dupixentdiaries-blog

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Current Skincare Regimen

While on Dupixent, this is what I’ve been using on my skin at present --- and to positive results:

Sunday Riley Their Good Genes exfoliating toner has made my skin feel so soft. It really does live up to the hype. I haven’t been using this frequently though --- maybe only twice since I first purchased it a couple of weeks ago --- because I’ve noticed it does make my skin flake after use. (That’s probably the exfoliation part for me, literally.) But the days after are smooth and soft.

I use their Water Cream to moisturize in the morning. It does the job and smells like lovely cucumbers, which feels refreshing at the start of the day.

Witch Hazel I’ve been wiping off the day/makeup with witch hazel, which is a much better fit than makeup remover for me. I reacted negatively to Make Up Forever’s blue-tinted remover in the past and stopped using it. And I also have an allergic reaction to oils so any oil-based remover is out of the question for me.

Witch hazel is an astringent so it feels very cooling and comes handy in a pinch when I get hives or feel itchy. I prefer it to aloe vera in these circumstances.

Other than product... I just pat my face with warm water in the morning. I haven’t regularly used soap on my face in the years since withdrawing from steroids. I did try a sample of Sunday Riley’s Ceramic Slip clay cleanser and it worked well to wash my makeup off. But even if a cleaner seems to work for me, I still prefer going as natural as I can --- meaning, getting by with as little product as possible.

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Second Dose (1 Month)

So...I cheated a little.

I didn’t want my body to get used to Dupixent over time so to keep it from growing reliable on frequent doses, I waited until 30 days after my loading (first) dose to take the second injection.

The absolute best thing about Dupixent so far has been the significant reduction in itchiness. No really, I’m actually getting proper sleep. I used to scratch my facial skin like mad during the night, and that’s not been the case this past month. My skin has also been less sensitive to environmental triggers, such as itchy fabrics. I’ve been able to experience this effect well past the second week. However, I did notice that I would get hives when touching itchy fabrics these past couple of days.

I go by the condition of my facial skin to know that my eczema is being managed. My face has never felt more smoother or looked more cleaner. I will say that even with the Dupixent, I did experience a slight flare when the weather suddenly flip-flopped. Even though it flaked, it did not feel itchy or grow puffy and red like it used to in past flares --- which was awful to experience.

My facial skin also gets a little oily now --- which is amazing! I’ve never dealt with that before. (Believe it or not, I was/am jealous of people with acne. I just wanna rub my dry face against theirs to soak in all that extra grease.) Even though I still flake here and then (depending on the weather; also my apartment is so damn dry, I’ve never been able to keep a plant alive except when I have the humidifier on them around the clock) but before, where my skin would be so dry that the flaking seemed endless, the foundation of the skin is soft.

My skin also seems to better respond to product, which I still only use sparingly. I mainly use a water cream (moisturizer) and witch hazel to wipe off makeup or calm any hives down. Before, almost everything used to make my skin react negatively. (Except for the Biologique Recherche for some time.)

I’m of the belief that I should respond more to my body and less to generalized prescriptions. The positive effects seem to last for me well after the second week, so I will continue with this “personalized” regimen.

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The Loading Dose (Day 5)

How do heroin addicts do this everyday?

Injecting myself hurt like a motherfucker. The first dose consists of two injections and it took a good thirty minutes of inner pep talk for that first shot to puncture skin. I’ve never been shy about needles --- every flu shot, blood test, and ear piercing was no sweat. But these hurt really bad. I think with the thick viscosity of the drug, the needles might be a little bigger, too.

The instructional videos tell you to inject at a 45 degree angle. There really isn’t much direction beyond that besides advising you to pinch your skin as the needle goes in (all the way --- I didn’t do this my first time and the drug fluid made a little mound under my skin) and then releasing your skin as you inject the drug. Injectable regions are limited to your tummy (except two inches around the belly button) and your thighs. 

I’m sure there’s little chance I injected myself the wrong way, but omg the injection sites have been sore for days. I went to a massage a couple of days ago and then the masseuse was rubbing my tummy and thigh, I felt like she was punching me. Hard.

The tricky thing about observing any skin changes is that I hadn’t been flaring for a few weeks when I started Dupixent. But there have been others. I experienced a pretty immediate loss of appetite and fatigue that still continues. I had really intense nausea the past couple of days that’s triggered by any food smells. 

Skin-wise, I definitely feel a reduced sense of itchiness all around, but I still find myself scratching certain spots that itch due to fabric or hair contact. I still wake up with flakey spots on my face but the flakiness is not as extreme. The only real miracle I’ve experienced this early on is that my feet sweat. I’ve never had this happen before, not even with fuzzy socks on. I’ll just be sitting around, exerting little to no energy, and my feet will feel sweaty. This is a pretty exciting change, one that hopefully indicates an improved circulation throughout my body since I’ve noticed that when I flare, I don’t sweat. My face just crusts over and stays waxen-looking until it dries up and flakes off.

I’m still red in some parts of my face. The greatest success has been that I don’t have to moisturize my face every day. It still gets dry but it’s not embarrassingly flakey. Not moisturizing everyday will help my skin not get used to product too quickly.

One big disappointment was realizing that the Dupixent isn’t going to reverse any steroid damage. My shoulders and inner arm areas are particularly scarred. The derm says they look wrinkly because scratching has thickened those areas over a long period of time. Cease the scratching, and they will return to a smoother surface. As long as they aren’t flaring (they look worse when they are) I’ve accepted them as scars. My skin overall hasn’t turned any softer or oilier. It’s still dry but not flaking as much --- and really, that’s all I was hoping for anyways. The insane itchiness, endless flakiness, and puffy redness were the worst parts of flaring for me.

I can’t stress enough how real this nausea situation has been. It’s like I want to upchuck at any smell, food or fragrance. 

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Eczema Skincare Regimen

First, I’ll share the products I’ve had the most success with.

Biologique Recherche

For about a year their P50 toner and Dermopurifiante cream were legit cures for my skin. That P50 was numbing which is the best thing ever for eczema. No itchiness, no scratching, no fucked-up skin. 

I’ve since learned that unfortunately our bodies get used to products and, over time, their effectiveness wanes. After 7 months or so, I used the toner again --- just as a one-off, not continuously --- and it worked fine (numbed, moisturized, and cleared) though it didn’t give the magical results it did that first time.

Sunday Riley

Right now, I’m using the Good Genes serum and it’s working well. Since I don’t want my skin to get used to it too quickly, I’m rotating it with...

SKII Pitera Essence

This was another great clearing, moisturizing solution for me. But I am noticing that I may be developing a sensitivity to it because sometimes I’ll get a little itchy after using it.

The best regimen?

Not moisturizing as often as I can. I’ve actually almost never moisturized the parts of my body with the best skin. These are the parts I’ve never experienced eczema (although some regions did flare up during TSW).

I will try to only moisturize the flaky parts of my face during the week. On weekends, even if I feel dry, I will resist moisturizing to let my skin breathe and develop its own oils.

I don’t use essential oils anymore after finding out I was extremely allergic to jojoba and coconut oils --- and that folks with eczema are generally allergic to any oils. Natural doesn’t always mean better, and I’ve found that my skin is more sensitive to skincare and makeup products that are made with mostly natural ingredients.

Another big thing: I don’t wash my face with any cleansers or soap. I actually haven’t done this for close to two years now. I figure, why strip my skin of the oils it so desperately lacks? I will, however, wash my eyes with soap when I wear eye makeup. (Makeup removers irritate my skin.) But not my whole face. 

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My Eczema History (Day 0)

In the interest of science and community, I will document my Dupixent treatment to the best of my abilities. I hope that by doing so, I will keep track of my treatment while informing those who have yet or are undergoing the same.

I am not sponsored in any way by the pharmaceutical manufacturers of Dupixent besides the copay assistance, for which my insurance company said I was eligible.

I’ve had eczema since I was a baby. Neither of my parents had it, nor did my grandparents from both sides. Growing up, the severity of the flares were inconsistent. Some months, they were virtually nonexistent while during others I flaked like crazy and the itchiness was unbearable. My parents tried extreme diets, acupuncture and Eastern herbal medicine (I am an Asian woman), and OTC hydrocortisone on my skin. The only true relief I experienced was when I was first prescribed a topical steroid, Triamcinolone, at medium strength when I was 10 years old.

I continued to use that for the next decade. I never graduated from that strength, nor did I ever resort to oral or intravenous steroids. I was never properly instructed on how to use topical steroids and, through a series of different derms due to moving around a lot, was continuously prescribed this brand of topical steroid for my eczema. The only departure was a stint with Protopic. The derm who prescribed me that recommended it so that my skin wouldn’t thin from regular steroid use. I remember I couldn’t take the burning, which was very pronounced for me, so I returned to steroids.

By the time I was in college, I was slathering on the topical steroid generously on my face, neck, shoulders, and arms --- even when I was not flaring. The effect was pretty magical. I first noticed the changes in my skin between applications when it would be radiant and taut and clear almost immediately after I used it --- and then dull and dry when I didn’t keep it up. During one winter break, I remember forgetting to bring the Triamcinolone tub with me to my parents’ house. I experienced the worst withdrawal ever: my face turned beet-red.

I dropped everything and traveled four hours back to my dorm to use the topical steroid again. My skin soon calmed down and with regular use, everything went “back to normal.” It wasn’t until I moved to another country three years later that I experienced especially bad RSS and soon thereafter, TSW.

Once I’d read up on experiences similar to my own online, I decided to cease topical steroids cold-turkey. Looking back, I regret that. The swelling and the edema oozing, and the extreme flaking was awful. I managed to still go to work every day by taking hot showers every morning and moisturizing as much as possible. My overall TSW experience was 3 years but I had no idea when I’d started out that the worst was yet to come.

It wasn’t until my last year of TSW, when I came back to the states, that my condition was so severe that I was left bedridden for some weeks. By then, I’d been living with my parents, unemployed. My skin became so dry and hard that it literally felt like tree bark. I couldn’t move my body sometimes. I did notice that the symptoms were cyclical. Even during the course of one day, my skin would feel more pliable at night while it was drier and stiffer during the day. Edema oozed so terribly to the point where I couldn’t sleep on a pillow because it heat up my skin, making it worse. Some mornings, I woke up with my skin stuck to my pillowsheet --- but most nights I couldn’t sleep at all due to extreme discomfort. It was the first time I’d ever seriously considered suicide. Death really did seem the kinder option for me at the time.

A major improvement did occur in the midst of all this once I stopped moisturizing. At one point, I noticed that constant moisturizing --- of any lotion, cream, or essential oil --- was making me drier and drier. When I ceased moisturizing, it was unbelievably uncomfortable. But day by day, the natural moisture of my skin improved.

I’m not sure at what point in my TSW I began to plateau because I started searching for work. And once I started working regularly again, TSW and eczema, overall, was more manageable.

I did go to a new derm during a particularly dry time and was prescribed the same Triamcinolone at the same strength. Whereas before there were never any warnings, either by the physician or on the labels, there were plenty this time around. Heeding them, I only applied a tiny amount for a very limited time during flare-ups, which are usually limited to seasonal changes for me. In the 2.5 years since, I’ve only applied topical steroids about four times and never for more than 4-5 days.

More recently, I’ve switched that out for Protopic which surprisingly no longer burns my skin. I’ve used two applications for no more than 4 days at a time.

Things that are bad for my skin:

1. Seasonal changes  Especially when the usual environmental allergens are at an all-time high, I experience flares. With the drastic temperature changes (hello, global warming), I notice changes in my skin overnight. The biggest characteristic of a flare for me is a hardened, dry crust on my face that will profusely flake off for several days. I don’t really experience a reddening of my skin unless I scratch. Because of this hardening, the inflicted skin (usually my face) also thickens and bloats. I hate this most of all. 

2. Dust mites I will immediately break out in large, angry hives and it will be very painful and itchy for me. Usually two Zyrtec pills do the trick.

3. Sweat + Heat It’s weird --- sweating can be the best or worst for my skin, depending on the temperature. When it flares and gets crusty, it’s nearly impossible for the afflicted skin to sweat. (Believe me, I’ve spent time at the gym trying to sweat, thinking this will loosen up the hardened skin without resorting to moisturizers.) Heat and sweat have less to do with flare-ups and more to do with itchiness for me. 

Things that are great for my skin:

1. My period I really think eczema is hormonal somehow because the first day of every period, my skin is at its best. It feels and looks normal. The week before my period is the worst. I always know it’s coming because I get so dry.

2. Sex It’s seriously the best thing for my skin, I’m convinced of it. Too bad I feel like I have to have great skin in the first place to feel confident enough to find someone to fuck.

3. LSD Not sure how scientific this is but I do believe that a large part of my scratching is psychosomatic. I find myself mindlessly scratching myself when I’m idle, even if there isn’t an itch. The few times I’ve microdosed, I was able to bring this under control, even throughout the night, and as a result my skin was less red and flaky.