Archive for the 'About Eczema' Category

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The SolveEczema view on dry skin

I am reposting a part of reply I just wrote to a comment, since not everyone reads the comments (and I tend not to even read what comes in frequently, because of all the spam).  It covers the issue of myths about dry skin, from my perspective:

With eczema, dryness is almost a separate issue. You won’t hear that from anyone else, because the accepted view is that dryness causes the eczema, which I have found in my experience of actually eliminating eczema is not the case. I say “almost”, because dryness is a modulator that can make people more susceptible with lower levels of detergent exposure, as described on the site. I hear (more than I care to think about) from SolveEczema.org users who use products I find unacceptably drying, who are nevertheless happy because they get rid of the eczema.

   I’m going to write more about the dryness issue in my book – which, thanks to the crowdfunding, I can describe as “upcoming”! My bar soap experiments ended up bringing me to an entirely different idea about dry skin and how products cause it than I expected. Perhaps given the experience with detergent, I shouldn’t have been so surprised.

   Again, I believe dryness alone isn’t the reason for the eczema. After seriously experimenting with over a hundred different bar soaps, I also eventually came to the conclusion that dryness associated with the use of the products was not the result of stripping the skin of oils. I came up with a general rule and gave it a name (with some apologies for the presumption, but in hopes of making it more memorable):

   Lumsdaine’s Law: For most people, under most conditions, eczema and dry skin are more the result of what is left on the skin than what is stripped from the skin by washing.

   Adding too many moisturizing ingredients to soaps seems to backfire. We all think – as I thought before I did these experiments – that skin gets dry from washing because oils are removed, so adding moisturizing ingredients should help, right?  As with so many things, our assumptions trip us up.

   What I found is that immediately after washing with a “moisturizing” product, the skin feels soft – just as it feels soft right after washing with water or moisturizing with a creamy, absorbed moisturizer – but if I only used that product (which I was fastidious about doing while I tried each soap), over time, my hands became horribly dry. It happened over and over again with different “moisturizing” products, the opposite of what I expected.

    The surprise came when I got fed up with how dry my hands were from one product and just went back to my regular soap before my “trial” was over. My hands went back to normal almost immediately, far faster than could be explained by the typical view of how they became dry and how they might have normalized. I was able to repeat this with other products – which led to the lightbulb moment.

    I describe this in my talk – water, alone, a small layer of water on the skin, increases the permeability. Not enough to create eczema, but enough that if one, say, doesn’t dry the skin well enough after washing in the winter (with all the dry air), the hands chap. Increased permeability leads to water loss, leads to dry skin. I warn about absorbed, creamy (what I call “emollient”) moisturizers in my site, in part because they seem to create these same conditions. The skin feels more hydrated immediately after applying – just as it does with small amounts of water, right in the moment – but over time, the skin loses water (among other things). I think this is what is happening with very “moisturizing” soaps. (By the way, this is also why I recommend drying well, with a soap-washed towel, after a shower, NOT patting lightly and moisturizing over too much water – the opposite of the traditional recommendation.)

   I’m not saying some moisturizing ingredients aren’t good or are always going to create these conditions. One of the most lovely soaps I have ever used is the Luxo Banho Creme, which has sweet almond oil in it. But overusing moisturizing ingredients – which results in the kinds of products that make the skin/hands feel very moisturized immediately following usage, perhaps to the point that they don’t even feel clean – seems to create the conditions that lead to water loss over time and dry skin. The Luxo Banho – and every soap I have used that I consider the best – leaves the skin feeling clean and normal, not overly moisturized. On the other end of the spectrum, I think soaps can be drying if saponification is too complete and the end result may thus be far too alkaline – there’s a couple of products where I believe that may be the case – but that’s just a guess.

   Sadly, people with dry skin buy the “moisturizing” products which are in turn going to make their dryness worse, and assume it’s about their skin, not the products they are using!

Image credits: Dry land/water excerpted from freedigitalphotos.net photo by prozac1.  (I can’t seem to force WordPress to directly subtitle the photos anymore, no matter what I do, sorry!)  Soap dish by A.J. Lumsdaine.

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Eczema Baby Scratching – Now Not Scratching

http://www.indiegogo.com/solveeczema
Eczema itches. Quality of life studies say even mild eczema can be as miserable as severe eczema, because no one sleeps. Babies don’t sleep, siblings don’t sleep, parents don’t sleep. It affects health and development. None of the studies quite hits home like this 2-minute video, sent to me by a mom who used the web site to help her son. I’ve edited out a long segment where baby Zack just digs at his neck, but it’s still hard to watch. Stick with it ’til the “after” photo, though (note: it’s silent, there’s no music):

Please help me to help more babies like this one. If you can, please make a donation to my crowdfunding project. The hope is to fund a medical study, but that level of funding would take high visibility on the crowdfunding website. If you can’t afford much, even $1 will make a huge difference in whether the project gets the visibility to attract other contributors, and you can keep your name and amount anonymous. You can donate at:
http://www.indiegogo.com/solveeczema
It ends February 29, just weeks away. Thanks so much for all the moral support and support so far!

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When We Don’t Know What We Know

We know this stuff, and yet, why don’t we add it up?

Even my sleeping bag label tells me to wash it in mild “non-detergent soap,” because the makers know the high-tech fabric will lose its water repellency — become more permeable — from detergent residues.

Some researchers use detergents for transdermal drug delivery (getting drugs to absorb through the skin).

detergent pollutionHere’s something I just stumbled across on an environmental company’s web site:

“Detergents also add another problem for aquatic life by lowering the surface tension of the water. Organic chemicals such as pesticides and phenols are then much more easily absorbed by the fish. A detergent concentration of only 2 ppm can cause fish to absorb double the amount of chemicals they would normally absorb…”  (Photo of detergent pollution thanks to U.S. Fish and Wildlife Service.)

Read more from the above company site at: http://www.lenntech.com/aquatic/detergents.htm#ixzz1YCiQinWP

It’s not difficult to see that under such conditions, the skin is also a less capable barrier against pathogens.

Lastly, here’s a detailed and alarming study looking at concentrations of synthetic detergents and pesticides in surface and groundwater in India:  “The synthetic detergents (or surfactants) and pesticides are the two most common group of chemical compounds that are increasingly being used in modern civilization. Surfactants are common contaminants of aquatic environments due to their large consumption in all types of washing and cleaning operations”. [NC Ghose, D Saha, A Gupta, Synthetic Detergents (Surfactants) and Organochlorine Pesticide Signatures in Surface Water and Groundwater of Greater Kolkata, India, J. Water Resource and Protection, 2009, 4, 290-298 doi:10.4236/jwarp.2009.14036 Published Online October 2009.]

I could go on.  We know all this stuff, and yet … it’s as if we don’t remember the minute we’re in a different sphere of life or work.

(Thanks to Free Nature Photos for the image of the Aussie Tree Frog

http://www.freenaturepictures.com/frog-pictures.php)

 

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Big news on the research front from England, still more work to be done

Noted dermatology researcher Dr. Michael Cork in the UK will soon be publishing an article linking detergents with eczema, a continuation of his long-standing work. I am thrilled for this verification of what I have been saying all along.

          Unfortunately, if the popular press article I read tonight is correct, the study still does not differentiate between detergents and soaps. I have mentioned Dr. Cork’s work in the past; his recommendation has been to remove all surfactants, soaps and detergents.

          While removing all surfactants may work in time, I personally find it takes much longer than using true soaps and the results are not as satisfactory. Being able to “wash off the eczema” with soap as described on my site is important to allowing children to maintain a normal life and skin after exposures they can’t control, not to mention simply giving people a way to get clean that doesn’t cause the eczema. Knowing they can keep themselves and their homes clean by changing what they wash with, rather than eliminating all washing products, is a big deal to most people.

          I also have a very different take on what causes dry skin and eczema, and why people from atopic families are more affected.  That is a topic I need to write far more in detail, but I’ve come up with a short way to convey the basic idea (please forgive my giving it a title, it’s a way to hopefully make it memorable):

Lumsdaine’s Law:  For most people, under most conditions, eczema and dry skin are more the result of what is on the skin than what is stripped from the skin by washing.

          I include a link to the Daily Mail  article about Dr. Cork’s groundbreaking publication below.  Here also is my letter to the reporter who wrote the article:

Dear Mr. Utton,

I appreciated reading your well-crafted article “Soap linked to childhood eczema – study.”  The article does a beautiful job clarifying a difficult-to-explain topic (and make interesting as you have done).

I would like to take issue with your assertion that “…despite the recognised hazard of detergents, no one until now has made a connection between their increased use and the rising rate of eczema.”

Please see feature article about my web site in the magazine Allergy & Asthma Today, “Hidden Link Between Detergent and Eczema,” 2006.

As long ago as 2004, I was quoted in a newsletter of the Eczema Association of Australasia saying, “Finally, in researching this problem, I’ve discovered that our solution is consistent with what may be the solution to the overall problem of rising infantile eczema and asthma. … The only theories about it are that we are too clean, the so-called hygiene hypothesis. As for the studies that ostensibly support it, they typically demonstrate a more direct causal link with detergent use than lack of germs.” [emphasis mine]

I have for years been helping people around the world solve their children’s eczema when nothing else worked.  Tens of thousands of people over the years have visited my site and blogs.  I have even heard from doctors who used my web site for their own families.  Many doctors have told me they refer patients to the site, and at least one allergy clinic in Atlanta has permanently linked to it.. .  Interestingly, I mention Dr. Cork on my web site, because as far as I’m concerned, he has been the closest to right of any academic researcher for all these years.

Because I am an engineer and writer, and not a medical researcher, I am limited in what I can ethically (and legally) convey through any of the above publications, but I did discover the cause through empirical problem solving and personal research years ago, have a more nuanced view, and noticed early on that people with atopy were most likely to be helped by removing detergents (and wrote about it).

And although I have a somewhat different take on the why the eczema happens and why people who are genetically linked are susceptible — and I believe there is considerable support for my interpretation in existing medical literature — and I differentiate between soaps and detergents (the use of true soaps actually declined then leveled off as the use of detergents skyrocketed), I am also glad for academic verification of the basic premise of what I have been saying all along by such a respected and careful researcher as Dr. Cork.

Kind Regards,

A.J. Lumsdaine

Read more:

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The role of surfactant in asthma

I’ve gotten much feedback over the years that the changes described in Solveeczema.org do more than help eliminate eczema for certain people, they help reduce or eliminate asthma, even in atopic family members who do not have eczema.  I’m not going to do too much analysis here, I’m going to let this article speak for itself:  The role of surfactant in asthma .  I haven’t yet looked for more recent research, but I feel like I’ve hit a gold mine.

We humans make surfactant essential for the proper function of our airway lining.  What happens when stronger, artificial surfactants are introduced with other inhaled substances, such as dust?

Listen to this:  “…sputum samples from patients with asthma have a low surface activity.”

And, “Interestingly, a washing procedure [of the airways ] with saline … restored surfactant function.”

I’m not drawing conclusions, but this is very, very interesting.

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Persistence of Detergent Residues

I think this research paper by Horiuchi Utako from Gunma University in Japan speaks for itself — the translation of the abstract isn’t perfect, but the meaning is perfectly clear:

1)  A lot of detergent remains in clothing even after excessive rinsing.

2)  A significant amount of those residues can migrate onto other surfaces that come into contact with the clothing, including skin.

The abstract is short and is well worth reading.  The interesting conclusion to Solveeczema users:  “wash the diapers for the babies with hypersensitivity using soaps in stead of synthetic detergents.”

The paper appears to have been published in 1983.

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Update on mattresses: Avoiding dust

Here’s an interesting development.  In a previous post, I wrote about our experience choosing a mattress that wouldn’t be an allergy source for this specific detergent problem.   In trying to find something that wouldn’t shed detergent-laden dust or introduce potential allergens such as latex, we chose an organic cotton mattress with a food-grade polyethylene dust-mite barrier from Naturepedic, on a solid maple platform bed from Pacific Rim.

With some months of experience behind us now, I have to add a wonderful observation.  Not only have we had no problems with detergent dust, we have had no problems with dust of any kind!  In my experience, the space under mattresses is a breeding ground for large dust bunnies.  Under this mattress, there have been no dust bunnies to speak of, and almost no dust at all.

I don’t know if the dust-mite barrier is entirely the reason, or if it is a combination of the barrier and the higher-than usual space under the bed (good air circulation) — but the rest of the room has remained quite low-dust as well, with no dust bunnies around the bed, either.

In contrast, the traditional mattress in the other room begets as many dust bunnies as ever, as I have come to expect is normal under a bed.

Quite apart from the allergy issue, it’s wonderful not to get those piles of dust under the mattress.  I never realized shedding from the mattress could be such a source — especially since we vacuum our traditional mattress every time we change the bedding.

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Picture Eczema

(I’m still stretched and stressed by medical paperwork and still not able to spend much time with the site.  So, here is a post from my draft archive…)

They say a picture is worth a thousand words.  I receive many wonderful words of thanks, but relatively few pictures.  Or I should say, I receive a lot of offers to send pictures – only to hear later almost as many epiphanies of how eczema changed parents’ lives without their realizing it.  It happened to me, too, in the same way.

A friend – whose baby’s eczema is entirely related to detergent exposure – recently gave me a “before” photo of her son with terrible baby eczema.  I have some beautiful “after” photos that I took myself.  I am wondering whether to post them on my blog – the “before” photos are so fuzzy.  And my friend says they were only taken after they had already started removing detergents and the eczema was 90% better. Typical story.  

In the past, when people wrote to tell me their stories of dramatic transformations, I often asked if they were willing to share photos.  People were very generous, offering to go through their photos to find good “before” and “after” comparisons.

In my own case, looking for those photos was an eye opening experience.  Until I needed photos for the newsletter articles, I hadn’t realized how much our picture taking habits had changed:  after the eczema became severe, we took far fewer pictures.  We took photos from a distance, or of a “good” side when the eczema waned.  We don’t have any photos showing the eczema at its worst, not one. 

That story played out over and over again when parents contacted me and offered to look for photos.  Like me, these parents did not realize how their picture taking had been affected by trying to work around the eczema.  So many times parents got back to me – often with sheepish apologies – only to report in wonder that in fact they didn’t have any good “before” close ups of the eczema at its worst.

So, if people have photos and offer them, that’s great and it helps for other parents to see them.  There are a few on the “Letters” page of Solveeczema.org, and a few more in my files that I’ll get around to posting someday.  But I almost never ask for them anymore.

If you are just starting the process described on the Solveeczema website, it’s a good idea to take a few photos of the eczema at its worst.  If detergents are the problem, when the eczema is cleared up, old photos help explain the choices you continue to make to protect your child.  

As much as parents may forget altering way they take photographs of their child with eczema, they also seem to frequently forget how bad things were once everything is cleared up.  There is nothing like old photos to remind yourself of what you did for your child, and just how much better things are when the eczema is cleared up.  This comparison, too, seems a perennial, wonderful surprise – like a cosmic pat on the back.

 

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A Success to Share from Florida

I have been hearing from more and more people whose doctors gave them an article about solveeczema.org or a link to the web site.  I heard this from a mom in Florida recently:

I want to start by saying Thank You!!!  You have helped my family sooo much.  I have two children with allergies and eczema.  I have been through so many doctors, and all they kept saying was use more lotion, use more drugs.  One doctor told me, “You’re in a search for a cause and effect that does not exist … use more lotion!!!”

I was desperate … on top of caring for my son’s disability I was dealing with the scratching and bleeding and cries through the night.  I always thought the detergent, which was [commonly recommended scent- and dye-free detergent],  was causing a problem… however the doctors said no.

Finally I switched to our current allergist who gave me your printout.  I removed the detergent and used soap flakes for washing clothes and also used Ben’s Bar from Ipswich Bay Soap Company.  After two weeks my kids’ skin cleared up completely.  They still get some spots from time to time on their feet and hands, but we can deal with that.  My daughter had been covered from head to toe.  Also my son has a breathing problem which needed a nebulizer from time to time.  Barely ever do we use it now (except if he has a cold).

Thanks soooo much again.  Before reading your article, going to the park with my daughter was such a nightmare.  She would be itching and scratching so hard blood would show.  I thought how unfair it was for a child to not be able to enjoy life.  My kids are doing soooo well.  Their skin looks beautiful and they are very happy!!!!  Thank you.

Kattie

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Not an allergic reaction to detergents

Eczema from detergents – per solveeczema.org – is caused by how detergents affect skin membrane permeability and function and is not a true IgE-mediated allergy to detergents. In fact, very few people (if any) have a true allergy to detergents, most detergent allergies are actually allergies to product enzymes and additives. Sodium lauryl sulfate, known to be highly problematic for people with eczema, is a detergent analog of a surfactant our bodies make and use to regulate membrane permeability, among other things. I’m not sure we even could be allergic to it in the true sense; again, the eczema comes about from how it affects the skin membrane.

Thus you could not test for detergent reactivity with traditional allergy blood tests. Initially I sometimes used the word “allergy” in regards to this reaction, with some justification, but it’s not a true allergic reaction to the detergents themselves.

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