Eczema News – Tattoo and Eczema – is it worth the Skin?

Tattoo EczemaBlues Skin

Tattoo has been rising in popularity – from TV shows, to ordinary persons in the gym! You see them (almost) everywhere and it’s no longer the ‘hip’ or ‘happening’ guys and gals who tattoo. How does tattoo affect your skin barrier? Will tattooing lead to skin rash/eczema and can eczema sufferers have tattoo? This is a NEW topic we’re exploring and one that although not applicable to kids, we never know how popular tattoo will be and how (young or) old it will be considered norm/OK/cool to have a tattoo!

Tattoo and Skin Barrier

Tattoo works by damaging the skin barrier.

The (permanent) kind of tattoo involves depositing the tattoo pigment via needle into the dermis. The dermis is NOT the top skin layer, but instead the second layer, i.e. the needle penetrates the epidermis, the dermal-epidermal junction, into the dermis. Wound and trauma is caused to the skin barrier.

The wound needs to heal – the better it heals, the better the tattoo and overall surrounding skin will look. The body generates an immune response to defend against the pigment and in the process, lock the pigment permanently.

Tattoo for Eczema Sufferers

In certain states (in US), the law prohibit operators tattooing on the affected skin lesions for eczema and psoriasis patients. There are instances of discoloration of the tattoo and thus the patient/customer has to moderate his expectations and the tattoo artist has to be told about the skin condition.

Apart from the tattoo not appearing as it would on normal skin, there is also a risk of eczema flare-up (not limited to the tattoo-ed skin). The healing process may take longer or be more painful for those with pre-existing skin conditions.

Tattoo Complications

Even if you have normal skin, there are still various skin complications that come with tattooing:

Allergic/ Irritant contact dermatitis – The skin can be sensitive to the tattoo pigment used.

According to American Academy of Dermatology, the type of ink had evolved from metal sales, lead, cobalt and carbon to organic azo dye with plastic-based pigment (which are also used in industrial printing, textile and car). While Patch Testing is recommended where the pigment is first ‘patched’ on the skin and left for 48-72 hours to observe any reaction, organic dyes which are insoluble may not trigger a hypersensitive reaction. Thus, one may falsely assume his/her skin will not react to the dye, but when the dye is impregnated into the skin barrier, a hypersensitive reaction occurs.

The symptoms of allergic skin reaction are itch, rash, scaly, flaky or bumpy. If scratched, it is also prone to skin infection. Sometimes, these symptoms are not immediate but may take months/years to surface as the body gradually develop a delayed hypersensitivity response to it or when it comes into contact with cross reactants (e.g. thimerasol). The level of itch and discomfort is significant – in a study of 40 patients, it was shown to be comparable to that faced by patients with psoriasis and eczema. Granuloma (small, red raised bumps) can significantly alter the aesthetics of the tattoo.

What’s in the Ink?

Of the pigments, the red pigment seems to trigger the most hypersensitive reaction due to the content mercury sulfide (cinnabar). Other components of the red pigment are ferric hydrate (sienna), sandalwood or brazilwood. All other colors are also able to trigger hypersensitive skin reaction.

  • Black pigment uses carbon (india ink), iron oxide and logwood.
  • Blue pigment is colbalt aluminate.
  • Brown pigment is ferric oxide.
  • Green pigment is chromic oxide, lead chromate and phthalocyanine dye.
  • Purple pigment is manganese and aluminum.
  • Yellow pigment is cadmium sulfide.
  • White pigment is titanium oxide and zinc oxide.
  • Fluorescent inks contain fluoroscene.

There is no regulation on the ink used – but to keep track of any news on faulty ‘product’, copy down the company, brand, color and batch number of pigment used. For a more detailed explanation of which pigment may trigger which skin reaction, see Dr Audrey Kunin’s post on DermaDoctor

Photo-allergic dermatitis – This refers to skin inflammation (swelling) after pigment’s exposure to light. The colors most associated with this sort of photo-sensitivity are red, brown and yellow.

Skin infections – Various skin infection can be due to either the ink or the tools used. The potential types of skin infections are:

Bacterial infection – Sterilization of equipment and use of quality pigment reduces the likelihood of bacterial infection

Hepatitis B and C – Sterilization + immunization against Hep B for both the one getting the tattoo and the tattoo artist

Tuberculosis, Myco bacteria, Syphilis, HIV, Malaria

Lichenoid – A delayed hypersensitive response, mainly from mercury in red pigment that led to papules or plaques forming (lichen planus reaction).

Pseudolymphoma – Common with red pigment, where delayed hypersensitive reaction result in red nodules/plaques.

Sarcoidal (Köbner) Granuloma – These are itchy and (swollen) bumps that appear underneath the skin and thus modify the look of the tattoo, a form of autoimmune disorder.

Keloid – Large, raised scars that alter the appearance of the skin/tattoo.

MRI sensitivity – Certain pigment in eyeliner tattoo ink can trigger hypersensitive skin reaction should the person undergo a MRI scan.

Tattoo Safety

Tattooing being increasingly popular also leads to more artists operating from their home. Beware though as home artists may not follow the requirements expected of a licensed artist (on sanitary, request for client’s information, recording of pigment used, wound care, needle disposal). Do not be afraid to play safe – as seen above, the complications can be severe.

Ask to see sterile packaging in original form, INSIST on sterilization, if you have a skin condition, let both your dermatologist and the artist know. As mentioned before, ask for the batch number of the ink used on you. Explore the use of safer chemicals or colors and consider patch testing before tattooing.

Do not tattoo over a mole because the change in appearance of moles is a key ‘warning’ sign of skin cancer.

Is Temporary Tattoo then Safer?

No, for henna dye that contains paraphenylenediamine (PPD), it can cause severe allergic reaction. It is also known as black henna, which is pure henna mixed with PPD.

What Research Says

I looked up Pubmed for possible research but most reported isolated or very small scale studies, mostly on what has been covered above. Of emphasis is that patch testing turned up negative for people who eventually had a positive hypersensitive reaction to red pigment, thus patch testing doesn’t fully cover ‘better be safe, then sorry’. The safest is not to even tattoo.

Source: AAD

Mom E-votional (Infographic) : Healthy Life Expectancy

Life Expectancy Eczema Blues

Quality of life matters – we want to live longer, but not in sickness (or itchiness for that matter!)

I read about HALE – Healthy Life Expectancy in Dr David Katz’ book Disease Proof and it’s a simple truth presented – we are living longer, but sicker. Above is the HALE of United States, but you can always access this page on World Health Organization to find out the life expectancy of your country. For instance, in Singapore:

From 1990 to 2012, men are living longer from 73 to 80 and women from 78 to 85 (we Singaporeans live longer than our friends in US). Of these years, men spend 6 years in sickness and women spend 8 years in sickness.

Quality of life matters.

Eczema, itch takes a little of that away, chronic diseases take a lot more of life away. Our health care system is built on treating sickness but we ought to take preventive steps instead. Last week devotional brings the importance of diet, this week, look at your loved ones and yourself, and be determined to live good, long lives, not sick ones.

Deuteronomy 5:33

You shall walk in all the way that the Lord your God has commanded you, that you may live, and that it may go well with you, and that you may live long in the land that you shall possess.

God, you desire for us to live long and well. Help us in our busyness to treasure our body and care for it, amen!

Live Long, Healthy Life

Eczema News – Honey and Eczema : Is it Effective?

Honey Eczema Manuka Honey had been covered briefly in this blog 3 years ago when my child had Hand-Foot-Mouth-Disease. It is sometimes applied on the skin for its anti-inflammatory and skin repair properties. Is it effective as a moisturizer or as a topical treatment for eczema? Today’s eczema news look into the recent studies on honey’s impact on atopic dermatitis.

What Honey are we talking?
Ηoney is made up of sugars (mainly fructose), water, vitamins (B complex and C) and minerals (calcium, copper, magnesium, iron, phosphorus, potassium, selenium, chromium and zinc). It also contains amino acids, antibiotic-rich inhibine, proteins, enzymes and antioxidants (flavonoids).

According to WebMD, honey is tested in the lab (not on humans) to fight bacteria (including staph bacteria common on eczema skin) and food-borne pathogens like E.coli and salmonella. However, as you’d see below, controlled trials on honey and eczema are very few and efficacy not proven. Notwithstanding, honey is often used for infected wound healing.

Raw or unprocessed honey is not to be taken orally for infants for risk of botulism as their immune system has not yet fully developed to withstand the botulism bacteria.

Clinical trials/Studies on Honey
I found the below studies on PubMed:

1. Randomized controlled trial in New Zealand on Kanuka Honey – The control is aqueous cream, with 15 adults participating who were all non-allergic to honey, with eczema lesions and not using corticosteroids or antibiotics. There is no evidence of efficacy over aqueous cream, which represent a negative control as it is not recommended as eczema treatment.

2. Partially controlled study on honey mixture – this mixture contained honey, olive oil and beeswax with varying proportion of corticosteroid ointment vs Vaseline in control group. 8 out of 10 patients (out of 21) patients showed improvement after 2 weeks. However, due to the honey being mixed with other ingredients, it did not present a solid case for use of honey.

I read in this article for the choice of the honey mixture, namely:
Honey for its anti-inflammatory and antibacterial properties that help to decrease pain and the appearance of scars, faster wound healing. Manuka honey is reported to have the highest bacterial compound methylglyoxal to fight bacteria.

Olive oil for its anti-inflammatory and antibacterial properties

Beeswax for its anti-inflammatory properties
Olive oil and Honey – Contain flavonoids that inhibit allergic reactions

Have you bought any skincare products with honey? How did it work out on eczema skin? Do share in the comment!

(Video) Family Mealtime should look like this!

For parents of picky eaters, the last date to sign up for the Picky Toddler Solution is on 16 October. Dietitian moms behind this course has prized it to be cheaper than private sessions with pediatric dietitian.

For parents of picky eaters, the last date to sign up for the Picky Toddler Solution is on 16 October. Dietitian moms behind this course has priced it to be cheaper than private sessions with pediatric dietitian.

This is the last of the short video series by two Mom Dietitians, previous videos were on Magic Phrase to end feeding battles and Mom’s Role in Feeding Kids. Today, it’s another short video on what Happy and Healthy Family Mealtimes should be. Dietitian Natalia Stasenko, RD is no stranger to this blog as she had provided valuable information on a Toddler Nutrition series covering

How Much to Eat
What to Eat
What Not to Eat

In this video (click link here then input your email to view the 2nd and 3rd video), the following tips are shared:

  1. Picky eating typically starts at around 2 year old.
  2. Either of the extreme approaches are wrong, either (i) Give up serving healthy selection  of food (Mom’s Job!) and cater to what the child wants and when he/she wants it! OR (ii) Controlling and turn meal time to be a battle session.
  3. A Happy and Healthy Mealtime should incorporate selection of foods, including healthy options and what your child normally likes to eat. The whole family sits together and each pick their own foods from the serving.
  4. It is not advisable to have a separate meal time for the child = Sending message that he/she is not expected to eat what the family eats.
  5. Inculcate a positive attitude to eating, valuing family meal time and trusting the child to feed himself/herself (the child’s job!

P.S. I’VE SIGNED UP AS AFFILIATE FOR THIS PICKY EATER CLASS, BUT MORE SO AS I’VE WORKED WITH NATALIA BEFORE AND SHE’S VERY PASSIONATE ABOUT KIDS NUTRITION.

Mom NeedyZz Cartoon – Pregnancy Sleep Position

Mom Sleep Cartoon 1

Hi to all fans out there!

Most of you are moms and I thought to have some laugh among us girls, this Mom NeedyZz cartoon will have more of our life, our sleep, not limited to carrying and raising eczema babies.

Do let me know if you have any idea for sleep-related cartoons, after all, this cartoon strip is for all of us, super moms!

Mei aka MarcieMom

p.s. if you like to read my book, do check out EczemaQnA.com

(Video) Mom’s Role in Feeding Kids

Nuts with Toddler Feeding

FeedingBytes Kids Diet VideoLast week, I’ve shared a short video on Magic Phrase to end feeding battles. Today, it’s another short video by two Mom Dietitians that clarify’s the Mom’s Role in Feeding Kids. Dietitian Natalia Stasenko, RD is no stranger to this blog as she had provided valuable information on a Toddler Nutrition series covering

  • How Much to Eat
  • What to Eat
  • What Not to Eat

In this video (click link here then input your email to view the 2nd video), the mom’s role in feeding our kids is clarified:

  1. Selecting a healthy variety of foods
  2. Structuring meal and snack times

Kids’ stomachs are smaller and their attention spans shorter, as much they may eat more frequently, of smaller portions compared to adults. The parents’ role is to ensure healthy foods are served, i.e colorful fruits and vegetables, grains, proteins AND to plan meal times, rather than allow the child to eat anytime all day long.

It is OK if the child rejects certain foods, eats small portions of some or generous portions of others OR even vary on different days. Face it, even adults can’t have the same appetite daily.

It is not OK if the child eats junk all day, or start to link food with emotions (“emotional eating”). Here’s where the dietitians recommend structuring meal and snack times and when it’s not the scheduled time, to offer water instead.

Child’s Feeding Job

The child’s job is to decide what and how much to eat, otherwise, he/she will lose the ability to self-regulate eating and instead eating becomes a power struggle or easily turn into emotional eating.

All parents worry about the child’s growth and whether eating enough. However, it should be more focused on healthy selection of food, right attitude towards eating and enjoying family meal times!

P.S. I’VE SIGNED UP AS AFFILIATE FOR THIS PICKY EATER CLASS, BUT MORE SO AS I’VE WORKED WITH NATALIA BEFORE AND SHE’S VERY PASSIONATE ABOUT KIDS NUTRITION.

Mom E-votional (Infographic): Our Plate Matters to Our Body

Infographic Health Eating Food Label

EczemaBlues.com 1st Infographic! and what else is worth spending time on other than our food!

I’ve been reading up on food (Dr David Katz’ Disease Proof) and distilled the main points in the above infographic. I started being aware of what I eat when I set out to ‘worship God with my body/strength’ and I thought how to have strength without the right foods. Eczema/not, allergy/not, what we put on our plate matters to our body and the DECISION IS YOURS to make!

Bible verse:

Mark 12:30  And you shall love the Lord your God with all your heart and with all your soul and with all your mind and with all your strength

God, it’s not easy to eat right all the time!

Takeaway is easy, fast food is fast.

Busy mom and dad, one meal doesn’t kill right?

Help us though to love you God, love the body we have,

love our spouse, our kid,

love enough to make it a point to eat healthy,

putting nutrition NOT junk in our mouth.

Bon Appetit, Lord!

Noone can Force-Feed us, it’s Our Responsibility

(Video) Picky Toddler – Feeding Battles Magic Phrase

Kids Nutrition Video Picky Eater

Watch two dietitians share tips on feeding picky toddlers

Two Mom Dietitians had teamed up to present an online training class for feeding picky toddlers. I’ve interviewed one of them, Natalia Stasenko, RD before on a Toddler Nutrition series covering

How Much to Eat

What to Eat

What Not to Eat

In the video above (click link here), the dietitians shared about a magic phrase to end feeding battles

Toddler Nutrition

You Don’t Have to Eat

Generally, for picky eaters, the parents find themselves pleading, tempting or rewarding for eating food. However, the more pressure placed on the child to eat, the more likelihood that child will resist and not eat. On the other hand, children are more likely to consider trying foods when there’s less pressure to eat.

However, what if the child really doesn’t eat? Both dietitians shared that it’s unlikely that children will not eat meal after meal. To gain some insight as to why a child may not want to eat then, parents have to look at the eating pattern of the child and the existing circumstance. For instance, if the child has been grazing the whole day (i.e. eating small amounts of food throughout the day), he/she is unlikely to feel the need/drive to eat a proper meal. Also, the child can be tired, or feel more like playing or doing other activities to ‘release steam’ rather than eat.

There will be a next video on parents’ role in feeding and a clue is that it is not our job to get the child to eat – yes, we prepare and present the food but eating should come from appropriate inner drive from the child. Watch this video here!

p.s. I’ve signed up as affiliate for this picky eater class, but more so as I’ve worked with Natalia before and she’s very passionate about kids nutrition.

Elderly Skin Conditions series – Asteatotic Eczema (Xerosis or Cracked Skin Eczema)

Picture of asteatotic eczema

Picture of asteatotic eczema from pcds.org.uk with direct credit link from clicking imaage

This is another 4-part series, focusing on elderly. For those of you who have been following this blog, you know I’ve been passionately persevering in bringing you information for eczema children. This month, however, I’m inspired to focus on elderly because (i) I see a desire among elderly ladies in the eczema support group meeting to care for their skin and (ii) I am ashamed that I can’t convince my own elderly parents of the right skincare. Hopefully, with this series, elderly who surf the internet and found this blog will find the series useful and adult kids (yes, you and me included!) will be empowered to help their aged parents with the correct skincare. So here we go!

So far we have covered stasis dermatitis (at the lower extremity), incontinence associated dermatitis (at the genital area up to upper thigh) and for the last part of this series, we will explore asteatotic eczema, another common elderly skin condition affecting the lower leg.

What is Asteatotic Eczema?

Also known as xerosis (abnormal dryness), cracked skin eczema or eczema craquele, it is a scaly, flaky, cracked skin condition due to dry skin. The symptoms are scales, cracks, fissures, redness, dryness and itch. If the skin is cracked deeply to injure the capillaries, bleeding fissures may be seen. These symptoms usually present at the lower leg but may also affect the arms, thighs, hands and lower back.

Asteatotic eczema is most prevalent in elderly, above age 65.

What Causes Asteatotic Eczema?

As discussed in the very first post of this series, elderly skin has weaker ability to retain moisture, thus more likely to have dry skin. Less oil and sweat glands also contribute to skin dryness. Their skin is also thinner. The dryness is worsened during winter or cold air-conditioning where the humidity is low (below 50). Other possible factors that contribute to dry skin are long, hot showers, rubbing to towel dry (instead of dab dry), harsh soaps and lack of moisturizing. Dehydration and malnutrition may also play a role, for instance not drinking enough fluids and lacking essential fatty acids and zinc.

Other causes include underactive thyroid, severe weight loss and lymphoma. Medications such as retinoids, diuretics and protein kinase inhibitors may also cause asteatotic eczema.

Complications of Asteatotic Eczema

As with all dry, itchy skin conditions that lead to chronic scratching, infection can occur. Lesions may form and overtime rubbing causes skin discoloration. Also possible are thickened skin (lichenification) or red patches of skin. With damaged skin barrier, the potential for allergic and irritant contact dermatitis increase.

Prevention of Asteatotic Eczema

Good Skincare Routine – Refer to these videos on skincare (shower, moisturizing), with the few basics below:

  1. Avoid harsh soap and products with top irritants, like fragrance
  2. Lukewarm shower, keep it short and for elderly who do not sweat much/head outdoors, daily shower is sufficient (or wet wipe the body on few days/week)
  3. Moisturize after shower
  4. Have humidifier if bedroom’s humidity is below 50.
  5. Dab dry and not rub dry after shower
  6. Do not use products that increase friction to skin, e.g. exfoliating bits found in facial wash or wool/scratching material
  7. Frequent change of towel, and use softer material towels

Treatment of asteatotic eczema may include a combination of keratolytics (able to soften, loosen and facilitate exfoliation of upper skin cells), moisturizers and topical steroids (again, use with care given the already thin skin of elderly and higher potential for irritant dermatitis from chemicals in creams).

While looking up asteatotic eczema, I realized that there isn’t much written on it including research in Pubmed. I wonder if it’s because it seems not as serious as other skin conditions, or that research is often more focused on children and adults (or difficulty to conduct studies). In any case, we should not forget the skin health of our elderly family members and that’s what this entire past 4 weeks have been about! Share and support each other in our elderly skincare!

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