Mark, the husband, is going to be featured more prominently in this year I Am Kate cartoon, but no, never to replace the wife. Follow their marriage and life here.
1. Should I pat myself completely dry after shower?
3. What temperature water should I not use during shower?
6. How many minutes after shower should I moisturize? (Ideally: It’s immediate, but dermatologist’s rule is (how many) minutes)
8. What item should I not use on my skin to wash myself? 11. How many minutes should I shower? Too long shower dries the skin!
12. Meaning: Not harsh. Be sure not to use harsh cleanser for your shower!
2. What plant can be made into a bath oil for your skin?
4. How often do I shower in a day?
5. What I use to clean my hair
7. Showering too many times is _ _ _ _ _ _ to the skin
9. The gentle action that you can take dry the skin after shower, using a towel
10. What can I use on my skin during shower to make it smoother? Bath _ _ _
Learning to shower right is very important, think of many times you shower in a year! If you like the pdf version, click here and here for the answers!
More on showering in the following posts:
Last week, we briefly looked at the different types of surfactants and understand their functions. This week, we’re looking deeper into baby skin and the research around cleansing baby skin.
Baby Skin Structural Vulnerabilities
In the Skin Fact series, we’ve discussed much about baby skin structural differences. Below is a recap of certain baby skin characteristics that increase its vulnerability during skin cleansing:
Higher transepidermal water loss due to thinner stratum corneum – More vulnerable to water loss during bathing and skin barrier breakdown when there’s excessive friction (from over-washing or from rubbing skin when toweling dry).
High surface-area to volume ratio – along with a thinner stratum corneum and immature drug matebolism, make baby skin more vulnerable to harmful chemicals used during bathing
Less total lipids – make it vulnerable to further reduction of skin lipids lost during washing
Cleansing Baby Skin – Research on What’s Best
From a search on Pubmed for review articles on the research for baby skin cleansing, there’s actually not much research on it. From a 2009 European round table meeting, the consensus is:
- Liquid cleansers in bathing are beneficial over water alone – Water cannot remove dirt, oil that can only be removed by oil. Prolonged washing with water dries the skin and depending on the pH of the water itself, it may be more alkaline than the natural pH of the skin.
- Liquid cleanser are preferred, rather than soap which alters the skin pH and affect the skin lipids, increase skin drying and irritation – Learn more about soap and its impact on skin pH in the skin pH series. The pH of skin can affect its skin lipids, which (a lower skin lipids) in turn causes drying, itchiness and skin inflammation.
- Liquid cleanser should be mild, non-irritating, non-stinging (especially to the eyes as babies may not be able to blink fast enough) and non-pH altering, and contains moisturizing function
For cleansing of baby’s skin, I’ve found two other articles that offer recommendation on what’s best for baby skin.
Apart from the three points above, additional points are:
4. Avoid Anionic Surfactants, these are those that cleanse very well but most irritating to skin, an easy way to identify them is to look out for those chemicals ending with Sulfates.
5. Choose those with large head groups and have the ability to form larger micelles. Surfactants organize into groups of molecules called micelles and generally the larger these micelles are, the less irritating the surfactant is. This is related to larger micelles being less able to penetrate the outer layer of skin (stratum corneum).
6. No preservatives is not best as bacterial growth can happen in such products
7. No scent does not mean no fragrance (potential irritant) is used, it can be one fragrance masking that of another.
Why Baby Skin needs Cleansing
Just like last week we asked the question ‘Why not just use water to clean?‘ (because 40% of dirt, oil can only be removed by oil), we also have to understand why baby skin needs cleansing. Baby skin has saliva, nasal secretions, urine, feces, germs and dirt which can potentially irritate the skin when left on the skin. It is also possible that both skin allergy and the body (ie food allergy) can develop from foods being left on the skin for too long. It is therefore important to clean baby skin. However, baby skin, given its structural vulnerabilities, should not be over-washed and to avoid using baby wipes on face or baby wipes that are non-hypoallergenic, especially those containing fragrance and MI.
Next week, I’d (make a brave) attempt to look into how surfactants affect skin and in particular, impact on eczema skin. It’s a very ‘chemical’ topic and not easy, so appreciate if there’s feedback to improve on the blog post, and share your best cleanser!
Happy New Year and look forward to this year’s first session on the topic of Skincare for Kids.
Skincare for young children is important as they are able to understand skincare, and have to take care of their own skin for those who are schooling. Young children may also resist moisturizing and parents have to teach children how to moisturize and understand its benefits. Children who are in primary school also have to be aware some of the school activities that may trigger their eczema flare-ups and learn the basics of managing their eczema in school.
The speaker for this session is dermatology nurse Sister Wong, who is the Senior Nurse Educator at National Skin Center and trained in Dermatology and STI (Sexually Transmitted Infections) Nursing in UK. She had spent many years in the inpatient nursing care in CDC and currently based in outpatient services in National Skin Centre. She is also in charge of training programmes for the nurses in Dermatology.
Block your Friday lunch, on
22 January 2016 (Friday) – Venue, NSC Room 401, 12.15 noon to 1.15pm
Do note though that this is not a consultation session. For those bringing your child, there will be balloons for sculpturing, puzzles and coloring to occupy your children.
You must RSVP so that we can order lunch and arrange the layout for the seats. If you’re coming, please email [email protected] your name, mobile and email, number of adults & kids coming.
One last thing, the session would be starting on-time and information on my blog is not pre-approved by NSC.
Look forward to your RSVP and meeting you!
Personally I find it difficult to think and plan when at home, as the demands of the home/ child seem endless and even if I’ve planned, my plans are hard to carry out unless in the middle of the night (like now, 1am, preparing this post, asking myself ‘why do I keep doing this?’ and replying to myself ‘Just keep doing what God has blessed you with’). Follow Kate’s cartoon here.
To print out the pdf, click here and read these skin facts series to learn more about our skin, and our baby skin and eczema skin are different.
Kicking off Wednesday posts in 2016, like to explore this group of ingredients which is present in all cleansers but also have the potential to irritate skin.
Surfactants are ingredients that are active on surfaces, mainly to lower the surface tension on the skin and remove dirt, sebum, oil from cosmetic products, microorganisms and exfoliated skin cells in an emulsified form to be washed off. The different type of surfactants affect their cleansing, foaming/ lathering, emulsifying, solubilizing abilities as well as its potential to irritate.
Why not just Water?
Before we go on, the simple question to ask is why not just use water to clean our skin. This is because water alone is not effective in removing dirt which can be removed only by oil. Hydrophilic dirt can be removed only by water, and fat-soluble lipophilic dirt only by oils.
Groups of Surfactants
Surfactants are divided into hydrophilic (water loving), hydrophobic (water repelling) and lipophilic (oil loving). Surfactants consist of a fat-soluble (lipophilic) part and a water-soluble (hydrophilic) part. The lipophilic part sticks to oil and dirt, and the hydrophilic part allows it to be washed away.
Surfactants perform different functions, namely:
- Emulsification – arrange itself at interface between two immiscible liquids to create an emulsion
- Solubilization – blending oily solution into clear liquid
- Wetting – increase contact between the product and dirt
Apart from functions, manufacturers also consider mildness, biodegradability, toxicity, moisturization, skin appearance and feel, smell (fragrance) and lubrication when formulating their products.
There are four major groups of surfactants, classified by their polar hydrophilic (water loving) head group:
Anionic Surfactants – Negative charge
Give effective cleansing and foam, good wetting properties, excellent lather characteristics, but moderate disinfectant properties and also likely to irritate skin.
E.g. Carboxylic acids – Stearic acid for stick products like deodorants and antiperspirants; Sodium stearate for soap
Sulfates – give effective cleansing, foaming and cheap; common irritant, e.g. Sodium lauryl sulfate (SLS), an alkyl sulfate used in detergents; Sodium laureth sulfate (SLES), an alkyl ether sulfate used in shampoo
Sulfonic acid surfactants – more expensive than sulfates but less irritating, e.g. dioctyl sodium sulfosuccinate, alkyl benzene sulfonate
Taurates (derived from taurine), Isethionates, Olefin sulfonates, and Sulfosuccinates.
Phosphate esters – Alkyl aryl ether phosphates; alkyl ether phosphates
Cationic Surfactants – Positive charge
Effective for conditioning cosmetics, positive charge makes the surfactants electrostatically attracted to the negative (damaged) sites on hair and skin protein which makes them resist rinse-off. Difficult to ‘mix’ with Anionic Surfactants. Also irritate. May be used as antimicrobial preservatives due to ability to kill bacteria.
Quaternized Ammonium Compounds (or Quats). e.g. Cetrimonium chloride and Stearalkonium Chloride
Amphoteric surfactants – both positive and negative charge (depending on environment)
Help improve foaming, conditioning and reduce irritation. Moderate antimicrobial activity. Used in mild cleansing products, but not effective cleansers and emulsifiers. Both Alkaline and Acid, help to adjust the pH of the water used in solution.
E.g. Sodium Lauriminodipropionate and Disodium Lauroamphodiacetate.
Cocamidopropyl betaine, cocoamphoacetate and cocoamphodiacetate
Non ionic Surfactants – No charge
Used in heavy thick creams, such as hand or body creams, as emulsifiers, conditioning ingredients, and solubilizing agents.
Relatively low potential toxicity and they are considered the most gentle surfactants, but they are also the most expensive
Able to solubilize fatty acids and cholesterol in skin, thus may remove skin lipids
E.g. Cocamide DEA (coconut diethanolamide), widely used in personal care products for its thickener property and foam booster
Fatty acid esters of fatty alcohols, sorbitan esters, sucrose and cholesterol derivatives used like emulsifiers
In the following Wednesdays of this month, we will explore the impact of surfactants on skin, baby and eczema skin and some of the research in this area. I’m learning much about this as I read as well and it’s not all so easy to understand! Any expert reading this who would like to help out are welcomed, do leave a comment if you have expertise in this area or there’s something to correct in my post (no offense will be taken!).
- Chemist’s Corner – Learn to Formulate Cosmetic Products
- Beauty Review – Surfactants, skin cleansing protagonists
This year we’re continuing with the characters from last year’s Mom NeedyZz cartoon but focusing on Kate charting her life. A little like what I always feel in the beginning of the year. I pray that all mothers have a little ‘me’ time to think through their life, but yes, we’d always still be a mommy.
Happy New Year to everyone! I pray that this blog will be a blessing to you in 2016 and I’m inspired to create activities for eczema children to learn about their skin and eczema. This is the first one that I’ve created, so give me feedback and thank you for letting EczemaBlues be a part of your life!
3. Act of applying lotion or cream on your skin
6. What shower (temperature) should I NOT take because it dries my skin?
7. Should you moisturize daily or weekly?
8. Name of cream I should apply when I go into the sun
10. Name of the thick cream you apply, the thicker the cream, the longer it last
11. What is a function of our skin – against chemicals and harmful substances (start with P)
12. What should you NOT do when wiping yourself dry with a towel? (Clue: opposite of pat dry)
13. Will scratching damage our skin?
1. Name of liquid I produce that sometimes make me feel itchy
2. What part of me should I keep it trimmed and short to limit skin damage if I scratch?
4. The time frame when you should moisturize after shower
5. Name of the watery liquid you apply on your skin
8. Are long or short showers better for me?
9. What is the body organ that covers our body?
11. What ingredient should I avoid? (Clue: Smells nice!)
I hope you like this crossword and that it is a tool for your child with eczema to learn about his/her skin and how to protect it!
Most of you would know that I co-authored with Professor Hugo, NUH, a book ‘Living with Eczema: Mom Asks, Doc Answers‘ published last year. As an end of the year special, I picked five questions asked and Professor Hugo’s reply (almost half the book is Q&A, I picked these 5 based on being common questions parents of eczema children asked). The book is structured with information surrounding key topics like diagnosis, prevention, triggers, treatment including things that don’t work and future research, followed by Q&A. None of the questions I asked were ‘screened’ as we wanted to keep it as an authentic exchange between a mom and the doctor of her eczema child.
MarcieMom: The Hygiene Hypothesis has been interpreted by some to mean they should expose their infants to dirt, and possibly, avoid the use of anti-bacterial products. Is this recommended?
Infants with defective skin barrier or lower immunity would be even more susceptible to the penetration of irritants or allergens, or more susceptible to bacterial infection. So, should a mother take more hygiene precautions for her high-risk infant?
Professor Hugo: In theory this is correct, but the problem is that every baby is unique and needs a different degree of exposure of immune stimuli. This is very difficult to assess in a baby. However, in general, products that destroy the body’s own bacteria, such as antibiotics, should be avoided and only given if necessary (in case of a bacterial infection). There have been studies showing that early administration of antibiotics
increases the risk for subsequent allergy, including eczema. Hygiene precautions taken by parents seem to have little impact on the development of eczema.
MarcieMom: While the skin prick test (SPT) is a faster, more reliable and cheaper option than the blood test, I have heard of parents avoiding it because the name “skin prick” test sounds traumatising for the child. What do you do in your practice to encourage fearful parents to let heir children take the SPT?
Professor Hugo: A good SPT, performed by an experienced person, should be painless. In our department we say that a SPT should be associated with no blood and no cry, even in infants.
MarcieMom: In your experience, how reliable are patients’ observations in relation to what is triggering his/her eczema?
Professor Hugo: Most parents fail to identify the triggers of their child’s eczema, or come up with lists that are non-reliable. Don’t forget that eczema is a chronic disease, needing a chronic or regular trigger. This is very diffi cult to identify, especially when a house dust mite allergy is involved, which can mimic multiple food allergies.
MarcieMom: How long should a patient use the prescribed corticosteroid before giving feedback to the physician of no noticeable improvement in the eczema?
Professor Hugo: Although corticosteroids are still the cornerstone treatment of eczema patches, they are only part of the holistic treatment of eczema. If all measures are taken appropriately, an effect of corticosteroids should be seen within one week. Most children can be treated with mild corticosteroids; only in severe eczema are more potent corticosteroids necessary.
MarcieMom: How do you build trust and relationship with your patient?
Professor Hugo: In a nutshell: be honest, don’t lie, and focus on limitations.
There are many more Q&A in the book and if you like to read it for free and you live in Singapore, it’s available in our national libraries island-wide. Wishing all families with eczema kids a happy new year and your encouragement keeps me going and faith that I’m storing treasures in heaven in this blog ministry. Just like the book, this blog is also dedicated to you.
We dedicate this book to
all children with eczema and
their families and hope that
this book will help all of them.
Prof Hugo and MarcieMom