If you wake up with blood under your fingernails, this is for you. I know exactly what that is, because I woke up like that for twenty-two years and I never once said it out loud to anybody who wasn’t a doctor.
If you sleep in cotton gloves, tape your sleeves down, or cut your nails to the quick before bed so you can’t do as much damage — this is for you.
If your partner has ever put a hand on your arm at 3am to stop you — this is for you.
If You Sleep in Cotton Gloves or Cut Your Nails to the Quick Before Bed, This Was Written for You
I kept the gloves in the bedside drawer. Two pairs, because one pair was always in the wash. My husband kept the nail scissors on his side, and on the bad weeks he would hand them to me without either of us saying anything about it, the way you hand someone the remote.
I taped my sleeves at the wrist with the micropore tape you buy for dressings. I slept on a dark towel so I wouldn’t have to change the sheets in the morning. I once went to a hotel with a friend and packed the tape, the gloves and the towel, and lay in the dark hoping she was asleep before I put any of it on.
And none of it worked, not really. The gloves come off at some point in the night. The tape comes off. The nails grow back by Thursday. Every single one of those things is a way of limiting the damage my hands could do, and not one of them is aimed at the reason my hands were moving.
You Are Not Scratching in Your Sleep Because You Lack Willpower While Unconscious
I want to say that again, because it is the sentence that changed this for me, and because I spent two decades believing the exact opposite.
You are not scratching in your sleep because you lack willpower while unconscious. You’re scratching because the itch never switched off, and the itch never switched off because nothing you’re using has repaired the actual fault.
That is not what I had been told. I had been told, in one form or another, at nearly every appointment, that I scratch too much. Which, yes, I do — in my sleep, since I was a child. I had been asked whether I was moisturising. I had been asked whether I had found my trigger yet, and whether I had been disciplined about the food diary. I had been asked about my stress.
So I did what you do. I went back for a stronger steroid and used it exactly as prescribed, and when the course finished it came back angrier than before. I bought the expensive tub of ointment. I did a dairy elimination and then a gluten elimination. I bought a humidifier for the bedroom. I switched to the free-and-clear detergent. I put the thermostat down. I bought silk pillowcases, and then bamboo ones.
Here Is the Fault: Between Your Skin Cells Sits a Mortar, and in Eczema Skin It Runs Short
Here’s the fault. Between your skin cells sits a mortar of ceramides, cholesterol and fatty acids that holds the wall together. In eczema skin that mortar runs short. Water walks out — that’s the dryness and the tightness. Soap, dust, detergent and pollen walk in — that’s the reaction.
There is a gene, filaggrin, that helps build that mortar, and it runs in families. Mine runs down my father’s side. Nobody chooses it, nobody administers it, and no amount of discipline puts it back.
Water Walks Out of That Wall All Night. By 3am It Has Been Walking Out for Hours.
This is the part nobody ever put on the night for me, and once somebody did, the 3am waking stopped being a mystery about my character.
The leak does not take the evening off. From the moment the lights go out, water is walking out through the gaps in that mortar — under a duvet, in a warm room, with nothing going back on. Nobody is applying anything at two in the morning. So the wall gets drier and drier while you are unconscious, and dry skin on a barrier that is already short of mortar is exactly what an itch is made of.
Which is why the gloves and the tape and the short nails were never going to be enough. They are all attempts to police the hands. The hands are the last link in the chain, and they were never where the chain started.
The Red Patch Is the Last Thing That Happens. Not the First.
The red patch is the LAST thing that happens, not the first.
By the time you can see a flare, the wall has been open for days. The patch is the smoke. Everything in my bathroom cabinet was aimed at the smoke. The steroid switches off the alarm. The ointment lays a tarpaulin over the hole. The elimination diet is trying to work out which brick the wind is coming through.
Not one thing I had used in twenty-two years contained any mortar.
A Thick Cream Is a Tarpaulin Over a Hole in the Roof
The obvious question, and the one I asked, is: why not just use a thick moisturiser? Put more on before bed. Put a lot more on.
Because a thick cream is a tarpaulin over a hole in the roof. It slows the water leaving. It doesn’t put a single brick back. That’s why it feels good for an hour and changes nothing by Thursday.
Slowing a leak is not the same as closing it. I had been slowing that leak, religiously, twice a day, for most of my adult life.
The Steroid Calms the Surface. Underneath, the Next Flare Is Already Building.
A steroid borrows an off-switch. It works, and it works fast, and I am not telling you to stop using one — if your doctor has given you a topical, keep using it as directed and tell your doctor what you are adding. I did.
But borrowing is the right word for it. Nothing about it puts mortar back into the wall, so when the course ends, the wall is exactly as short as it was, and the thing that was being held down is not being held down any more. Anyone who has come off a course and watched it return angrier knows precisely what that repayment feels like.
That was my whole pattern. Calm surface. Quiet fortnight. Then the worst night of the month, at 3am, with the gloves back in the drawer.
Active ReLeaf Is a Steroid-Free Gel, $42, That Goes at the Mortar Instead of the Patch
What I use now is a spot gel called Phoilex Active ReLeaf, and I want to be plain about why, because the reason is the same biology as everything above. It is the first thing I have ever used that is aimed at the wall instead of the smoke.
It carries a Triple Ceramide Complex — the mortar itself, put back into the wall rather than laid over it.
It carries stabilised Vitamin D3, which settles skin that is on high alert by working with your own immune cells rather than borrowing a steroid’s off-switch. Nothing is borrowed, so there is nothing to pay back when you stop.
And it carries colloidal oatmeal, Chinese skullcap and bisabolol, which take the itch and the redness down on contact, so you can sleep tonight while the wall is being rebuilt underneath. That last part matters more than it sounds. A wall takes weeks to rebuild, and nobody can be told to just put up with the itch until then.
It is steroid-free. It is $42. I told my dermatologist I was adding it, I didn’t stop anything she had given me, and I’m not telling you to either. I just added the thing that had never been in any of it.
Phoilex Active ReLeaf Spot Gel
Steroid-free barrier-repair gel · 60 mL
- Triple Ceramide Complex — the ceramides, cholesterol and fatty acids the wall is short of, put back into it instead of laid over the top of it
- Stabilised Vitamin D3 — settles skin that has been on high alert for years by working with your own immune cells, without borrowing a steroid’s off-switch. Nothing borrowed means nothing to pay back when you stop
- Colloidal oatmeal, Chinese skullcap and bisabolol — take the itch down on contact, tonight, while the wall is being rebuilt underneath
- Steroid-free, fragrance-free, and safe to use alongside everything your doctor has already given you
90-day money-back guarantee · free shipping over $75
The Itch Eased in the First Few Days. The Flares Spaced Out Around Week Eight.
Honestly, here is what it looked like. The itch eased within the first few days — not gone, eased, and that was the part I noticed first, because it is the part that decides whether you get a night.
The dryness let go over the first few weeks. The insides of my elbows stopped feeling like paper by the end of the day.
And the flares spaced out around week eight. That is the one. I still flare. I just don’t flare every three weeks, and I have not woken up with blood under my fingernails since the spring.
Every time my steroid cream wore off, the flare came back worse. I was scared I’d made my skin worse for good. Switched to this — no rebound. The nights are finally quiet.
I slept in gloves for six years. I stopped putting them on somewhere in the second month and I only noticed a week later, which tells you everything. Nails are still short. Sheets are clean.
My husband used to wake me up at 3am to stop me. He hasn’t had to do it since about week eight. He is the one who told me to write this.
Ninety Days, Money Back — the Tube Can Be Empty
90 days to decide, not 90 seconds
Use it for a full twelve weeks. If your skin is no calmer than the day it arrived, write to us and we refund it — the tube can be empty. You risk the postage, nothing else.
It comes with a 90-day money-back guarantee, which is the only reason I was willing to try one more thing after twenty-two years of trying things. If nothing changes, you send it back and you have lost nothing but the postage.
Keep Everything Your Doctor Gave You. Add the One Thing That Was Never In It.
So there are two options from here.
You can buy another pair of gloves, and more tape, and a thicker cream, and get up in the morning and change the pillowcase. There is no shame in any of that. I did it for twenty-two years and I understand completely why you do it.
Or you can put back the thing the wall was built short of, give it a few weeks, and find out whether your hands at 3am were ever about you at all.
Phoilex Active ReLeaf Spot Gel
Steroid-free barrier-repair gel · 60 mL
- Triple Ceramide Complex — the ceramides, cholesterol and fatty acids the wall is short of, put back into it instead of laid over the top of it
- Stabilised Vitamin D3 — settles skin that has been on high alert for years by working with your own immune cells, without borrowing a steroid’s off-switch. Nothing borrowed means nothing to pay back when you stop
- Colloidal oatmeal, Chinese skullcap and bisabolol — take the itch down on contact, tonight, while the wall is being rebuilt underneath
- Steroid-free, fragrance-free, and safe to use alongside everything your doctor has already given you
90-day money-back guarantee · free shipping over $75
P.S. If you take one sentence from this, take this one: the red patch is the last thing that happens, not the first. Say it out loud the next time you catch yourself auditing last week for what you did wrong.
P.P.S. To my husband, who read this before I posted it and who spent years putting a hand on my arm in the dark: you were never stopping me. You were the only person in twenty-two years who treated it as something happening to me rather than something I was doing.
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