Photo of chef Elizabeth Falkner cooking in a professional kitchen. She is leaning over and adding an ingredient to a plate.Elizabeth Falknerโ€™s career was just starting to take off. She was in her early 30s, a chef and owner of a trendy San Francisco restaurant, when she began to experience painful, itchy skin rashes and lesions on her legs.

At first Elizabeth chalked it up to irritation from wearing shin guards โ€“ sheโ€™s an avid soccer player. Then the rashes appeared on her arms and hands.

โ€œIt kept getting worse โ€“ it was a burning sensation,โ€ she says. โ€œI went to my doctor and was diagnosed with moderate-to-severe atopic dermatitis.โ€

It didnโ€™t help that Elizabeth ran a high-profile restaurant and cooked every day in a hot kitchen. At one point her doctor suggested she stop cooking for a while. Her reply: โ€œWell, thatโ€™s not going to happen, not at the peak of my career.โ€

Atopic dermatitis runs in Elizabethโ€™s family. She has worked with her doctor to identify what causes her skin to flare up, as well as create a treatment plan.

Now 50 years old and living in New York City, Elizabeth no longer works daily in restaurants but continues to cook as a celebrity chef and is a recognizable face on TV cooking shows on top of being an author.

Elizabeth is raising awareness of moderate-to-severe atopic dermatitis through a collaboration with the National Eczema Association, Dermatology Nursesโ€™ Association, Sanofi Genzyme and Regeneron Pharmaceuticals, Inc. They launched UnderstandAD.com to better educate people about atopic dermatitis and raise awareness about the physical and quality-of-life impact of the disease.

Allergy & Asthma Today recently sat down with Elizabeth for a Q&A interview:

Q: How did working in restaurants worsen your symptoms?

A: Restaurants are a highly stressful line of work and itโ€™s a hostile environment for your skin. When I had symptoms on my legs, I would march through it. But when it was on my hands, it was really bad and really painful.

As a chef, youโ€™re constantly working over heat and washing your hands. Youโ€™re constantly around different foods with different ingredients โ€“ your hands are in a lot of different types of food, whether itโ€™s garlic, tomatoes, lemon, flour, chocolate โ€ฆ anything. Itโ€™s pretty harsh activity for your skin.

Symptoms would go away and then come back. I couldnโ€™t scratch it because that made it worse. I couldnโ€™t wear gloves because that would make my hands sweat. I would hide my hands and hide the pain, especially when I was at the front of the restaurant.

Even though my doctor recommended I back off from cooking, I was determined to keep at it. I didnโ€™t let it stop me.

Q: What was your treatment?

A: I have tried over-the-counter and prescription lotions, creams and ointments, as well as homeopathic remedies. They work for a while, but never really take the symptoms away. You have to monitor it to see if itโ€™s helping your skin, and if itโ€™s not, then you try the next one.

My doctor and I have talked about lifestyle changes. I stay active and eat healthy. Iโ€™m constantly trying new recipes and using fresh ingredients that are in season. I donโ€™t eat fast food or processed food โ€“ and Iโ€™m positive thatโ€™s helping me on multiple levels with my health.

Q: Stress is a common trigger for atopic dermatitis. How do you handle it?

A: Stress is definitely a trigger for my flare-ups. I deal with it by being very physically active, even more so now that I donโ€™t have the pressure of being in a restaurant 12 hours a day. Iโ€™m training for the New York City Marathon. I do yoga, pilates and a Korean swordfighting fitness program. I recently got certified in scuba diving. Anything I can do that is physical reduces my stress โ€“ and itโ€™s fun.

Q: Do you think atopic dermatitis is not taken as seriously as it should be?

A: Definitely. Itโ€™s a disease thatโ€™s affecting so many people but you donโ€™t hear about it very often. Everyone thinks itโ€™s just a skin rash that you get, and itโ€™s way more than a skin rash. And itโ€™s hard to explain to people because itโ€™s not like a mosquito bite. Itโ€™s an inflammatory reaction and it feels like itโ€™s always there.

Even though I have atopic dermatitis, I am someone who said, โ€˜Donโ€™t make a big deal out of it.โ€™ But it is a big deal. UnderstandAD allows me to talk about it with other people. I never had that. I actually got emotional when we were shooting video for the website because I thought, โ€˜My gosh, all those years I just blew it off.โ€™

Because a lot of people with the disease donโ€™t talk about it, like I did, it can be alienating. I know for a lot of people, they just want to stay home and not do anything. They want to hide it. So being able to tell family, friends and colleagues about it is important.

Q: What advice do you have for people with the disease?

A: Thereโ€™s no cure for atopic dermatitis, but there are a lot of different ways to manage it โ€“ and itโ€™s different for everybody. There has been a lot of research on atopic dermatitis recently, so itโ€™s important to discuss the disease and develop a treatment plan with a doctor or dermatologist.

And finally, just try not to let it take over your life. You canโ€™t let any disease do that to you. People are strong and can work through things. You donโ€™t have to go it alone.


Atopic Dermatitis Defined

Atopic dermatitis is a chronic inflammatory skin disease. Its cause is unknown, however scientists believe it results from allergic inflammation due to environmental factors and family history.

Common symptoms include intense itching, swelling, skin dryness or cracking, redness, crusting and oozing.

Exposure to food and environmental allergies โ€“ including pollen, mold, dust mites and pet dander โ€“ can worsen symptoms, as can irritants such as wool or manmade fibers, soaps, dust, sand and cigarette smoke.

Talk with a doctor if you or your child experience symptoms of atopic dermatitis. There is no test to confirm the disease; however you can be tested for allergies to determine what may trigger it.

โ€“ National Institutes of Health