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Doctor Q&A

Science of Skincare Products – Eczema Supportive Care

This is a 4-part series focused on understanding the science behind skincare products so that parents of eczema children and eczema sufferers can better understand what goes into the bottle. Read more about Dr Briand here.

  1. Science behind Skincare Products
  2. Skincare Product safety and expiry date
  3. Skincare Product stability
  4. Eczema Supportive Care
Lotion, Cream or Ointment as Eczema Moisturizer

MarcieMom: Thank you Elisabeth for joining me again for this last part of our skincare products. I’ve covered in this blog that moisturizer has preventive effect on eczema and for those with eczema, moisturizing frequently is able to reduce the use of corticosteroid cream. What I would like to focus in this interview is whether the type of cream, how we apply and when we apply will make a difference in the functions of the moisturizer.

We are aware that the more liquid a moisturizer is, the shorter time it will last but it is more comfortable to apply than an ointment (which has little to no water content), especially in hot and humid weather like Singapore or during summer. Does the nature of whether it is lotion, cream or ointment affects the efficacy of the skincare product? For instance, does being lotion meant it is more easily absorbed and being ointment meant it will be longer-lasting?

Dr Elisabeth: Many kinds of products are indeed available to help and promote skin health. The same principles as those described earlier work for all of them: products with few ingredients and safe ones will be better for sensitive and fragile skins.

Various kinds of products will, as you said, give different kind of feel and the aim may (or may not) be different as well. The purpose of the two products is different, while ointment is often used to bring a lot of fatty acids to the skin and add an occlusive layer to reduce the TEWL (Transepidermal Water Loss or water that is lost through the skin), cream is more used to bring water to the epidermis, as well as other hydrophilic compounds that could be of interest. Creams bring also hydrophobic compounds (fatty acids, hydrophobic active ingredients, …) but to a lesser extent.

The long-term efficiency of a product will depend on how it is structured and how quickly the compounds are delivered to the skin and absorbed.

For ointment, they generally have an occlusive layer that will remains on top of the skin, which is the purpose of these ingredients so that it can prevent water to evaporate from skin. So the feel it gives and that specific function will last for a rather long time. On the contrary, water and active compounds are delivered quickly and evaporate or absorbed quickly by skin. As a consequence, the moisturizing feel disappears rather quickly

One of the achievements that may be reached by using innovative structure is to make cream that have a feel comparable to a classical cream, but will display a long-lasting delivery of the active ingredients, and then combined some of the advantages from an ointment (long-lasting relief and effect) and from a classical cream (pleasant feel, bringing water to the skin).

Ceramides in Moisturizer for Eczema, Dry Skin

MarcieMom: The other ‘big’ question that all parents have is each skincare company claims that their product is able to hydrate, build the skin structure better. These typically belong to the group of moisturizers that contain ceramides or have the ability to restore the skin lipids. In your view Elisabeth, is there certain characteristic (such as ingredients or process) that will differentiate a category of moisturizer as being better at restoring skin functions than others?

Dr Elisabeth: Efficiency is claimed by all companies, of course, because all products will bring the element that will help skin moisturizing, at least in the short term. It is clear however that some products will be more efficient than others; just like some products will have better feel than others etc. As mentioned in our previous discussion, this is why scientific innovation and knowhow comes into play: in our view, they are the key to make better, more efficient and safer products

Ceramides are indeed one of the components that enter in the composition of skin membranes and seems to play a role in its restoration. There are however several types of ceramides and all of them do not seem to display the same efficiency according to various recent publications. What will help skin to be restored is to protect it from threats, and nourish it with proper ingredients. A general appellation of Natural Moisturizing Factor has been created to describe these ingredients that can play a positive role in skin restoration. Ceramides are only one of them. For example, vegetal oils are mainly made of fatty acids that interact with skin cell membrane and help it to be “nourished”. Some of these oils also have additional compounds that will play a positive role.

Glycerin and other Natural Moisturizing Factors

Glycerin, urea, aminoacids, cholesterol, and many other ingredients can play a role in restoring skin functions. What is important is to determine which ingredients will be helpful in a specific situation, and how you can maximize the efficiency of this ingredient in the molecular structure that you create inside the product.

Skincare Moisturizing Routine – Any Tricks?

MarcieMom: Readers of this blog are familiar with basic skincare, such as moisturizing right after shower and making sure to moisturize enough. Either due to cost or belief of effectiveness of certain way of moisturizing, some parents may

  • apply brand A moisturizer in the day, and brand B at night; or
  • apply brand A on certain days of the week and brand B on others (or alternate by weeks);
  • apply brand A (a lotion) and brand B (an ointment) over it.

In your view, which is the skincare moisturizing method that make sense? For instance, with constraints that many families have, such as budget and time to moisturize (e.g. child in school or simply to reduce the number of times moisturizing is needed).

Dr Elisabeth: A daily moisturizing routine is indeed driven by various factors, lifestyle included. A product can be efficient, but if it is a hassle to use it, it won’t be used properly and will become inefficient. I would say there is no “you have to” routine, just find one that is working for you. If you keep in mind the principles I already described: using efficient products with few and safe ingredients, you can find what works the best for you. And it may be completely different from what works for another person. And it can be the same product or products for a very long period of time.

Skincare Moisturizer as Eczema Support

Regularly changing skincare products from time to time can be a good idea when you are using products that contain a lot of ingredients. or that contain an ingredient you are slightly sensitized to. So you will give a rest to your skin that would otherwise be exposed to some ingredients that could become unhealthy with time and regular use.

MarcieMom: Many eczema sufferers feel that rotating the emollient seems to make it more effective than always using the same emollient. Is there some basis for that?

Dr Elisabeth: The efficiency of a product is determined by its ability to bring what is needed by the skin to be protected to help restore its functions. Rotating products can be a way to bring various efficient ingredients that are not found in only one products. But as I just mentioned before, there can be other reasons that can make an emollient less efficient, so you have to switch from it for a while. Some ingredients can lead to some sensitization of the skin. Not strong enough to give a rash, but strong enough to lead to some irritation if used over long periods of time, that would explain why a product would become less efficient. Reducing the number of ingredients can decrease this risk and in that case, your emollient will work for a longer time.

Thank you Elisabeth of being ever so patient in this series of interviews on skincare products, tackling specifically the science behind it. It is truly enlightening and practical!

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – Mom Self-Motivational Talk

Mom NeedyZz Cartoon - Mom Pep Talk Motivational
Ouch – don’t give up!

I’ve been through that – just never actually dressed up to give myself the pep talk lol! Share your self-motivational tips in any of the Mom NeedyZz cartoons here.

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Skin ish Mom Column

#SkinishMom Says – Don’t link Contagious to Eczema

I came across this ‘harmless’ article that was simply sharing about the closure of a children zoo in Gothenburg (the second largest city in Sweden). What caught me was the headline “Animal ‘eczema’ closes Gothenburg kids’ zoo“. I know that animals get eczema but I’m curious about the inverted commas. So I read on and the writing below both infuriated and saddened me:

A statement on the park’s website added that vets had taken samples from the lambs and goats and were currently waiting for test results. Staff suspect that the animals have contracted a skin disease similar to eczema that can be passed between animals and humans and vice versa.

… one of the vets working at the zoo told the TT news agency that humans symptoms would include “sores and blisters on hands”.

I know the writer of the article was probably saying that the appearance of the rash looked similar to eczema and it was suspected that it could be pass on to humans. However, one could easily misread it as the skin disease was similar to eczema which is contagious.

Eczema is not contagious (PERIOD).

Eczema is not contagious

It saddened me because so many children and their parents all over the world are already struggling to manage the eczema in school. Apart from the difficulty of implementing a skincare routine in school, tacking the social impacts of eczema is also an uphill task. Schoolmates may think the eczema rash is contagious especially if the eczema child has rashes on the face, arms or legs, constantly scratching and the rash looks like it’s spreading on some days (flare-ups). Eczema children get shunned because they are feared to infect others. Their parents face a difficult task of explaining eczema to the teachers and getting the school to communicate with the students. We don’t need any news article to possibly further fuel the wrong notion that eczema is contagious, IT’S NOT!

I’ve emailed the online paper to request if they can amend their writing, will update when I hear from them.

#SkinishMom

 

Categories
Doctor Q&A

Science of Skincare Products – Stability

This is a 4-part series focused on understanding the science behind skincare products so that parents of eczema children and eczema sufferers can better understand what goes into the bottle. Read more about Dr Briand here.

  1. Science behind Skincare Products
  2. Skincare Product safety and expiry date
  3. Skincare Product stability
  4. Eczema Supportive Care
Stability in Skincare Product

MarcieMom: Is it possible that a moisturizer has not spoilt but is no longer effective? Is technology required to ‘hold the ingredients’ together to be stable?

Dr Elisabeth: Generally yes. The best skincare products can be quite sophisticated, “high tech” products, so if the structures that hold the different ingredients are degraded, then there can be a significant loss of efficiency. To make a parallel, if you stomp onto your mobile phone and it is crushed, you will still have all the components of the phone, but the structure will be destroyed and the phone may not work any more! Using industrial processes enable to make structures that will increase the stability of a product. You will not be able to achieve these structures with a bowl and a mixer. A lot of scientific and industrial knowledge is necessary to make products that will last for a long period of time.

At Skintifique, we have developed products that have very novel internal structures, which is what give them distinctive properties, be it for moisturizing the skin, protecting it from common allergens and irritants such as Nickel and other metals, or providing long lasting moisturizing and soothing.

Stability in Skincare Product ingredients
Tips on Buying a Safe and Stable Skincare Product

MarcieMom: Any tips for parents to make sure that they are buying a product that is safe and stable and not using one which has stopped being so?

Dr Elisabeth: Choosing a product that is safe and efficient is a major concern for parents and people with sensitive skins. The first tip I would recommend is to choose skincare with the least number of ingredients. No ingredient is completely safe for everyone, and by reducing the number of ingredients you are exposed to, you minimize the probability your skin will react to one of the constituents. So in that case, fewer means safer. Of course, the better known the ingredients, the safer the products: a skincare product that would only contain 8 ingredients but 3 of which no one has ever heard of, or used in a skincare, would not necessarily be the safest choice…

Fewer ingredients means Safer

I would recommend buying skincare from a brand you trust and that must fulfill stringent regulation. It can be established brands but also new ones (and as a representative of a new brand, I can only emphasize that some new brands can be even safer and better than established ones!), a key point is : do I trust this brand or do I have reasons to? Of course, one sometimes needs to try new products, if only to get better benefits than with current products, so then another key point is: can I make a test, eg buying initially 1 tube, or getting a sample etc. Some tips can help to reassure about the professionalism of a company: is there an easy way to contact them, are there some credential that tell you who is behind, are they prone to answer your question to one of their products, are their products manufactured in reliable places

EU Regulated Sensitive Skin Product Labeling

Use products that have been designed for sensitive skins or children. They have been assessed by independent experts in toxicology with more stringent criteria, especially in the EU. Since 2013, there is a new regulation (European cosmetic regulations) that have clarified what is necessary for a product, and fair labeling is a major part of it. Evidence has to be provided before a product can be labeled as suitable for children and sensitive skin. An independent toxicologist expert is mandated to consider all the evidences claimed for a product. What is not done yet is a previous approval of cosmetic product before it is commercialized, but you have to give all these information as soon as a state authority requests it. So if you are a serious skincare company, you have all the tests done, certificates needed and so on in a « cosmetic file » that is ready to be consulted by state authority.

There can always be untrusted company that are selling  products with not all the tests made but if it is discovered, consequences can serious…   What is not described in the regulation is the exact method and tests you have to performed to build your evidence, but some consensual recommendations are coming out from bench of experts in toxicologist. As an example, one of these recommendations is to use much more stringent safe limit for a product destined for a child. To illustrate it, this is roughly how is estimated the toxicology profile of a cosmetic product for an adult and a child:   To determine if a product is safe for an adult and how much of this product, at the maximum, it is advised to applied on skin, you determine the exact concentration of each ingredient, and how much of each of these compound is applied on the skin. You have toxicological profile for each ingredient allowed in cosmetics, with the maximal dose at which it is not toxic. The limit of exposure for each of the component of the cream is determined, and the maximum amount of a skincare that can be applied daily is determined by the ingredient with the lower dose of exposure allowed.   To determine if a product is safe for a child, you make the same analysis, but with more stringent criteria. For exemple, the maximal dose of each ingredient allowed per day is divided by a factor of 2.3 and since you have to take into account the various mass of people (generally a factor 12 between a child and an adult), the overall factor of safety is about 27 compare to a product designed for an adult.

As long as it is within the expiry date or period after opening (PAO), and unopened, it should be safe, but as soon as the product has changed in color, odor, aspect, throw it away.

MarcieMom: Thank you Elisabeth – now we all know what to look out for especially when most of us have so many creams and lotions at home for our eczema child and after keeping for some time, we struggle whether to throw it out or still use it.

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Support Group

Eczema Support Group on Skincare and Skin Aging

Eczema Support Group Lunch Skin Aging and Care
Join us for a relaxing Friday lunch and meet new friends who are passionate about their skin

Caring for our skin is critical, especially as our skin is the largest surface exposed to sun and the environment. Skin ages both intrinsically and from external stress – sun exposure, air pollutants, smoking and lifestyle. In June’s Eczema Support Group’s session, we will learn with senior dermatology nurse Sister Wong:

  1. Skin structure and how Skin Ages
  2. Causes of Skin Aging
  3. Care for our Skin, answering questions such as the ones below and many more!
  • Sun protection : What sunscreen protection should you use? How to correctly apply sunscreen and don’t we need sun for vitamin D?
  • Bath : Should we bathe more or less? Hot or cold water?
  • Moisturizer: What lotion or cream to use? How do I know it is safe?

Sister Wong 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.

Mark your calendar on 5 June 2015, Friday, Lunch provided at National Skin Centre, Level 4, Room 401, 12.15 pm to 1.15pm

YOU MUST RSVP – You must RSVP so that we can order lunch and arrange the layout for the seats. If you’re coming, please email me ([email protected]) your name, mobile and email, number of adults & kids coming, and a NSC staff will confirm your RSVP.

Information shared during the session is not medical advice, information on my blog is not pre-approved by NSC.

Look forward to seeing everyone! Mei

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – BFF tells it like it is

Mom NeedyZz Cartoon BFF tells it like it is marriageLast week, Kate was really struggling with asking for help and connecting with spouse Mark. Similar experience, anyone? Sometimes, it’s hard to ask for help.. just simply hard to even think how to ask when the day of taking care of a newborn is so energy sapping. Share your journey in any of the Mom NeedyZz cartoons here.

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Skin ish Mom Column

Ask #SkinishMom – Follow Hugh Jackman, get Regular Skin Cancer checkups

If you want to follow a celeb, follow Hugh Jackman’s lead in going for regular skin cancer checkups, especially if you’re at high risk. It’s reported by People that he was first urged by his makeup artist to have a spot on his nose checked in 2013. It turned out to be basal cell carcinoma – the most common type of skin cancer. Subsequently, Hugh Jackman went for regular 3-monthly checkups and had 4 skin cancers removed.

Risk Factors for Skin Cancer

Given that Hugh Jackman hadn’t been using sunscreen and had lots of sun exposure, he’s at increased risk of skin cancer. The risk factors for skin cancer are:

Skin Cancer Risks

  • Sun Exposure. A tanned look is viewed as healthy but in fact, it’s quite the opposite! The tanned skin meant that the skin cells exposed to UV radiation had increased the production of melanin (skin pigment) to protect the skin from further damage. It is also often misunderstood that we need vitamin D and have to suntan. While it is true that sunlight helps to provide our body with vitamin D, the exposure should not be so much till you get a tan. Check out sun protection from the American Academy of Dermatology.
  • Sun Exposure-related Factors. Your age (the longer you’ve lived, the more sun exposure), your gender (male, if work/sports is outdoors) and where you live (warm climate at high altitude).
  • Fair skin. The less pigment in your skin, the more likely for sun damage, therefore fairer skin is at higher risk. Also at higher risk if you have blonde or red hair, or skin that sunburns or freckles easily.
  • Moles. When moles take on a different shape, darker color or irregular edges, it may be a sign of skin cancer. According to a previous interview with dermatologist Dr Verallo Rowell in this blog, her advice was that while not all moles become skin cancer, the risk is higher when (i) there are many (more than 50), (ii) ‘ugly duckling’ sign where one mole looks different from the others, (iii) family history of melanoma, (iv) photo aging evidence and (iv) have characteristics of

A for Assymetry

B for border irregularity

C for irregular pigment distribution

D for diameter of 6 mm or more

E for evolving or changing noted in size

  • Personal or Family History. If you have had skin cancer or immediately family member with history of skin cancer.
  • Weakened immune system. People with weakened immune systems (HIV) and those taking immunosuppressant drugs.
  • Exposure to radiation. People who received radiation treatment for cancer or skin conditions such as eczema, psoriasis and acne may have an increased risk of basal cell carcinoma.
  • Exposure to certain substances. Exposure to certain substances, such as arsenic, industrial tar, coal may increase your risk of skin cancer.

If you’re not in the high risk group or prefer to do some self-inspection, here’s the symptoms to look out for:

Symptoms of Skin Cancer

Skin cancers are named after the type of skin cells and basal cell carcinoma is the most common type of skin cancer.

The symptoms of Basal Cell Carcinoma:

  • Unusual bump, sore, skin growth
  • Small, pale, waxy, translucent skin bump (center indent or blood vessels seen)
  • Red scaly patch
  • Brownish scar or flesh-colored lesion
  • Bleed if injured or crusted.

The symptoms are Squamous Cell Carcinoma:

  • Unusual bump, sore, skin growth
  • Rough (pink) skin bump
  • Red scaly patch
  • Bleed easily

The symptoms of Melanoma:

  • New spots on skin
  • Change in size, shape, texture, color or bleeding of an existing mole
  • Sore that does not heal
  • Pigment, redness or swelling that spreads outside the border of a spot to the surrounding skin
  • Itchiness, tenderness or pain

Typically at the physician, there are a couple of tests including skin biopsy to get an accurate diagnosis. Check your skin regularly so that you’d know when something is out of the ordinary.

Slapping on sunscreen,

#SkinishMom

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Doctor Q&A

Science of Skincare Products – Safety and Product Expiry Date

This is a 4-part series focused on understanding the science behind skincare products so that parents of eczema children and eczema sufferers can better understand what goes into the bottle. Read more about Dr Briand here.

  1. Science behind Skincare Products
  2. Skincare Product safety and expiry date
  3. Skincare Product stability
  4. Eczema Supportive Care
Skincare Product Expiry Date

MarcieMom: Thank you Elisabeth for joining me again for this series. Quite a few times I look at a product and wonder what will happen after the expiry date, and if it will spoil without visible change.

How is this expiry date determined? Is there a real need for an expiry date, as in will certain ingredients really spoil?

Dr Elisabeth: Every product sold in established market must pass mandatory regulatory requirements that are essentially designed to ensure safety of the products for consumers. Expiry date of a product is one of the aspects that is often covered by regulatory requirements. I will talk here more about products produced or sold in European Union, which is one of the most stringent worldwide. It means the product must pass several tests that prove it will not spoil during that period of time.

To ensure the safety of a product, you can strictly follow the regulations that are mandatory, or you can also add extra care to that aspect. Regulation is the minimum required, and you can always do better by putting yourself higher internal requirements.

In products produced and/or sold in E.U., you can have two mentions of expiry, one is an actual expiry date, and the second one is Period After Opening or PAO.

If a product has passed tests that will prove it is stable for at least 36 months, expiry date is optional, but you have to indicate how long this product can be used safely after it has been opened. 

Period after opening symbol skincare

Some other products will display an expiry date. There are multiple reasons to indicate an expiry date. It can be because 1. the products did not pass the test for a period corresponding to 36 months, 2. it has not been tested for this long period of time, 3. it has passed the test for that period of time, but for various reasons, it has been decided to shorten its shelf life.

In the last case, the reason behind is often to ensure a maximum of safety. The tests that mimic product aging are well known and well controlled but are still tests. Real life can be quite different than what has been modelized in a lab, and adding an expiry date is a way to ensure a maximum safety for customers.

Using a product for a longer period that is indicated may not be necessarily harmful, and the product can still be good, but you are on your own. There is no data to support the fact that it is safe or not…

Safety and Expiry Date in Skincare Product
Quality of Raw Materials – Product Spoilage

MarcieMom: I suspect that an organic skincare lotion I bought may have got bacteria because after a few weeks of using, my daughter developed impetigo (or of course, the impetigo could simply be a complication from eczema and the scratching everywhere). What are the factors that increase the chance a skincare product will spoil? Is it the type of ingredients, where they are made and flown to, or what temperature they are kept in?

Dr Elisabeth: A serious skincare company will take great care of offering products with the best quality, to avoid risk of products spoiling.

The first factor that will induce spoiling of the product is the quality of raw ingredients used in the product and the quality of the manufacturing process. Having strict controls over these factors will help to avoid problems of contamination and oxidation, which are the most frequent causes of product degradation.

The quality of raw ingredients is obviously essential, as any contaminant present in the ingredients with contaminate the final products. Another source of contamination can be the material that is used to manufacture or package the product. Finally, the last main source of contamination is humans that work on the preparation of the cream. They must take great care of personal hygiene before working (washing hands, using single-use gloves, round cap and masks) and only do so under the highest safety and quality standards. The preservatives used in the skincare provide a good reassurance and generally protect the products reasonable well, but reducing the amount of microbiological contamination from the start, ie from the moment the ingredients are sourced and they are manufactured, is the best way to avoid spoiling later on. In E.U., manufacturers of skincare have to follow “good manufacturing practices” regulation, and at Skintifique, for instance, we have applied extremely strict criteria when choosing our suppliers of raw materials and our industrial partners, precisely so as to have the highest assurance on the quality and safety of our products

Stability Tests on Skincare Product

Stability tests are made to ensure a safe use of the product, but as I said earlier, these tests are designed to mimic quite standard situations. Real life conditions can be harder than what has been modelized. For example, sunscreen creams that have been forgotten in the car on a back sit, and stayed for a long time in a very warm environment, under the sun, have experience several cycles of heat/cooling, which is one of the harder conditions a skincare product can experience. These conditions exceed what have been tested in a lab, and the product can go bad earlier than what is said on the packaging. To ensure that a product will not spoil, you should keep them away from heat and UV. Putting them in a fridge can help keeping them, but may induce a change in the structure of the product (its texture won’t be the same).

To ensure that a product will not spoil, you should keep them away from heat and UV.

MarcieMom: Thank you Elisabeth for sharing about safety and expiry dates of skincare products – next time when I’m offered the chance to visit a skincare company’s plant, I shall look out for these areas! Next week, we will touch on the stability of a product. Can’t wait to learn more!

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – A New Mom’s Day runs by 3 hours

Mom NeedyZz cartoon Spouse Help for New Mom
Why does a Mom who needs help feels she has to do it all?

I confessed – I did do it all even though it was very tough in the first year of taking care of my daughter with eczema – cooking 3 dishes and a soup and cleaning the house. Share your mom’s journey and what’s on your plate in any of the Mom NeedyZz cartoons here.

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Skin ish Mom Column

#SkinishMom Investigates – Apple Watch and Skin Irritation

There were quite a few reports of users getting skin irritation from wearing Apple Watch and this got #SkinishMom into an investigative mode. It’s not news that items we wear can cause skin irritation, for instance, nickel in jewelry is a common irritant. It’s also not news that wrist bands can lead to skin irritation, for instance, there was a voluntary recall for Fitbit Force after news of rashes last year. As for Apple, there was also a reported instance of a child getting skin irritation after using iPad (due to nickel allergy). So what’s with these materials and their contact with our skin?

Skin Irritation and Apple Watch - Top 6 Suspects

Suspect #1 – Allergic Contact Dermatitis to Nickel

Allergic contact dermatitis involves the immune system by which a hypersensitive reaction (rash) results from a previous contact with the allergen. Of the metal materials, nickel is one of the most common cited that cause this rash. In 2013, when UK issued new coins containing higher level of nickel, it was reported to pose an allergy risk.

For both Fitbit and Apple, there are nickel in the wristbands. From Apple website,

Apple Watch, the space gray Apple Watch Sport, the stainless steel portions of some Apple Watch bands, and the magnets in the watch and bands contain some nickel. However, they all fall below the strict nickel restrictions set by European REACH regulation.

REACH stands for Registration, Evaluation, Authorisation and Restriction of Chemicals. It is a regulation of the EU, which is known for setting strict standards on safety. EU had restricted the amount of nickel in jewelry and products that come into contact with skin in the ‘EU Nickel Directive’.

If Nickel is so much trouble, why do jewelry and wristband manufacturers continue to use it? It is usually selected for its corrosion resistance, toughness, strength at high and low temperatures, magnetic and electronic properties that are superior to other metals.

Suspect #2 – Allergic Contact Dermatitis to Methacrylates 

Methacrylates is a polymer that is commonly used in adhesives and also in both Fitbit and Apple Watch. From Apple website:

The Apple Watch case, the Milanese Loop, the Modern Buckle, and the Leather Loop contain trace amounts of methacrylates from adhesives. Methacrylates are found in many consumer products that come in contact with the skin, such as adhesive bandages. Some people may be sensitive to them, or may develop sensitivities over time. Apple Watch and its bands are designed so that parts containing methacrylates are not in direct contact with your skin.

Suspect #3 – Irritant Contact Dermatitis to Sweat

Irritant contact dermatitis is a delayed hypersensitive reaction due to prolonged exposure to an irritant. There is a wide range of possibilities that trigger irritant contact dermatitis, almost anything is possible including our sweat. Since Apple Watch and fitness trackers are worn to keep track of heart rate and fitness goals, it is likely that it comes into contact with sweat. From an interview with dermatologist Dr Cheryl Lee, she explained:

The salts from sweat can crystalize and act as an irritant to the skin. If you can see that your baby’s sweat has dried and has a salty residue, then I would recommend rinsing it off with plain water (no soap) to prevent it from becoming an irritant. If the sweat is not crystalized, I wouldn’t worry about it much.

Suspect #4 – Irritant Contact Dermatitis to Soap

Those familiar with eczema skincare know that soap is not recommended as it is drying (alkaline) and often irritate sensitive skin. In fact, soap is seldom patch tested as it is almost a certainty that leaving it on your skin for 2 days (norm period for patch test) will result in a rash. If your Apple Watch happens to trap the soap and you’re wearing it without removing, the soap may be the culprit behind the rash.

Suspect #5 – Heat Rash

If it’s hot and humid weather and your Apple Watch is constantly in contact with your skin, it may result in blocked sweat ducts. Similar to a common baby rash Miliaria (as babies have immature sweat ducts, thus more prone to blockage), your blocked sweat ducts can trigger skin rash.

Suspect #6 – Constant Friction

I couldn’t find a Pubmed article on friction and skin rash but from my understanding, it could be

  • Constant friction causes chafing that can be painful. Moreover, exposed skin is more vulnerable to irritants.
  • The sweat residue increases the friction.
  • Wet (sweaty) skin makes the chafing worse.

So What to Do if You Really WANT AN APPLE WATCH?

If you have not bought the Apple Watch

You can take a patch test to see if your skin will react to materials in Apple Watch, especially nickel. A patch test is quite expensive and take 2-4 days for the patch results to show and require repeat consultations to view how your skin has reacted. I read from WSJ that you can try taping a nickel coin on the inside of your arm for 2 days and see if a rash appear. (I’m not sure if it’s accurate reflection though as the nickel quantity or type of nickel alloy may be different.)

Or decide not to take the risk or take the risk with a later generation of Apple Watch (where possibly nickel and other improvements to apps would have been made!)

If you have bought the Apple Watch > No reaction – Good for you!

If you have bought the Apple Watch > Skin rash – Top 6 tips to Try

Skin Irritation and Apple Watch - Top 6 Tips to Limit Skin Rash

  1. Place a barrier between your skin and the wristband – you can put a layer of emollient over but be sure that your skin is clean. Slapping moisturizer on top of sweat and irritant may worsen the rash. Of course, use a moisturizer that will not irritate your skin in the first place (ingredients to avoid).
  2. Clean your sweat off and put on the watch only when your skin is clean and dry.
  3. Make sure to wash soap off or use a gentle non-soap cleanser if you have sensitive skin.
  4. If it’s hot and humid, you may want to take off the watch for a few hours. (Maybe when you’re sitting down and not exercising?)
  5. Not wearing it too tight or too loose – Apple had provided guidelines on this; both too tight and too loose can cause skin rash, think of a waist band that’s too tight or a watch that’s too loose and created friction.
  6. Keep the Apple Watch clean – it somewhat defeat the purpose of cleaning your own skin and then putting on something that has a host of sweat residue and debris for hours a day. Apple also has guidelines on cleaning their watch.

I’m actually glad that I didn’t go out to get an Apple Watch (it’s not available in Singapore anyway!) because I always get skin rash with watches (leather or metal) and a gym mate told me you can’t play all your iTunes songs on the Apple Watch and can’t blue tooth the songs from the watch to the earphone (gasp! That’s the main reason why I want an Apple Watch). Do share your experience in the comments!

Update on 29 June 2015 – Apple Watch is available in Singapore and one reader Nicholas pointed out in the comments below that you can blue tooth your iTunes songs to earphone. (Hmmm.. should I get one?)

Sticking to watch-free (skin rash free) wrist,

#SkinishMom

p.s. I’m not sure if Apple is reading this post, comments are my own, from understanding of skin, rashes and reading online. But if Apple is reading this, do amend a formatting error on your guideline – REACH, not REACh (sorry, but I kinda get irritated by formatting error!)

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Doctor Q&A

Science of Skincare Products – Science in the Bottle

Science Behind Skincare Products with Dr Briand

Dr. Elisabeth Briand, R&D manager at Skintifique. Elisabeth holds an Engineering Master’s degree in food industry and a PhD in chemistry. She had 10 years experience in academic research as a physico-chemist, in France at Paris VI and Paris XI faculty of Pharmacy and in Sweden, at Chalmers University of Technology.

Science of Skincare Products with Dr. Elisabeth Briand

This is a 4-part series focused on understanding the science behind skincare products so that parents of eczema children and eczema sufferers can better understand what goes into the bottle.

  1. Science behind Skincare Products
  2. Skincare Product safety and expiry date
  3. Skincare Product stability
  4. Eczema Supportive Care

MarcieMom: Thank you Elisabeth for joining me for this series. I’m really excited about it because most parents (me included) wonder the differences between skincare products and whether it’s better to get one from a company with the ‘science’ background (or home-made is better).

Let’s start with what’s in the bottle – the ingredients. From a previous interview series, we have learned a few general principles relating to skincare products, to choose those

  1. Without the common irritants, such as fragrance, preservatives, parabens, propylene glycol, lanolin and dye
  2. With as few ingredients as possible, to reduce the likelihood of sensitivity to ingredients
  3. Whether labeled as natural or organic, the overriding factor is whether these ingredients lead to hypersensitive reaction for our skin
Science in skincare product bottle
Skincare Product Ingredients – Active & Support

MarcieMom: How is the selection process of ingredients determined? For instance, is there always a need for a ‘base’ for a skincare product and then add on active ingredients? Do these ingredients have to work together?

Dr Elisabeth: The choice of ingredients is indeed key to develop a skincare product. Some ingredients will be chosen for their activity, some others for making a support for these active ingredients. Ideally, a very strict and rigorous selection process should be carried out. Each company has its own priority for this; for instance, some will prioritize on ingredients they believe give a distinctive feel (texture, fragrance) when applying a product, some others will focus their research on how improving the efficiency of a product by using one specific ingredient. At Skintifique, we focused on a new innovative approach: using both a minimum number of ingredients and very safe ingredients. Making a product safe, efficient and pleasant to use within these constraints require a lot of skills and knowledge in various fields (physic-chemistry, formulation, microbiology and pharmacology).

One way to make a skincare product is to add a set of ingredients with a specific function (eg moisturizing, or protecting the skin from specific allergens or irritants) to a “base” that has a well-known profile of safety, texture and efficiency. In that case, the base will bring the safety and the basic functions a moisturizer must have (generally, humectant, emollient and occlusive function, it sustains stability and safety tests) and the added specific ingredients will bring the specific features of a product (soothing, …).

At Skintifique, we have focused our work on how developing new materials that will enable the use of very few ingredients while maximizing their effects. It means developing products with a new approach, based on how molecules can interact with each other. That’s why the composition of our products may seem very simple, but the products are actually based on very sophisticated science, both in the base(s) that we use, in the functions we add to them and in the ability to mix these functions into the base.

Functions of Skincare Product Ingredients
  1. Occlusive, as protection for the skin
  2. Humectant, the ability to draw water from the environment into the skin
  3. Moisturize, smooth the skin and fill in cracks

MarcieMom: I noted that your product has patent technology. Does a patent technology that enable the functions of the moisturizer to be better than non-patent technology? In other words, what is it about being developed in a lab that makes the skincare product more effective than just the sum of ingredients?

Dr Elisabeth: A lab facility is required when you want to make innovative products.

Developing a skincare product can be done rather easily if you are looking for a product with basic moisturizing functions or just a feel good benefit. There is a long history in the process of making a cream and the principles that drive the stability and the efficiency of classical moisturizer are rather well known.

If you want to add extra features to a product, for example a release in time of active ingredients, a longer stability, or something revolutionary such as having a activity that reflects the needs of the skin (eg the cream is more active when the skin needs it), while using a very low number of ingredients, then you have to think differently of how it is traditionally made. It requires a lot of research.

This is the type of products we strive to do at Skintifique and that is why we protect, with patents and otherwise, the technologies that are used in our products. To achieve the development of our products, we have to make numerous tests and iterations that are possible only in a lab. We needed specific equipment to process and also analyze the various formulations.

It is a little bit like in cooking. Using eggs, flour, milk and sugar, you can make simple cakes (which will not harm you if you eat them, but which will not provide anything special in terms of taste and feeling), or you can also achieve a new culinary chef d’oeuvre, if you put a lot of knowledge, expertise and skills only a chef can bring in making it.

Development Process for Skincare Product

MarcieMom: Can you briefly describe the key processes to make a skincare product from sourcing to making the final cream/lotion. How is it different for a company like Skintifique versus say, a company that does not have the laboratory or facilities?

Dr Elisabeth: The general process to make a skincare product is simple at high level: decision on what the properties of the skincare should be and how to make it (e.g. a highly moisturizing product with few ingredients for people with sensitive skin vs a skin tanning product for fun), then identify, or invention of, the best technologies to do the product, including choice of raw ingredients that must fulfill strict criteria in terms of safety and purity, then a lot of trials in the lab and with real life volunteers, then industrial production, quality check and then, commercialization. For serious skincare companies, quality is a major priority and a lot of quality-check procedures are made all through the process (raw ingredients, industrial process, finished products…)

Making innovative products requires a lot of research and development work, and the results will condition the industrial process. For instance, using only a few ingredients to make a product like our Hydrating Gel requires modifying a lot the various steps needed to process a product. That is why a strong effort is made both on the invention work in the lab and on industrial scale-up phases. For more classical cream, this scale-up process is less critical.

MarcieMom: Thank you Elisabeth for helping us in this post – it is enlightening as we now understand the key components of a skincare product and how having technology and laboratory affects the final product. I look forward to next week’s interview where we learn more about the safety and stability of a product.

p.s. Declaration of no self-interest – I just want to let readers know that Dr Elisabeth left a comment on my blog and I felt she was very helpful. When I realized her area of expertise, I suggested that we could collaborate on a ‘science-y’ series as I’ve always been intrigued by it. No money has changed hands, only time invested to bring this series to you all!

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – Post-it to Do in New Mom’s Life

om NeedyZz cartoon Endless Things to Do in Mom Day
Sometimes you can never check off fast enough the things to do!

Share your mom’s journey and coping mechanism for the things to do in any of the Mom NeedyZz cartoons here.

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Skin ish Mom Column

#SkinishMom Investigates – Skin ‘Smell’ and Heal

Can our skin smell? I don’t mean whether your skin smells, I meant if your skin is able to smell. Apparently, yes. Came across a few studies supporting that and though medical advancements using the skin’s ability to smell are far off, it’s amazing to learn how God designed our body!

Skin Smell and heal

Quick points from #SkinishMom’s investigation:

  1. Keratinocytes, of our skin’s epidermal layer, reacted to a chemical odorant of sandalwood to re-generate in wound healing.
  2. Olfactory receptors (that allow us to smell) are also present in our skin and over 20 types of tissue cells, including liver, lungs, prostrate and gut.
  3. Olfactory receptors found in the testicles may be helping the sperm smell its way to the unfertilized egg.
  4. Olfactory receptors in the lungs also help the lungs to switch off airways to limit inhaling poisonous gas.

The skin being the largest organ of our body truly comes into contact with a lot of our environment. Even in food allergy, it is no longer new to recognize that food sensitization (allergy) can come from our skin. In fact, studies support this hypothesis and it is increasingly recognised that we should take care of our skin, strengthen its barrier to protect our body. The next time you itch for a scratch, think about how a defective skin barrier goes beyond a scar.

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Eczema Tips

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

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – Is Switching to Formula Milk a Boon or Bane?

Mom NeedyZz cartoon Husband Job in Milk Feeding

I guess depends on whose side you’re on! Follow this breastfeeding cartoon series here.

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Skin ish Mom Column

#SkinishMom Investigates – Skin Biomarkers

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

The Connection between Skin and Brain

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

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

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

Skin as Biomarker for Health Condtions

What Our Skin Can Tell Us – Biomarkers

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

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

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

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

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

Signing off for a bath and full body moisturizing,

#SkinishMom

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

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

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

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Eczema Tips

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!

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Mom Sleep Cartoon

Mom NeedyZz Cartoon – Couple Talk on Breastfeeding

Mom NeedyZz Cartoon Couple talk on Breastfeeding

Miscommunication is the result of

Asking the Wrong Friends for advice (here and here)

What will happen next week? Follow this breastfeeding cartoon series here.

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Skin ish Mom Column

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

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

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

Frustrated Mom

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

Warning skincare product label

1. Ignore the Picture

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

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

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

Hypoallergenic means less likely to result in allergies

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

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

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

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

Noncomedogenic refers to less likely to clog pores

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

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

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

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

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

List of Ingredients that could Irritate in skincare product
List of Ingredients that could Irritate

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

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

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

Go for some skincare shopping now, test your knowledge!

#SkinishMom

Categories
Eczema Tips

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!