthy, so I am grateful.

Current Eczema Treatment

I’m still only on Protopic and I don’t plan on backing off at this time. I don’t want to go back to Dupixent yet if Protopic is keeping my skin from having severe eczema. I worry about Protopic side effects, but also worry about Dupixent side effects. Eczema is an autoimmune condition. I don’t think I’m going to like any medications, because they suppress my immune system and the immune system has a very important job. That said, I don’t want to live with severe eczema. It’s a dangerous game of balance that I am playing. For now, I will not change things and will keep putting my trust on Protopic (as I bite my fingernails nervously).

Doing Well, Sans Dupixent

It's been a four months since I stopped taking Dupixent and I'm happy to share that I've been doing okay! My eczema has maintained mild to moderate, as it became with the help of Dupixent.

Being On Dupixent

I began Dupixent one year ago and took it for eight months before stopping it in order to get pregnant with my second child. I came to the conclusion that Dupixent, along with periodic use of Protopic (which I also took before Dupixent), significantly improved my skin. Aside from healthier skin, Dupixent also caused an intense face-flushing reaction to my first sip of alcohol (very red and super hot), but it would wear off once the alcohol was out of my system and I would be able to have more drinks at that point without the flushing. 

Based on available animal testing data, my allergist and I estimated that I should be off Dupixent for three months before trying to get pregnant. It's now been four months since I stopped Dupixent. 

Being Off Dupixent

I was scared to get off Dupixent, but it's been okay - my skin has not worsened. Currently, I have flare-up spots throughout my body, but I can sleep, there's no shedding and the spots are containable with Protopic. And there are even times when my flare-up areas are sparse. Let me be clear: the only products I'm using are aquaphor on my face and Protopic for any flare-ups. I'm not even using an antihistamine at this point and have rarely touched my steroid creams. I find my healthy skin situation to be remarkable.

I do still have a face-flushing reaction to alcohol, but it is very minimal. Does this mean that Dupixent is still in my body and whatever's left behind is still helping? Or is the face-flushing caused by something else — maybe Protopic, as a few fellow eczema fighters experience? If so, did Dupixent permanently improve my body somehow? Who knows?! Time will tell. For now, I will continue to live my life, grateful that it does not revolve around my eczema and staying positive that the future will stay on this healthier path. And I will keep my fingers crossed that when I do get pregnant again, I do not experience the eczema nightmare my first pregnancy triggered. I'll take it one itchy day at a time. It's easy to do when the days are unbearably itchy!

My Pregnancy with Eczema - Updated

2/16/19 update: 2 years after my first pregnancy, I’ve realized I was probably going through Topical Steroid Withdrawal (TSW). Read more about it on my post about my second pregnancy. Below’s post is unedited and how I reacted to my first pregnancy at the time.

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I  gave birth to my first baby 15 months ago after a roller coaster pregnancy full of challenging eczema flare ups. True, I'm a chronic eczema fighter, but my ten plus years of eczema did not compare to the eczema I experienced during my pregnancy. 

1. My Eczema was Pregnancy-Induced

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For the first few months of my pregnancy, I blamed the disruption of my eczema treatment for the severe flare ups. When I wasn't pregnant, I used acupuncture and took herbal pills to control my eczema, but I had to stop both when I became pregnant.

Months later, I changed my conclusion: my pregnancy itself was the reason for my severe eczema flare ups. Maybe it was the pregnancy hormones or my body reacting to the changes in my body, but I blame my pregnancy for causing eczema. 

2. Doctors Told Me Steroids are Safe and Okay

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My OB/GYN doctor told me that I could take a steroid pack to help handle my eczema. According to my doctor, this medication does not cross the placenta, so is fine.

What a relief I felt! I almost got a steroid pack, but then ...

3. Doctors Told Me Steroids are Dangerous and Not Okay  

All my other doctors - allergists, general physicians, even my pharmacist scared me away from taking oral steroids. They all resorted to "ask your OB/GYN," because it seemed they didn't want to be held accountable for a formal recommendation. Ultimately, I didn't take any oral steroids while I was pregnant.

4. Second Trimester: Horrible Eczema

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Months four through six were the worst for my eczema, although it started in month three. By "worst," I mean the worst eczema I've ever had in my life. It was the worst few months I've ever experienced, complete with debilitating, leaking eczema all over my face and body that didn't even let me sleep for days at a time. There was edema, weeping, flaking, redness, hot, dry, full of lines. My recovery was swift, hard to believe and with no explanation. After 3 - 4 months of all-consuming eczema, my skin cleared up. Redness went away. Swelling went down. Al the lines on my face left, so I looked 20 years younger. And no more oozing. I could finally sleep. 

During the fifth month, my eczema drastically improved on its own, similar to how morning sickness goes away during the second trimester. It felt good to finally shift my attention to the little baby I was baking. 

5. Last Weeks of Pregnancy: Eczema Returns, Not as Bad

Late in my third trimester, my eczema came back, although it was not as severe.

6. Giving Birth with Eczema

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My skin didn't look or feel great when I went into labor, but at least my body and face didn't feel like a statue. My eczema didn't get in the way of my giving birth, thankfully. And my husband and I welcomed our first child!

7. Post Birth: Eczema and Medication

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After being shamed by doctors to not take steroids while pregnant, I kept battling my eczema without much help. However, I went straight to the pharmacy to pick up my Prednisone pack as soon as I gave birth. Unfortunately, my pharmacist lectured me for taking oral steroids while I was breastfeeding. I have no words for that. 

After I gave birth to my daughter, my eczema stuck around. My face looked purple when I took her to baby yoga. My skin wasn't as horrible as my pregnancy's second trimester, but it was definitely not good. It has since turned around and my skin is beautiful, with only mild-to-moderate eczema due to my getting a new allergist and starting Dupixent and Protopic earlier this year.

8. Getting Pregnant Again

Today, according to my OB/GYN, I can stay on Protopic if I get pregnant again. Dupixent, however, is not safe. I took my last Dupixent injection two weeks ago. I will stay off it for about 3 months, then will start trying to get pregnant again. I'm more terrified than excited at this point and am keeping my fingers crossed that my second pregnancy produces another healthy, beautiful baby, but without the eczema torture this time. 

Return to Normalcy!

It's been 3 good days in a row. I still can't believe it! My face is basically back to normal. No swelling, no shedding, no redness, no weeping. It's a tiny bit itchy and a tiny bit dry, but it looks fantastic.

And much of my body has healed - my legs are still rashy, red, itchy and with scabs, but they are getting better.

Why the miraculous recovery? I'm not totally sure. At the end of last week, I caved and started using steroid creams on my body. Soon after, my face cleared up. But I didn't use steroid creams on my face ... It's a little odd. My body is still itchy - not as bad as it was, but still itchy. I've been sleeping much better the last few days, but last night, I did have a disruptive night because of my itchy body. It's almost as if I still have eczema symptoms on a body that is disguising itself as normal. I think the reality is that my body is trying to stay flared up, but the steroid creams are pulling it back. An internal eczema fight! I know who I'm rooting for ...

Here's the deal on steroids and my pregnancy: I've been avoiding them throughout my entire pregnancy and it has been hell. My dermatologist and allergist told me to not take them and my OBGYN all along has said they are okay. I saw my OBGYN last Friday and asked why she had a different opinion. She said people tend to overreact with pregnant woman and very confidently said that steroid creams and pills are okay during pregnancy. She guaranteed that the medication doesn't cross the placenta. So yes, it's still a category C medication, where a woman should only take it if the benefits outweigh the risks, but the reality is that the risks are itty bitty. I take itty bitty risks all the time. Getting in my car and driving in the rain is a risk, for crying out loud.

So, I ordered a steroid pack. Coincidentally, my skin got better at the same time, so I didn't start it, but I plan on using it if my skin turns again. I'm not going back to how it has been the last five months. I'm going to focus on my pregnancy instead of my skin. I swear, I can feel her kicking more all of a sudden. It's probably because I'm not obsessing over my itchy skin. I am full of hope, optimism and happiness right now! 

Steroid Conundrum While Pregnant

The thing about chronic eczema is that it needs to be treated continuously. If you're lucky, you'll find something that works for a good amount of time. Nothing will work forever, since the body changes and adapts. For me, herbal pills seem to help.

Steroid packs help, of course, but they're not great. Once the pack is finished, the body rebounds pretty hard at times and the eczema comes right back, maybe even worse. Wouldn't it be wonderful if steroid packs had zero negative side effects and could be taken forever? The reality is that they're pretty unhealthy and I try to avoid them as much as possible. What about steroid creams? I gave those up years ago after I lathered myself with them for years. I am quite certain that I permanently damaged my skin around my eyes and mouth (two main eczema-prone spots for me) and will likely look like a 120-year-old by the time I'm 60. Thus, I am super hesitant about using steroid creams. 

Insert my pregnancy into the mix. Now I'm unable to take my herbal pills and my eczema has crept into unbearable levels. My dermatologist confirmed the mess on my face is indeed eczema and nothing else. She gave me steroid creams and told me to hold off on the steroid pack, since "it could be worse." (It could be worse! Oh, eczema.) Both steroid creams and steroid packs are category C treatments. In the pregnancy world, category C is a label used for products that have been known to hurt animal fetuses, but enough studies haven't been done to confirm the same for humans. A pregnant woman is advised to only use category C products if the benefits outweigh the risks. Well, damn. Put that way, I'm going to avoid all category C products unless absolutely necessary. I'd rather not sleep well and tear my skin out rather than hurt the growing baby inside me. My dermatologist confirmed the munchkin isn't getting hurt by my flare-up. It's all superficial and only felt by me. Except the not sleeping well, of course. 

So I will continue to hold off. If, later on, I'm so unhealthy that it's affecting my pregnancy, I'll reconsider the steroid creams and packs. Even though my OBGYN is okay with my taking the medications, I'd rather stay on the safe side. Scratch, scratch, scratch ...