News & Research

Eczema News – Use of Bath Oil Reduce Xerosis and Eczema

Last week, we looked at the study on detergent and this week, we’re focusing on bathing (video on Baby Bath Basics). We know that soaps are to be avoided as it is drying to the skin and adjusts the skin pH to more alkaline than it should be. You also know that I use bath oil for my daughter Marcie, including a cartoon below on care after the bath!

But does bath oil really help dry skin (xerosis) and eczema? This study in Norway examines that, let’s take a look at it!

Bath Oil for Eczema Child
We use bath oil, instead of soap for shower; A few times, we slipped cos the floor is really bath oily!

Study title: Can Early Skin Care Normalise Dry Skin and possibly Prevent Atopic Eczema? A pilot study in young infants

Study objective: Assess if xerosis, and possibly eczema, could be reduced at six months of age by early introduction of frequent oil baths/facial fat cream in infants with dry skin.

Study method: 56 six-week-old infants with xerosis (dry skin), but not eczema, are separated into 2 groups – one using bath oil frequently (up to 7xs/week) and moisturizer on face, while not the other (sparse use). The skin outcome is measured at 6-month old.

What’s Bath Oil to do with Baby Skincare?

The observation is that for babies with eczema, the onset of their eczema (45% of eczema kids have eczema in first 6 months of age) is characterised by altered skin barrier, increased water loss and defective lipid layer. Bath oil retains the moisture on skin. Moisturizers and bath oil are often part of eczema skincare but can it have preventive effect? 

Bath Oil Preventive on Xerosis and Eczema

A note on Xerosis (dry skin)

The study aims to investigate if frequent use of bath oil and moisturizer can reduce dry skin. Dry skin is an indication of defective skin barrier, being unable to retain moisture and have low skin lipids. The defectiveness of skin barrier is in-part genetic, linked to filaggrin gene, but also have an environmental element to it. In the study, the researchers put it succinctly as

Xerosis (dry skin) is a common feature of AE.. The abnormalities found in the stratum corneum involve increased water loss through the skin and reduction in total skin surface lipid. Normal desquamation of the stratum corneum depends on pH dependent proteases with normal function at low pH. Elevated pH of the stratum corneum increases serine protease activity, with secondary generation of inflammatory cytokines and reduced activity of lipid-processing enzymes, resulting in a defective lipid layer.

A Western lifestyle with excessive use of soap and water and skin care products may change the pH of the skin surface in addition to changing the hydration of the skin, thereby influencing the barrier function of the skin.

Skin pH is one of the many factors leading to defective skin. Do read Dr Cheryl Eberting’s series on skin pH. In the post I did with Professor Hugo in 2011, it is mentioned that the lack of filaggrin gene also increases the skin pH and leads to increased skin inflammation. (fyi: elevated skin pH, increasing skin pH = more alkaline than the skin should be, one of the reason why soap is never recommended for dry skin as it’s alkaline – we want the skin to be slightly acidic).

Conclusion: The intervention group had more often normal skin (75%) at six months than the observation group (37.5%), and less often probable atopic eczema. No adverse reactions were reported.

My take: I do use oatmeal-based bath oil on alternate day. Now that my child is at preschooler age, we no longer soak her in the bath tub but just apply and rinse like normal bath lotion.

What’s your take? Do you have a few seconds to drop a comment and share?

News & Research

Eczema News – Antimicrobial Household Products’ Exposure and Allergy

Kicking off 2015 with eczema research news update – The year often starts with some ‘spring cleaning’, so this study published in November 2014 is timely for those of us who are taking out the household cleaning chemicals – will it increase the likelihood of allergy and eczema in your child? Here’s a summary of the study, full study available for free here.

Detergent and Allergy Rhinitis


Study title: Association between exposure to antimicrobial household products and allergic symptoms

Study objective: Investigate antimicrobial household product exposure and allergic symptoms in Korean children > 25,805 questionnaires completed. The age of the children were mostly from 3-8 years old, with about 15% at 0-2 year old.

Study method: An antimicrobial exposure (AE) score was derived and used to measure associations with allergic symptoms.

What are Antimicrobial Products?

They are products that contain antimicrobial agents that kill microorganisms or inhibit the organisms’ growth. Typical ingredient is triclosan and triclocarban. Antimicrobial products used in household are toothpaste, soap, hand sanitizer, dishwashing detergent, fungicide, laundry detergent, deodorant, aerosol cleaners, wet wipe and pesticide.  Toothpaste, soap, hand sanitizer, dishwashing detergent and wet wipe were the most widely and frequently used.

Potentially Harmful Ingredients 


Chloroxylenol, also known as p-chloroxylenol, is an active preservative agent

Tetrasodium ethylenediaminetetraacetate (EDTA)


Conclusion: Subjects with a high AE score (fourth quartile) were more likely to have symptoms of wheezing and allergic rhinitis (but not eczema).

Use of antimicrobial products related to wheezing and rhinitis.
Use of antimicrobial products related to wheezing and rhinitis.
Table taken from study, Nov 2014 Association between exposure to antimicrobial household products and allergic symptoms.

My take: I’m not very obsessed with eliminating all chemicals used at home but instead, I almost never use detergent on cleaning floor and my laundry cycle is 2 hours (more here). Floors cleaned using water, or with soap, is reported to be as clean as if using antimicrobial product.

News & Research

Eczema News – Nipple Eczema – Types of Rash

EczemaBlues Nipple Eczema

There’s a recent study on Nipple Eczema: An Indicative Manifestation on Atopic Dermatitis published in July 2014’s American Journal of Dermatopathology. The study of 43 individuals with nipple eczema, part of whom had eczema history and the others without eczema, showed no definite difference between the patterns of their nipple skin inflammation. It prompted me though to read further on nipple eczema, after all, it’s an issue close to women, plus breastfeeding mothers.

Nipple Eczema – is it Eczema?

Nipple eczema is often confused with Paget’s disease because of similar symptoms. Paget’s disease is a rare type of cancer at the nipple-areola complex (1-4% of female breast cancer). The confusion is that both have the appearance of eczema rash, possibly accompanied by itch, pain, tenderness, scales, cracks, oozing, nipple discharge/bleeding, redness and erosion.   However, one distinguishing feature is that Paget’s disease affect the nipple first whereas nipple eczema affects the surrounding skin, i.e. the areola. It is also more likely to be unilateral than bilateral.

Nipple eczema can occur for both men and women, not limited to women who are breastfeeding/ pregnant.

Types of Nipple Eczema

Allergic contact dermatitis – If triggered by skincare product used on body, appearance of the rash would be on both breasts. A case study was reported in Indian Journal of Dermatology where topical application of ingredients like propylene glycol, chlorocresols and parabens trigger nipple eczema (though only on one breast).

Another study in June 2014 noted allergic contact to CI+Me-isothiazolinone, a chemical found in detergents, preservatives and fabric softeners. Thus possibly traces of CI+Me-isothiazolinone in undergarments triggered the eczema at the breasts.

Other possible chemicals that trigger nipple eczema could be protein allergens (food) from the baby’s mouth.

Atopic dermatitis (AD) – Due to the weaker eczema skin barrier and increased likelihood of sensitization to products, the risk of nipple eczema appears to increase with age for AD patients.

Irritant contact dermatitis – Chemicals, product ingredients and friction can irritate. Clothing may irritate or friction from exercise or from exercise bra/ disposable breast pad/ poor-designed nursing bra. There may be both irritant/allergic contact dermatitis to creams used on nipple during pregnancy/breastfeeding. Soaps, detergents, fragrance and bleach are possible irritants.

Yeast infection – This is more likely for women with history of yeast vaginitis or from babies who have thrush (i.e. yeast infection with white spots on baby’s tongue or mouth). The yeast infection will affect skin at the base of the nipple, with appearance of fine cracks. Yeast infection is reportedly more common after antibiotic use.

Bacterial infection – Eczema skin is prone to be colonized by staphylococcus aureus bacteria and the breast/nipple skin is not spared. Skin damage can lead to increased susceptibility for bacteria infection and the damage may come from scratching (on an AD patient) or certain activities during breastfeeding, such as use of uncomfortable breast pump, over-washing and cleaning of the nipple area which dries and damages the skin.


Diagnosis is not easy as the symptoms look similar. Typically, ruling out Paget’s disease (esp if nipple eczema is only on one breast) is a priority. After which, patch testing can be taken to analyze which possible chemicals the patient has come into contact with that may possibly have triggered the rash.

What if Breastfeeding?

Nipple eczema can bring about soreness, pain and burning sensation, and prematurely terminate lactation and breastfeeding. Women who have eczema or sensitive skin may be more prone to nipple eczema. The breasts can be washed with lukewarm water and moisturized. Check with your doctor before applying cream on the breast/nipple to ensure safety for the baby. If prescribed cream, ask for clear instruction on wiping it off before breastfeeding. The liquid to wipe off the cream can be milk expressed from breast.

Anyone has experience on nipple eczema? Do comment and share. Breastfeeding does not come easy for many mothers (ME included!) and I can’t imagine piling on an itchy, painful nipple on top of the struggles. Do share and encourage another if you can!

News & Research

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

News & Research

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 that 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!

News & Research

Eczema News – Is Baby Wipes causing the Rash?

Contact dermatitis_ rash_baby_MI

In the beginning of the year, there was a ‘scare’ – news circulated that baby wipes is the cause of terrible rash on the face of babies. This is in response to a study published from observations of 6 children, with ‘disfiguring patches to crusting, swelling, blistering and tiny cracks in the mouth, cheek, hands and/or buttocks’. Even though it’s half a year since that news, many parents are still very wary about baby wipes. Now, let’s admit it – baby wipes do come in very handy, so let’s take it as we still need baby wipes. So what do we know about these rash-causing baby wipes in order to choose the ones that are safe?

Putting it into Perspective

The rashes can be various types of dermatitis –

Atopic dermatitis where the child is allergic to ingredient, and rashes develop very quickly even for small amount of contact.

Contact dermatitis where sensitization occurs overtime, i.e. the irritant has been in contact with the skin for some time. This is more common.

In both types of dermatitis, the ingredient to look out for (and avoid) is methylchloroisothiazolinone or methylisothiazolinone. The treatment is similar – avoidance + prescription to reduce skin inflammation. The potency of the cream will depend on each patient and also where the rashes are. Avoid wiping the baby’s face (more sensitive, thinner skin) with wet wipes, especially when you are not clear about its ingredients.

Research Studies

I looked through the research on methylisothiazolinone published in 2013 and 2014, the more common conclusions are:

1. Increasing reports of sensitization to methylisothiazolinone (MI), with many studies citing it as an ‘epidemic’. MI is also named 2013 “Allergen of the Year” by the American Contact Dermatitis Society.

2. MI is an ingredient contained in baby wipes, and it is a preservative used in cosmetics, household, and industrial products to prevent bacterial and fungal contamination.

3. The % of sensitization range from about 2% to 4%, so it is not a sure thing that your child will react to it.

4. A patch test can be requested to check if there is hypersensitivity to methylisothiazolinone and in this regard, improvements to patch test for this have been suggested to modify the test solution concentration and also to increase the length of observation to 7 days.

5. The age group most susceptible to this is female above 40 years (6% sensitization), on the face due to cosmetics. Certain occupations are painters and beauticians. Parents are also affected due to the use of baby wipes, so not just the kids! Studies here and here.

So my take is if your child or yourself doesn’t react to baby wipes, you can continue using but take care to use less often, not on the face, and find those brands without MI if possible. What’s your favorite brand?

News & Research

Eczema News – Outgrowing Eczema for Children

Outgrow Eczema for babies and childrenMany parents are concerned with whether (and W-H-E-N) their child will outgrow eczema – the stress, the sleep deprivation, the constant itch and scratching that comes with eczema can indeed be very challenging for both parents and the child. Are there any factors that give us hope that our child will have a higher chance of outgrowing eczema? Is there anything that we can do to increase the likelihood of ‘outgrowing’?
1st things 1st – What’s Outgrowing?
There is no definition for having ‘grown out’ of eczema – how would you as a parent deemed your child to be free from eczema? No rash within a certain time period? A reasonable amount of sleep, dry skin without rashes that requires daily moisturizing? The majority of babies (40% -70%) with eczema will have it in remission by the grade school or teen years (study here). Dry skin with occasional flare-ups would be considered as having outgrown eczema.

Key Predictive Factors
1. Severity of Atopic Dermatitis – The more severe the eczema/ AD, the less likelihood the chance of outgrowing. There is also a study that the more severe the AD in a child, the less likelihood the child can outgrow milk and egg allergy. The interplay between eczema and allergy is not fully understood – does one lead to another? There is this study that showed food allergy being associated with an earlier onset of age for eczema in children. Conversely could a defective skin barrier render the immune system more vulnerable to an onslaught of allergens? Or both can co-exist independently? Similarly the mechanism for outgrowing isn’t clear. Is untreated eczema reducing the chance of outgrowing?

2. Gender – Various studies had highlighted a difference between teenage males vs females, for instance in this study, eczema is more likely to develop for teen girls while teen boys are more likely to outgrow it.

3. Presence of other allergic conditions – Having other allergic conditions like asthma and allergic rhinitis associated with a lower likelihood of outgrowing eczema.

There are many factors involved in eczema, but specifically on outgrowing, it seems that the above 3 are the most predictive. The BIG question is what can parents do and I’d say that treating the eczema is of utmost importance. The longer it goes untreated (aka the longer you try alternative/unvalidated treatment while the skin is constantly inflamed and child is scratching), the higher chance of infection, the thicker the skin gets from scratching (thus even more difficult to treat) and the likelihood of more allergens/irritants penetrating via the defective skin barrier.

What’s your take on this? Do share in the comment!

News & Research

Eczema News – Herpeticum for Atopic Child?

Has Eczema Herpeticum recur for your child?
Has Eczema Herpeticum recur for your child?

Eczema herpeticum has been covered in this blog before, and for the past few months, there seem to be more parents contacting me or commenting on this topic. There are a few key questions, with the main one being whether a child with eczema/atopic dermatitis is more susceptible to eczema herpeticum and whether once a child gets it, he/she will keep getting it. Let’s look into research in this area:

Quick Basics of Eczema Herpeticum

Eczema herpeticum happens when a patient with eczema gets infected with the herpes simplex virus, the same virus responsible for cold sores. Symptoms of eczema herpeticum are painful, rapidly worsening eczema with blisters, sores, accompanied by fever. A child can get the virus from sharing towel or in general, coming into contact with the mucus of someone who has the virus (who may not necessarily have the cold sores/ herpeticum).

Treatment includes anti-viral medication, oral acyclovir. In view of how fast the drug can work to control the herpeticum in conjunction with the increasing length of hospital stay when not treated fast enough, it is usually advisable to administer acyclovir expediently (see article here, here and here).

Are Children with Eczema/ Atopic Dermatitis more prone to Eczema Herpeticum?

Yes, generally due to the defective skin barrier and lower immune system, eczema kids ‘catch’ skin infection much easier. This article suggest that those with skin inflammation that is uncontrolled are more likely to get eczema herpeticum. Other possible hypothesis of eczema kids getting herpeticum involve the gene, gene expression, filaggrinhistory of food allergy/asthma and early onset of AD.

Will Eczema Herpeticum Recur?

Yes, and it is also possible to get secondary bacterial infection, i.e. from Staph aureus bacteria. For more on staph, see here. I’ve found a study (on mice) that noted the mice infected with staph bacteria get higher penetration of the herpes virus. More on herpeticum here.


It is quite often heard of delayed administration of the anti-viral drug because of misdiagnosis, being confused with impetigo. Anti-bacterial drug will not treat herpeticum and delayed treatment can severely affect the body, leading to blindness (keratoconjunctivitis) and death. Hospitalization was required for half of the patients, and those who are hospitalized had a higher likelihood of recurrence (article here).

Share your experience in this post, esp. when studies in this area is difficult to conduct, experiences may just help!

Photo Credit: NIAID via Compfight cc

News & Research

Eczema News – Bioresonance : What?


The Bioresonance companies must be doing a good job marketing (in Singapore), via Google ads or other channels, because more parents are asking about this and whether they should try it. Offhand, I think the picture I chose says my first thought – I mean, seriously, cells give off vibes? But as always, I approach a topic methodically, by looking at information over the web and also at Pubmed. Let’s first find out what bioresonance is:

Abnormal Waves

Bioresonance is on the basis that certain medical conditions give off abnormal aka unhealthy waves, and a device is used to detect these ‘sick’ waves and then normalize the waves and sent back to treat the person. It is on the basis that a sick person likely has something (bacteria, allergens) that disrupt the normal electromagnetic oscillations of the cells. Diseases that bioresonance purport to treat include allergies, eczema, cancer, arthritis, liver problem and chronic fatigue.


If you search Pubmed, you’d see it being associated with many health conditions and to me, it seems strange how a ‘treatment’ can purport to treat so many varied conditions. I looked through the articles on Pubmed and those that support the efficacy of bioresonance are from bioresonance practitioners and limited to case studies. Other independent articles show:

Articles citing bioresonance as inappropriate test for allergy, here or unproven here.

Citing bioresonance as not proven treatment for eczema, here and here.

My take?

I don’t think it’s medically sound but I understand that parents would want to try anything especially when the child is suffering from severe eczema, with bleeding, weeping/oozing skin with tears of pain and anguish. I don’t know if the bioresonance therapist will ask for patients to stop the conventional treatment – if they do, I would say no. Otherwise, if there’s no side effect (i.e. you still continue the treatment advised by your doc), then likely it may be money spent (and wasted).

Any parent has tried it? Is the consultation fun? I’m just thinking maybe if a child likes it, he/she will scratch less during the consultation time and be more aware not to damage the skin after but moisturize diligently? Do share your take in the comment!

Photo Credit: AlicePopkorn via Compfight cc

News & Research

Eczema Research News – Moisturizing, Fancy or not?

A good moisturizer is one the eczema child uses!
A good moisturizer is one the child uses!

Today’s topic is on Moisturizer, does Eczema need the fancy stuff? Any parent with eczema child would have come across moisturizing, after all it is standard treatment of eczema. Moisturizing is a topic that has generated MANY comments among parents, two of the more popular posts are

Help! What Moisturizer to Use on your Eczema Baby (52 comments)

How much Moisturizing is enough? (17 comments)

Many dermatologists have also shared their moisturizing tips on this blog (see the ‘moisturizer’ tag) and some of these are

Sensitive Skincare Product series with Dr Verallo-Rowel and the CEO of VMV Hypoallergenics, Laura – much time had been devoted for this series, and this post is worth printing out and bringing out with her when you shop for moisturizer – Ingredients to Avoid

Reinforcing Amount of Moisturizer to Use with Dr Jeff Benabio

Topical Treatment, part of Combined Approach series with Dr Bridgett

Today, I want to look at the latest eczema related studies published on moisturizer, with the hope of finding out the type of moisturizer. When doing so, I found this article from National Eczema Association, new insights for moisturizers for skin diseases which have explained

  1. Functions of moisturizer – Occlusive (preventing water loss) and as humectant (helping to attract moisture)
  2. Ceramide-based moisturizer studied to help eczema, but over the counter moisturizer also helps
  3. Natural oil not studied to help, and if using, those with the highest linoleic acid /oleic acid ratios are better, such as safflower oil, sunflower seed oil, and sea buckthorn seed oil (vs olive oil).

So what’s the research on moisturizer?

  1. Improves eczema as reduce inflammation and water loss (here)
  2. Protects against irritants (here)
  3. Update for a study in October 2014 that has many dermatologists excited because it is the first randomized controlled trial evidence that daily full-body emollient therapy from birth can prevent atopic dermatitis. Emollient enhancement of the skin barrier from birth offers effective atopic dermatitis prevention.
  4. Another study in October 2014 that concluded daily application of moisturizer during the first 32 weeks of life reduces the risk of atopic dermatitis/ eczema in infants. Allergic sensitization during this time period is associated with the presence of eczematous skin but not with moisturizer use.

(no specific brand mentioned in studies)

What moisturizer to buy? I think one that you can afford, your child does not object and does not contain the top irritants. What moisturizer are you using? And which ones have you found useful and which ones would NEVER recommend? Do share in the comments, thank you!

News & Research

Eczema Research News – More Sun and Vitamin D?

Does the Sun help? And is more sun good for eczema child? or bad?
Does the Sun help? And is more sun good for eczema child? or bad?

Today’s topic is on Vitamin D, should we need more Sunshine? Sunshine has been covered in this blog, but mostly to understand whether we need sunscreen (answer is yes!) and what types of sunscreen and how to apply. Tips on sun protection from renowned dermatologists have been shared, such as

Protecting Skin – by Dr Ava Shamban

Common Skin Rash in Children – Sunburn – by Dr Robin Shaffran

AAD Skincare Video for Eczema – by Dr Joshua Zeichner

AAD Skinccare Video – Sunscreen – by Dr Sonia Badreshia-Bansal 

Children Skin Conditions – by Dr Lynn Chiam

There is much talk about whether sun is good for our children with eczema, and there are some companies that recommend Vitamin D products (be it skincare or oral supplement). What we know about the sun and our skin is

  1. A child’s skin is thinner and thus more susceptible to harmful effects of ultraviolet light, such as sunburn and skin cancer.
  2. UV light is required for the skin to synthesize Vitamin D; vitamin D that comes from sunlight has been shown to increase the production of skin proteins (cathelicidin) and antimicrobial peptide (AMP) which protects against skin infection.
  3. For eczema patients, sun exposure is drying for skin and can aggravate eczema, esp. flare-up.

No wonder there is so much controversy on sunshine and vitamin D; in line with this Eczema Research News series, below are the studies from 2013 onward of the efficacy of Vitamin D:

Vitamin D deficiency is associated with atopic dermatitis (eczema) in children, more severe eczema (here, here)

Increased sun exposure during summer holidays associated with reduced eczema, but not related to Vitamin D level (here)

Children living in hot and humid climate have more eczema flare-ups (here), but contradicted with this study

Vitamin D has some protective function for food allergy in infants (here)

What age Vitamin D supplement is given, and in what form (soluble or tablet) may alleviate or worsen allergic diseases – as to which is best is still unknown (here), no conclusive evidence (here)

Updating with study in Nov 2014 – where 186 children were regularly followed up at clinics for a four-year follow-up period. Low cord blood Vit D levels were associated with higher risk of food sensitization throughout childhood. Cord blood Vit D levels were inversely associated with the risk of milk sensitization at age 2, at which age a higher prevalence of milk sensitization was significantly associated with the risk of allergic rhinitis and asthma development at age 4.

Have anyone tried any Vitamin D related treatment? Do share in the comments, thank you!

News & Research

Eczema Research News – Reduce Staph Bacteria?

Reducing Staph Bacteria helps Eczema Child
Reducing Staph Bacteria helps Eczema Child (picture from

This is part of a quarterly round-up of some of the recent eczema-related studies, so that we can be aware of possible treatments and their efficacy (and I can also keep myself updated with the latest eczema research!)

Today’s topic is on Staph Bacteria, should we Reduce it? Staph, short for Staphylococcus aureus, is a bacteria that is frequently found on the skin of eczema patients. I have wrote about staph bacteria from as early as 2011, covering topics from:

What Causes Your Child’s Eczema – Staph (series from review article “Features of childhood atopic dermatitis” by Hugo Van Bever and Genevieve Illanora)

Staph Bacteria series with Dr Clay Cockerell

MRSA (Methicillin-Resistant Staph Aureus) decolonisation

At the same time, I have been encouraging parents to bring their children for swimming or to clean the child’s eczema skin with chlorhexidine, with the intention of reducing the staph bacteria which promote skin inflammation via the provocation of mast skin cells. My purpose today is to update on the literature behind staph bacteria, in the hope of knowing if we ought to be more vigilant at reducing the staph bacteria on our child’s skin.

What is Staph Bacteria?

Staph is short for staphylococcus aureus, a very resilient bacteria found on the skin that can survive in dry condition and on dry skin with little oxygen.  It tends to involve areas that are warm and moist especially such as skin near mucous membranes such as the nose, mouth, genitals and anal area. It is found in about 25-30% of healthy adults who are known as carriers and generally does not cause an infection in those with otherwise healthy skin. However, in almost 90% of eczema patients, staph bacteria colonizes their skin.

What harm does Staph cause?

According to a research paper, the staph bacteria “causes immune-system cells in the skin to react in a way that produces eczema-like rashes. The release of the molecule, called delta toxin, by staph bacteria caused immune-related mast cells in the skin to release tiny granules that cause inflammation”. 

How to reduce Staph bacteria on our child’s skin?

Swimming, bleach bath, chlorhexidine

What’s the studies on treatment involving the active reduction of staph bacteria?

We are interested in this, obviously, it is important to know if the measures that we are taking in the care of our child’s eczema skin is effective. Based on the studies I looked up on PubMed from 2013 onward:

Bleach bath is effective in eczema treatment, via reduction of staph bacteria (here)

Confirmation that children with eczema have staph bacteria colonization on their skin (here), likewise for adults (here, in particular it was hypothesized that staph bacteria colonization may have facilitated the penetration of allergens into the skin, triggering rash)

Update for August 2015 study which contrary to previous studies, showed that a four-week, twice-weekly regime of bleach baths is no more effective than water in a double-blinded, placebo-controlled cross-over trial.

Staph bacteria associated with higher severity of eczema (here)

A number of studies mentioned the concern over MRSA, and that prescription such as fusidic acid may lead to the bacteria being resistant to treatment (here).

Have you tried any of the staph bacteria reduction tips for your child? Is it effective? Do share in the comments, thank you!

News & Research

Eczema Research News – Do Antihistamines work?

Will Antihistamine Work for Eczema?
Will Antihistamine Work for Eczema?

This is part of a quarterly round-up of some of the recent eczema-related studies, so that we can be aware of possible treatments and their efficacy (and I can also keep myself updated with the latest eczema research!)

Today’s topic is on Antihistamines, do they Work? I’ve read in forums that some patients swear it helps with the itch, while others swear at it for being totally useless. What’s the research in this area? I’ve found a few studies online, but before we go into them, let’s get some Antihistamines’ basics.

What are Antihistamines?

Antihistamines are medication that are taken orally to block the activity of histamine at skin H1 receptor sites, thus alleviating itch. The older generation of antihistamines is sedative, usually prescribed to relieve itch and scratching at night.

Backtrack a step for some of you to understand the rationale – One of the characteristic of eczema is itch, which triggers patients and children with eczema to scratch at the inflamed skin/ lesion. Scratching worsens the skin inflammation, exacerbating the itch-scratch cycle. Scratching also thickens the skin, further breaks down the skin barrier and risks infection. Thus antihistamines are prescribed to alleviate the itch, to reduce scratching.  More on scratching here.

There are broadly two types of antihistamines,

1) the sedating types such as alimemazine, chlorphenamine, cyproheptadine, hydroxyzine and promethazine.

2) the non-sedating types such as cetirizine, levocetirizine, loratadine, desloratadine and fexofenadine. Supposedly, the non-sedating type can bind more selectively to the H1 receptors and last longer for 24 hours but many reported not effective.

How are Antihistamines supposed to help Eczema patients?

Oral H1 antihistamines have been prescribed for eczema patients, usually for their sedative effects. It appears that the sedating type is more commonly concurred to relieve itch better than the non-sedating. However, longer than 2 weeks’ use have been described to render sedating antihistamine ineffective to the patient.

Can Antihistamines be prescribed for Children with Eczema?

Yes, studies had been conducted for children from age 1, and different antihistamines have different age limits and the dosage depends on the weight of the child. Read that hydroxyzine is not recommended for below 6-month eczema baby and promethazine and alimemazine not for children under 2 years old.

Are there side-effects to Antihistamines?

Antihistamines may cause side effects such as drowsiness, headaches, constipation, dry mouth and blurred vision, and worsen condition such as glaucoma and retention of urine.

What’s the verdict on Antihistamine on Eczema?

After reviewing PubMed, it appears that it is difficult to isolate the effect of antihistamine as trials undertaken had used antihistamines as an add-on therapy (imagine which eczema patient would take part in a study that prohibit you from moisturizing and treating your eczema, insisting you consume only antihistamines!). Therefore, there is no conclusion as to whether antihistamines work. Based on a selection of antihistamines’ studies published on PubMed, cetirizine improved eczema (along with topical treatment) while chlorphenamine did not show difference in alleviating scratching at night. Hydroxyzine reported to work better than cyproheptadine in another study.

As you can see, there’s no clear conclusion on whether antihistamine is useful, neither is there clear study on whether the sedating type is more useful than the non-sedating. What is your experience? Do share in the comments, greatly appreciate!

News & Research

Eczema Research Focus Month – House Dust Mite

Removing House Dust Mite even when there's no sensitization improves eczema
Removing House Dust Mite even when there’s no sensitization improves eczema

The above is a cartoon from Life of Eczema Girl. In the cartoon, I shared that there is no need to do crazy cleaning if the child does not have an allergy to house dust mite. Now, I’m not sure if I have to take back my words as I’ve come across this study that concluded that higher indoor house dust mite worsens the skin of eczema children, whether or not they are sensitized to house dust mite. The main points of the study are:

1. 95 patients of average 23 month old

2. Indoor house dust mite levels associated with the severity of skin symptoms, especially in eczema children who are not sensitized to dust mite

3. Possibly due to house dust mite being an irritant instead of an allergen

4. Practical implication to reduce house dust mite levels

How often is your cleaning? Did more measures to reduce house dust mite improve your child’s eczema? Do comment!

News & Research

Eczema Research Focus Month – Obesity and Asthma

Obesity linked to eczema and other allergic conditions
Obesity linked to eczema and other allergic conditions

This is an interesting study – on obesity. Obesity had been covered in this blog, including tackling obesity in eczema children. Obesity has impact on inflammation and chronic diseases, and in this study, there is some relationship established between obesity and TV on various allergic conditions. The study is part of the ISAAC study, which is questionnaire-based, instead of trials. In any case, it’s never good to be obese! The main points of the study:

1. Study covered children aged 6-7 years adolescents aged 13-14 years

2. Associations between obesity and symptoms of asthma and eczema

3. Vigorous physical activity positively associated with symptoms of asthma, rhinoconjunctivitis and eczema in adolescents, but not children

4. Viewing television for 5 or more hours per day associated with an increased risk of symptoms of asthma, rhinoconjunctivitis and eczema in adolescents

In a separate study, weight loss improved inflammatory skin condition psoriasis. So, even more reason to be healthy – exercise and don’t consume excess EMPTY calories – foods like sugar, fried food and transfat are pro-inflammation foods. Share your diet for your family in the comment!

News & Research

Eczema Research Focus Month – Food Allergy

Eczema affects food allergy, does it cause it?
Eczema affects food allergy, does it cause it?

Last week, we looked at Probiotics. For today, we’re looking at the relationship between eczema and food allergy. In this study, it was indicated that a breakdown in skin barrier and skin inflammation in eczema could lead to increased food sensitization -> food allergy. This had been covered in the outside-in hypothesis post. Main points of this study:

1. Infants with an impaired skin barrier/ eczema, are more likely than to be sensitised to a variety of foods such as egg white, cow’s milk and peanut.

2. The more severe the eczema, the stronger the correlation to food sensitivity.

3. Repair of skin barrier therefore may reduce food allergy.

My family is already moisturizing lots for our daughter, what about yours? Do you think moisturizing from young had reduced food sensitivity? Share in the comment!

News & Research

Eczema Research Focus Month – Probiotics

Probiotics studied to help with on-gut inflammation
Probiotics studied to help with on-gut inflammation

This month, instead of the regular Friday sharing by eczema friends around the world, I’d be sharing some of the newer research studies this year. #1 Many parents and friends have been busy and I’m still waiting for their sharing (contact me if you like to share!) and #2 There are many new research that have practical implications if proven. So, let’s get to them!

Today’s focus is on Probiotics. Probiotics have been covered before in this blog – studies showed probiotics has preventive effect on eczema and nutritionist Judy Converse shared about it here. I came across this study that showed probiotics have effects on non-gut inflammation, namely Chronic Fatigue Syndrome (CFS) and Psoriasis. Main points:

1.  Probiotics, apart from maintaining gastrointestinal microbial balance, also affect the systemic immune response.

2. Study size: 22 patients with the gastrointestinal disorder ulcerative colitis (UC), 26 patients with psoriasis, and 48 patients with CFS.

3. All of the above are inflammatory diseases, and study indicated possible effect of probiotics on non-gut inflammatory conditions

Updating this post with a study on Singapore kids in November 2014 – conclusion was no impact for kids fed with supplementation with Probiotics in the 1st 6 Months of age did not protect against eczema and allergy.

My take – so far the studies on probiotics are fairly positive, my family is already taking it.

What about you? Write a comment to share!

News & Research

Coins, Bras and Specs – Nickel Allergy

nickel allergy eczema contact dermatitis EczemaBluesThis is a quick post, as a study had just been released about the new coins in UK, where “nickel-plated coins deposit higher levels of nickel onto skin than cupro-nickel coins, and hence pose an increased allergy risk“. It could also trigger dermatitis/eczema.

Got me interested to dig a little into nickel allergy, and here’s a quick snap shot of what I’ve found:

1. Once sensitized to nickel, it’s usually persist life-long; more common in women with ear-piercing and fashion jewelry and also for certain occupation like hairdresser (article ref). Spectacle frames induced allergic contact dermatitis (study)

2. It can take time to be sensitized to nickel – I’ve often seen people asking if their bra could cause the rash, but they have been wearing a (different) bra months ago and rash only started to appear = it is possible that it’s really the bra cos sensitization takes time. Some bra hooks contain nickel (note: the latex in some bra can also trigger rashes.)

3. A diet low in nickel can improve the eczema – less of cocoa, chocolate, soya beans, oatmeal, nuts, almonds and fresh and dried legumes.

News & Research

Women Itch and Scratch Differently from Men

Gender Men Women Pruritus Itch Eczema Blues This study is published in June 2013 British Journal of Dermatology and I think it wasn’t reported as much as many are reporting the link between antibiotics and babies developing eczema. But I do think this study is interesting:

1. Study is on “Gender differences in chronic pruritus: women present different morbidity, more scratch lesions and higher burden

2. A study of 1037 patients

3. Found women had more “localized itching occurring in attacks, with stinging, warmth and painful qualities”, more visible scratch lesions and greater impact on their quality of life

4. Study is useful in future sex-specific diagnostics or even therapeutics in pruritus.

News & Research

Antibiotics given to Baby linked to Eczema

antibiotics eczema baby linkThis is a new study published in the British Journal of Dermatology, & thank you to EndEczema for directing me to the original study. From what I’ve read in UK online news, the results of the study are:

1. Babies given antibiotics in the 1st year are more likely (40%) to develop eczema

2. The reason is not fully known, though “One potential explanation is that broad-spectrum antibiotics alter the gut microflora and that this in turn affects the maturing immune system in a way that prompts allergic disease development,” said researcher Dr Teresa Tsakok, who works at St Thomas’s hospital in London.(taken from Guardian).

3. Study is based on systematic review of 20 studies, not a ‘study’ in itself.

4. Nina Goad, spokeswoman for British Association of Dermatology, said this study did not imply withholding antibiotics when necessary, but instead provide insight into possible causes of eczema.

5. Caution is this review does not necessarily indicate a causal relationship, because it could be eczema children require antibiotics as they have a higher chance of skin infection.

As to the gut flora being linked with eczema, there’s increasing evidence of there being a link between gut flora, skin flora and immune system though the exact mechanism of how it affects and what to do to prevent eczema is still not known. For more on diet studies, refer to Diet and Eczema Studies.

Update on July 2015 study that concluded eczema could lead to an increased infection risk, with a possible reason due to lack of microbial exposure during critical periods in early postnatal life… and overprescription of antibiotics could have a direct effect on the susceptibilities of organisms to commonly used antimicrobials.