You know how it goes. You look amazing at 3pm on a Wednesday when no one’s around, but the second you need to leave the house for something important, your skin decides to have a meltdown.
That’s my experience anyway. And in my case, by meltdown I mean an eczema flare-up of epic proportions.
Not only in the creases of my arms, legs and stomach but sore red rashes covering my hands, around my mouth, across my cheekbones and eyes. The pain and discomfort is unbearable. At its worst, my eyes swell up so much I can’t open them.
On a good day, however, my skin is calm, clear and glowing.
Such is the contrast that I even warned my now fiancé in the early weeks of our relationship that being with me can be like dating two different people. There is the socially acceptable face and the one that society shies away from.
Now 28, I’ve grown used to shapeshifting between the two – and dealing with people’s reactions.
While managing the physical side of eczema takes up a lot of energy, the emotional side is just as draining. It has taken years to think of myself kindly during flare-ups, to fully accept both sides of me.
In January 2021, inspired by others on social media dropping the facade about everything from weight to acne, I took a huge leap and announced my eczema with a post on Instagram, including a photo of my skin at its most inflamed and painful. Embarrassed and fearful of how others would react, I had hidden this part of me for so long.
Katie Mackie says that during an eczma flare-up her eyes can swell so much she cannot open them
Katie says that on a good day her skin is calm, clear and glowing
Instead of judgment, however, I was met with overwhelming love and support. My inbox filled with messages from people admitting: ‘I’ve got eczema too.’
Suddenly I wasn’t alone. And that felt huge. I had struggled with the pain and shame my whole life. I have had eczema since birth.
Some of my earliest memories are of screaming as a toddler when my mum gently lowered me into emollient or oat baths, my skin burning as it did when she applied steroid creams. As I reached school age, my eczema appeared in the crooks of my arms, backs of my knees and on my stomach – areas prone to friction and sweat, which exacerbates the condition.
And it didn’t go unnoticed. In PE lessons, kids would point at my knees and ask why they were so red. I recall my best friend reaching to hold my hand as we played, then recoiling when she saw the raised, red, scaly lesions all over it. ‘What’s that?’ she exclaimed. It made me ashamed and very self conscious.
During my teens, eczema appeared all over my hands and face – most sufferers experience it moving to different parts of their body. People would stare and say ‘oh, what have you done?’ as though I was to blame.
The eczema on my hands is known as pompholyx dyshidrotic, characterised by intensely itchy, watery blisters. If I accidentally knocked them, I’d be on the floor in pain.
This happened during my GCSE maths exam, when it was so severe that my skin cracked and bled onto my exam paper.
I eventually raised my hand for help, knowing that doing so would cause some of the other 250 pupils in the exam hall to stare while the invigilator ran over with tissues and sympathy. Later, getting dressed up with friends also presented problems. The first time we went clubbing aged 18, we all applied fake tan. Never again. It clung to my eczema, turning it deep red and making it burn. I scrubbed to get it off, which only made it worse.
The eczma on Katie’s hands is is known as pompholyx dyshidrotic – characterised by intensely itchy, watery blisters.
The eczma first presented itself when Katie was a teenager
That didn’t stop me trying to cover facial eczema with lashings of foundation, which again only intensified the pain. Still people would stare in the street. A few immature boyfriends responded to my eczema flare-ups with awkwardness and even disgust.
During my second year at university in 2017, I also developed alopecia areata. I lost several patches of hair, mainly around the sides and back, with one large bald spot at my crown. My insecurities were so pronounced it led to panic attacks almost every day. Completely drained, I had never felt lower.
I tried everything to get some relief – including a two-month vegan diet and cutting out caffeine and sugar – but none of it made any difference. I started wearing clothes bearing logos or slogans purely so I could tell myself that when people stared, they were just reading what the words said, rather than looking at my hair and red and flaky face.
I sought help from the university’s counselling department, initially to deal with the impact of alopecia. When my amazing therapist spotted the eczema on my hands, we addressed that, too.
I started cognitive behavioural therapy (CBT), which taught me how to challenge my thoughts, take back control in difficult moments and gently piece my confidence back together.
Having the tools to recognise what I was feeling and respond to it, rather than just react, was life-changing.
By my third year at university, the alopecia was starting to heal, and having a new flatmate who was open about her own eczema was a revelation. Finally there was someone who understood.
Slowly, my feelings of desperation shifted to anger. Why had I been trying so hard to cover up something that’s not my fault?
The more I learned about marketing strategies as part of my degree, the more I realised how much of it is designed to profit from insecurities. That frustration became fuel. That inspired me to launch my Instagram account, followed by the community page and Itch N Bitch podcast, aimed at connecting with people who understand the mental health consequences of a severe skin condition. I now have more than 25,000 followers.
Katie used cognitive behavioural therapy to take back control in difficult moments and gently piece her confidence back together
After my beloved gran died in 2023, I experienced the worse eczema of my life, a reaction to the grief and stress. But I refused to hide away. Instead, I shared photos of the flaring on my face, neck, eyes, hands and body.
At the same time, I started to experience streaming eyes and my face would swell as though I was going into anaphylactic shock. When the swelling retreated, eczema would erupt.
Clearly, I was experiencing an allergic reaction that was triggering my eczema, too. Though my GP was happy to send me away with steroids, I pushed for a referral to a dermatologist and then for allergen tests 18 months ago. They revealed I’m allergic to grass and tree pollens as well as certain fragrance mixes found in deodorant and perfume. Even a minute on a packed train surrounded by people wearing either can cause historic areas of eczema to redden and prickle.
Stress is my biggest trigger so I’ve learnt how to offset it, declining invitations that make me feel overwhelmed and knowing when not to overcommit at work or to push myself too hard.
My biggest cheerleader is my fiancé Solomon, also 28. We met nine years ago before I went to university when I was having a rare six-month spell without any eczema. He has always been so understanding through subsequent flare-ups, a legacy of him suffering from terrible acne in his teens. He will do the dishes and the laundry without ever making me feel guilty that I can’t.
These days I’ve learned to avoid dairy (which makes my skin itchier), stick to healthy, balanced meals and have switched to hypoallergenic bedding and cotton clothes, avoiding wool and scratchy textures.
I also have an air purifier in my bedroom at night – a real game changer. The trusty toolkit I carry everywhere contains hydrating mist spray, soothing ice packs that I keep in the freezer and antihistamines.
As a result, I’ve just had the best six months in terms of my skin. I still post on bad days though. If pictures of my red raw skin help even one person feel less alone, then it is worth every uncomfortable stare.
Follow Katie on @Mackies_Moments and @itch_n_bitch
As told to Sadie Nicholas
