In the years that I've been racing and competing in fellrunning and endurance events, there is a common thing that has either stopped me from considering some challenges, or really destroyed me after others. That common factor is not fatigue, it isn't injury and it isn't the inability to push through when it matters most. That thing is my skin.
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| Irrelevent picture! |
For as long as I can remember, ecsema has been an ever present part of my life- to a greater or lesser extent. Sometimes flare-ups happen, sometimes they don't. But what I can predict with utter clarity is that if I'm out in wet conditions for a period of time- my skin is going to suffer for some time afterward. Not only that, but if I run hard for a day and try to go to bed without a shower- covered in sweat and grime- I'll itch for the entire night, not get any sleep- and although I might be able to "race" the next day, the following 3 weeks will be utter misery from a skin point of view.
This isn't just hands, or just legs or whatever, this is full blown, entire body itch to the point of - and beyond- bleeding. It isn't pretty. And this is the exact reason why I'll always opt for a LONG event where you just don't stop- like the Spine, over a 2 day event where you "sleep" in the middle. If there isn't a provision for showers and dry clothes the next day- uh-uh- that race isn't going to happen for me.
It's kind of annoying with long distance walks and cycles as well. If I'm doing a multiday cycle or fastpack, not having somewhere to stop at the end of the day and get clean is a real bind- and I haven't really found a way around it. If you look back to my attempt to bikepack to Kielder, it was at the end of the first day when I'd gone pretty hard over the hills, and camped in a random field- coated in sweat, that sleep simply didn't happen. This subsequently meant I was knackered on day 2, and kyboshed me (along with ridiculous temperatures) for a full attempt.
So. It screws you up. What can you do about it?
For years I have been trying various lotions and potions... trying to ignore it- and for years it has really screwed me up. Part of the awfulness of recovering from long and wet days in the hill hasn't necessarily been the physical tiredness, but the feeling of trying to rip my skin off, and the consequent inability to sleep and rest.
I have gone through the usual arguements with a lot of people (and dermatologists)- I'm not allergic or intolerent to foods- my diet can stay the same for a lengthy period and my skin will go through phases of good to horrendous.
The shower gel I use, I have used for literally decades- for the very reason that it seems to be ok and doesn't destroy my skin on a regular basis- so it isn't that.
Equally, I've probably been through more than my fair share of versions of treatment. For anyone that tells someone with ecsema to "swim in the sea"- basically- shut up. You know how the phrase "to rub salt in a wound" means to make something more painful... having ecsema is like having an entire body of wound. Sticking that in salty water is like bathing in stinging nettles. Don't suggest it.
Also- moisturiser... the eternal "this is what you need to do" thing. All well and good until you sweat, and then you have sweat trying to get out of blocked pores, and building up in an incredibly itchy layer inbetween your skin and the cream/oil based moisturiser- and no. It is not pleasent at all.
Steroid creams are de rigeur and are a necessary part of skin recovery. They aren't great- yet, they do work. Last year I saw a dermatologist who finally listened to me and realised it isn't my diet, my soap, my fitness regime, or anything like that- it appears I'm kind of allergic to my own sweat. Well, not exactly- it's water, or dampness on my skin for long periods of time. That starts the itching, which causes an itch/scratch response, which self perpetuates until I can get it dry and get some steroid cream on.
There was a suggestion that there might be a medication that might help. Not to the point of a miracle cure (though at one point in a flare up, they did put me on Prednisalone for 2 weeks, which was LITERALLY a wonder drug in terms of clearing up my skin, but is really really NOT something you want to be on long term). The drug was methatrexate- a Disease Modifying Anti-Rheumatic Drug (DMARD) and is generally used to treat Rheumatoid Arthritis and other things of that ilk. It can be a pretty potent drug and I was given the warning that it is metabolised by the liver, so it would probably be a very good idea not to drink alcohol due to the fact THAT is also metabolised by the liver- and you probably don't want to make it work too hard due to the fact you only get one....
It wasn't much of a decision to be honest... the prospect of having better skin and not being able to drink alcohol, or continue on as normal. I stopped drinking- not much of a hardship to be fair- and that was August/September last year.
So how are things going?
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| Worst nights "sleep" ever |
Well, I would be lying if I said that everything was hunkydory and I have no issues with ecsema now. Depending on the season, how stressed I am and what I've been up to, it does come and go. I haven't really had the opportunity to get out and do multiday expeditions this year because of one thing or another, but am hoping to do so pretty soon next year. With any luck, the combination of methatrexate and judicous amounts of steroid cream, I should be able to get through a few days without tearing myself apart.
I'm a year in now- has it been worth it?
Yes, I think it has. Ok- I get a monthly blood test to make sure my liver function is fine (I then put everything into an ever expanding spreadsheet- so I'm treating it as a variable that I can track through my training as well). My skin is generally better- though it has to be said, I have had a couple of major flare ups- one in August and one in November- and while this can be attributed to stress and weather etc. it is a good reminder that the issue isn't completely cured, and still needs to be monitored and have adjustments made for it.
One other thing that was a game changer was a podcast about ecsema, which I have since directed numerous other sufferers toward. If you have ecsema- whether you are a sports person or not- the PCKP podcast No.67 should be on your mandatory listen list. Find it HERE
Dr Rachel Hilton is one of those dermatologists you wish all dermatologists were like. She appears to actually know what she is talking about- and there are some real knowledge gems in here. (Yes, it is aimed at medical professionals, but give it a listen- even if you aren't, you'll take something away from it).
So am I cured? No.
Will I be doing any Mountain Marathons? No.
But hopefully I should be more comfortable doing consecutive day travel, running or cycling with less repercussions. We shall see.
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