#SkinishMom Investigates – Skin Biomarkers

There was a news article on BBC News in February this year that Skin may help spot Alzheimer’s and Parkinson’s Disease. It got #SkinishMom into an investigative mood – What can our Skin actually Tell Us? MarcieMom had interviewed dermatologist Dr Verallo-Rowell in the Skin Health series covering how to watch out for skin cancer via skin changes, but our skin can tell beyond skin issues – it’s amazing that there is the potential for our skin to tell us about our brain and heart!

The Connection between Skin and Brain

The connection between the skin and brain starts from our body embryo stage. Subsequent to fertilization of the egg by the sperm, the embryo forms into 3 layers (ectoderm, mesoderm and endoderm). The brain, nerves and skin share the sam layer (ectoderm).

The brain and skin are always communicating with each other, to the extent our skin is sometimes termed the ‘diffused brain’. For instance, the brain sends stress signals to our skin (more in this interview with Dr Claudia Aguirre). Essential fatty acids (omega-3) is beneficial for both our skin and our brain. Babies’ brain development is affected by the lack of touch and was reported that for Romanian babies who were orphaned (and lacked touch), there was a black hole in their brains. Babies whose cries are attended to showed lower level of brain toxicity (from US pediatrician Dr Sears’ talk).

So the brain and our skin are intricately linked, which opens up the possibility that our skin can serve as biomarker to tell us about our brain’s health!

Skin as Biomarker for Health Condtions

What Our Skin Can Tell Us – Biomarkers

Apart from what our skin can tell us about skin disease, our skin can also tell us about our immunity – here’s from Dr Verallo-Rowell where she explained the link between inflammation and our skin.

Look for markers of inflammation: your acne flaring up, rosacea attacks becoming frequent, the eczema bigger, wider spread; those with psoriasis too – the lesions are bigger and persistent; boils recurring more often. These may indicate a lowered immunity from such things as too much exercise.

Here are a few potential diseases that can be uncovered via skin:

  1. Parkinson and Alzheimer – via skin biopsy of skin behind the year to detect presence of an increased in the protein tau and alpha-synuclein. These two protein deposits were found in the brain of sufferers from these two brain disorders.
  2. Oxidative stress to skin – this is part of an interesting prevention biomarkers project where the researchers found out was that people who ate a high flavonoid diet (a category of plant nutrients that have antioxidant and anti-inflammatory properties) do not exhibit genes that get activated by oxidative stress in their skin. Extrapolating this, if there is an easy way to test the impact of our diet on our health (via skin tests), it will make it so much more convincing to get people to change their eating habits! (This reminds me of a bible verse 2 Corinthians 5:7 – We walk by faith, not by sight; even if you don’t see the benefits of healthy eating, you should go by faith and eat healthy!)
  3. Carotid atherosclerosis – Facial pigmentation may be a useful biomarker for carotid atherosclerosis, which is a degenerative disease of the arteries that result in plaques.

Our skin have lipids, proteins, inflammatory mediators, nucleic acids and molecules that serve as a potential to tell us about our health. I wonder if there is the potential of treating our health via our skin too.

Signing off for a bath and full body moisturizing,

#SkinishMom

p.s. just after I tweeted this out, featured guest Dr Claudia Aguirre shared this article she wrote on HuffPost with me, and here’s more reason to reduce stress!

Scientific evidence has shown us that stress equates to inflammation, and this can cause havoc on the skin. From acne breakouts, to rosacea flushes to eczema flare-ups, stress is the fuel to the fire of inflammation lurking in these conditions. What’s more, stress not only triggers or exacerbates particular skin diseases, it can also lead to dehydration, lines, blotchiness, hair loss and brittle nailsfor those without an inherent condition.

On the flip side, the distress these “stress-related” skin conditions causes is also very real, feeding a vicious cycle. Getting that awful pimple before your date, or the significant hair loss after a traumatic event — these can in turn cause psychological distress, even to the point of creating a psychiatric condition such as depression and anxiety. The statistics are telling: People with the most visible skin conditions (vitiligo, psoriasis) have much higher risk factor for developing anxiety, depressionand even suicidal thoughts.

Eczema ‘Cure’ Series – Do How We Bathe Matter?

If you’ve been following this blog, you’d know I don’t jump into eczema (miracle) cures. I still don’t.

But as I read journeys of how eczema sufferers are cured, I realized that there are common approaches they take. These may not be THE (or even an) eczema cure but I think there’re certain situations which they may help improve eczema. I hazard a guess and this series is more about a holistic approach to controlling eczema – I suppose you can call it a cure if one approach singularly works well for you!

There is a fair amount of suggestions by the dermatological community on how and what to bathe with to help eczema skin. Some eczema sufferers also shared on what they use, though in general, it is less often cited as a ‘cure’ compared to the first 3 series of this post on:

Personally, I alternate between an oatmeal-based bath, a chlorhexidine-based bath lotion and a hypoallergenic cleanser for my eczema child (Marcie, who’s 6 years old now!). I haven’t dared to try a bleach bath nor mixing vinegar though these two have also been recommended by dermatologists. Let’s explore the various baths for eczema sufferers!

Bath for Eczema Skin

Bath to Try #1 – Soaking

If you have a bath tub or your child still fit into one, soaking in a bath tub (not hot water, but use lukewarm or room temperature) for not more than 10 minutes can help the skin to absorb water. Especially for those of you who have to endure dry, winter months, possibly dissolve a thick emollient into the bath as well! Note: Don’t soak your head in the tub!

Bath to Try #2 – (Colloidal Oatmeal) Bath Oil

Bath oil – Try colloidal oatmeal bath or other bath oils but be sure they do not contain the key irritants such as fragrance. Oatmeal bath can relieve eczema itch. Bath oil tend to leave a film on the skin and possibly a quick rinse will suffice instead of trying to wash the ‘film’ away – I guess that’s a bit defeating the purpose of using a bath oil. Here’s a study on bath oil for infants.

Bath to Try #3 – Bleach Bath

The main purpose of bleach bath is to kill the staph bacteria that often colonizes eczema skin. I’ve the privilege of interviewing dermatologist Dr Cheryl Lee who is an early proponent of bleach bath (more here). Bleach bath is to be limited to no more than 3 times a week. A study on bleach bath here.

Bath to Try #4 – Chlorhexidine

I used to wipe my child’s skin with chlorhexidine when I noticed persistent itch or redness. Since I’ve been prescribed a chlorhexidine-based shower lotion, I’d use it say once a week especially as my child has quite a few ‘high bacterial’ habits! More on chlorhexidine and bleach bath from my interview with dermatologist Dr Clay Cockerell.

Bath to Try #5 – Vinegar Bath

If bleach sounds too aggressive/ chemical/ toxic to you, consider vinegar. I’ve had an informative interview with Dr Cheryl Lee where she shared how vinegar balances the skin pH level on top of killing the staph bacteria. Vinegar bath may be stinging for some eczema skin/wounds, check with your doctor first.

Other Baths

Some like to add magnesium flakes into bath, while others use salt.

Bath NOT to Take #1 – Hot

So many eczema sufferers SUFFER FROM ITCH and sometimes, uses hot water to numb the itch for a relief during shower. However, hot water strips moisture from skin, avoid at all costs.

Bath NOT to Take #2 – Soap

Soap is drying because it’s way too alkaline for our skin, more here on soap here. It often causes skin irritation too.

Bath NOT to Take #3 – Too Long

Too long a shower strips moisture from skin – it’s a bit mind boggling when you first heard of it, shouldn’t the longer you shower be more moisturizing? It’s not – think of it as a thunderstorm washing off the cement in the brick wall.

Bath NOT to Take #4 – Bubble Bath

Most of the bubble bath solutions contain irritants, avoid bubble bath for children with eczema.

Bath NOT to Take #5 – Exfoliating Bath

Our skin exfoliates on its own – using scrubs can further break down the skin barrier which is already ‘weak’ for eczema sufferers.

Bath NOT to Take #6 – Bath without Moisturizing After

Pat dry (not rub dry), moisturize within 3 minutes after shower. More in this video.

If bathing is so troublesome, why not forgo bathing? First of all, that’s downright unbearable, especially for us in hot weather cities (Singapore, Asia, Australia and parts of US too!). Secondly, bathing has a purpose to remove dirt, sweat and skin debris which can also be irritating if left to accumulate on the skin. Instead, you can try shortening the length of a shower or reducing the number of times you shower (in a day, not a week! – No way I can don’t shower everyday in Singapore!).

Do share your bathing tips in the comments, we love to hear more of what you’re doing!

Ask #SkinishMom – Why can’t Skincare Product Label be Easier to Read?

#SkinishMom Parenting Skin Expert

Ask #SkinishMom any question – parenting, skin, eczema or plain venting!

My child has eczema and our whole family has sensitive skin. I’m trying to read the label of ingredients but gosh, why can’t they be in simple English? I can’t understand why some cheap products have so many ingredients while the more expensive ones have fewer. Then I can’t understand why certain luxury brands have so many ingredients as well. What are these ingredients all saying anyway? I just want to know – To Buy or Not To Buy for my family of sensitive skin!

Frustrated Mom

I totally understand. Why can’t skincare companies just say plainly what their ingredients are, like ‘Sorry, we’ve added some preservatives which aren’t too fab for your skin but if we don’t, your product won’t even make it to the shelf without spoiling.’ So, here are the #SkinishMom Get-Past-the-BS Skincare Product Label tips:

Warning skincare product label

1. Ignore the Picture

Nice looking pictures have no bearing on the contents inside. What I do look for is if the picture is blurred and resolution bad, I would conclude that if they don’t even put in effort into getting the picture right, how can I then trust they’d get the product formulation right.

2. Be warned about ‘Hypoallergenic’, ‘Natural’, ‘Organic’, ‘pH balanced’, ‘Dermatologist-recommended’, ‘Good for Baby’ and ‘Noncomedogenic’

The use of these terms are not regulated and therefore you should take these terms with a pinch of salt.

Hypoallergenic means less likely to result in allergies

Natural means more natural ingredients used – there’s usually some reason why certain ingredients are selected, for instance, tea tree oil has antiseptic properties but is also a top allergen. So being natural does not equal no skin rash.

Organic carries weight if it is certified, means the plants have been grown organically without pesticides.

pH balanced refers to being close to the pH of the skin, as being over alkaline and over acidic will dry or redden the skin

Dermatologist recommended and Good for baby has no meaning at all, it’s almost a signal to me that the product company chooses to use a term that has no clear definition

Noncomedogenic refers to less likely to clog pores

3. The more ingredients, the more likely it’d irritate

The general rule is if with more ingredients in the bottle, the higher chances one of it will irritate your sensitive skin.

When I look at luxury brands, I do notice that they have a long list of ingredients – my guess is to distinguish themselves, they aim for a mix of ingredients to get the fragrance and texture to smell/feel sophisticated with a large number of natural extracts. Personally, I tend to get rash when I use perfume. And when I examine the ingredients in my branded skincare product, I see lots of potential irritants (see below).

4. Don’t get a skincare product with the top irritants

This is the part that gets a bit technical. The easy part is avoid the ingredients below. The tougher part is they have many different names, good news MarcieMom had interviewed a renowned dermatologist (Dr Verallo Rowell) who cares so much about us lot with sensitive skin that she listed the different names in this interview.

List of Ingredients that could Irritate in skincare product

List of Ingredients that could Irritate

Avoid also ethyl alcohol that is drying for skin. Avoid surfactants (chemicals ending with sulfates), that dries and damages the skin.

5. Don’t buy if you don’t like the first half of ingredients 

Ingredients that have the highest percentage have to be listed first. For ingredients of less than 1%, they can be listed in any order. Look for the active ingredients too and see where they fall in the ingredient order. The active ingredients can vary widely, for instance, some focus on vitamin A which is listed as retinol or others have patented names for restoration of skin lipids. Not all have to be higher percentage in order to be effective.

Go for some skincare shopping now, test your knowledge!

#SkinishMom

Eczema ‘Cure’ Series – Chemical-Free

If you’ve been following this blog, you’d know I don’t jump into eczema (miracle) cures. I still don’t.

But as I read journeys of how eczema sufferers are cured, I realized that there are common approaches they take. These may not be THE (or even an) eczema cure but I think there’re certain situations which they may help improve eczema. I hazard a guess and this series is more about a holistic approach to controlling eczema – I suppose you can call it a cure if one approach singularly works well for you!

There are some eczema sufferers that report an improvement in their eczema after ‘cleaning’ their homes of all chemicals (no pun intended!). Personally I don’t use much chemicals at home, for instance, my floor is cleaned with water and we don’t use anti-bacterial wash every time. It can be very difficult to adopt a zero-tolerance for chemical in your life, given how they are in a lot of products, even baby wipes! I do believe though that some individuals’ skin are more sensitive to chemicals than others and therefore for them, eliminating chemicals work well for their eczema. For the rest of us, perhaps a moderated approach to limit chemicals only in certain areas. These are my suggestions!

Chemical Alerts for Eczema

Chemical Alert #1 – Detergent

This is likely one area you have to be careful with because detergent residue can be irritating to child’s sensitive skin and it is also worn in close contact with the skin. Detergent residue can make up 2% of the weight of a clothing and it contains irritants such as

  • Sodium Lauryl Sulfate
  • Triclosan
  • Formaldehyde
  • Sodium Hydroxide
  • Linalool
  • Sodium Flouride

These chemicals are also present in fabric softener, bubble bath and baby wipes; read more in What and How Much Detergent to Use for a Child with Eczema

These chemicals irritant and can cause contact dermatitis. What I do is wash using a longer cycle and use a hypoallergenic detergent. It may also mean that the clothes don’t get cleaned as it would with stronger detergent but it beats having eczema. Be careful of new clothes too, wash them before wearing as they also contain chemicals (read this mom’s sharing on trying on new clothes for her eczema child).

Chemical Alert #2 – Anti-microbial Products

This is one of those oxymoron – we want to clean to be safe but the cleaning leads to more danger. Generally speaking, the concerns are:

  1. Increased use of antimicrobial products (ingredient triclosan and triclocarban) lead to prolonged contact through the use of everyday products like dish washing detergent, hand sanitizer, deodorant and soap. This overtime can lead to contact eczema where the skin starts to develop rash when in contact with these, for instance, occupations that involve frequent hand washing tend to get this.
  2. Exposure to the ingredients in anti-microbial products had been associated with wheezing and allergic rhinitis
  3. Avoid soap and surfactant that remove skin lipids, understand more from Dr Cheryl Lee in Moisturizer and Skincare Products
  4. Constantly using anti-microbial products to kill bacteria can actually lead to bacteria becoming resistant to cleaning, partly contributing to why hospitals have higher rate of staph bacteria infection although they clean the hospital often (see this study)
  5. Also the hygiene hypothesis, whereby the more ‘ bacteria cleaning’ we do, the less our body is capable of dealing with foreign matters thus sometimes going into an overdrive when exposed to something harmless

Chemical Alert #3 – Fragrance

Fragrance is undoubtedly the top irritant – avoid fragrance for the whole family with a baby with sensitive skin, as advised by dermatologist Dr Cheryl Lee MD in Eczema and Skin pH, point 7 on allergy avoidance. Other chemicals to avoid are nickel, formaldehyde releasing preservatives, propolis (in beeswax), neomycin and bacitracin. For alternative names to fragrance, see the compiled list from dermatologist Dr Verallo Rowell on Sensitive Skin Products – Top Irritants.

Other common irritants for children with eczema is listed in Contact Dermatitis for your Eczema Child and nickel is one that showed up in quite a few studies. Coins and jewelry of nickel has to be avoided for those sensitive to nickel.

Chemical Alert #4 – Hair Dyes and Tattoos

It would unlikely be affecting eczema children but teens and adults should take care of the potential dangerous effects from using hair dyes (with A-List Celebrity Hairstylist Kristan Serafino on alternative hairstyling tips) and tattoos.

Chemical Alert #5 – Chemical in the Air

Chemicals that we breathe in can also affect allergic condition, like asthma. Read how dermatologist Dr Cheryl Lee avoid VOC paint and redo her home carpeting. Avoid polyaromatic hydrocarbons as well.

Chemical Alert #6 – Baby Wipes

Baby wipes are a life-saver, especially when traveling. Be careful not to use it on the face though as the skin is thinner on the face and an ingredient in baby wipe methylchloroisothiazolinone or methylisothiazolinone has been linked to cause skin rash overtime.

On the point about the air, many food allergens can come into contact with our skin from the air. Especially if you or your child has egg allergy, it’d be best to dine in a restaurant with good air ventilation instead of hawker centre where the ‘egg’ content in the air is higher (something my co-author Prof Hugo Van Bever shared in our book launch). What other chemicals are you avoiding? Share in the comments!

#SkinishMom Investigates Drinking Water for Dry Skin

So, is drinking 8 glasses of water good for skin?

Drinking Water Skin Hydrate

There is little research to back up that drinking more water is going to hydrate the skin, make the skin glow or smooth. The practical reason for this is that research is usually conducted for ‘products’ when they can be patented, thus the lack of research on water. The only research that I can find on Pubmed on water is Effect of fluid intake on skin physiology: distinct differences between drinking mineral water and tap water. The results seemed convoluted though with no clear conclusion.

The conclusion from most dermatologists though is lack of water is bad for the skin but excess water does not benefit the skin.

What happens to Skin when Drinking Too Little Water?

Our body needs water for its organs to function so it will reduce hydrating cells to channel water for essential body functions. The skin will then look duller and wrinkles and pores will be more apparent. However, there is no change to the underlying skin structure but the wrinkles and pores are ‘temporarily’ more obvious when the body is dehydrated. But prolonged dehydration can speed up aging as the skin is persistently drier and more prone to skin irritation as well.

So, does Drinking Water Help with Hydrating Skin?

Water that we drink does not go straight to the skin – it goes to intestines, bloodstream, filtered by kidneys. If you drink excess water, the body will pass it out – it wouldn’t go specifically to hydrating skin cells although water will hydrate all cells in general. To target skin cells, moisturizing is required and avoid doing a list of things that will actually dry your skin such as:

1.     Scrubbing or exfoliating your skin

2.     Drying (instead of dabbing dry) with a towel

3.     Sun-tanning (and not using sunscreen)

4.     Long bath and Hot bath

5.     Using soap

6.     Not eating enough omega 3 (which our diet is generally lacking in, essential fatty acids)

Bottom line – Drink when you’re thirsty.

Signing off SkinishMom, and yes, just remembered that thirst is often mistaken for hunger so I’m drinking up!

Eczema ‘Cure’ Series – Home Remedies

If you’ve been following this blog, you’d know I don’t jump into eczema (miracle) cures. I still don’t.

But as I read journeys of how eczema sufferers are cured, I realized that there are common approaches they take. These may not be THE (or even an) eczema cure but I think there’re certain situations which they may help improve eczema. I hazard a guess and this series is more about a holistic approach to controlling eczema – I suppose you can call it a cure if one approach singularly works well for you!

Many eczema sufferers are wary of chemical and steroids. I agree but am also wary of going into extremes of attributing everything bad to chemicals and steroids, especially given that eczema is a condition that comes about from many factors (so would focusing on just one aspect be over-simplification?). But I’m definitely supportive of home remedies that work – if they work without side effect!

Eczema home remedies

Home Remedy #1 – Moisturize

Moisturizing is one approach that most would agree is beneficial. It’s accepted that eczema patients (adults and children) have defective skin barrier and a moisturizer have various functions to

  • Protect skin from drying/ losing too much moisture
  • Protecting skin from irritants
  • Absorbing water into the skin
  • Filling up the ‘holes’ in the skin or restoring the skin lipids (that help keep the skin cells together and prevent infection, learn more from dermatologist Dr Cheryl Lee in this Over-Alkaline skincare interview)

See also the research on moisturizing where it had been shown to reduce steroid usage and preventive effect on babies with high risk

Watch the video on how to moisturize baby’s sensitive skin.

Home Remedy #2 – Don’t Moisturize (with Irritants)

There are also sharing by eczema sufferers that their eczema improved after STOPPING moisturizer use. My guess is that there could be ingredients in the moisturizers that they have been using that are triggering the eczema, a form of contact dermatitis. There is a test to determine which ingredient in skincare product that you could be sensitive to, known as patch test (interview with Laura Verallo Rowell, CEO of VMV Hypoallergenics).

There are indeed individuals whose skin are sensitive to many common ingredients and therefore, it would make sense for this selected group to stop moisturizer use. Not for general population with dry skin though.

To be safe, start off with a moisturizer that doesn’t contain the top irritants, compiled by dermatologist Dr Verallo Rowell with alternative names to these irritants.

Home Remedy #3 – Keep the Skin Moist

I wouldn’t really call it a ‘home remedy’ as clothing products that are able to trap moisture close to the skin and studied to improve eczema usually have invested money into the technology behind the clothing. One such technique is Wet Wrap which had been shown to help eczema and if you’d like to know more about what goes into the wrap and how to use it, read here. My national (Singapore) eczema support group also runs regular wet wrap session, do sign up at the top right box of my blog to be kept posted!

Home Remedy #4 – Ways to Kill Staph Bacteria

Staph bacteria is a common cause for eczema where increasing research showed that eczema skin is colonized by this bacteria which produces toxins that can worsen skin inflammation. There are ‘natural’ ways to kill the bacteria, for instance swimming or bleach bath or shower with a chlorhexidine-based bath wash.

If you don’t like the idea of bleach, read this interview with dermatologist Dr Cheryl Lee on vinegar spray.

Home Remedy #5 – Oils

Though no conclusive research, there are eczema patients whose skin improved after primrose and borage oil (see dermatologist Dr Cynthia Bailey’s comment in the post) and virgin coconut oil (see this very informative interview with dermatologist Dr Verallo Rowell on different types of coconut oil – make sure you get the right type!)

Home Remedy #6 – Anti-Inflammatory Natural Ingredients

There are also quite a few natural ingredients that have anti-inflammatory properties like honey, lavendar or able to protect skin like colloidal oat (interview with dermatologist Dr Claudia Aguirre).

Personally, I feel that the biggest home remedy is to avoid triggers. Logically it makes sense to identify these triggers because no treatment or remedy can be helpful if the skin is under constant ‘attack’. After which, I do believe in moisturizing and as for using natural ingredients, I’m all for it as long as it’s not something that irritate you (beware that natural does not equal no hypersensitive reaction) nor past expiry (as a home-made product may be less stable so the expiry date matters more).