Trauma factors are defined as any situation that is a threat to life. These include life-threatening accidents, being involved in military combat, being abducted or witnessing an abduction, experiencing a natural disaster, being diagnosed with a life-threatening disease or being physically or emotionally abused. Although the symptoms that occur after a traumatic situation are not permanent, they can result in diseases that require treatment.

In particular, reliving similar traumatic situations more than once, trying to escape from situations that remind the individual of the trauma, continually visualising the trauma through dreams and flashbacks can all occur. These occur due to acute stress or post-traumatic stress disorder. Acute stress and post-traumatic stress disorders are treated by psychiatric specialists.

What must be done to prevent these disorders?

It is firstly necessary to understand the symptoms that a traumatic situation will cause. The first symptoms after experiencing trauma are surprise and the inability to accept the situation. Subsequently, feelings of fear, despair, anger, guilt, unhappiness, and remorse set in alongside a feeling of hope and relief due to the danger being over. Sleep deficiency, tiredness, nightmares, loss of memory and concentration, headaches, loss of appetite and motivation, back pain and heart palpitations may also accompany these symptoms.

The same trauma does not cause the same symptoms in everyone. Furthermore, even if the trauma is destructive, it does not cause situations that require clinical treatment in the majority of people. Certain individuals will struggle more, especially those who have experienced significant trauma in their childhood years, those who have certain personality disorders, who do not have good familial and friendship support, who have had considerable stress in their recent past, who consume too much alcohol, or are more susceptible to clinical diseases.

What must be done in the case of trauma?

Firstly, give it some time. It may take weeks or even months to understand, accept and learn to live with what has happened. Try to evaluate what is going on. Instead of thinking about what could have happened, try to evaluate what has happened and how you can prevent it next time. Contact others that have experienced similar trauma. It will be useful to get together with others that have been through similar situations and exchange life stories. This is why it is useful to create support groups and charities. Cry. Do not avoid expressing emotions. If needed, then cry Call for help and support. It may be useful to talk about and discuss the situation. It is important to get support from family and friends.

Spare time for yourself. You may sometimes want to be alone or spend some time with certain people. It may be useful to limit your other duties and spare time for yourself. Talk about the topic. You may want to talk about the topic from time to time. This will comfort you. Sometimes, talking about the topic can increase the emotions of sadness and result in crying. Do not shy away from this.

Return to your normal life. Return to your normal life as quickly as possible. Eat regular meals even if you do not have an appetite. Return to your previous exercise and sport activities even if you may struggle to do so. Try to return to your normal activities with friends. Apart from the time that you spend talking to support groups, try to return to your normal activities and enjoy time with your friends, spare time for life. Manage your time well. The confusion of the trauma may have turned your whole life upside down. It will be useful to plan and manage your time well. Try to use all possible support factors. Try to use all available support groups including friends, relatives, family, social aid and try not to remain alone.

Do physical exercises. Exercises such as running, bike riding, walking going to the gym etc. may be helpful. Relaxing exercises. Do relaxing exercises such as stretching, breathing, yoga and go for a massage. Art activities. Join musical and artistic activities. Do not let the mixed emotions worry you. Trying to lock up the emotions will cause them to build up and make it more difficult to overcome in the future. Avoid using substances such as alcohol or drugs to deal with your problems and worries. Due to the fact that we often make inappropriate decisions because of our emotional state at this time, do not make life-changing decisions. Postpone them.

Regardless of all this, if you have stress due to the trauma you must seek the help of a professional. This is especially the case if you relive similar traumatic situations more than once, try to escape from situations that remind you of the trauma, and continually visualise the trauma through dreams and flashbacks, where psychiatric help is recommended.

Assoc. Prof. Dr. İpek Sönmez
Head of Department of Psychiatry

Hand Eczema

Our hands are at the forefront of our social interaction and their appearance is important. However, when the weather starts to cool down, our hands start to dry up, causing chapping and even bleeding. Hand eczema, which is an allergic reaction seen
in both adults and children, is a disease that can both be treated and prevented with simple precautions.

What is eczema and hand eczema?
Eczema is an itchy skin disease that causes redness, scaling, and blisters. Hand eczema is where the eczema forms in the palms, fingers and/or the back of the hand. It
causes dryness, redness, peeling, sweating, irritation and sometimes pain

What causes hand eczema?
When hands are subjected to water, cold, dry air, cleaning materials containing irritants, chemical substances, plastic gloves and soil, they can become irritated.

The skin reacts to this irritation in the form of redness, blisters, itching and pain. Chronic hand eczema due to repetitive and long-term eczema can cause calluses, chapping and bleeding.

What are the symptoms of hand eczema?
In the first stages (acute), eczema causes redness, blistering, sweating and scabbing that results in flaking. During the subacute phase (after the acute phase), slight redness, flaking and scabbing occurs. During the advanced (chronic) phase, the skin on the hands thickens, flaking worsens and slits occur on the hands.

In which cases and for who is eczema more common?
This disease is more commonly seen in women. Additionally, children and adults who are genetically susceptible to allergies may have this disease. Occupations that require constant contact with irritant substances and allergens can increase the risk of this disease.

This includes cleaners, health personnel, hairdressers, laundry workers, metal workers, those who work in the food industry, car mechanics, builders, typographers, painters etc. Hand eczema is also common in housewives that are often in contact with water, soap and detergents. Hand eczema is common in those who have painting, drawing, crafts, or gardening as their hobby. In recent years, there have been scientific publications that have shown that “slime” has become a popular choice of toy for children, which also causes hand eczema.

How is hand eczema diagnosed?
Hand eczema can be diagnosed upon examination. In some cases, in order to distinguish it from other diseases, a fungi inspection and hand skin biopsy may be needed. A patch test can be conducted to determine the cause of hand eczemas that are thought to be allergic.

How is hand eczema treated?
he firstly determined and the patient must avoid contact To treat this disease, the causes of the hand eczema must with these factors as much as possible. The substances that the patient is in contact with on a daily basis must he determined. If the cause is thought to be allergic in nature then the allergens must be determined with a patch test.

The hands must not come into contact with soap and water for long periods of time-they must not be washed frequently. The pH value of the soaps that the patient uses must be suitable for the skin’s pH and they must also not contain perfume or colorants. The patient’s hands must not touch water that is either too cold or too hot – they must
use warm water. Before washing their hands, the patient must remove their rings. The irritants that collect under the rings can cause the eczema to flare up.

Hands must be moisturised often with a moisturiser that does not contain allergens or irritants in order to protect the skin. Barrier creams reduce the loss of moisture and
the possibility of getting hand eczema by helping to protect the skin. It is suitable to moisturise the hands after they have been washed and fully dried.

In cases where the patient has to be in contact with water, detergents and other irritants, cotton “eczema gloves” must be worn under a plastic glove. The gloves must not be worn for long periods of time due to the fact that they will cause perspiration. Powdered gloves must be avoided. Direct contact with acidic foods such as tomatoes, oranges and lemons must be avoided. The patient’s hands must not touch water that is either too cold or too hot, they must use warm water.

The medical treatment consists of topical cortisone creams/pomades that are recommended by a doctor and accompanying moisturisers. Topical antibiotic
creams/pomades can be advised for some cases. Thinning creams can be added to the treatment for cases where the skin has thickened. Medicine containing cortisone can be
used in cases where the eczema is severe, where cortisone vials can be inserted intramuscularly or injected through the veins. In cases where these treatments do not work, pimecrolimus, cyclosporin, methotrexate, phototherapy and alitretinoin treatments can be applied. The period of treatment depends on the severity of the disease, how far it has spread and how long the patient has had this disease. When subjected to substances that are triggers, the hand eczema can reoccur. In such cases the patient must be examined by a doctor once more and their treatment must be readjusted.

Dr. Serap Maden, MD. Dermatology