by AJ Lumsdaine | Jun 20, 2014 | Must Reads, Solveeczema.org
I appreciate hearing from someone in medical school. When I first wrote the website, I was doing citizen science before there was a term for it, so I had no framework to do anything but share through our own journey, in order to help as many people as possible until I could write something more traditionally scientific. I thought the site would appeal mostly to natural practitioners but be ignored by allopathic practitioners until I could do a study and publish in more traditional outlets.
I found almost the opposite. Don’t get me wrong, I’ve heard my share of positive feedback from naturally-oriented practitioners who found the site useful. But I’ve actually gotten the most ready acceptance from allopathic practitioners who read the site. If they just glance at it or page through it and think they know what it says, they may be dismissive, but if they actually read it, they are invariably positive, even enthusiastic. I’ve heard from many doctors over the years who not only have used the site for their families, but refer patients to it. I’ve been thanked by many parents who had my site information because a doctor gave it to them. I’ve heard from doctors who just appreciate being able to wash their hands frequently and still have healthy skin. My own doctor once told me that she had just commented to a colleague that, “She really has solved eczema!”
I think the reason my site has been surprisingly well-received by allopathic practitioners is that my perspective pulls together so many loose threads from available research, and views the whole through a new lens that is consistent with what is already known. I’m putting empirical problem-solving into the context of the available research, with which it is absolutely consistent. Too often people make good empirical observations and then overlay a vague and unscientific framework to explain it (which may or may not be accurate or generalizable, often not). It’s not surprising then that allopathic physicians don’t accept the empirical observations, no matter how sound.
And, there is a difference between understanding something scientifically and getting people to implement a problem-solving heuristic in order to address an environmental problem affecting their health — my site is mainly a problem-solving heuristic, although I do have to explain enough that people understand why because my perspective is so different. People still need their doctors in implementing such a heuristic for safety’s sake, for anything medical really, but the site is not a medical treatment per se, so doctors who understand what it’s trying to achieve typically appreciate having that resource available.
The one specialty exception has been dermatologists! Which is understandable, because what I am saying does in some ways fundamentally conflict with what they learn about the skin. For example, one of the key stumbling blocks is the accepted traditional idea that skin becomes dry from washing because of lipids stripped from the skin. I take a different view, that skin becomes dry because of water loss resulting mainly from the molecular properties of residues ON the skin, residues left from washing or absorbed from contact with dust or surfaces. (See previous blog posts for more — scroll down to links for “Posts on understanding and solving dry skin”.)
My view is really radically different, but if you think about it, the idea that skin is dry because of stripped oils or lipids from washing is more an educated assumption not incontrovertibly proven by thorough scientific study, the way it was assumed in the early days of AIDS that the virus was dormant rather than locked in a fierce battle with the immune system which the immune system eventually loses, as was eventually found. My view that the water loss results mainly from the interaction of (primarily syndet) residues of certain molecular properties with the skin isn’t yet proven, either, but it’s at least consistent with very basic biological science that every medical student learns. Most importantly, my view pans out in solving the problems of dry skin from washing and very often, eczema.
So…
You asked how I came up with the statement that detergent-reactive eczema “likely accounts for 25-60% of eczema, depending on the age group and locality, higher if other allergies and an inherited predisposition are factors.”
(I’ll answer that in my next post.)
Best regards,
AJ Lumsdaine
by AJ Lumsdaine | May 13, 2014 | About Eczema, Must Reads, Solveeczema.org
Using SolveEczema.org for dogs and cats with atopic dermatitis:
Image courtesy of anankkml / FreeDigitalPhotos.net
Atopic dermatitis is not just a growing problem for people, more and more household pets are suffering as well. Horses can be affected, too. I will deal with this topic a little more in my book, but I felt like I had to write at least something now. Because dealing with this issue for dogs, cats, and horses is far easier than it is for babies, animals cannot help themselves by telling us how they feel, and these environmental aspects of the problem are addressable and not their fault.
Households that try these environmental strategies may also find that in addition to helping skin, the animals may themselves end up less allergic, and be less allergenic to people.
As I point out on the SolveEczema.org website, these are my own ideas, they are novel; I am not a health professional and I am certainly not a vet. The ideas are the result of “citizen science”, consistent with the body of available mainstream research but have not themselves yet been the subject of such research. The information is supposed to augment the relationship between health professional and patient, not supplant it. I always strongly suggest people keep their health professionals in the loop, and that’s not just a liability disclaimer, it’s because it’s important. Your doctor or vet or naturopath knows you, your child, your pet, and if anything else is at issue or something goes wrong, they know what to do to keep you safe. Having a trusting, working relationship with a good health care provider is like gold.
As I also point out on my website, it’s necessary to read through the information before making any changes, and especially before making assumptions. People often incorrectly think they know what the site is about, and either take the wrong or inadequate measures, or dismiss it out of hand.
For example, many people believe that because there is a genetic component to the susceptibility, that the problem cannot be primarily environmental in origin. There are actually fundamental reasons under the circumstances that the problem CAN’T be primarily genetic even when there is a strong genetic component, which I will discuss in the book. People — and pets — with the atopy, those WITH the genetic susceptibility, are the most likely to be HELPED by these environmental measures.
The fundamental problem for cats and dogs is this:
*The dust in people’s homes, which cats and dogs are more directly affected by even than people, is full of substances that significantly impact the permeability of their skin. The increased permeability leads to excessive water loss, dry skin, and more allergens crossing the skin barrier. The disrupted skin is also more susceptible to bacterial and fungal infections, and not just because of the broken skin, but because the substances inactivate important proteins. These substances also increase healing time of membranes. Solving this problem involves changing what is in the dust, which is very doable, not having a dust-free home which is impossible.
*The surfaces dogs and cats spend most of theirs days lying on are coated with these same substances, which can be absorbed from contact.
*Many of these substances are in the fertilizer and poison products sprayed around peoples grass and homes outside as well, which dogs and cats also spend a lot of time in contact with.
*Most commercial cat litters are full of these substances. When a cat grooms herself, she not only ingests them, she also dissolves these substances into the dander, making the dander even more allergenic than otherwise. When a cat walks around the house, these substances are tracked around the house and added to the dust of the home.
*Most products used to wash dogs, even “natural” ones, contain these substances, and residues left in their coats (and there are ALWAYS residues) cause the same problems described above.
Image courtesy of Ashley Cox / FreeDigitalPhotos.net
Trying the strategies from the website does not have to be a lot of work. Please be aware that the site is geared to people with infants who have the most permeable skin and greatest susceptibilities, and who need to see the fastest, most dramatic results. To help animals, you don’t have to sweat the small stuff, just be aware of what measures will have the greatest benefit and impact.
A few things to remember:
*Please only make changes AFTER reading and understanding the website. Begin with the slideshow overview to understand. It is 45 minutes long, only 6 slides. My apologies to everyone, I originally made it for a crowdfunding for the book, I am not a media person, and the video puts even ME to sleep (sorry!). It is still the most up-to-date summary and worth beginning with: http://vimeo.com/33522513
*Helping a cat or dog with AD is not as difficult as helping an infant human — the whole house has to get on board, but you won’t have to sweat the small stuff (like makeup or deodorant) — however, the same principles apply.
*Keep your vet in the loop. Treat as recommended by your vet, especially for bacterial or fungal problems that may have developed, as well as flea control. Where treatment product choices are possible, choose only products that don’t contain detergents as defined on the SolveEczema.org website. DON’T MAKE ASSUMPTIONS ABOUT WHAT THAT MEANS! (People are almost always wrong when they assume.)
*Treating fungal problems is more of an art, and can sometimes require long-term application. Treatment fungal problems initially can cause Jarisch-Herxheimer responses, known as “die-off” reactions, which seem to make things worse. This disruption in the membrane can actually make things worse and stymie results, plus it’s just uncomfortable for the pet patient, so effective antifungal treatment may involve both using a steroid temporarily with the antifungal, followed by longer-term antifungal therapy. To minimize die-off for a known fungal problem, sometimes it’s necessary to back off the treatment and begin very, very slowly, with very small amounts ramped up to full strength, and to treat for a very long time. Switch treatments if one no longer seems to work.
*Getting a good well-filtered vacuum is an essential step.
Image courtesy of artur84 / FreeDigitalPhotos.net
*If you have carpeting, especially old carpeting, consider removing it and replacing it with some kind of non-allergic surface like hardwood flooring or Marmoleum/natural lineoleum, perhaps with area rugs as necessary (washed only with non-detergent products). A friend clued me in to a way to find Marmoleum cheaper: Talk to the local supplier and ask if you can add square footage to the next really large order they get (provided you like the material). We know someone who got really high quality Marmoleum for the price of cheap vinyl that way. Natural linoleum is not as easy to install and it’s better to have an experienced pro do this.
*Can you wash out the cover of your pet’s bed or bedding? Follow the SolveEczema.org website strategies for superwashing. If you have hard water, it may take more washing than suggested. Use one or two washes with just 2 cups of white vinegar in the wash.
*Remember that the dust in your home is mostly made up of your skin cells, hair, and lint, and that your pet spends most of their day in it. Marketing is powerful — even if there are better ones out there, people can be very strongly and irrationally attached to their personal care products (especially since there can be worse ones out there). You’re just changing what you use in order to help your pet, and it does not have to be a compromise, you can find things you like as much or better, but you may find some you like less in the process. Don’t give up!
*For most good products, the biggest influence on whether new products work well and produce lovely results, in my experience, is not the products themselves but the hardness of the water. It will be more difficult to find acceptable products for people with hard water.
*If you don’t have time to superwash the laundry, you can take a lower-key approach that may take longer and produce results more slowly over time, but is far less work. First, switch to a very benign detergent like Planet (the only syndet I feel comfortable recommending) for a few weeks. Then switch to just using baking soda and/or vinegar in the laundry for a few more weeks. Then switch to true soap in the laundry, but wash each load twice. Once with soap, and then once with just water. Be sure to follow all the directions about washing out the dryer of previous detergent residues, and be sure to clean out all the detergenty lint in the laundry room.
*For cats, investigate non-clumping cat litters, like cedar chips. Unfortunately, the clumping litters are the ones with significant amounts of detergents or clays that are very hydrophilic and could theoretically cause the same problems.
*Take a look at the ingredients of the products you use in your yard and patio — detergents are very commonly used in all kinds of products like fertilizers and poisons because they reduce surface tension and spread products more evenly. example link
Image courtesy of imagerymajestic / FreeDigitalPhotos.net
*In the case of benefiting just the animals, you also don’t have to switch your dishwashing products, but I recommend doing so anyway as a healthy step for the benefit of everyone’s mucous membranes. Our digestive systems make up a goodly portion of our bodies’ immune systems. If you don’t take this step, do at least buy non-detergent soaps to wash the water bowls and toys of pets with AD.
*You can’t necessarily use bathing to control exposures of animals as you can children, but you probably won’t need to. But still, use baths judiciously relative to exposures, as “eczema removal time”, such as when the dog (or cat, IF appropriate) is scratching from spending time in the yard.
*With pet fur, it’s also probably impractical to moisturize. People who use the site strategies usually find over time that they no longer need to anyway. Absent these abnormal environmental influences, a pet’s skin should not need moisturizing. As with humans, the creamy absorbing moisturizers can backfire and cause more water loss later (see SolveEczema.org blog posts about dry skin).
*Most vet sites recommend to control other environmental allergens like mold and dust mites. I will write more about this contributor to dermatitis for people, too, soon.
*Remember that even people who do not get eczema themselves usually benefit from these steps in the health of their skin and other membranes. it may not be apparent at the beginning, but a few months into this, pay attention to your own skin — you may find it’s better than you ever remember. If not, you should find better products, because they exist!
*Although all members of a household usually benefits from the SolveEczema.org strategies, it’s normal for pets to have eczema but not the humans, or vice versa, or for both to have it. (The reason for that should be evident from reading the site and blog.)
*I know how difficult it can be to change products. Marketing is very powerful, even when people are aware of it. I remember what that’s like, but now feel much happier with most of the best products I’ve found. That said, dogs and cats are likely to see some results even if there is a “holdout” in the household. If you try the site strategies for your pets with eczema, please let me know how it goes.
I have listed some pet products on my Amazon astore, which is there for people’s convenience, but there are other products out there, and the site discusses how to evaluate them. When people purchase through those links, I receive a small percentage without increasing the buyer’s price (usually on the order of $15/month, not significant, but I need to say so in case it makes a difference to people one way or another). The link is: http://astore.amazon.com/solvsblogastore-20
Use a search engine to learn about “canine atopic dermatitis” — although I don’t necessarily agree with various sites about what to do about it, it’s clear that it’s a growing problem.
If you are helped by these strategies, please consider returning to the website donations page and making a donation — most people don’t (and that’s okay, that’s obviously not why I do this!), but they do help. People are often willing to pay far more for treatments that don’t work, so if this has been worthwhile to you, please consider a donation, it does help. Thanks!
A.J. Lumsdaine
http://solveeczema.org/donate.html
by AJ Lumsdaine | Oct 18, 2013 | Must Reads, Solveeczema.org
Autumn – by Monika Lumsdaine
A favorite photo
Every year when the weather turns, thresholds to reacting drop along with declining temperatures and humidity.
The change can be hardest of all on people who have recently solved their child’s eczema or are in the process, because it can suddenly seem as if something else is causing eczema to resurge.
Especially for those whose children are age 3 or younger, it’s worth a re-read of my first post on Autumn Eczema.
Also, because kids with eczema often have more allergy issues, I’ve posted our family’s best cold and cough home remedy (which I’ve moved to its own page).
And while I’m at it, here is a compendium of my very favorite posts [updated December 2015]:
Some summaries – what SolveEczema.org is all about:
My favorite FYI’s:
Posts about finding soaps and non-detergent products
What some other people have done (or not):
My very favorite Off-Topic Posts:
Autumn by Monika Lumsdaine is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
by AJ Lumsdaine | May 14, 2013 | About Products, Must Reads, Solveeczema.org
Sources of pure soap laundry powder or liquid
Always check ingredients first, manufacturers change product ingredients all the time.
A small % of Amazon purchases linked through here goes to SolveEczema if purchased through the link, on the order of $15/month).
To save money or time, do it yourself! There are many online recipes for laundry powder and gel using bar soaps, and various amounts of borax, washing soda, and baking soda.
Here are the pre-packaged products I found (some of the photos are of older version of packaging, but all the links are up to date as of 9/30/2022).
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Pure Soap Flake Company
Laundry powder, soap flakes, soap bars
Pure Soap Flake Company
http://puresoapflakes.com/
They have an unscented laundry powder which is just simple soap, baking soda, borax and washing soda. They also produce a laundry power without borax, and one with just plain soap flakes. I have personally found the plain soap flakes plus washing soda get the best results in my machine, but I have very soft water. Their laundry products benefit from first being dissolved in hot water.
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Zote Laundry Soap Flakes
Pack of 8 (17.63oz) Zote laundry soap flakes on Amazon
Still the most popular laundry product in Mexico. (From animal tallow. Also contains fragrance and optical brighteners.)
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Molly’s Suds
Molly’s Suds makes three laundry products that appears to contain no detergents or surfactants at all, their Original Laundry Powder formulation, their Oxygen Whitener, and the Baby Laundry Powder. The Baby Laundry Powder does contain enzymes, which I cannot comment on the allergenicity of, and the Original contains peppermint oil.
Given the ingredients, it might also make a good laundry booster when combined with a liquid soap or soap flakes, especially for people with hard water. (Always check the ingredients when ordering, their products have changed over the years, and they make other products that look similar that do have detergents in them.)
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Dr. Bronners Liquid Soap
Dr. Bronner’s
32-oz Dr. Bronner’s Baby Mild liquid on Amazon
For many people, the only easy soap to access is Dr. Bronners. Unscented Baby Mild as probably the best place to start. Combine with baking soda, borax, and/or washing soda for better efficacy in laundry.
Dr. Bronner’s website has a page with recipes for all kinds of uses, including machine and handwashing laundry.
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- Cal Ben Seafoam Laundry
25 lb. box
Cal Ben Seafoam Laundry Soap
More complicated list of ingredients than most of these, plus sprayed with citrus oil, but it’s essentially soap-based. I have used this product successfully. [Update 2022: After skin problems for everyone in the household, we discovered that CalBen had switched many of their product ingredients. The Dish Glow and Shampoo, long staples in our household, no longer meet the site criteria, which is truly sad since they had, hands down, made the best soap-based shampoo on the market. I am still trying to assess the situation with other products like the laundry powder. Stay tuned for further updates.]
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Zum Clean Laundry Soap (the product now has updated packaging)
Zum Clean Laundry Soap
64-oz Sweet Orange on Amazon
http://www.indigowild.com/category/natural-home-cleaning/
Liquid laundry soap, various fragrances. No unscented, although I have seen them make a run of unscented for customers wanting to buy a lot, then they sell the rest (it’s been awhile though). Zum has been around a long time and has stayed an entirely soap liquid laundry product. I recently looked on their site (2022) and found they are now making a powdered laundry soap product
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Vermont Soap Company Castile Liquid Soap Unscented
Vermont Soap Company Castile Liquid Soap Simply Unscented
Home
Longtime soap maker. They also sell dog and horse shampoos that are all soap-based. This soap is multi-purpose.
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Softly Pure Soap Flakes (Australia and New Zealand)
formerly Lux Flakes
In 15kg and 1kg boxes
Always double check ingredients before buying, but this appears to just be just soap flakes, formerly Lux Soap Flakes. Pure soap flakes may work better if combined with baking soda, washing soda, and/or borax, per recipes on the web. In my experience, having a water softener is more important than laundry conditioners, because soap works better in soft water than detergents do.
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Savon de Marseille
Traditional French Soap
Savon de Marseille Soap Flakes
Marius Fabre Marseille soap flakes on Amazon
Traditional soap flakes. Can be combined with washing soda and borax, especially in hard water. This is a long-standing company that makes other true soap products. Their liquid soaps use minimal ingredients and pure olive oil, and are also an option combined with washing soda and borax.
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Pure Soapworks Liquid Laundry Soap or Laundry Powder (Canada & USA)
http://www.puresoapworks.com/specialtysoaps.htm
This company seems to carry a full line of soap products, both powdered and liquid laundry soap. (The powdered appears to be part tallow soap, so not vegetarian. The liquid appears to be all plant-based soap.)
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Grandma’s Laundry Soap
Grandma’s Old-Fashioned Laundry Soap
Grandma’s laundry soap on Amazon
http://grandmaspureandnatural.com/laundry
A lard-based soap flake product, so, not vegetarian. This appears not to have any dyes or unnecessary ingredients. This company also sells a soap-based stain remover stick and bar soaps. They seem to understand the difference between soap and detergent per the site.
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Ma’Bella Laundry Powder
This is a simple mix of the wonderful Ma’Bella soap with washing soda and borax.
by AJ Lumsdaine | May 11, 2013 | Must Reads
In order to help people with my site and blog, I try to stay away from saying anything controversial — aside from my belief that eczema is eminently solvable and understandable, and that there is nothing really wrong with these kids absent these relatively new environmental influences. I only wish what I have to say in this post weren’t controversial — I don’t know why it is, but it is. Forgive the lack of photos, I’ll try to remedy that soon. This post is excerpted from a letter I wrote many years ago, and it highlights the philosophy that led to the way I went about problem solving eczema for my son. I have posted this opinion anonymously online since, but I may as well come out and say it. There are critical (unnecessary) barriers to solving intractible health problems, and real people suffer while we all wait for those in ivory towers to break them down. In the era of distributed knowledge and the Internet, that must change.
When people use the site to problem solve their own children’s eczema, the breakthrough is usually when they can see the eczema outbreaks are not random. In my experience, when people accept they can solve the problem, they are more than halfway there. When they see they are in control, they’re there — they may not yet have all the influences or rashes eliminated, but they know they can do it. I believe the perspective discussed below could help solve other currently-deemed intractable diseases. I hope the following is helpful to others:
—AJ Lumsdaine, SolveEczema.org
More than ten years ago, Danish researchers Hrobjartsson and Gøtzsche published the watershed study, “Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment,” in the New England Journal of Medicine. The two researchers looked through the history of placebo-controlled clinical trials and found over 100 studies that included three patient groups rather than two: 1) a group given treatment, 2) a group given a placebo intended to mimic treatment, and 3) a group given nothing at all. The authors decided to compare the groups given nothing to the placebo groups, and found that there is no significant clinical effect associated with placebos. In other words, the placebo effect – interpreted as improvement resulting from patients’ belief in a treatment – is more myth than reality.
As you might imagine, the study generated quite a firestorm in the medical community. I remember reading a letter by the head of Harvard Med School, in which he scratched his head at the earth shattering results, but also said he wouldn’t want anyone to give him a placebo.
And after such earth-shattering results, then what happened?
Hrobjartsson and Gøtzsche followed up with another study in 2004: “Is the placebo powerless? Update of a systematic review with 52 new randomized trials comparing placebo with no treatment.” Again they “found no evidence of a generally large effect of placebo interventions. A possible small effect on patient-reported continuous outcomes, especially pain, could not be clearly distinguished from bias.”
Although these researchers were arguably the first to make a dent in ironclad beliefs about placebos, especially in the media, they are not the first to analyze and refute the concept.
In 1997, researchers Kienle and Kiene wrote, “In 1955, Henry K. Beecher published the classic work entitled “The Powerful Placebo.” Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher … claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher’s article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. … These factors are still prevalent in modern placebo literature. The placebo topic seems to invite sloppy methodological thinking. Therefore awareness of Beecher’s mistakes and misinterpretation is essential for an appropriate interpretation of current placebo literature.”
No one is claiming that placebo-controlled trials are unnecessary. On the contrary, these studies further emphasize the importance of placebos in clinical trials to eliminate the junk drawer of biases and other effects that needs to be separated from the clinical effect of the drug or treatment under scrutiny. But the studies also point out how sloppy definitions of the placebo effect have perpetuated false beliefs.
The popular lay understanding of the placebo effect — the myth — is of powerful physical changes that result from an expectation or hope, a belief that good will happen if one is taking a medication (or that bad will happen if one is expecting bad side effects).
On the other side of the spectrum, is the definition of placebo effects as what is attributable to everything else that is not a medication effect – including the natural course of the illness, other effects caused by a placebo, even reporting biases among researchers and patients. When the definitions are confused, the placebo effect is falsely supported as resulting from belief in treatment.
For a classic example of confusing changes from belief in treatment with other effects caused by a placebo, look no further than a watershed arthroscopic surgery trial from a few years ago, meant to test whether placebo-controlled surgeries are necessary and oft-cited as demonstrating that placebos are powerful. Unfortunately, the many who wrote about this study as proving the power of placebos, meant placebos-as-causing-physical-effects-from-expectation. But that’s not how the researchers of the study were using the term. (This is one reason, especially in this day and age, full medical articles really must be made available to everyone online, not just abstracts.)
Patients were divided into three groups — patients to receive one of two popular arthroscopic surgeries, and a patient group to receive a sham surgery in which they were operated on and closed up without any actual surgical intervention.
Patients in all three groups improved, and this was taken as proof the placebo effect is powerful, and equated to mean the belief in treatment produces powerful effects.
But in fact, if people read the full article, they could see the placebo in this study wasn’t just the surgery. Patients in all three groups – those given one of two different kinds of common knee surgeries and those in the placebo surgery group – all patients followed a comprehensive regimen of rest, walking aids, gradual exercise, and analgesics, in addition to their surgeries. So, the placebo in this study was not just a sham surgery, the placebo was a sham surgery AND a comprehensive regimen of rest, walking aids, gradual exercise, and analgesics. Unfortunately, there was neither a group that got the same regimen of rest and rehabilitation but did not get surgery at all, nor was there a control group that got nothing, to determine whether the observed improvements were from an independent effect of the placebo (i.e., improvements from just the rest and rehabilitation) or the natural course of the disease.
The study authors merely examined whether two common knee surgeries produced better outcomes than a placebo surgery (they did not), the study design in no way supported the existence of real clinical changes stemming from patients’ belief in treatment. In fact, the study authors made oblique reference to the Hrobjartsson results and suggested themselves that the effects they observed could be the result of the natural course of the disease or related to an independent influence (but not the result of a belief in the treatment).
Despite such serious research supporting the need for a revolution in how we think about the placebo effect, nothing has really changed in over a decade.
Too few studies bother to delve into how the natural course of a disease plays into the picture. If we know now from definitive research that improvements aren’t from belief in the treatment, but the result of something else, shouldn’t we be acting on this?
I’m sorry to burst one of the happiest bubbles in popular medical mythology, but there is just no good evidence that belief in a treatment alone produces a significant clinical change down the road, only wishful interpretations that it does.
Now, I’m not suggesting there is no mind-body connection, far from it. I’m only saying that just because we see some obvious mind-body connections, does not mean that the conscious brain has unfettered control of all physiological processes. Just because you can jump over a box, does not mean you can leap tall buildings in a single bound.
I’m also not saying, believe it or not, that there will never be a role for harnessing hope in medical treatment. I’m just skeptical that sham treatments are the right vehicle. If a passenger tries to catch a moving train, for example, a sudden surge of hope might make all the difference in whether she catches it and reaches her destination. The surge in hope won’t allow her to keep outrunning a train forever, though. In other words, a short-term belief could affect the long-term outcome in a significant way – but only if the train is real, not a mirage (or a sugar pill).
There is a much more serious issue at stake here than whether we can harness the power (however minor it has proven to be) of belief in treatment. The popular concept of the placebo effect—as resulting from belief—undermined the crucial role of empiricism in medical practice, which has in turn seriously degraded the scientific authority of clinicians (even within the medical profession, very rigorous and scientific observations by good clinicians of individual patients are typically deemed “anecdotal” by definition). This has in turn led to an over-reliance on statistical studies in medicine to problem solve for individuals (leading naturally to “one-size-fits-all treatments”), rather than to PROVE solutions found through empirical means.
In the decades since the concept of the placebo effect was first embraced, how many millions of times have doctors come across clinically significant improvements in their patients, even cures, but dismissed what they saw as the probable result of their patients’ beliefs in treatment, the irreproducible products of their patients’ minds? How many times have clues to cures been left uninvestigated because of how beliefs about placebos lead to handwaving about the “vagaries of the human body”?
We know now, we have solid proof now, that significant clinical changes are not the result of beliefs but of something else. Something else — like the rigorous plan of rest and rehabilitation in the arthroscopic surgery study — that could, through empirical problem solving, be discerned and tested and turned into a solution or many solutions.
Every day, the belief that clinically significant improvements in individuals may merely be the result of the placebo effect costs our world opportunities to solve or cure tough diseases.
by AJ Lumsdaine | Feb 4, 2013 | About Eczema, About Products, Must Reads
There’s a saying about the weather in many places, if you don’t like it, wait a few minutes.
Something similar might be said of real soap, except we’re talking a time scale more akin to aging wine.
Fine soap may need aging
Many soapmakers discuss the need for aging soap. How much time it needs depends on the ingredients, the process to make it, and to a large extent, the opinion of the soapmaker. I’ve read opinions that newly made soap should sit anywhere from 48 hours to several weeks to months. Real Aleppo soap*, a type of soap thought to have been made in Aleppo, Syria, for thousands of years, is reputedly aged for six months to a year before it is sold.
While I find many soaps are drying because of a common practice of adding too many moisturizing ingredients on the erroneous belief that more moisturizing ingredients make the soap more moisturizing to the skin (see the SolveEczema view on dry skin), other soaps that may be too drying just after production are fine and lovely after sitting for a few months. The aging process is said to reduce alkalinity and water content (for bar soap).
I have so benefitted from letting soap sit before I use it, I now just keep a stock handy and try never to use anything brand new. So many times now when I have experimented with a bar or a liquid soap and found it too drying, I find if I simply put it away for 6 months, it’s usually different, sometimes a completely different product, when I try it again. I had an $8 bar of Savon Extra Pur Orange that I found unacceptably drying, but didn’t want to give away because I had paid so much for it. It sat on the shelf for a year before I used it, and when I did then, it was a revelation, one of the loveliest soaps I had ever tried. I find this over and over again, even with Dr. Bronner’s liquid castile soap, which many people use to implement SolveEczema.org, but I find unacceptably drying when new.
Some soaps I never have to let sit. Sappo Hill is consistently one of the best soaps I have ever used. Maybe they let it sit before selling it, maybe they just really know soapmaking, I don’t know. Sometimes all the sitting in the world doesn’t fix a soap; I just got up and tried one I’ve been keeping around for two years and no luck.
Anyway, I just wanted to pass along that tip: if a real bar soap seems drying at first, put it on a shelf for six months to a year like the soapmakers of Aleppo do. I think they’re on to something there.
Aleppo soap, Syria
Photo by Bernard Gagnon, from Wikimedia Commons
*I’ve read there are now many pretenders, as Aleppo soap is a luxury item that doesn’t yet enjoy the kind of place “brand” protection of products like champagne. Link. Link2. Having tried to find the real stuff myself, I’d appreciate if there were an official designation!
