News & Research

Is There Anything You Can Do to Prevent Eczema for Your Unborn Baby?

Should you restrict your pregnancy diet? Take some supplements to reduce the chance of your baby having eczema? Should you breastfeed longer? Should you feed your baby partially hydrolyzed formula?

Read this compilation of the recent studies, and better still, share in the related forum posts.

Pregnancy Diet and Allergy Risk

So, You are Pregnant and You know that Your Family has an Eczema/ Allergy History. Is there anything that you can do?

This February 2018 UK study investigated how maternal or infant diet can influence risk of allergic disease. The conclusion was maternal probiotic and fish oil supplementation may reduce risk of eczema and allergic sensitisation to food, respectively.

However, in the US, the American Academy of Pediatrics (AAP) in their 2019 paper did not support maternal dietary restrictions during pregnancy and lactation to prevent atopic disease.

Recommendations on impact of maternal diet for atopic dermatitis do vary by country

For instance, World Allergy Organization guideline recommended probiotic (for high-risk cases) and prebiotic (for not exclusively-breastfed infants) supplements for eczema prevention, but European (EAACI), North American and Australasian guidelines do not support this.

So, check with your doctor on probiotic and omega-3 for reducing the chance your baby will have eczema

How Long Should You Breastfeed?

Now your baby is born, how long should you breastfeed?

A retrospective cohort study (46,616 children) in Japan in September 2019 found that breastfeeding, especially colostrum, had prophylactic effects (preventive) on food allergy.

But this finding was only true for high-risk children with infantile eczema. On the other hand, prolonged breastfeeding increased the risk of food allergy.

Scary isn’t it? We seldom hear anything negative about breastfeeding, but this study highlighted risk of prolonged breastfeeding

How can prolonged breastfeeding be negative? It may be related to introducing solids later (if you are breastfeeding longer) or any other factors that are difficult to measure in a study.

There is this PROBIT trial that aims to look at the benefits of breastfeeding. It supports exclusive breastfeeding for at least 3 months as there is reduced eczema for up to teenage years.

This is consistent with what was presented in February 2019 Annual Meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI) where it was concluded –

Exclusive breastfeeding may not prevent eczema or eczema diagnosis, but may play a protective role in decreasing the chronicity of eczema in childhood.

Similarly, the AAP in US recommended exclusive breastfeeding for the first 3 to 4 months as it is linked with reduced incidence of eczema in the first 2 years of life.

Should You Persist in Breastfeeding?

The AAP recommendation is that breastfeeding beyond 3 to 4 months does not help prevent atopic disease for your baby. So, if like me, you are finding breastfeeding a struggle, you can stop without feeling guilty. (Phew!)

Prolonged breastfeeding has limited evidence to support its benefits

What about the Type of Milk?

Don’t even get me started on HA hypoallergenic milk. Read this forum post on how bad an experience it was for our family. But seriously, does research support using partially hydrolyzed milk?

The AAP cites a lack of evidence that partially or extensively hydrolyzed formula can prevent atopic disease in infants and children, even in those at high risk for allergic disease.

What’s even scarier is that this French study in 2019 found that partially hydrolyzed formula was associated with higher risk of food allergy and wheezing.

Because allergy testing is not accurate for infants newborn, there is the chance that pediatricians may recommend switching to HA milk if newborn is diagnosed with eczema rash. Please check if your pediatrician or see an allergist to confirm if that is still the right recommendation.

On the other hand, in Singapore, a study in 2018 showed evidence that feeding partially hydrolyzed milk to high-risk infants did reduce the incidence of eczema. This is helpful if :

  1. Your baby is high-risk, meaning his parent or his sibling has eczema, and
  2. You are unable to feed 100% breast milk and have to use formula milk, then
  3. Choosing a partially hydrolyzed milk formula is preferred over cow’s milk and calculated in the study to be cheaper (notwithstanding the partially hydrolyzed milk is more expensive than cow’s milk).

Now Back to Breast Milk…

Interestingly, there are quite a few news on how breast milk is applied on skin to treat eczema rash!

This 2015 Iran study undertook a randomized control trial to determine if APPLYING breast milk onto eczema rash is helpful. The finding? Human breast milk improve infant atopic eczema with the same results as 1% hydrocortisone ointment

Human Breast Milk as good as mild topical corticosteroid?!

Maybe it is not that hard to believe, considering breast milk has

Here’s many interesting reads on various news channel whereby mothers have used their breast milk to cure their baby’s eczema

Lizzie bathed her baby in her breast milk

Joy used an organic soap made from breast milk

Medela also has an article on the benefits of breast milk.

Infant Diet and Eczema Risk

Is there anything that can be fed to your baby to reduce eczema risk? So far, it seemed that fish and probiotics can be helpful.

This August 2019 Norway study concluded that eating fish at least once a week at 1 year-old was less likely to have eczema, asthma, and wheeze at 6 years-old.

Consuming cod liver oil at least 4 times per week at 1 year old also helps reduce allergy risk.

The other study looked into probiotics – a December 2018 New Zealand study concluded that taking Lactobacillus rhamnosus HN001 in early childhood was associated with significant reductions in the 12-month prevalence of eczema at age 11 years and hay fever.

Here is the “fine print” – the benefit of probiotics was only seen if included directly consuming by infants. The same group of researchers also concluded that taking HN001 during pregnancy and breastfeeding alone will be enough to prevent eczema without giving it directly to the infants. Is that true for you? Share in this forum post.

Solid Introduction

This exciting feeding milestone for many parents usually ends up a stressful one for parents with eczema children. Is it the food that trigger the rashes?

Wait. It is even more confounding because it is possible that the defective skin barrier can somehow increase sensitization to food.

Investigating allergy and trigger by eczema moms
I remembered I was all nerves googling late into the night, when already tired from taking care of baby

The latest AAP recommendation in 2019 is there is no need to delay the introduction of allergenic foods beyond 4 to 6 months for the prevention of atopic disease. However, early introduction of peanuts (4 – 6 months old) may prevent peanut allergies in high-risk infants. (check out this forum post for updated study.

Now in Singapore, a lot of parents feed solids after 6 months and generally wait till one year old before attempting allergenic foods, especially peanuts. Our Singapore researchers looked into it and concluded that the infant feeding recommendation to introduce peanuts early may not be applicable for Asian population.

Where do you live? And has any of the research held true for your baby? Share in the comments or the forum posts

News & Research

Eczema News – Do Elimination Diets Work?

Elimination diets are often tried out at home to see if the child’s eczema improved after eliminating certain foods. The common food allergens for young children are eggs, cow’s milk, soy and wheat and in certain cases, parents may

  • (Scenario 1) eliminate such foods when tested positive in allergy tests, or
  • (Scenario 2) eliminate such foods even when allergy tests didn’t return positive (for many reasons such as suspecting it’s food intolerance which doesn’t show in allergy test or not trusting that the tests are accurate), or
  • (Scenario 3) eliminate such foods without testing for allergies, either because doctors didn’t recommend allergy testing or such facility is not easily available where the family lives.

The question then is whether Scenario 2 and 3 are valid for parents trying out elimination diets for their child. A paper published in July 2015, in the College of Family Physicians of Canada sought to study the papers that have been published on elimination diets, specifically with regard to eliminating eggs and cow’s milk.

Insufficient evidence to support elimination diets
Insufficient evidence to support elimination diets

Result of study: There is insufficient evidence about the benefit of eliminating cow’s milk in unselected patients with atopic dermatitis (AD). Some evidence suggests that egg elimination might benefit those children with AD who are suspected of being allergic to eggs and who are sensitized to eggs.

MarcieMom’s digest on the paper:

#1 Go for allergy testing

I’m a supporter of allergy testing, simply because given that tests are fairly accurate and you can always take a few tests at different development stages of the child to corroborate what he is allergic (or not allergic to), I feel that taking allergy test beats the worry that comes with second-guessing.

#2 Outside-in versus Inside-out

It has been covered in this blog before on the possibility (and doctors are accepting that possibility with more research) that food sensitization can come from outside-in: meaning it is the defective skin barrier that allows food allergens in the air (on the skin) to result in the body being sensitized to the food allergen. It reinforces the importance of protecting the child’s skin barrier with good skincare routine, even from birth for infants at high risk.

#3 Observations can be misleading

Elimination diets rely on observing if there’s any change in the skin/ increase in rashes after consumption of food. However, this can be misleading because (i) allergic reactions may not show up immediately and (ii) prevailing allergens such as to house dust mite can ‘confuse’ the observations because it triggers eczema flares from time to time.

#4 Lesser case for elimination diet

It is mentioned in the paper that40% to 90% of infants with moderate to severe AD are food sensitized based on positive results of skin-prick tests to 1 or more food allergens” but “only 35% to 40% of food-sensitized children with AD have clinical signs and symptoms of food allergy according to multiple double-blind, placebo-controlled food challenge studies“. This means that it is more likely that a child will be tested positive to a food that he can actually consume and not trigger a food allergic reaction. As such, it seems to not justify eliminating a food when it is not even tested positive in the first place.

#5 Studies where elimination diets improve eczema

There were two studies mentioned in the paper that reported an improvement in eczema after elimination diet, (i) was eliminating eggs for infants who are sensitized to eggs, and (i) was using hydrolyzed milk.

#6 Elimination diet risks

The risks of elimination diets are

  1. Nutritional deficiency – the paper mentioned that calcium, vitamin D and E were deficient.
  2. Turning intolerance due to elimination – the paper mentioned that early low-dose cutaneous exposure to food allergens leads to allergic sensitization, whereas early oral consumption of food proteins induces immune tolerance. This means that taking a food, suspecting it is an allergen for the child and eliminating it, make it more likely to have a food allergy as opposed to not eliminating that food.

The above is why the medical community generally only recommend elimination diets when tested positive, and after reviewing various test results and understanding the roles that other allergens play. When evaluating all the double-blind placebo-controlled food challenges, only about 6% of the children with eczema had a reaction to the suspected food allergen. It is therefore, more likely than not, that the eczema rash is not due to the suspected food.

What’s your experience in elimination diet? Has it improved your child’s eczema? Do share in the comments especially when many parents are interested in how other eczema families cope with diet.

Skin ish Mom Column

#SkinishMom Investigates Confusing Citrus on Skin

It was reported end June 2015 that an association (not causal link) was found between the consumption of citrus fruits (grapefruits and oranges) and skin cancer. Key points in these reports were:

  • Increased risk of skin cancer melanoma with drinking orange juice and eating grape fruit
  • Association, not causal
  • Possible (in theory) that psoralens and furocoumarins in citrus fruits make the skin more photo-sensitive
  • Association found from questionnaires filled by about 100,000 health professionals

#SkinishMom looked up Pubmed for more on citrus fruits and got into ‘Citrus Confusion’ – studies seemed in general to point to benefits from citrus fruits, including that of skin cancer protection. Below are the studies:

Citrus Confusion - Is it causing or protecting against skin cancer?
Citrus Confusion – Is it causing or protecting against skin cancer?

  1. Citrus peel use is associated with reduced risk of squamous cell carcinoma of the skin – showed that peel consumption, the major source of dietary d-limonene, is not uncommon and may have a potential protective effect in relation to skin squamous cell carcinoma
  2. Hesperetin induces melanin production in adult human epidermal melanocytes -Hesperidin, a flavonoid in citrus fruits, may protect from photodamage if its capacity to increase melanin production in human melanocyte cultures could be reproduced on human skin
  3. Topical hesperidin prevents glucocorticoid-induced abnormalities in epidermal barrier function in murine skin – Hesperidin can stimulate epidermal proliferation and differentiation, therefore protect against the side effects of topical glucocorticoids
  4. Protective effect of red orange extract supplementation against UV-induced skin damages: photoaging and solar lentigines – Red orange extract intake can strengthen physiological antioxidant skin defenses, protecting skin from the damaging processes involved in photo-aging and leading to an improvement in skin appearance and pigmentation
  5. Oral dose of citrus peel extracts promotes wound repair in diabetic rats – showed significant reduction in blood glucose and time to wound closure. Tissue growth and collagen synthesis were significantly higher

It is true though that psoralen (compound in citrus fruits) make the skin more photo-sensitive; there is a treatment for severe atopic dermatitis (eczema) in adults that prescribed psoralen to be taken 1.5 to 2 hours before phototherapy so that the skin will be more sensitive to the light (“PUVA“).

Taken together, #SkinishMom isn’t going to stop taking citrus fruits but always, sun protection please.

Skin ish Mom Column

#SkinishMom Investigates – Summer Foods and Skin

Summer Foods for Skin-  #SkinishMom.pngThere are quite a few articles out there on what summer foods you can eat in order for glowing skin and #SkinishMom decides to investigate! You can never take for granted that if a food is recommended on numerous health/ beauty websites, it means that it is the summer (super) food to eat for your skin – sometimes it’s just one website copying another. So #SkinishMom compiles the common summer foods and look at what they are recommended for (vitamins, antioxidants) and research Pubmed to see if there is a scientific basis for such recommendations.

For Water

This has been covered in this #SkinishMom column where it’s concluded (based on general dermatologists’ views online and research (or rather, lack of, since no one can earn money from researching water!) that being dehydrated is bad for the skin but excess water does not benefit the skin.

Foods to eat for water during summer is watermelon, cucumber, celery, cantaloupe, tomatoes and strawberries.

Vitamin C

Vitamin C is studied to varying extent (meaning: the trial is either small scale, or it may be at higher dosage than in a fruit or for application instead of oral or studied in mice) to:

  • Increase collagen production
  • Protect against damage from UVA and UVB rays
  • Helped skin healing, including pigmentation problems
  • Improve inflammatory skin condition (do you know mice are injected with a pro-inflammatory chemical to create inflammation, then administered an oral supplement to test the results, gasp!)

Summer fruits loaded with vitamin C are citrus fruits, oranges, grapefruits, lemons, limes and watermelon.


Our skin, being the largest surface of our body, is subject to oxidative stress – from the sun, air pollutants, stress, alcohol and the foods we eat. Free radicals are formed during our body’s natural metabolism and oxidative stress but our skin have antioxidants to balance the free radicals. Intake of antioxidants have been studied to prevent carcinogenesis (formation of cancer cells) and protect cells from oxidative damage (e.g. limit the effects of sunburn). One study showed that sunburn to cells was decreased by antioxidant treatment via (i) protection from free radical and (ii) increasing epidermal thickness.

Foods with antioxidants that are popular during summer are blackberries, blueberries, raspberries and strawberries. Drink up green tea too!


This compound is studied to for collagen production and quite extensively known for its anti-cancer properties for melanoma (along with proanthocyanidins in grape seeds). Together with soy isoflavones, vitamin C, vitamin E, fish oil, lycopene has been studied to induce an improvement in the depth of facial wrinkles after long-term use.

Foods rich in lycopene are guava, water melon, papaya, grapefruit and cooked tomatoes.

Vitamin A

Retinoic acid is essential for skin and bone growth and in the studies, mostly linked with cell development and use in cancer treatment. Be careful about taking too much neonatal vitamin A supplement as it has been studied to be linked to atopy and wheezing in children.

Foods rich in vitamin A are carrots, sweet potatoes and pumpkins (but these are considered fall vegetables). The case for beta-carotene for skin isn’t so clear in studies though.

Vitamin E

Vitamin E protects skin membrane and guard against UV damage as it has UV absorptive properties.

Avocado, broccoli and tomatoes are foods rich in vitamin E.

Omega 3

Essential fatty acids are essential from the time of our development in our mother’s womb! It’s critical for brain development (our brains are actually quite full of fats!) and for our skin, omega 3 is able to regulate oil production, have antimicrobial and anti-inflammatory properties. Omega 3 is also studied to maintain our skin (stratum corneum permeability) barrier, inhibit pro inflammatory compounds and elevate our sunburn threshold and promote wound healing.

Experiment different recipes using avocado, chia seeds and salmon! 

Green tea polyphenols

Geen tea polyphenols (GTP) inhibits chemical carcinogen, induced by UV radiation. Green tea being calorie-free is a healthy drink to acquire a taste for.

So this summer, drink enough water and eat some of these summer foods to help protect your skin – sun protection is still a must though!


Skin ish Mom Column

#SkinishMom Investigates Drinking Water for Dry Skin

So, is drinking 8 glasses of water good for skin?

Drinking Water Skin Hydrate

There is little research to back up that drinking more water is going to hydrate the skin, make the skin glow or smooth. The practical reason for this is that research is usually conducted for ‘products’ when they can be patented, thus the lack of research on water. The only research that I can find on Pubmed on water is Effect of fluid intake on skin physiology: distinct differences between drinking mineral water and tap water. The results seemed convoluted though with no clear conclusion.

The conclusion from most dermatologists though is lack of water is bad for the skin but excess water does not benefit the skin.

What happens to Skin when Drinking Too Little Water?

Our body needs water for its organs to function so it will reduce hydrating cells to channel water for essential body functions. The skin will then look duller and wrinkles and pores will be more apparent. However, there is no change to the underlying skin structure but the wrinkles and pores are ‘temporarily’ more obvious when the body is dehydrated. But prolonged dehydration can speed up aging as the skin is persistently drier and more prone to skin irritation as well.

So, does Drinking Water Help with Hydrating Skin?

Water that we drink does not go straight to the skin – it goes to intestines, bloodstream, filtered by kidneys. If you drink excess water, the body will pass it out – it wouldn’t go specifically to hydrating skin cells although water will hydrate all cells in general. To target skin cells, moisturizing is required and avoid doing a list of things that will actually dry your skin such as:

1.     Scrubbing or exfoliating your skin

2.     Drying (instead of dabbing dry) with a towel

3.     Sun-tanning (and not using sunscreen)

4.     Long bath and Hot bath

5.     Using soap

6.     Not eating enough omega 3 (which our diet is generally lacking in, essential fatty acids)

Bottom line – Drink when you’re thirsty.

Signing off SkinishMom, and yes, just remembered that thirst is often mistaken for hunger so I’m drinking up!

Eczema Tips

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 (


Skin ish Mom Column

#SkinishMom Investigates Coffee for Beauty Skin

Coffee. I have a love and fear relationship to it. 

Not love and hate. It’s impossible to hate coffee. I would sign off with ‘Chill with (Ice) Latte’, ‘Toast to Latte’ instead of XOXO. I’d rather sit in silence with my coffee than talk to my husband, so it’s totally untrue that women need to speak 20,000 words, maybe if they don’t have coffee to sip.

So on Jan 20, there’s a study published in JNCI (Journal of the National Cancer Institute) that if you drink 4 or more cups of coffee a day, you’re 20% less likely to get malignant melanoma (skin cancer). So does this conclude coffee is good for skin? Not so fast my fellow coffee drinkers, #SkinishMom knows coffee is diuretic and starts fearing when even a well-known doc said she’s cutting coffee. So, #SkinishMom is here to investigate coffee and SKIN.

Skinish Mom Coffee Skin Health

Top Question – Is Coffee Good for Skin?

No. It’s diuretic, meaning it makes you pee more and takes water from your body, including your skin.

No. It inhibit nutrient absorption, including magnesium, calcium, vitamin B & D, folate,  and iron.

No, its effect on cellulite is temporary. If you’ve read about caffeine products making puffy eyes or cellulite go away, it’s mostly due to temporary constriction of fat cells. Nothing has really changed. (this is from Dr Jessica Krant’s interview and read here for her interview with MarcieMom on face washing).

Yes. It is rich in antioxidants, that fight inflammation and free radicals. (read more from Dr David Katz’ reply on Oprah)

We also want to know – Is Coffee Good for Health?

There’s no point in taking something good for one part of you but kills the others. Remind me of loving the wrong man, but that’s much worse.

More reasons to Love Coffee

Lowers risk of Alzheimer’s disease, Parkinson’s disease, diabetes, depression, non-alcohol related liver disease. Improves fitness endurance, hair growth and memory.

More Fear Coffee factors

Increased risk of high blood pressure (cafestol in coffee beans possiblyraise LDL cholesterol), miscarriage, osteoporosis, anxiety, insomnia and many more from Dr Mercola.

But what’s in Coffee?

Coffee beans apparently is like one complicated super woman. As Mark Hyman, MD said

.. coffee has far reaching effects on the body and needs to be respected as a potent drug.

Coffee has so many biologically active compounds, it’s a lot more than just caffeine. There’s polyphenols, antioxidants, chlorogenic acids, caffeol, phytoestrogens and diterpenes. No one yet know how each affects our body.

This brings me to the next question – what Type of Coffee are we talking?

There’s a HUGE difference between espresso coffee and instant 3-in-1 coffee. The latter is likely mostly unknown chemicals with sugar and trans fat (partially hydrogenated oil) topping the ingredient list, promoting inflammation. And given that per cup, instant premix has less coffee than brewed coffee, whatever anti-inflammatory benefits you think you drink from the antioxidants likely get wiped out by the inflammatory sugar, glucose syrup, frutose syrup and trans fat.

Lastly, this one is no-brainer. Just because something may have protective effect doesn’t mean you go out of your way to do something to test its level of ‘protection’. If an insurance agent tells you you’re covered for critical illness, you don’t go out of your way to eat junk food (or do you?). Here’s the sun protection you should take.

Finally, remember. This study is not a clinical trial, meaning not cause and effect. It’s association. Lots of things are associated with other things.

Signing off with latte,


Doctor Q&A

Skin pH with Cheryl Lee Eberting, M.D.– Diet, Environment on Skin

Skin pH interview with skin barrier expert, Cheryl Lee Eberting, M.D.of
Skin pH interview with skin barrier expert, Cheryl Lee Eberting, M.D.of

This is the 3rd post of Skin pH series: Read the 1st post on Understanding Skin pH and its Impact here and 2nd post on Overly Acidic and Alkaline Skin here.

We are privileged to have Board Certified Dermatologist Cheryl Lee Eberting, M.D. again for this 5-week skin pH series. Read more on Dr Cheryl Lee here. Dr. Eberting invented the TrueLipids skin barrier optimization and repair technology; a technology that helps the skin to repair itself by recreating its own natural environment.  

MarcieMom: Thank you Dr Cheryl Lee for helping us understand skin pH – what happens in an ideal skin pH 4.6 to 5.6 environment and what goes wrong when it’s too alkaline or acidic. Today we put these knowledge to use on how we can have the right diet and environment for our skin pH!

Diet and Skin pH

There’s quite a lot of websites proposing that we eat more alkaline foods such as fruits and vegetables of pH 8 to 10 and less acidic foods of pH 3-4 such as soda and sugar drinks.

MarcieMom: How does what we eat affect our skin’s pH? Do you in your practice recommend diet for eczema kids based on food pH level, or should it be based on anti-inflammatory properties, or whether it had been studied to improve eczema (e.g. omega 3)?

Diet Environment on Skin pH

Dr Cheryl Lee: I don’t recommend diets based on the pH of foods, but rather, I recommend diets that are as close to the way they come out of the ground as possible and I certainly do recommend against the ingestion of any processed foods, drinks and candies.  The body has robust pH buffering capacities that can help to keep the body at an optimal pH.  More important are the effects of oxidation in our diets.  I like to explain it this way; our bodies come with a certain amount of “anti-oxidant juice”.  When we eat processed foods, animal proteins and sugars, our anti-oxidant capacious are called upon and utilized.  When we eat too much of these foods, we exceed the body’s ability to replace the anti-oxidant juice and then the body becomes damaged by the free-radicals and excess sugars that are generated when we over eat or when we eat unhealthy foods.

I think the most important dietary approach we should all take is to limit the ingestion of animal proteins as much as possible.  Animal proteins have been demonstrated to increase rates of carbamylation.  Carbamylation is a metabolic phenomena that happens when we ingest animal proteins. The breakdown products of animal proteins as well urea (this is why I also advise against the use of urea on the skin) in a pro-inflammatory environment that promotes high blood pressure, autoimmune disease, diabetes, heart disease, cancer and more.  Interestingly, a recent study even showed that in people who have an infection of the gut with the H. pylori bacteria are unable to adequately detoxify the heterocyclic amines that are generated when meat is cooked.  The H. pylori infection make the gut unable to detoxify these chemicals and these chemicals lead to gastric cancer.

Excess sugar also leads to something called glycation.  Glycation is what happens with excess glucose and glucose metabolic products permanently bind to fat, proteins and even nucleic acids (in our DNA).  The combination of the excess glucose and the proteins and fats are called advanced glycation endproducs (AGEs) and they are what ‘gunk up the system’ and lead to many pro-inflammatory pathways.

I think it is very important to eat lots of fruits, nuts and vegetables and to limit the intake of sugar and animal protein. Vitamins B1, B3, B6, B12, C and others can be helpful in promoting better food metabolism and in limiting the effects of poor diet.

Environment and Skin pH

Smoking, pollution, water and sun also affects the skin pH.

MarcieMom: Dr Cheryl, can you share with us the main environmental contributors and whether it makes our kids’ skin more alkaline or more acidic? What if there are certain factors that can’t be limited, for instance, the water available.

Dr Cheryl: Lets start with water.  The pH of your particular water supply can be quite variable and can be very alkaline.  I think this might be part of the problem in atopic dermatitis and may be part of the puzzle that is missing.  We (dermatologists) are having our patients take dilute bleach baths that are adding (though ever so slightly) to the alkalinity of the water and the skin.  We do know that the benefits of bleach baths are irrefutable and substantial though.  I have started advising the use of a vinegar-based gel to my patients after their baths.  They apply this gel to all areas that are affected by eczema and then apply their moisturizers or other topical medications right on top.This seems to be very helpful. This pH gel is something that I have filed a patent for and will be on the market next spring.

Another option is to use a vinegar spray.  For this I advise that you mix one part white vinegar (not rice vinegar, not balsamic vinegar) from grain (make sure it is not from wheat if you are allergic to wheat) or apple cider vinegar (preferred) with six parts of water and put it in a spray bottle and spray it on the areas of eczema.  Follow this with your regular moisturizers or medication.  I have also had some of my patients use vinegar baths rather than bleach baths and they too have benefited greatly.

I also want to mention the effects of air quality on eczema and our overall health.  Studies have shown that INDOOR air pollution can have a major detrimental effect on our health and leads to increased rates of asthma and related conditions and to the overall burden of disease.  Chemicals like polyaromatic hydrocarbons (from paints, glues, solvents, cleansers) can increase the rates of many health problems.

I always am sure to use VOC free paint in my home.  If I paint my furniture, I will leave it outside or in the garage for several weeks before I bring it inside.  If you can smell it, then you shouldn’t have it in your house.  When I redid the carpet in my home, I researched every little facet of carpet chemistry and found that an all-wool carpet is probably the safest carpet to have for this same reason.  The newer ‘no-stain’ carpets are bathed in a chemicals that is then baked on to make the carpets resistant to staining.  These chemicals have been shown to be very detrimental to our health as well.

A few more things I do in my home to help the air quality is to be sure to vent the air when I cook (smoke from cooked food is particularly pro-inflammatory and carcinogenic).  I avoid the use of cleaning chemicals in my house too.  I usually will use plain old fragrance-free soap and water, or vinegar, or a little bleach (when someone has the stomach flu) and that is it.  I intentionally avoid the use of antibacterial soaps and household cleaners as they are unnecessary, toxic and actually induce bacterial resistance in our homes and our bodies.

In addition to indoor air pollution, outdoor particulate air pollution is even pro-inflammatory and has been documented to contribute to 22% of the global burden of disease that can be attributable to one’s environmental factors.  A study just came out recently that even correlated exposure to polyaromatic hydrocarbons in air pollution to the rates of Attention Deficit & Hyperactivity Disorder (ADHD).  Numerous studies have also correlated ADHD to eczema and I believe there has got to be an environmental correlation to the increased rates of eczema too.  For years we dermatologists have been schooled on “the hygiene hypothesis” of eczema due to lower rates of eczema detected in children who grew up in rural areas as compared to those who grew up in urban settings.  The thought has been that a rural lifestyle exposes one to more bacterial and parasitic antigens earlier in life and that this was to be somewhat protective.  I believe the hygiene hypothesis is actually the complete opposite and that is should be called something more like the “lack of environmental hygiene hypothesis” as the effects of pollution in our food, air, and water is clearly and irrefutably a contributing factor to countless health problems and most likely to eczema as well.  This concept is very well established from a scientific standpoint, but is lacking in public education.  It is my hope that people with come to understand the role of toxins in their environment and that they may take actions to limit them.

Thank you Dr Cheryl for sharing with us what you practice in your home too! Next week we will continue with understanding what products we can use to get our child’s pH right!

Eczema Devotional

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

Infographic Health Eating Food Label 1st Infographic! and what else is worth spending time on other than our food!

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

Bible verse:

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

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

Takeaway is easy, fast food is fast.

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

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

love our spouse, our kid,

love enough to make it a point to eat healthy,

putting nutrition NOT junk in our mouth.

Bon Appetit, Lord!

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

Eczema Facts

Soda and Child series : Impact on Eczema, Allergy

Soda Eczema Allergy

For the past two weeks (here and here), we have explored the Top 10 Bads of Soda for our children. Today, we’d be going into whether soda leads to allergic conditions.

There is actually very little written on this, and I’ve scoured both the web and Pubmed. Thus far, the biggest culprit ingredient linked to eczema, asthma and allergies is Sodium benzoate. This has been covered last week where sodium benzoate is a preservative found in soft drinks, and linked to allergy and behavourial issues.

I only found one study on Pubmed, where 62 children from age 12 months to 13 years were observed for whether restriction in their diet led to an improvement in eczema. Among the restricted foods, soda (11.9%) was the highest, followed in decreasing order by food additives (9.2%), walnut (7.0%), peanut (7.0%), and other nuts (5.9%). When foods were grouped, the crustacean group was the most frequently restricted group, followed by processed foods, nuts, milk & dairy products, and meats.

The observation from the study was that atopic dermatitis/eczema improved for those children which had restricted 1 to 3 food groups, and those that avoided more than 3 groups didn’t showed significant improvement. There may therefore be some impact on restricting foods, but it is not clear nor a causal link directly established through this study.

There are many websites though, through personal testimonies, where various individuals found that removing sugar, caffeine, preservatives and artificial sweeteners from their diets helped. In this case, as there is little nutritional benefit of such ingredients for our children, restricting these ingredients from their diet should be a plus (if not for eczema, for healthy living!).

Eczema Facts

Soda and Child series : Top 10 Bads of Soda

soda and child health effects
Soda is really bad, opt for plain water for our children!

Last week, we started the Soda and Child series and today, we would continue exploring the other ingredients of soda.

#3 Phosphoric Acid – Phosphorous deplete calcium in the body which is essential for the child’s growth, putting teenage girls at risk of osteoporosis. There are some studies that show that drinking soda is related to drinking less of milk, but this is not very significant.

#4 Acids –The acids in soda contribute to an unnatural acid environment within the stomach and can lead to inflammation of the stomach and duodenal lining. The acids also erode the enamel on the teeth and thus up the risk for tooth decay (plus sugar also cause cavities)

#5 Caffeine –Some soda contains caffeine which stimulates adrenal glands. Colas, diet colas and many soda contain caffeine. Energy drinks which are getting more popular among children and teens also contain caffeine. Drinking too much caffeine, as adults can attest to, make us tremble, lose sleep, stomach upset, increased blood pressure and irregular heartbeat.

#6 Sodium benzoate or potassium benzoate –these are preservatives present in diet sodas which have been linked with allergic conditions and possible irritant to the skin, eyes and mucous membranes. Studies on rats indicate increase in anxiety and motor impairment after benzoate consumption.

#7 Aspartame – Used in diet soda as a sugar substitute, there are many studies linking aspartame to brain tumors, birth defects, diabetes, emotional disorders and epilepsy (from Mercola site). Interestingly, Dr Mercola pointed out that “when aspartame is stored for long periods of time or kept in warm areas it changes to methanol, an alcohol that converts to formaldehyde and formic acid, which are known carcinogens”.

#8 More on Artificial Sweetener – Below is an interesting extract from a post written by Mark Hyman, MD at Huff Post:

Artificial sweeteners are hundreds to thousands of times sweeter than regular sugar, activating our genetically-programmed preference for sweet taste more than any other substance.

They trick your metabolism into thinking sugar is on its way. This causes your body to pump out insulin, the fat storage hormone, which lays down more belly fat.

It also confuses and slows your metabolism down, so you burn fewer calories every day.

It makes you hungrier and crave even more sugar and starchy carbs like bread and pasta.

In animal studies, the rats that consumed artificial sweeteners ate more, their metabolism slowed, and they put on 14 percent more body fat in just two weeks — even eating fewer calories.

In population studies, there was a 200 percent increased risk of obesity in diet soda drinkers.

#9 MSG Monosodium Glutamate – MSG is found within the citric acid and has been linked to brain diseases like Alzheimer’s,learning disorders and psychiatric conditions.

#10 Diuretics –Sodas are diuretics which is dehydrating and affects digestion.

These top 10 Bads of Soda, even though studies may not have been conclusive causal links, are enough to stop me, my child and my family from consuming. Is there any impact on allergic conditions? Find out next week.

Eczema Facts

Soda and Child series : Impact on Kids Health

Soda Children Health

For the past few years, there is much awareness on the ‘danger’of soda –even celebrities are more mindful of endorsing soda brands (google Beyonce, Scarlett Johansson and Taylor Swift)! Sugar, which is a key ingredient in soda drinks, is inflammatory and well-known nutritionists like Rania Betayneh and Toby Amidor had offered tips on inflammation in this blog.

Every time I see someone close to me buying a sugared drink (or for that matter, when I buy a sugared drink myself!), I always joke about ‘Heres the inflammatory drink!’. Lately an acquaintance who loves soda had recently been diagnosed with a terminal chronic condition which led me to start looking at soda again. If it’s REALLY (Truly Bluely as my 5-year old daughter would say) BAD for health, we as parents would not want our child to consume soda. So, let’s review the effects on general health in this 3-week soda and our kid series, with the last post with a focused on possible effect on allergic conditions.

Top 10 ‘Bads’ of Soda

#1 Sugar – Sugar is empty calories and linked to obesity, which in turn is linked to a whole host of chronic diseases. It is also linked to increased risk of pre-diabetes (something to watch out for even for adults), metabolic disorders and heart disease which have symptoms like big waistline, high blood pressure and low HDL/good cholesterol.

More recently, sweetened drink has been linked to behavioral issues in children, with issues like aggression, depression and attention difficulties. As to which ingredient causes it, it is not clear but caffeine, acids, HFCS and sugar had been hypothesized to be behind the behavioral issues.

But can all the health problems be blamed on sugar?

The case made by soft drink companies/associations is that soft drinks should not be picked on for the rise in obesity and it is true to some extent – the additional 100-200 calories from a can of soda may not contribute to material weight gain, what is contributing is that because it doesn’t make your child feel full, thus there is a tendency to not reduce overall calories intake. The additional (empty) calories from soda can become truly weight-gaining unless one makes a conscious effort to exercise.

#2 High Frutose Corn Syrup –The HFCS in soda doesn’t make the child full and thus, misled the child to consume more of the drink. This has been covered in Dr Sears L.E.A.N series here, with the Dr Sears LEAN team’s tip below:

Drinking soda should be discouraged. Many juice drinks and all sodas are high in calories, provide no nutrients, and are usually sweetened with high fructose corn syrup (HFCS), which you should always avoid. Click here to learn more about why you should avoid HFCS:

Next week, we will be going through the other ingredients in soda drinks and learn the other possible effects on health of our children!

Doctor Q&A

Rise and Shine Feature – Healthy Child with Dr Sears

Dr. Bill Sears is one of America’s most renowned pediatricians, father of eight children, and author of over 40 books on childcare. He is the Associate Clinical Professor of Pediatrics at the University of California, Irvine, School of Medicine. Dr Sears Lean has a series on this blog that covers many aspects of raising healthy kids. Dr Sears shared many tips in this Singapore workshop ‘Keeping Your Child Healthy’.

Raising healthy babies and successful children with Dr Bill Sears

Diabetes in Children

Listening to the esteemed Dr Sears speak on healthy child is a privilege!

Diabetes is an increasing and worrying condition among children. The risk of diabetes decrease with healthy choices and conversely, increase with unhealthy ones. Although genes play a role, recent studies show that whether that gene is expressed is determined by healthy choices, including those at pregnancy. Eating too much junk food and lack of exercise contributes to the rising diabetes problem in children in the US.

Exercise for Children

Exercise can help the baby to be healthier as recent studies found that the body’s internal ‘medicine’ is released from the endothelium, the inside lining of blood vessels. Exercise creates an energy field and the glands along the endothelium open up, releasing ‘medicines’ for growth and regulating mood into the blood vessels, which in turn are circulated. An unhealthy diet and lack of exercise clogs the endothelium, preventing these ‘medicines’ from being released.

Effect of Omega 3 in Children

Increase intake of omega 3, such as fish oil with EPA and DHA during pregnancy has been associated with reduced post-partum depression, less premature births, fewer incidences of pre-eclampsia and less gestational diabetes. Numerous times during the talk, Dr Sears recommended that we stick to the Asian diet which is typically higher in fish and other safe seafood.

Stick to the Asian diet which is typically higher in fish and other safe seafood

Dr Sears also shared the theory that post-partum depression is linked to Omega 3 deficiency – the theory is that the baby drains the mother as their brain grows most during pregnancy and the first year. A baby’s brain is 60% fat and uses glucose and oxygen. Therefore, appropriate intake of omega 3, carbohydrates and antioxidants are required. Dr Sears illustrated that omega 3 is to brain like calcium is to bone, responsible for brain cell membrane fluidity and myelin development. Omega 3 has also been associated with improved cognitive abilities of children and improved visual acuity.

Smoking – Smoking is not recommended and linked to many risks for the baby, including sudden infant death syndrome, affecting the breathing of babies via the paralysis of cilia (found in windpipes for sweeping dirt from lungs), doubling the risk of respiratory infection and causes higher nicotine levels in breast milk. Moreover, smoking also lowers prolactin, which stimulates mammary glands in preparation for milk production.

Dr Sears’ Eating Tips for Pregnant Moms

  • Eat twice as often
  • Eat half as much
  • Chew twice as long
  • Take twice the time to dine

I didn’t get to have Dr Sears vet through this post before publishing, any and all mistakes mine. Next week, we will cover more of Dr Sears’ talk, including on attachment parenting and (the mysterious) colic.

Doctor Q&A

Skin Health Series – Diet and Lifestyle

This is the fourth of a much-awaited series, where I get to work with Dr Verallo-Rowell again (we last worked on Sensitive Skin Product Series in 2012). Dr Verallo-Rowell is a dermatologist, dermatopathologist and dermatology/laser surgeon, founder of VMV Hypoallergenics, and is also an author, esteemed researcher and speaker. 

Skin Health Connection Interview series with Dr Vermen Verallo Rowell VMV Hypoallergenics

Skin Appearance and Health Conditions

Some people’s skin seem to look more wrinkled, less glowing, dark colors under the eyes if they are not sleeping well. Smokers may have a grayish tone to their skin.  Having a diet heavy with sugar can make it prone to acne. Deficiency of certain vitamins and minerals can also cause the skin to be dry.

MarcieMom: Dr Verallo-Rowell, I know you are deeply passionate about nutrition.

Which are the worst foods you would seriously object to for skin?

MarcieMom: And out of curiosity, could you tell if someone is a chocolate addict or fan of soda from the look of their skin? I’m hoping an occasional indulgence in ice cream can’t be detected by you!

Dr Verallo-Rowell: Hahaha. One look at a patient with adult acne tells me I have to look at her history closely to see which of the stressors – see my last winding paragraph below – is causing the adult acne.

Processed foods are the MOST


In food, the most pro-inflammatory are processed foods because the oils used in processing them are generally more pro-inflammatory. Polyunsaturated they make the lipid bilayer of cell walls more fluid such that the cell wall’s protein receptors/signals do not function well. This is such a No NO NO for saturated oils.  Yet plant derived saturated fats like those from coconut oil are cholesterol free and more stable than polyunsaturates, are not as vulnerable to oxidation by reactive oxygen species our body makes, do not have trans fats because they need not be hydrogenized.  Note that less than 0.5 mg of trans fats does not have to be declared, hence everything now is “trans fat free”. 4 servings of a “trans fat free” product can readily reach 2 Gm. Remember any trans fat in our food is not good. Look instead at the Nutrition Facts and if says it has partially/hydrogenated oil in it – don’t use.

If (nutrition label) states partially/ hydrogenated oil, don’t use it

Also, omega 6 at too high an amount – which is what the seed oils contain at a ratio of 1:100 or more of the omega 3 they contain – is very pro-inflammatory because they are converted into pro-inflammatory eicosanoids. We need them – inflammation is needed to clear up bugs, and react to environmental assaults – but too much becomes too inflammatory and may continue into an inflammatory pathway of disease.

Foods to eat for Healthy Body and Skin

Like everything else in nature, balance is important, as it is in food. So the bit of ice cream and chocolate you indulge in wont make me recognize a skin change with you. Besides the mood elevating effect is also good for you. BUT, balance…eat  more fruits and veggies, brown rice, brown bread, oily fish and shellfish. (all rich in omega 3, anti-oxidants) Cook with coconut oil for high heat, with olive oil for low heat and minimize that canola oil – it’s a genetically altered long chain polyunsaturated flaxseed oil.

Cook with coconut oil for high heat, with olive oil for low heat and minimize that canola oil

Acne and Diet

In acne – the studies out there now show: high carb diets, and dairy products are more acnegenic. Interestingly of dairy products, the skimmed ones are more acnegenic, probably because of the sugar (more carbs) they add to add taste after the yummy oil is removed.

Can you tell you are Stressed from your Skin?

MarcieMom: Ending this series on a more serious note – we know stress is a trigger for eczema, and so is sleep-deprivation. For say someone who has a tough job/ running a business, taking care of kids and elderly, working through the night, could you tell that from his/her skin? And if someone wants to look into the mirror and know ‘Gosh, I need a break!’, what would you ask him/her to look at? (note: I’m being very fair here, both male and female can suffer from this!)

Look for Skin Inflammation

Dr Verallo-Rowell: Look for inflammation. This is the process that is now seen as the basic pathogenetic pathway in our cells triggered by stress. Most people think of stress in terms of the mental and emotional stresses of personal life and work. Very true, yet this kind of stress you are aware of, familiar with, share and moan about to your family and friends. It is stressful but other causes of stress that are not so obvious, hidden and may not be addressed by you and/or your physician.  Examples are the stress from recurring low grade infections – like being a streptococcal carrier with mild but recurrent sore throat or dental problems or UTI, or stones in the gall bladder; or less than 6 and more than 8 hours sleep; lack of exercise, obesity and of course a diet with more pro-than anti-inflammatory elements in it, or too much weight loss.

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.

MarcieMom: Thank you Dr Verallo-Rowell, I can feel so MUCH Passion in you about nutrition and anti-inflammatory vs pro-inflammatory foods, I’m inspired to learn more!

News & Research

Eczema Research Focus Month – Probiotics

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

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

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

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

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

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

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

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

What about you? Write a comment to share!

News & Research

Oral evening primrose oil and borage oil Ineffective for Eczema

This is a quick update on the study just published on evening primrose oil and borage oil. A quick summary of the study:

Study Objective: To assess the effects of oral evening primrose oil or borage oil for treating the symptoms of atopic eczema.

Scale: This is a review article, meaning it reviewed studies done by others according to certain criteria and methodologies. There are 27 studies, 1596 participants (up to August 2012) and 19 studies covered evening primrose oil and 8 covered borage oil.

Results: For oral evening primrose oil and borage oil, there was no significant improvement over placebos used in trial. There were also “fairly common, mild, transient adverse effects, which are mainly gastrointestinal”.
It was mentioned that there was a warning in a case report that if evening primrose oil was to be taken for a prolonged period of time (more than one year), there is a “potential risk of inflammation, thrombosis, and immunosuppression”. No long-term effects included in the studies.

Do refer to my Eczema and Diet post if interested to find out effect on certain supplements on eczema.

News & Research

Eczema and Diet Studies

Eczema and Diet on EczemaBlues
This post is just what it is – The investigative bug has caught up with me and given that there are (i) more studies on impact of diet on eczema, and (ii) more people (experts or not) claiming that their diet is ‘proven’, I’m setting out in this post to POUR THROUGH ALL THE ECZEMA and DIET studies I can find and make sense of it for you here; Let’s see my investigation report!

Studies on Pregnancy Diets

Impact on Preventing or Reducing Severity of Eczema in Newborn

Antigen Avoidance Diet during Pregnancy

In a trial conducted with 952 participants, there was no evidence of protective effect of maternal dietary antigen avoidance during pregnancy on the incidence of atopic eczema during the first 18 months of life. Another two trials that had 523 participants similarly did not see benefit of avoidance of antigen during pregnancy for babies up till 18 months nor on their skin prick test results up to 7 year old.


In a review article of 21 trials from 1997 to 2007, there was evidence that probiotics prevented the onset of pediatric atopic dermatitis. In another article covering up to 2011, there was evidence of probiotics for the prevention of atopic dermatitis in infants, and this benefit was seen both for mother and child, and whether taken during pregnancy or early life of child.

Studies on Children Diets

Impact on Preventing or Reducing Severity of Eczema in Young Children

Timing of Introduction of Solids

In a consensus document, the conclusion from reviewing 52 studies from 1998 to 2006 was that early introduction of solids can increase food allergy. The recommendation was to introduce at 6 months, dairy products 12 months, hen’s egg 24 months, and peanut, tree nuts, fish, and seafood at least 36 months for those with higher risk of food allergy. An update on a study on early introduction of eggs done in August 2015 showed that the elevated immune responses to egg were established prior to egg ingestion at 4 months and were not affected by whether eggs were introduced early.

Using Hydrolyzed Milk Formula

In a review article of 12 studies up to 2006, there was (i) no evidence to support hydrolyzed formula to replace exclusive breastfeeding, and (2) limited evidence that supported hydrolyzed formula for high risk infants who could not be 100% breastfed. One article that provided such evidence concluded that partially hydrolyzed formula is more effective than standard formula for high risk infants.

Prolonging Breastfeeding

In a trial of close to 14,000 mothers, there was no evidence of protective effect of prolonged and exclusive breast feeding on asthma or allergy.

Using Soy Formula

In a review article of 3 studies up to 2006, there was no evidence of reduction in allergies for children fed with soy formula.

Adding Prebiotics to Infant Formula

In a review article covering 13 studies up to 2012, there was limited evidence of prebiotics added to infant formula can prevent eczema, but the authors cautioned that further research is needed prebiotics can be routinely prescribed.

Adding Probiotics to Infant Formula

In two review articles (one of 12 studies up to 2007, the other up to 2008), there was insufficient evidence to recommend adding probiotics to infant feed.

Consumption of Omega 3 and 6

In another review article covering 10 studies up to 2009, there was no evidence for reduced risk of allergic sensitization or a favourable immunological profile.

Impact on Minimizing Eczema Flare-ups for Children already diagnosed with Eczema

Elimination Diets

In a review article, the conclusion from reviewing 9 studies (up to 2006) was that there was (1) no evidence of benefit to an egg and milk free diet, (2) no evidence of benefit to an elemental or few-foods diet, (3) some benefit to egg-free diet for infants with positive IgE to eggs, with improved eczema.

Dietary Supplements

In a review article covering 11 studies up to 2011, there was no evidence of benefits of supplements in the treatment of eczema. The background of this study was that many patients turned to supplement to avoid steroid treatment, fearing long-term effects. However, there was no evidence for supplements like fish oil, olive oil, corn oil placebo, zinc sulphate, selenium, selenium plus vitamin E, vitamin D, pyridoxine, sea buckthorn seed oil, sea buckthorn pulp oil, hempseed oil, sunflower oil (linoleic acid) and DHA.

The Conclusion

1st, I’ve made it a point to look at the studies themselves, rather than articles that refer to studies (so that I minimize the lost in translation effect). I also urge parents who are taking the leap to try a specific diet to ask your doctor and read up on studies, instead of relying on fad posts or personal testimonies.

2nd, I must make it clear that I’m no expert in reading studies, the review articles mentioned were all written by medical professionals. Should any medical professional coming across this post and see any misinterpretation, do point it out to the rest of me.

3rd, after this investigation, the following seem to be actionable take-away that we parents can ask our doctors on and decide if we should apply them:

1. Consider Probiotics

2. Not to introduce solids before 6 months’ old, and check with doc on timing for other more common food allergens

3. If you can’t breastfeed exclusively, consider partially hydrolysed milk formula

References (from PubMedHealth and The Cochrane Library)
1.    Food allergy and the introduction of solid foods to infants: a consensus document
2.    Meta-analysis of clinical trials of probiotics for prevention and treatment of pediatric atopic dermatitis
3.    Probiotics for treating eczema
4.    Dietary supplements for established atopic eczema in adults and children
5.    Effect of prolonged and exclusive breast feeding on risk of allergy and asthma: cluster randomised trial
6.    Omega 3 and 6 oils for primary prevention of allergic disease: systematic review and meta-analysis
7.    Meta-analysis of the evidence for a partially hydrolyzed 100% whey formula for the prevention of allergic diseases
8.    Probiotics supplementation during pregnancy or infancy for the prevention of atopic dermatitis: a meta-analysis
9.    Dietary exclusions for established atopic eczema
10.  Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child
11.  Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants
12.  Prebiotics in infants for prevention of allergy
13.  Probiotics in infants for prevention of allergic disease and food hypersensitivity
14.  Soy formula for prevention of allergy and food intolerance in infants
Doctor Q&A

Doctor Claudia Video – Eczema: Scratching the Surface

Aging Skin Eczema Skin Videos of Dr Claudia Aguirre Neuroscientist

Dr. Claudia Aguirre is a neuroscientist, a TED speaker and creator of Ted Education lessons. She is passionate about skincare, psychodermatology and frequently lectures worldwide. Also check out last week’s video on Aging Skin.

This video showcasing Dr Claudia Aguirre was when she worked at Dermalogica

Marcie Mom: In the video, Doctor Claudia explained atopic dermatitis and that elevated IgE (immunoglobulin E) triggered allergic response in certain people. There is no single cause of eczema identified, and no cure for the condition. It is instead a multi-factorial condition characterized by defective epidermal barrier that is more alkaline and has more enzyme activity that reduces the connectivity of the skin layers. Filaggrin is a protein that aids in the formation of skin layers (do watch the video to see the animated filaggrin) and converts to natural moisturizing factors. Dry skin lacks this normal functioning filaggrin gene, and has been linked to atopic diseases such as eczema, asthma and allergies.

Sweat and Eczema

Marcie Mom: Dr Claudia, in the video you mention that sweat is an irritant for many with eczema.

Can you explain how the chemicals in our sweat can cause the allergic reaction? Shouldn’t our skin be used to our sweat?

Dr Claudia: Well an irritant reaction is not the same as an allergic reaction. I explained that sweat can be irritating to eczema skin, as this epidermal barrier may not be fully functional. This is an interesting question though, as we are still understanding the chemical composition of sweat (be that eccrine or apocrine).

In general, sweat is composed of water, minerals (like sodium and magnesium), lactate, ammonia and various amino acids. It could be one of these compounds, the combination of them, the changing pH of the skin, or even the sweat’s water content that can cause the itching and stinging sensations to some people with Eczema.  Digging deeper, I found an interesting study that suggested the amino acid composition of sweat is similar to the composition of the protein profilaggrin (which is later converted to filaggrin). This is interesting because scientists can study filaggrin by using human sweat as a potential chemical model. In the end, sweat can make eczema skin uncomfortable, so I suggest bringing a cool damp towel to your workout, or maybe spritzing a hydrating spray, instead of rubbing or scratching this sensitive skin.

Aromatherapy, Stress and Eczema

MarcieMom: Stress is also a common trigger for eczema and suggestion such as aromatherapy is mentioned in the video. Out of curiosity, does the aroma work the same way as fragrance in skin care products, which is to be avoided? Or is there a specific type of aromatherapy for those with eczema?

Dr Claudia: No, aroma in skin care products varies widely. What you want to avoid are synthetic fragrances which can cause an irritant or allergenic reaction in the skin. Some people use perfume for years before they get a skin reaction. Aromatherapy typically employs essential oils, which are natural compounds. However these can be quite potent, so a trained professional with a background in aromatherapy should be consulted before any treatment. The act of breathing deeply alone can also reduce stress.

Water in Skincare Products to be Avoided?

MarcieMom: In the video, you also recommended water-free barrier repairing products and oatmeal compress. Is water to be avoided in skin care due to preservatives being required if there is a high water content or is it because the eczema skin ‘loses’ the more liquid product easily? As for oatmeal compress, do explain to us (I’m using oatmeal bath oil, but not sure how an oatmeal compress works).

Dr Claudia: Great question. I suppose it could be both. Paraben alternatives are preservatives that have a greater potential of being irritating than parabens. So ‘paraben-free’ formulations may actually be more irritating. The amount of water lost to a skin care product from the skin is most likely negligible, so I recommend anhydrous barrier-repairing products because they contain silicones to protect skin. Our skin has a lipid (oil) layer, so you want to replenish those oils to ensure a properly working barrier.

Colloidal oatmeal for Eczema

Colloidal oatmeal is a wonderful ingredient for eczema skin. There are many scientific studies on oats and dermatitis – and this should be your eczema skin’s best friend. Look for clinical colloidal oatmeal for best results. The compress is basically a wet wrap. This is used to lock in moisture and keep the actives on the skin. On wet skin, apply oat or other active ingredient, follow with a damp gauze and cover with dry wraps. This dry covering could be pajamas (good for kids), or other dry covering. Alternatively, a colloidal oatmeal masque is a really nice add-on to a skin treatment for hydrating and soothing skin.

Vitamin D and Eczema

Marcie Mom: Vitamin D has been mentioned much to boost immunity and for the skin.

How exactly can one with eczema get vitamin D, and what’s your recommended minutes of sun exposure for those with eczema?

Doctor Claudia: Everyone has different needs, so there is no single recommended amount of sun exposure. I advise those wanting to know to consult with a dermatologist trained in a bit of photobiology. Or you could ask a scientist (they are hard to find!). At a recent conference I met Prof. Brian Diffey, an expert in this field. In a recent paper, he concluded “Messages concerning sun exposure should remain focused on the detrimental effects of excessive sun exposure and should avoid giving specific advice on what might be ‘optimal’ sun exposure”.

Vitamin D is an essential hormone and we all need a good dose of it. So speak to a dietician or doctor to find which vitamin D supplements are good for you and be sun smart!

Marcie Mom: Thanks Doctor Claudia, your explanation is so helpful, as even though we can’t cure eczema – it doesn’t hurt to understand more of it in order to manage it confidently. I’m looking forward to more of your videos!

If you have something to share about the topics covered in this post, share in the comments or send this article to someone who has a similar experience. Your sharing will help others.

Doctor Q&A

Doctor Claudia Video – Aging Skin

Aging Skin Eczema Skin Videos of Dr Claudia Aguirre Neuroscientist

Dr. Claudia Aguirre is a neuroscientist, a TED speaker and creator of Ted Education lessons. She is passionate about skincare, psychodermatology and frequently lectures worldwide. Also check out next week’s video on Eczema Skin.

This video showcasing Dr Claudia Aguirre was when she worked at Dermalogica

Why Skin Aged

Marcie Mom: In the video, Doctor Claudia pointed out the growth of anti-aging skin products and treatments such as botox, dysport and hyaluronic acid injections. Topics covered in the video include (i) the difference between intrinsic and extrinsic aging and (ii) the biology of aging skin. Dr Claudia explained in the video that cells age due to oxidative stress and also pollution, lifestyle (smoking, stress) and ultra-violet rays (exposure to sun).

Characteristics of Aged Skin

Dr Claudia, I’ve been hearing of more and more elderly getting eczema, and scratching till they bleed. I saw in your video that ageing skin is drier, due to less renewed cells and a higher trans-epidermal moisture loss. Aged skin, as you pointed out, is characterized by epidermal thinning, wrinkles, flattened dermal-epidermal junction and collagen fragmentation. There is also less nutrient transfer and reduced sensation.

For eczema in elderly, is the thinner and weaker skin making the skin more vulnerable to allergens, thus triggering skin rashes?

Dr Claudia: The aging skin process can certainly make older skin more vulnerable to disease, but it’s important not to confuse dehydrated skin with eczema. Aged skin can be both dehydrated and dry, which can decrease the barrier function and allow more irritants and allergens to penetrate. In the elderly, another form of eczema known as asteatotic dermatitis commonly occurs on the shins, hands and trunk. This looks like a dry riverbed – dry, cracked and polygonally fissured skin. This can be due to aging, dehydrated skin and malnutrition. Overuse of soap and water can also trigger this. There may be other factors at play, so it’s important to get a proper medical diagnosis.

Prescription Medicine leading to Chronic Eczema

An interesting factor in elderly eczema has to do with the medication regimen older people often take. Prescription medications including diuretics and calcium channel blockers (CCB) can lead to chronic eczema. In fact, a recent French study concluded that “the long-term use of CCB is a risk factor for chronic eczematous eruptions of the elderly.” Those deficient in vitamin B6 may also have an increased risk of developing dermatitis. Since our skin needs essential fatty acids, those whose diets do not contain enough healthy fats may suffer from dry skin as well.

Menopause and Eczema

Marcie Mom: Can you also explain how menopause affects the skin of older women? Does this make the skin more susceptible to eczema?

Dr Claudia: Hormones sometimes play a role in developing eczema. In pregnancy, one of the most common skin conditions is eczema, where the hormonal changes shift the body’s immunity and predispose it towards allergic reactions and eczema. Of course, not all women suffer from this. For more read this post I wrote on the topic.

Hormones and Dry Skin

The female menopause results in a marked decrease in many hormones, and this decline can happen of a number or years. The decrease in hormones like estrogen and progesterone can lead to dry and dehydrated skin, and uneven pigmentation. Since the epidermal barrier required proper moisture and lipid content, this can cause more sensitivity and enhanced penetration of irritants and allergens. A decrease in thyroid hormones can also lead to dry skin. So reduced levels or female hormones can lead to dry, itchy, flaky skin – but not necessarily eczema skin.

For more info on hormones and skin, check out this article I wrote here.

Modern Diet Changes and Eczema

MarcieMom: Aging skin and menopause are part of natural body  growth (age) yet I kept having friends tell me they never knew of eczema starting at elderly till it happened to their parents! Is there such a phenomenon in the US and could it have anything to do with our diet? As you pointed out in your video, too many free radicals (unstable molecules) create oxidative stress that lead to wrinkles, hyper-pigmentation and inflammation.

Dr Claudia: See my answer to Q1!

Marcie Mom: Thanks Doctor Claudia, your explanation will certainly help clarify some questions for those with elderly family members with eczema.

News & Research

Does Fast Food Cause Eczema?

And you'll run faster as you choose healthier options!
And you’ll run faster as you choose healthier options!

The short answer is we don’t know, but get your kids away from fast food.

Apart from the risk of obesity, a recent study of more than 500,000 children in over 50 countries showed a linkage between fast food and chronic illnesses, namely severe asthma, hay fever and eczema. For kids who eat fast food 3 times or more a week, there’s a 30 percent increased risk in severity of the above conditions.  There’s no causal relationship, but signal a link between fast food and eczema. This study was widely reported because it covered a large number of participants and across countries, however, there are limitations which NHS (UK) pointed out. Professor Hywel Williams, one of the co-authors of the study, mentioned in an NIH interview that three or more weekly servings of fruit reduced the severity of symptoms in 11 percent among teens and 14 percent among children. Fast foods is defined as burgers, while eczema is an itchy rash in the past 12 months with symptoms defined as severe if sleep disturbance was reported at least once per week.

I also come across other interesting reports relating to trans fat (abundant in fast food) and coke, and eczema.

Dr David L Katz replied to a Q&A on to reduce intake of saturated or trans fat, as well as foods related to inflammation. He also suggested increasing omega-3s that can help increase anti-inflammatory hormones in the body. He pointed out flaxseed oil, which I’ve been giving my toddler Marcie. For those of us who are celebrating Chinese New Year, you’d be aware (and beware) as many of these commercial cookies have been prepared with partially hydrogenated vegetable oil and one piece of bak-kwa is 300 calories!

Dr Jeff Benabio in his video said that people severely allergic to formaldehyde can also be allergic to diet soda, as diet soda contained aspartame which after ingestion, created formaldehyde. Specifically, aspartame is hydrolysed to methanol, which is metabolized to formaldehyde then to formate.

For readers of this blog, you’d know I’ve been blogging about eating anti-inflammation food and staying away from inflammatory sugar and trans fat, in the link below:

Interview series with nutritionist Julie Daniluk on various anti-inflammatory foods, such as shiitake mushroom.

Interview series with Dr Sears L.E.A.N. on boosting immune system of children, via consuming more fruits and vegetables.

Interview series with nutritionist Toby Amidor on eczema kids’ nutrition & inflammatory foods.

So, in conclusion, there’s no doubt that fast food, which are high in trans fat and mostly fried, are to be avoided. I’ve been cooking healthy food for my family daily, and you’d be amazed at how fast you can whip out a meal once you’re used to it, faster than fast food!