Eczema, detergents, and bat white-nose syndrome?

When I originally wrote SolveEczema.org, I always understood that a medical study or publication would be necessary to bring the ideas into the medical mainstream.  I did the site because I wanted to help as many people as possible in the meantime.  

I have also always realized there are other implications to these ideas beyond eczema, but didn’t feel in a position to write about them.  I was moved recently by reading a Science News story about bat white nose syndrome, which is so lethal, the word “extinction” is being bandied about.  I spent weeks composing an email to a respected bat researcher who is on the forefront of trying to save these beneficial creatures.  I’m sure this is going to seem like it’s coming from left field, so it’s unlikely to make an impact.  But as with writing the SolveEczema.org site in the first place, I had to try.  

I’m posting the letter here, edited for clarity, as it again discusses some of some of the ideas underlying SolveEczema.org.

A.J. Lumsdaine

Little brown bat
Credit: Missouri Dept of Conservation

Dear Dr. Reeder,

I have followed your work on bat white-nose syndrome in lay publications like Science News. I have for many years been concerned that something like this could happen to bats because of an unrecognized environmental influence that, if at issue, I’m surprised took even this long to cause such devastation.

I have to ask you to please bear with me while I explain.  There are so many preconceived notions to overcome about what I am about to say, there isn’t really an easy way to say it.

For 8 years now, I have run a noncommercial website with a novel approach to eczema and allergies that helps families ameliorate or eliminate their children’s eczema and other atopic manifestations like asthma without any treatment, by getting to the environmental cause.  Yes, I realize bats don’t get eczema, but please bear with me.  The site has been used by people all over the world, including doctors for their own families, and has inspired a green cleaning book.  Last year alone, even though I don’t do any advertising or optimization, the site had nearly 40,000 unique visitors and 130,000 page views/360,000 hits, plus many thousands more on the associated blog.  Around 80% of the visits are from bookmarks and direct links, only 20% from search engine links, meaning most visits are from people referring the information to each other and returning themselves.

from Sammysskin.blogspot.com

Eczema from detergents,
plus infection Credit: sammysskin.blogspot.com

If you want to see a well-written, well-documented anecdotal demonstration of this, a mom in Georgia has been blogging about using my website to help her once severely eczematous son lead a normal life without treatment (that’s him on the right before she found my website):  http://www.sammysskin.blogspot.com  Again, this does relate to bats, please bear with me.

Eczema, asthma, and allergy rates have risen precipitously in many nations around the world since WWII, affecting nearly every other child in some hotspots. Dogs and cats, by the way, face a concurrent increase in eczema and other atopic manifestations like allergies.  Most mainstream medical researchers acknowledge that even though there appears to be a genetic susceptibility, given the rapid rise, and how those who move from geographical regions with less eczema to regions with more eczema acquire eczema at the higher rates, the cause must be primarily environmental.

Normal skin, no treatment

Sammy’s skin returns to normal
Credit: Sammysskin.blogspot.com
Used with permission

People are using my website to not only eliminate their eczema, but also their asthma, allergies, and dry skin, in the way the underlying basis predicts.  The underlying problem is the way modern synthetic detergents — which are dramatically more hydrophilic and oleophilic than the surfactants (soaps) used by humans for thousands of years prior — affect the skin barrier, causing excess water loss and thinning of membranes.  The reason detergents cause such dramatic effects is not because, as is traditionally believed, washing products strip the skin of oils.  In my observation, it’s because residues that persist on the skin directly increase the permeability and cause excess water loss as a result, even just those residues that migrate from contact with clothing washed in detergent, or detergent-laden dust.  Ingested detergents on dishes and even in processed foods, and inhaled detergents in dust (which is predominantly skin cells and lint in modern indoor environments, in other words, full of detergents) affect lung and gut membranes as well.  The surprise was that ingested detergents also affect skin membranes.  In my experience, the eczema is expressed proportionally to permeability increases.

Everyone, not just those expressing eczema, appears to be affected and experiences degradation of the skin barrier and other membranes.  Only some people, especially children whose skin is naturally more permeable and absorbs more detergents (and proportionally so), experience the eczema more readily.  Detergents also facilitate antigen penetration of membranes and thus overall antigen load, and can negatively impact sensitive membrane healing times.

It is my belief — and I realize these are all just my ideas but they do happen to lead to real solutions for many, many individuals who could not find those solutions in standard approaches on the subject — that the expression of eczema is, under normal environmental conditions and in the absence of these modern exposures, a “healthy” signal from the immune system to the conscious brain when faced with too much allergen/antigen in the environment, under that immune system’s particular conditions at the time, in the same way that pain serves the nervous system (mostly as a warning to the conscious brain).  The classic interpretation of allergy is that the immune system becomes confused and attacks the body, but my interpretation is that allergens being similar to pathogens to the immune system, require more energy to differentiate between them.  If the immune system can “tell” the conscious brain to offload allergens to better and more accurately face a microbial threat, for example, allergy could confer a survival advantage.  Aeroallergens typically produce respiratory symptoms, contact allergens cause skin symptoms, etc.  There is a roughly linear relationship between eczema rates and atopy by nation, and in societies where there is very little of both, the rates of eczema can be very, very small, i.e., the triggering of that signal is uncommon and could be beneficial.

In other words, I believe the eczema itself is a signal that some people express, under certain genetic and physical conditions.  Eczema isn’t a problem that affects one person and never the next, there is a continuum, where more and more people are affected as the environmental cause increases.  Everyone has the potential to express this signal.  In severe atopic dermatitis, the inputs, feedback, skin barrier, immune response, and expression of the signal are all abnormal and out of control because of modern environmental influences, overwhelmingly, I believe, detergents.  The signal is expressed for some people as certain thresholds are crossed, for more and more people as the exposures increase.  Remove those influences, and people can be completely normal, without treatment of any kind.  In order to accomplish that, typically a whole household must make the changes, and inevitably, everyone in the household experiences surprising benefits — most notably to skin but also allergy — not just the person who had eczema.

Healthy Indiana Bat
Credit: Andy King/USFWS

Please continue to bear with me, this is absolutely relevant to bats.  It’s very important to realize that there can be very substantial physiological effects from very tiny exposures.  And in the presence of small amounts of water — sweat, for example, or other membrane surface dampness or condensation — the effect on permeability is dramatically amplified.

In the course of using the website to eliminate eczema, if properly implemented, it is a universal experience that everyone in a household undergoes a beneficial change in their skin, even if they don’t have eczema or atopy.  Over the course of about two months, the skin becomes completely different:  thicker, more supple, and less dry.  Most people are eventually able to wash with soap and stop using moisturizers.  This happens for anyone, for people who use the site just to eliminate dry skin.

Little brown bat with white nose syndrome

Little brown bat with
white nose syndrome
Credit: USFWS

It’s clear, too, from empirical observation, that many people with eczema are affected by fungal organisms (and sometimes bacterial) while the skin is compromised, and those areas must be treated to kill the fungal organisms before the skin will completely heal.  Research (with no cognizance of this detergent issue) also shows that people with eczema are more susceptible to infections on affected skin than people with skin conditions that also disrupt the skin, like psoriasis.  Research with detergents on sensitive eye membranes show they can substantially increase healing times.

Since fungal cells are more like mammalian cells than they are even like bacterial cells, and those fungal cells can replace mammalian cells, it’s necessary to be extremely careful in treating those “infections” or colonizations because if the fungal cells die off all at once, the result could be an alarming and even more compromising loss of skin, such as sloughing off of large surface areas and bleeding depending on how affected it is.  If antifungal treatment is ramped up very, very slowly over time, though, die-off is minimized and normalization of the skin can be achieved over time without the risks associated with sudden die off.  Fortunately, fungal organisms tend to grow slowly, so this process works better with fungal organisms than you might expect with bacterial.

Gray bat

Gray Bat
Credit: USFWS

Here’s why I believe this is important to bats and specifically to your work:  First of all, the obvious:  bats’ wings are mostly skin.  Bats (and frogs) live at that land-water/wet-dry interface, in other words, where they would constantly be affected by the small amounts of water that amplify the detergent effect on membranes I described above.  Although bats to my understanding stay in dry parts of caves, they do live in cool, dark, damp places where fungal organisms can be very opportunistic if a modern influence were to so fundamentally compromise bats’ evolved defenses.  In other words, bats and frogs would in theory be most affected by detergent pollution, the proverbial “canaries in the coalmine”.  It’s interesting that in Australia, Roundup was banned until the maker removed, not the poison, but the detergent in it which was killing frogs.

Foam from aquatic pollutants.
Credit: Eurico Zimbres

Detergents are ubiquitous outdoor environmental pollutants now, especially in aquatic environments.  Their use has been on the rise outdoors as well as indoors in recent decades.  They are readily absorbed (attached to, really) by living membranes.  Bats in particular would be susceptible to exposure, as bats eat a lot of insects, obviously, and presently virtually all pesticides and herbicides for large-scale use are mixed and sprayed with detergents in order to reduce surface tension and spread the active ingredients more evenly.  New biological controls intended to reduce poison use and highly target certain bad bugs without harming the good ones, if sprayed with detergents (as is almost certainly the case), may be having the unintended consequence of exposing bats to more ingested detergents as they consume non-targeted insects that have detergents on them.  Bats could also outright come into contact with sprays or dusts, or detergents in water, and it doesn’t take much.

If detergents affect bat membranes the way they do human skin – and I see no reason they wouldn’t – detergents would both degrade bat membranes (thinning the wings) and make them more susceptible to fungal colonization.  Ingesting detergents also appears to cause eczema and membrane degradation in human skin — difficult-to-correlate membrane degradation even in humans who do not express eczema — and can do so in very, very small quantities.  Although other mammals may not express eczema, which as I believe is an evolved signal/adaptation and not the direct effect of detergent contact irritation, the underlying basis for the skin barrier dysfunction would almost certainly extend to other mammals, whether they express eczema or not.  Since humans and presumably other mammals use endogenous surfactants in critical functions of life, including to control skin membrane permeability, it makes sense that exogenous detergents could throw a monkey wrench in this adaptation.  It’s also very possible that there is no adaptation that would allow for a survival advantage to bats by expressing this signal of eczema as there would be for larger mammals.  In other words, there is no reason to believe bats would experience any benefit from eczema as humans and perhaps even their pets would, so any corresponding genes would have died out long ago.  Nevertheless, bats (and frogs) would experience negative impacts to their membranes from significant exposure to exogenous detergent sources.

I want to reiterate that ingested detergents, even in small quantities, can cause surprisingly significant physiological effects.  The amount of detergent that penetrates the skin of a banana or shell of an egg from normal processing practices, if ingested, is enough to cause patches of skin changes in susceptible infants.  These are some of the most minor influences in a home today, in the most susceptible group — I am just pointing out that if other influences are effectively controlled, in the most susceptible (babies), even such minor influences can have visible effects.  How much more detergent are bats undoubtedly consuming and contacting relative to their body weight and skin surface these days?

I have witnessed infants go from clear skin to bubbly, itchy, severe-looking rash in 20 minutes just from contact with the clothing of an adult who was substantially detergent-free except for face wash or moisturizer containing detergents, with no direct skin-to-skin contact.  I have seen this even from an adult, in similar circumstances, simply leaning over a susceptible infant, without any direct contact.  If these children are removed from the exposure and washed immediately with ordinary soap (see my site for how “soap” is defined, very important) to remove detergents, reversal of even a severe rash to normal skin (provided the infant has been living in a substantially detergent-free environment already) can be just as rapid and stunning.

I think in order for researchers to truly figure out whether it’s possible to help the bats they are studying to recover, researchers probably need to remove that environmental influence from their labs and persons completely.  If researchers are not detergent-free, they are producing detergent-laden dust that would affect creatures as tiny as bats, with already compromised membranes, in ways most people could never imagine.  Understanding these influences from the detergent-eczema arena could shed light on how and why bats are being affected, and how to help them in new ways.  It’s not as difficult as it might sound to achieve results, but it’s necessary to really understand and these are my own novel ideas, not yet in the mainstream of eczema research.  But they are helping a great many people worldwide in the way the underlying ideas would suggest.

I want to propose to you that this line of inquiry is worth looking into, because if detergents are indeed an unrecognized factor in worldwide frog and bat population crashes, rescue of bats may be more effective, and the long-term solutions could be straightforward, if not simple.  People making newer biological controls for targeted insecticides may simply need to take care to use only surfactants which are no more hydrophilic than typical alkaline soaps, for example.

In one interview I read recently, you are quoted as saying, “For a long time, a lot of us — myself included — said fungal infections don’t kill mammals, so that can’t be what’s killing the bats.  But it turns out that because of the bat’s unique hibernation cycle and the nature of the fungus, it does kill them.  The big question now is:  Can we prevent extinction?”  You may be surprised to learn of a growing body of research discussing new kinds of fungal susceptibilities, colonizations and diseases in humans, especially children, because of modern influences.  Like you, researchers believed these microorganisms had no role in human disease — until a variety of new influences like chronic use of steroids or antibiotics — and I would personally add, detergents — created new susceptibilities especially in vulnerable populations.  Given what I have learned over the years about detergents and eczema, I think it’s highly likely that detergent pollution plays a central role in susceptibility of bats to fungal diseases.

Over the years, I have occasionally sent letters like this to researchers without response.  It’s very likely my letters just end up in spam folders, as I expect this one is likely to.  So I am posting it on my blog as well, in hopes that one of my readers may have a bat researcher in their lives with whom they can share it.  This letter also happens to explain the underlying concepts again which, if nothing else, also helps my readers.

I am moved by the specter of the extinction of these beneficial creatures; I hope this letter proves useful to you.  Thank you for taking the time to consider my input.  I wish you all the best in your work to save bats from this urgent threat.

Sincerely,
A.J. Lumsdaine

http://www.SolveEczema.org
This post subject to the following:

Creative Commons License
This work by A.J. Lumsdaine is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.

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Like So Many Things, Soap Gets Better With Age

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!

 

Sammy’s Skin

Sammy's skin after using SolveEczema.org

Sammy’s skin after using SolveEczema.org

Sammy's red skin

Sammy, before beginning SolveEczema

I just want to share again a link to this blog, about a mom who was on a quest to cure her son’s eczema and ended up using SolveEczema.org:   Sammy’s Skin – The Story of a Boy, His Eczema, and the Quest for a Drug-Free Cure.

Much of what I do with SolveEczema.org is try to figure out how to get people over all the typical barriers and myths so that they understand enough to do their own problem-solving and persist with the strategies to solve the eczema.  I heard from Sammy’s mom when she was in the middle of her quest, and given the many barriers, I really feared she wouldn’t be able to persist with the site, even though I thought her son would probably benefit.  Not only did she persist, but she has started a bulletin board where she is helping other families who want to use the SolveEczema site, and moderating with two other moms:  http://solveeczemaforum.proboards.com

I have always wanted to start a bulletin board myself; I’ll be very honest that I think these dedicated moms are doing a better job at encouraging, answering questions, and creating a community than I would have.  We all learn from each other.

Happy Thanksgiving, everyone!

Detergents in (some) Water Softener Salt?!

Photo from www.sxc.hu by mokra

What? Detergents in water softener salt?!

Alert for SolveEczema.org users:  TAKE CARE TO USE ONLY WATER SOFTENER SALT PRODUCTS IN THE SOFTENER THAT ARE PURE SALT, AND NOT A SALT PRODUCT WITH ADDITIVES!!  Read on.

Soaps work better, they clean better, in soft water than in hard water.   Soaps perform better than detergents in soft water — one reason detergents were invented in the first place was to perform across different water conditions including hard water.  Detergents perform better in hard water than soaps do , though nothing performs what I could call well in hard water, soap or detergent.

Because soaps perform so much better in soft water, I recommend mechanical water softeners to people who otherwise have hard water.  Soaps work better, it takes less time to wash out old detergents from clothing, it takes less soap by far to get things clean, white fabrics stay white and don’t grey as they do in hard water, and hair and skin stay soft.   It’s easier to keep bathroom surfaces clean without so much scale on surfaces.  There are many advantages.

As I mention on the website, several studies have looked at water hardness versus eczema, and found that people living in areas with harder water have more eczema.  For example,

Atopic eczema and domestic water hardness

Ecological association of water hardness with prevalence of childhood atopic dermatitis in a Japanese urban area,

As a result of these studies, a group in the UK did A randomized controlled trial of ion-exchange water softeners for the treatment of eczema in children.  In contrast to the studies above, which simply measured water hardness and correlated with eczema prevalence, here mechanical water softeners were installed in some homes and the results to the eczema of the children with and without assessed.  Participants were told not to change the way they bathed or washed their laundry.  The results:  No benefit was found from the softeners, although interestingly, over 50% of the parents chose to buy the water softeners at the conclusion of the study.

Photo by Kimberly Vohsen, from sxc.hu

Given that the water softener study protocol asked families to maintain their washing and washing product habits through the trial, it’s not surprising to me that they found no benefit from the softeners.

What do SolveEczema.org users take from these studies?  Very little, because the study designs don’t take the type of washing products used by the families into account, and in the study of installed softeners, the researchers specifically asked families not to adjust the type or amount of products they used.  (They have eczema, they’re using detergents!)


I have recently become aware of a another potential concern for SolveEczema users.  SOME WATER SOFTENER SALTS HAVE DETERGENT ADDITIVES!

Additives help keep the ion-exchange resin in the softener clean, and prevent inconveniences like “bridging” of the salt, and since water softener companies are unaware of the connection between small amounts of detergent and eczema, and believe the amount of detergent introduced by the additives is small, they believe it’s all good.

But taking a look at the Morton web site, I found this frequently asked question (with answer):  “After using Morton water softening products why does my skin itch?  …Even though it is unlikely that the additives in the salt product could be the cause of the skin itch, you may wish to try a product with no additives, such as Morton®White Crystal® products or Morton® Potassium Chloride Pellets. …”

Because of the additives, Morton also does not recommend using the water softening salt with additives in aquariums.  As mentioned above, they do sell water softener salt products without additives, and I called their corporate office recently to suggest they pay attention to the issue of detergents and eczema, since much potential future growth in the water softener business will likely come from families whose kids have eczema (from detergents).

Another parent wrote to me with this information from the Cargill site regarding Diamond Crystal salt pellets with an additive called Softener Care:
What exactly is “Softener Care” additive?
The Softener Care™ additive is a surfactant called sodium hexametaphosphate. In the pellets, it provides added durability, thus reducing the tendency towards mushing and bridging which can interfere with normal softener operation.”

It appears that Diamond Crystal/Cargill also sells products without the additives.

Photo by Arianne van Noordt, from sxc.hu

Our local hardware store always sold only pure salt for the water softener, but when this came to my attention, my husband told me he had just bought a bag that was different because the hardware store stopped carrying the old kind we had been using.  Lo and behold, it had detergent additives in it!  Luckily, he hadn’t yet poured it.

It gets exhausting keeping after all the many sources of household detergents, but this one is particularly important to get right, since it would introduce low levels of detergents in the household water supply.

I still recommend water softeners for those wishing to try the strategies on SolveEczema.org, because of so many benefits to skin and household, and because it takes so long to get results with hard water — hard water results often are never as good as with soft water.  So, if you are trying to follow the SolveEczema.org site strategies —

TAKE CARE TO USE ONLY WATER SOFTENER SALT PRODUCTS IN THE SOFTENER THAT ARE PURE SALT, AND NOT A SALT PRODUCT WITH ADDITIVES!!

 

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Meaningful Mentions

Two meaningful online mentions for SolveEczema.org:

1.  Healthline.com, a prominent health information site on the web with an impressive medical review board, selected SolveEczema.org for its list of Best Skin Disorders Blogs of 2012!

skin disorder blogs

2.  And truly meaningful to me, Mom CJ writes in her beautifully-written blog, Sammy’s Skin, her family’s journey with her son’s severe eczema, and how they ultimately found a drug-free solution with SolveEczema.org.  She contacted me by email along the way, and I know many of the barriers she faced to getting her son cleared up, more even than most families.  My hat is off to her.  Along with two other moms who used SolveEczema, I’m told CJ has begun a facebook group to share with others.  If only I were better with facebook, I’d provide a link!   But she has shared their intention to start and run an online forum, something I have wanted to do but have not had the time for — I will follow with more information when I hear more.The following photos from Sammy’s Skin are used with permission:

Sammy's Skin before using SolveEczema.org

Sammy’s Skin before using SolveEczema.org

Sammy's Skin before using SolveEczema.org

Sammy’s Skin before using SolveEczema.org

 

Sammy's Skin improving with SolveEczema.org

Sammy’s Skin improving with SolveEczema.org

Sammy's skin after using SolveEczema.org - and the best reward ever, Sammy Smiling!

Sammy’s skin after using SolveEczema.org – and the best reward ever, Sammy smiling!

Q&A: Reading Labels and the confusing business of telling soaps from detergents

I received a letter recently with a request to better explain how to find products that meet the SolveEczema site criteria.  I get product questions enough that I thought I’d just post my reply here on the blog:

My letter:

I’m glad the site helped!  I know it’s confusing to tell which products meet the site criteria and not — if it helps, I have difficulties evaluating product ingredients myself!  (Unfortunately, the majority of products available on store shelves do not meet the site criteria, which is why so many people have problems finding ones that do.)

First, you researched your daughter’s problem and implemented something that helps — so you are a problem solver, and that’s what’s important here.  I come across many moms who are very systematic, determined, and smart, many of whom have no science background whatsoever — and they’re as and sometimes even more effective than someone whose training might at first be a barrier to looking at the problem a new way. So don’t feel like it’s you.  It’s just the position we are all in because of what’s in our environment, how ubiquitous that influence is, and how poor the information we have is to assess it.

I have had friends who told me, “Just tell me what to use” — which works up to a point, but getting the best result takes understanding what is going on and problem-solving in your own environment.  Often people think they are detergent-free yet miss even very obvious influences until they do understand.

Plus, products are different everywhere — I get letters from all over the world — and companies change their products all the time.  I just got a letter from another mom who ordered some products from a company I recommended, Eco-Me, and there were sugar detergents in the products she received.  I looked on the company’s website, and they had different pages on their site for those same products with completely different ingredients.  I remember when I first checked them out, everything they made was okay per the site, but no longer.  They may be in the process of reformulating.  Worse, they have used the word “soap” in the INGREDIENTS list for something that is not a traditional soap.  It’s the first time I’ve seen “soap” used in the ingredients for something that isn’t a true traditional soap.  However, if you understand, you should be able to figure that out when you evaluate even those products.

One of the most important reasons to understand is for parents to really see the problem as environmental and not a “defect” in their children.  There’s a huge difference, psychologically, between needing a chronic treatment and knowing the problem isn’t you, especially for kids.

The video slideshow overview explains everything fairly simply, in case you haven’t already watched it.  You may want to take a look again at the slide showing the difference between soap and detergent chemical names, it may help.

So, everyone has trouble assessing ingredients.  I have trouble assessing ingredients.  If this were easy, more people would have figured it out.

The underlying principle is this:  I believe “normal” eczema and allergies are a signal from the immune system to the conscious brain, the way pain is for the nervous system.  Whether the “signal” is expressed or not depends on whether a certain threshold is crossed, and that depends to some extent on the state of the immune system, genetic factors affecting skin and immunity, environmental factors affecting skin (such as local humidity, but also whether the skin is damaged because of long-term exposure to detergents, etc), the state of the gut and whether certain proteins are crossing into the bloodstream (and, I suspect, necessitating increased circulating biological detergent to denature those proteins), etc.  But by far the greatest influence now comes from the effect of modern synthetic detergents, which (because of how they are designed) dramatically and unnaturally increase the permeability of skin.  In my experience, the expression of the eczema is proportional to the effect on the permeability.

Removing detergents is not very successful with water alone, residues are incredibly persistent.  As the site says, it’s necessary to use something else to get them out.  Plus, people need a way to get clean in the normal course of life.

So, what else can be used?  Something that doesn’t increase the permeability of the skin beyond a certain point.  The major class of washing products that work appears to be, empirically, traditional alkaline soaps.  Luckily, because they are made in such a narrowly defined way per the relevant characteristics of the end products, they’re pretty much all okay (provided the individual ingredients aren’t allergenic for a given person).

The rise in eczema, asthma/atopy around the world in the latter half of the 20th century has coincided with the increased use of detergents.  Many of the observations that led to the hygiene hypothesis take on new meaning when looked at in that light.  For example, people in many rural areas have less eczema than in urban areas.  One proposed interpretation is that people on farms are less clean and are around certain germs that challenge the immune system.  I’d make the separate observation that soapmaking is traditional in rural environments, farmers spend more time out-of-doors (instead of in indoor environments with the greatest exposure to detergents and detergent dusts).  Amish farm families have an even lower rate of eczema than farmers in the same regions; the Amish still make and use their own soap.

Anyway, back to the issue at hand…

As I describe in detail on the site, words like “soap”, “detergent”, “surfactant”, “emollient” and others, are used very differently in different consumer contexts.  Common definitions have changed over time.  I define the words in a way that allows people to get results with my site, and my definitions are definitely supportable on technical grounds.  However, that’s not how those words are necessarily used when labeling products you buy.

The word “surfactant” just means surface active agent — substances used to reduce the surface tension of water — and covers both traditional soaps AND detergents (by my definition of those words).  HOWEVER, on ingredients labels, the word “surfactant” is invariably used to describe synthetic detergents.  Often it is used to avoid using a name with more negative connotations for consumers.  Lots of products containing SLS or similar detergents describe them as “coconut-based surfactants”.

So, to be very technical about it, no, you don’t have to avoid all surfactants, because soap is a surfactant, but you probably do need to avoid anything LABELED as having a “surfactant” for the time being, because invariably it means it contains a synthetic detergent.

To use the site, you can use borax, baking soda, vinegar, or other non-surfactant washing products I mention.  And you can use any traditional alkaline soap (so long as you don’t have an individual allergy to the ingredients and it’s not so alkaline as to be badly drying).  There is a short list of the most commonly used soaps and their chemical names on my slideshow.  If the label says “saponified [oil]”, that’s soap, or if the label lists an oil and potassium or sodium hydroxide, and no detergents, that’s soap.  Castile soap is soap made with olive oil.  Fortunately, the number of pure soap products seems to be growing.

Sometimes products list only the oils in the ingredients, and it’s not clear whether the products are traditional soap or not.  In that case, if you want to try the product, it’s better to call or write the company first to verify what the product is.  Is it just oil?  Is it saponified oil? Or is it something else made from those oil ingredients (which would make it a detergent by my site definition).

Natural products companies in the last few years have begun to heavily use sugar detergents, which seem to be more mild than other syndets (a “syndet” is a synthetic detergent), and at first I cautiously recommended them.  But I’ve heard from too many people for whom they did not work, so I’ve conditionally withdrawn my recommendation and am hoping for a better sense of these over time.  (I generally suggest problem-solving only with products you can be very sure of, and experimenting with things like these later once you know what you may be dealing with.)

As I say on the site, check ingredients.  I do have one caveat, though.  I tell people to ignore the front label, and to read the ingredients label, which tends to be more accurate and precise.  The front of the product may say “soap” but the product may be entirely detergent.  Usually the ingredients label, however, will be more clear.  If it says something is a “saponified” oil or a “soap” it’s usually traditional alkaline soap.

IMPORTANT NOTE:  However, another mom brought to my attention recently those Eco-Me products I mentioned above, that used to all be non-detergent — they used the word “soap” on the label of their dish soap product for a detergent.  It’s the first time I’ve seen that.  The label (Suzy dish soap) includes:  ” Coconut-base Soap (Decyl Glucoside)” — “Decyl glucoside” is a sugar detergent.

Given the trend in the “natural” product industry, it’s probably a good idea to search the names of the most common sugar surfactants and know what they are.  You’ll generally see the roots of the words for sugar in the names (glucose <=> decyl glucoside).  And also to just know the chemical names of the most common soaps.

The only reason I mention charge properties (anionic, nonionic) is that soap is anionic, so if a surfactant ingredient is described as an amphoteric or nonionic surfactant, you know it’s not soap.  However, many harsh detergents are anionic, too — sodium lauryl sulfate is anionic, as are many problematic syndets.

Additionally, it’s important to realize just how problematic hard water can be. Few people really appreciate just how much of a factor water hardness is to getting results.  Soaps clean so much better in soft water, far less product can be used, and everything rinses better.  Skin and hair feel so much better, too.  Soaps don’t work very well in hard water.  Nothing rinses well.  Very hard water can mean the detergent removal process effectively takes months rather than weeks or days.  Many if not most of the people who contact me with problems, it turns out, have hard water.

I do my best to give a list of products that will work, and I check the ingredients very carefully.  But most companies that sell soap products also sell some or many products that don’t meet the site criteria.  Products change, and there’s no way for me to keep up on everything.  I go to a great deal of trouble to describe how to figure out products on the site, but unfortunately, the difficulty is just because of the situation we are all in, it’s not you, and it’s not for a lack of scientific skills.

I know you asked for a “dumbed down” explanation; please let me know if anything is still unclear.  It will help me know what I need to do a better job explaining for the book.

I hope it helps.  Good luck to your family and your baby for a regular no-eczema childhood!

Kindly,
AJ

 

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Better than the washing test — “diagnosing” detergent-reactive eczema

Better Than the Washing Test — “Diagnosing” Detergent-Reactive Eczema

 

Now here’s a word I never thought I would use in mixed company:  PATHOGNOMONIC
From Medicine.net:

“Pathognomonic: A sign or symptom that is so characteristic of a disease that it can be used to make a diagnosis. For example, Koplik spots in the mouth opposite the first and second upper molars are pathognomonic of measles.”

Although I must always warn that 1) I am not a doctor, and 2) these are my ideas and not yet established by scientific study, I am ready to go out on a limb with this usage of the above hopefully correctly-spelled word:

I believe now that a persistently clear diaper area — when disposable diapers are used — for a child who otherwise has generalized eczema, is PATHOGNOMONIC of detergent-reactive eczema.

(It pays to be familiar with why the washing test is helpful for understanding the site information and future prevention, and the washing test does have its uses, but it can also have a lot of false negatives, so to speak.)

Now, it’s possible that the problem could be detergent-reactive eczema yet the diaper area not be entirely clear, such as with diaper rash or yeast-infected rash, so having a rash in the diaper area doesn’t necessary rule out detergent-reactive eczema.  However, having a CLEAR diaper area when disposable diapers are used, despite generalized eczema, is pathognomonic for detergent-reactive eczema.

Although this is probably no surprise to SolveEczema.org readers — it makes sense given the basis for the eczema — I wasn’t willing to, well, go out on a limb until I knew more.  And, until there is a scientific study or studies, I am open to finding out that I am wrong.  But I don’t think so.

Hopefully that insight is helpful to new users and doctors who refer patients to the website.  SolveEczema.org

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The roar of the crowds, the ITCH of the greasepaint?…

Brad Pitt portraitWell, add stage makeup to another class of products that appears to frequently have detergents in them, sometimes pretty strong detergents like SLS.  Wow, I was a theater buff as a teenager and remember the thick oily makeup and the greasy cold creams necessary to remove it.  Things must have changed.  I’m guessing detergents help the makeup go on easier and wash off with less pain and … grease (elbow and otherwise).

I was handed a container of stage makeup recently that was supposed to be hypoallergenic.  SLS was the second or third detergent on the list!  I don’t even know what came after.  No wonder Brad Pitt, who I’ve read has eczema, had so many problems finding makeup that didn’t bother his skin when he was filming The Curious Case of Benjamin Button.  (I wonder if that has anything to do with why he plans to retire from acting?  I hope not!  It would be such a waste and so totally unnecessary.)  Given the odds, it’s also possible one or more of his kids has some eczema, dry skin, asthma, or allergies.  (I did try to find a contact address to send a link to SolveEczema, but Pitt is famously private and anyone online these days gets so much spam, it seemed a fool’s errand.)   Note from the universe to Brad:  Switch to true soaps at home and use only makeup that contains no detergents!

Photo attribution:  Thomas Peter Schulzen
Creative Commons Attribution-Share Alike 3.0 Unported license

Catching up … if my computer will cooperate …

Well, when I drop off the face of the earth for awhile, at least relative to my blog, I feel like I should catch up before posting more.  But I’m not someone who writes well about the usual slogs of life, so — my apologies!  I am still wrapping up from the crowdfunding and cleaning up after a particularly long season of computer troubles.   (I didn’t win the Changemakers healthcare competition, by the way — I didn’t expect to — but take a look at the winners who did, and some who didn’t, it’s both eye opening and inspiring.  Links on my last post.)

I heard somewhere that Steve Jobs had an employee whose job was just to take care of all the time-consuming technical hassles so that all Jobs had to do was use his computers for their intended purposes when he wanted.   (I need that guy!!!!!!!)  Barring that, I sure wish the computer industry was paying attention to what the rest of us slog through that keeps us from using our computers the way WE intend to use them…

Anyone at Apple have eczema?  I’m happy to barter some expertise…

Social Competition Entry: Ending the eczema and allergy epidemic, without drugs or expensive interventions

I have entered SolveEczema.org in a healthcare competition – Innovations for Health – sponsored by the Ashoka and Robert Wood Johnson Foundations. It’s unlikely to win, but if the entry is well-received, I may make good connections or find resources to help further work in the future. The organizers have told entrants to reach out to our social networks for comments, that they make a big difference.

Please make a comment to the competition entry, or contribute to the discussion. Early finalists will be announced March 19.

The entry:
“Ending the eczema and allergy epidemic, without drugs or expensive interventions”
http://www.changemakers.com/innovations4health/entries/ending-eczema-and-allergy-epidemic-without-drugs-or-exp

To learn more about the competition in general, please see:
http://www.changemakers.com/innovations4health/