Eczema ‘Cure’ Series – Does the type of Water Matter?

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

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

Water for Eczema Cure

The Water Not to Use – HOT

Hot water strips moisture from the skin and it is never recommended by dermatologists. It may feel good because the heat temporarily numbs the (itch) nerves and so a hot shower offer temporarily relief – avoid at all costs. Consider other bath options that are more beneficial for eczema, dry skin and relief such as a cool compress.

Does the Water Type Matter?

Drinking water – There was a study in 2005-2006 in the US that showed a possible link between the chemical dichlorophenol present in tap water and higher incidence of food allergy. If the food allergy manifest as skin rash, then it’s possible that changing the water we drink help our eczema. Apart from this one study, no other study was found in Pubmed. Apart from tap water, fruits and vegetables also contain this chemical, found in pesticides. (note: See Singapore PUB link on Singapore Drinking Water Quality, dichlorophenol is present)

Updated on 27 Oct 2016 – For those of you wondering about the benefits of alkaline water, interesting read on MedicalNewsToday – no benefit and even showed harm!

Bathing water – Too Alkaline – Tap water is alkaline with an average pH value of 8. As the skin pH is slightly acidic, washing with alkaline contribute to skin dryness. Thus, another reason to limit your shower time. Read more from dermatologist Dr Cheryl Lee on vinegar bath increases the acidity of the bath water.

Hard water vs soft water – Hard water is caused by limestone (calcium carbonate) dissolving in the water and it is the white deposit that is seen in kettles, bath tubs and steamer. Hard water has been associated with higher incidences of eczema and identified as environmental trigger. However, in a randomized-controlled trial, there was no significant difference in families whose eczema children use hard water versus soft water (via a water softener). However, many eczema sufferers personally feel better about using soft water, partly due to lower pH level and less detergent needed in soft water washing.

Spring water – A well-known spring water spa for eczema sufferers is La Roche-Pasay in France. It’s possible that a higher selenium content or the presence of a certain bacteria (Vitreoscilla filiformis) in spring water is beneficial for dry skin.

What Matters for Shower

The important thing is to moisturize immediately after a shower – this one step outweigh the type of water you use or even what you use to shower with (no soap). Immediately moisturizing traps moisture on the skin and limits the evaporation of moisture from the skin after bath. Leave some moisture on the skin, don’t rub very dry and trap some of that with an emollient cream/ointment right after bath.

For me, I don’t use any special water but always limit the time taken to shower. It’s usually quite fast like within 5 minutes, followed up moisturizing. What’s your experience on water you use at home? Do share in the comments! Also if you missed the rest of the Eczema ‘Cure’ Series, below are the links:

Diet

Home Remedies

Chemical-Free

Does How we Bath Matter

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

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

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

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

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

Bath for Eczema Skin

Bath to Try #1 – Soaking

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

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

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

Bath to Try #3 – Bleach Bath

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

Bath to Try #4 – Chlorhexidine

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

Bath to Try #5 – Vinegar Bath

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

Other Baths

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

Bath NOT to Take #1 – Hot

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

Bath NOT to Take #2 – Soap

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

Bath NOT to Take #3 – Too Long

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

Bath NOT to Take #4 – Bubble Bath

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

Bath NOT to Take #5 – Exfoliating Bath

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

Bath NOT to Take #6 – Bath without Moisturizing After

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

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

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

Eczema ‘Cure’ Series – Chemical-Free

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

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

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

Chemical Alerts for Eczema

Chemical Alert #1 – Detergent

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

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

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

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

Chemical Alert #2 – Anti-microbial Products

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

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

Chemical Alert #3 – Fragrance

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

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

Chemical Alert #4 – Hair Dyes and Tattoos

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

Chemical Alert #5 – Chemical in the Air

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

Chemical Alert #6 – Baby Wipes

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

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

Eczema ‘Cure’ Series – Home Remedies

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

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

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

Eczema home remedies

Home Remedy #1 – Moisturize

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

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

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

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

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

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

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

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

Home Remedy #3 – Keep the Skin Moist

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

Home Remedy #4 – Ways to Kill Staph Bacteria

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

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

Home Remedy #5 – Oils

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

Home Remedy #6 – Anti-Inflammatory Natural Ingredients

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

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

Eczema ‘Cure’ Series – Diet

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

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

Now, many eczema sufferers report curing their eczema from eliminating certain foods from their diet, typically these are (i) diary, (ii) wheat and (iii) sugar. Is there a basis for this? Think along with me!

Unusual suspects for Eczema cure

Suspect #1 – Allergy to Diary and Wheat Undetected

This is the most straightforward reason why cutting certain foods from diet heal your eczema – it’s possible that you have an allergy to certain foods but you’re not aware of it. The unawareness could be due to:

  1. You have not taken an allergy test, be it either skin prick test or blood IgE test. Watch the video on allergy testing and #SkinishMom column on why sometimes doctors don’t get you tested (other than the other obvious reason which is they don’t have the facility to test and don’t want to refer you to another doctor..)
  2. Foods like diary and wheat are so prevalent in our diet that you may not notice. Generally speaking the more common something is, the less likely that you can identify it on your own as the trigger for your eczema. That is why although house dust mite is a very common trigger, parents tend to not associate their child’s eczema flare up with it. For common allergens for children of different age, see here (extracted from Professor Hugo Van Bever’s article – Prof Hugo is my co-author for Living with Eczema Mom Asks, Doc Answers!)

Suspect #2 – Food Intolerance or Hypersensitivity not Easily Tested

While allergy testing (for increased blood IgE immunoglobulin) is straight forward, detecting food intolerance or hypersensitivity is a whole different ball game. Even allergist or your nutritionist can be floored by it. For instance, reaction to a food intolerance can be gradual, not necessarily in small amount (unlike allergy) and can be intolerant only when certain foods are in certain state (eg raw versus cooked). Learn more on the differences between allergy and food intolerance.

As such, it could well be that your intolerance reaction is in the form of skin rash but because it is delayed reaction, no doctor has told you that a certain food is the culprit. However, when it is removed from your diet, your skin condition improves.

Here’s an interesting research on how children have tummy ache but didn’t get diagnosed as related to food sensitivity.

Suspect #3 – Gluten Sensitivity comes in Many Forms

Similar to the above, gluten sensitivity can come in many forms – Celiac Disease, Non-Celiac Gluten Sensitivity or Wheat Allergy. While there are tests for celiac disease and wheat allergy, testing for non-celiac gluten sensitivity is not straightforward. This could be why many reported their eczema improving after cutting gluten yet they are not tested to be allergic to it.

There has been some (small scale, not conclusive) research suggesting that eczema sufferers tend to have gluten sensitivity which is why cutting gluten has worked for them.

Suspect #4 – Sugar Intolerance

For other eczema patients, cutting out sugar improves their eczema – a possible reason is that they have an intolerance to fructose or sucrose. This is due to the lack of digestive enzyme frutase and sucrase. However, tests for these are more expensive and being in many of processed foods and foods we eat, you may not think of testing for it.

Also cut the soda, read its harmful effects in this Soda and Child series.

Suspect #5 – Milk Intolerance

Similar to above, one could also be intolerant to milk from a lack of digestive enzyme lactase. It’s possible that the intolerance reaction gets triggered from different amounts and therefore, you may not know it’s from milk.

Read also alternative food sources from nutritionist Natalia Stasenko if your child is intolerant to milk.

Suspect #6 – Cutting out Inflammatory Foods

I’m personally very careful about NOT eating inflammatory foods and if your child with eczema is obese too, read tips from nutritionist Rania Batayneh on an anti-inflammatory diet.

The basic concept of inflammatory foods is that these foods promote the production of substances that put stress on our body, being increasingly recognized as the cause of many health conditions which are linked to prolonged inflammation (chronic inflammation). To understand this better, see interview with nutritionist Toby Amidor.

I’m not clear how inflammatory foods directly link with eczema but the general link is that eczema is skin inflammation (rash) and the overall reduction of inflammatory foods may have a greater impact on certain individuals than others (my own guess).

Suspect #7 – Eating Clean

This term ‘clean eating’ is quite ambiguous but generally taken to mean that we don’t eat processed foods, fried foods nor trans fat. There are also people that said once they cut out processed foods, cook and eat healthy, their eczema improved. I’m a big supporter of that, not so much for improving eczema but more for general health. In terms of research that supports doing so, there is a large scale association study that showed children who ate fast food more than 3 times/week are 30% more likely to have more severe allergic conditions. (side point – Prof Hywel Williams who led the study also wrote the foreword for my Living with Eczema book!)

Suspect #8 – Going Vegan

Some eczema sufferers choose to go vegan or cut down on meat. There is a basis for this as explained by dermatologist Dr Cheryl Lee in this post on Diet and Environment on Skin. Animal proteins and sugar are pro-inflammatory and give rise to excess free radicals that damage our body and our skin. My own guess is that some people get affected by animal protein more than others which is why going vegan works wonders for their skin!

Suspect #9 – Being Able to Take Action reduces Stress

This is my own guess – it is known that stress triggers eczema flare-ups (see dermatologist Dr Claudia Aguirre’s interview on Stressed Skin is Skin Deep) and most patients also feel helpless especially when there is no clear trigger or solution offered by their doctor. Being able to take proactive steps to eat healthy, cut sugar or figure out gluten-free recipes may reduce stress and inspire new interest in cooking. So the reduced stress possibly helps the eczema and for more on stress affecting acne, see dermatologist Dr Verallo-Rowell’s interview on Diet and Lifestyle.

Above is my thoughts on why eczema sufferers or parents of eczema children feel that changing diet ‘cured’ their eczema. Did diet change work for you? Share in the comments!

One reader, from Odylique Essential Care shared this post that they compiled from research papers and their infographic (Credit:www.odylique.com)

eczema-diet

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