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 – 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,


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.

News & Research

Eczema News – Eczema is Cardiovascular Risk

You know when something is so stressful, sometimes we say it’s bad for our heart? Add eczema to that list.

Heart Risk for Eczema

Dermatologists Jonathan Silverberg and Philip Greenland looked at data for 27,157 and 34,525 adults aged 18 to 85 years from the 2010 and 2012 National Health Interview Survey. After the analysis, they noted that adults with eczema are likely to:

Smoke more (100 cigarettes in lifetime and still smoking)

Drink more (12 drinks annually and still drinking)

Have higher cholesterol 

Exercise less

Weigh more, measured by BMI of more than 35

Be at risk of hypertension (2 related consultation visits)

Be at risk of lifetime prediabetes

Have sleep disturbances, resulting in fatigue, daytime sleepiness or insomnia

This is a data analysis, meaning having eczema does not cause you to have a heart attack. However, it is a reminder that we have to be even more vigilant at taking care of our health and not letting eczema literally take over our life. 

If sweat triggers your child’s eczema, opt for other less sweaty exercise or find a setting that allows for showering and moisturizing after (sweat residue irritates skin for some). Keeping fit helps reduce obesity and likely improve sleep. When you’re making an effort to be healthy, it is less likely you will eat poorly, drink and smoke. Choose a diet of fresh fruits and vegetables, cut back tans fat and sugar, quit smoking and you’d reduce risk of diseases by 80%.

Eczema is bad for our skin, but not let it be bad for our heart or our life.

For encouraging stories of eczema sufferers around the world, read
the weekly stories shared in 2013.

Skin ish Mom Column

#Skinish Mom – There’s more to Skin Tingling than Scarlett Johansson

On 20 December 2014, the research paper by Melanie L. Shoup-Knox Ph.D. titled Physiological changes in response to hearing female voices recorded at high fertility was reported on The Telegraph. It was further reported by The Daily Mail, Medical Daily amongst others. The gist is that voices of females recorded at their most fertile period produced the greatest increase in galvanic skin response. 

Put simply – Fertile women electrify the skin of men (and other women too!)

Wait a minute, why would women be attracted to women? It’s got nothing to do with LGBT but Dr Melanie’s interview response in The Telegraph was “Women, on the other hand, may get a competitive advantage from detecting the fertility status of other females.’’

What’s all this to do with Scarlett Johansson? Well, she has a deep, supposedly sexy voice, attractive enough for Theodore (played by Joaquin Phoenix) to fall in love with (Samantha, the intelligent OS) and we all listened in for 126 minutes of the movie Her.

Skinish Mom Cartoon Columnist Skin Tingling Men

So, what’s Not About Scarlett Johansson? You see (or rather feel), tingling is more likely due to medical condition than physical attraction. The ‘news angle’ when this study came up was female voice, fertility and reproduction. But Skinish Mom’s focus is on skin. Surely, there’s more to skin tingling than mating. Here’s a list of the possible medical conditions:

Anxiety attack – Case in point: If you get anxious after drinking caffeine, there’s higher autonomic arousal meaning higher heart rate and skin conductance level.

Arsenic attack – It’s no joke if you’re a copper smelting worker. The higher arsenic air level leads to tingling in the legs.

Anaesthetics attack – There are studies of tingling after local anesthetics’ use, especially in dentistry. Btw, epidural also results in paresthesia in up to 20% of patients, well, I’m the lucky 1 out of 5.

Carpal tunnel syndrome



Multiple Sclerosis


Transient ischemic attack (TIA) aka mini-stroke

You get the point, it’s not about Scarlett Johansson. There’s no need to list a full possible list of medical conditions, though if you are experiencing tingling and fear it’s more than the passing pins and needles, read PubMed Health.

Educational note 1: Tingling is medically known as Paresthesia, defined as an abnormal body sensation, such as numbness, tingling, or burning.

Educational note 2: Galvanic Skin Response (GSR) is the measurement of skin electrical conductance.

Side note 1: I really like the movie Her from beginning to middle but find it too boring to reach the end. So I never knew the ending!

Side note 2: I discovered a very cool gal Samara O’Shea, who launched a letter-writing service in 2005, way before the movie Her – read Samara’s take on Her.

Side note 3: Why would anyone study women’s voice? Well, everyone’s interest is different and that’s how our society progresses. We can’t all be the financiers who brought down Wall Street. Dr Melanie’s interest is in evolutionary psychology and her other studies were on yawning. Yawning induces brain cooling and thus linked to medical conditions affecting cranial-facial blood circulation. Gotcha (yawning).

Doctor Q&A

Rise and Shine Feature – Eczema Skin Function and Care

Dr Lynn Chiam Dermatologist Children Skin Conditions Eczema

Dr Lynn Chiam shared during the Rise and Shine Expo on ‘All about Children’s Skin’. She consults at Children & Adult Skin Hair Laser Clinic and subspecializes in pediatric skin conditions. She was formerly the head of pediatric dermatology at National Skin Centre, Singapore. She has also shared her expertise on Teen Eczema, Hand Eczema and Facial Eczema.

Eczema Baby Skin

MarcieMom: Thanks Dr Lynn for spending some time here, and helping to address follow-up questions to your talk. You mentioned that the skin function includes protection against sun, and that baby’s skin offers less protection. How about skin of an eczema infant? And the skin of an eczema adult? Do they offer even less protection against the sun as the skin barrier of eczema patients are already defective?

Dr Lynn: Protection against the sun depends on the integrity of the skin as well as the amount of pigment cells in the skin. In general, a baby’s skin is less mature and contains less pigment cells compared to an adult and thus is more susceptible to the adverse effects of the sun. Darker- skinned individual tend to get less sun burn as compared to fair-skinned individuals.

In infants and adults with eczema, their skin barrier functions is defective and they can get broken skin as a result of scratching. This can make them more susceptible to sunlight and exposure to excessive amount of sunlight is known to trigger or aggravate the eczema.

Eczema Baby Skin is more susceptible to sunlight and exposure to excessive amount of sunlight is known to trigger or aggravate the eczema.

Eczema Baby Skin Infections

MarcieMom: You also mentioned that the skin forms part of our body’s immune system. Is this due to the skin flora? Does the ‘porous’ eczema skin means that babies with eczema have a lower immunity and does this lower immunity translate to falling sick often? What is the implication for parents in caring for the general health of an eczema baby?

Dr Lynn: The skin contains cells which are involved in the reaction that our body mounts in response to an infection and inflammation. They are known as “B” cells and “T” cells. They can be thought of as “soldier cells” that defend our body when it is “attacked”. The skin flora on the other hand describes the bacteria, fungi and viruses that reside on our skin without causing any harm to our body. They are not part of the immune system.

The “porous” eczema skin allows bacteria and viruses to penetrate more easily and thus eczema patients are at a higher risk of getting skin infections. The skin of patients with eczema do have lower immunity to prevent skin infections but in general this not lead to overall decrease in their body’s  immunity. Children with eczema  do not fall sick more often as compared to their peers.

It is important for parents and health care providers to recognise eczema superimposed with skin infection as the skin infection has to be cleared for the eczema to heal well.

Wet Wrapping for Eczema Baby

MarcieMom: Is wet wrap/dressing recommended for infants below 6 month old? Does the thinner skin of babies affect whether they ought to be wet wrapped?

Dr Lynn: As the skin of an infant below 6 months has a larger surface area: volume and is thinner as compared to adults, they tend to absorb a larger percentage of creams that is applied. Thus it may lead to side effects as a consequence of more creams that is absorbed via the skin into their system. Thus I will generally not advise wet wraps for infants unless the eczema is very severe and the creams used are very gentle.

Wet wrap is not advisable for infants unless the eczema is very severe and the creams used are very gentle

Topical Steroid Potency for Baby

MarcieMom: Similarly for steroid potency, is there a certain age by which the skin is thick enough to consider stronger potency steroid cream?

Dr Lynn: There are no guidelines for the potencies of steroids to be used according to age. In general, I will not use anything stronger than a mid-potency steroid in children less than 8 years old. The potency of the steroid used also depends on the thickness of the skin and the severity of the eczema. The neck, inner aspects of elbows, back of knees and wrist are generally considered to have thin skin and only low to mid-potency steroids should be used. Contrary to this, more potent steroids have to be used on the palms, soles and areas where the skin is thick as a result of the eczema.

For more severe eczema, a more potent steroid should be used to control the inflammation before tailing to a less potent one.

Thank you Dr Lynn for sharing your thoughts on the above questions, and thank you for the wealth of information you’ve provided in this blog.

Doctor Q&A

Rise and Shine Feature – Seminar with Dr Lynn Chiam on Children Skin Conditions

Dr Lynn Chiam Dermatologist Children Skin Conditions Eczema

Dr Lynn Chiam shared during the Rise and Shine Expo on ‘All about Children’s Skin’. She consults at Children & Adult Skin Hair Laser Clinic and subspecializes in pediatric skin conditions. She was formerly the head of pediatric dermatology at National Skin Centre, Singapore. She has also shared her expertise on Teen Eczema, Hand Eczema and Facial Eczema.

Baby Sweaty Hands and Feet

Palmar Hyperhidrosis is the excessive and unpredictable sweating from hands, even when it is not hot or exercising.  This is due to overactive sweat glands. Primary hyperhidrosis refers to the excessive sweating from hands, feet and armpits and affect 2-3 percent of population with genes being a factor. Minimally invasive procedure can be carried out but for children, use of antiperspirant or prescriptions containing aluminium chloride.

Children Body Odour

Children may also experience body odour and it is the bacteria and not the sweat that creates the smell. Avoid tight clothing/foot wear and wash clothes thoroughly.

Children Hair Loss

Alopecia Atreata (Hair Loss) is a type of hair loss due to the immune system attacking the hair follicles (auto-immune condition). For most, the hair will grow back and if so, some opt not to treat the condition. Treatments can be topical corticosteroids, injections containing steroids or immunotherapy.

Sun and Baby Skin

The UV rays can cause sun burn, sun spots, wrinkles, enlargement of blood capillaries and even skin cancer. Particularly for children whose skin is thinner and less protected against UV rays, sun protection measures should always be taken. Avoid direct sunlight from 10am to 4pm, wear shades, hats and appropriate clothing. Also bear in mind that the sand and the sea can also reflect the rays, and thus sitting in a shaded area also requires sun protection.

Sunscreens are divided into chemical absorbers and physical reflectors; chemical absorbers absorbs the light and converts them into harmless rays but these are known to trigger more skin irritation than physical reflectors. Physical reflectors reflect the light off the skin. Be sure to put sufficient amount, one teaspoon on the face and to use one at least SPF30.

Stress and Baby Skin

Stress is also known to trigger skin conditions such as eczema and pimples/acne and therefore parents are encouraged to share stress relaxation techniques such as massage and breathing with their children.

Q&A with Dr Lynn Chiam

Dealing with Drool – Dr Lynn answered a question on dealing with the child’s drool and her tip is to use a wet cloth to dap away the saliva, followed by a dry cloth to dap dry and then moisturize immediately.

Air-conditioning – Children with eczema can sleep in air-conditioned room, bearing in mind that there is no ideal environment as too hot can also trigger eczema. A temperature of 24 to 25 deg C is comfortably cool.

Oil as Moisturizer – Dr Lynn pointed out that oil is not as easily absorbed onto the skin as moisturizer, and thus does less to improve the skin barrier function.

Water as Irritant – Dr Lynn explained that eczema skin is like a crumbling brick wall and prolonged washing can weaken the skin barrier function. Therefore good skincare includes a bathing routine that is not in hot water and not longer than ten minutes.

Steroid cream – Dr Lynn explained that steroid potencies range from 1 to 7, 1 being the strongest and 7 the weakest. There is also new generation topical corticosteroids that have less side effects.

Next week, I’m asking questions for eczema children in relation to what Dr Lynn had shared during the Rise and Shine seminar, and as always, grateful to her for reviewing the above.

Doctor Q&A

Rise and Shine Feature – Seminar with Dr Lynn Chiam on Skin Conditions

Dr Lynn Chiam Dermatologist Children Skin Conditions Eczema

Dr Lynn Chiam shared during the Rise and Shine Expo on ‘All about Children’s Skin’. She consults at Children & Adult Skin Hair Laser Clinic and subspecializes in pediatric skin conditions. She was formerly the head of pediatric dermatology at National Skin Centre, Singapore. She has also shared her expertise on Teen Eczema, Hand Eczema and Facial Eczema.

Common Baby Skin Conditions


Eczema is one of the most common skin conditions, affecting 20% of children. It can be inherited, and also associated with allergic conditions such as allergic rhinitis. Typically, eczema appears before the age of 7, as a red and itch rash at joints, face (for young children), body and requires treatment. Apart from good skin care routine (relating to shower, moisturizing), topical corticosteroids, antibiotics, antihistamines or wet dressings may be prescribed by the doctor.

Eczema is also affected by the environment, such as environmental triggers (house dust mite, pollen and dander) or irritants that include heat/sweat, rough textiles and low humidity. Allergy testing can be conducted, such as skin prick test, to find out potential allergens for the child. House dust mite is the most common environmental allergen and these dust mites cannot be fully eliminated from the home. Sunning mattress, washing bedding in 60 deg C for an hour and weekly cleaning can reduce the level of house dust mites. Dust mites thrive in humid environment, so humidity can be lowered but care to be taken not to have the bedroom too dry or moisture can be stripped from the skin.

Food allergy on the other hand is not as common in eczema, affecting 5% of children and 1% of adults. The common foods that trigger eczema are egg, milk, crustacean seafood and wheat.

Warts in Children

Warts are caused by virus, and spread by contact with another infected person. Warts can spread from one part of the body to another, and recur as the virus is hidden deep in skin. Warts can be left alone or treated with cream, freezing with liquid nitrogen, laser or electrocautery.

Molluscum contagiosum

Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), a member of the poxvirus family. This virus thrives in warm, humid climates and in areas where people live very close together. The virus can be caught in swimming pool and similar to warts, the growths can be left alone or frozen.

Cold sores in Children

Cold sores are caused by the herpes simplex virus (HSV type 1), and can cause cold sores around the mouth. Cold sores can be spread from person to person, and signs that accompany cold sores include fever, poor feeding and irritability. This usually resolved in 1-2 weeks.

Hand Foot Mouth Disease (HFMD) – HFMD is due to the enterovirus, and can incubate for 3-5 days, commonly occurring in children younger than 5 year old. It is accompanied by fever, poor appetite, a vague feeling of being unwell (malaise) and sore throat. There is no specific treatment for it and usually resolve within a week.

Urticaria (Chronic Hives) – Hives are formed in response to histamine released from specialized cells along the skin’s blood vessels. This could be due to allergic reactions, insect stings, sunlight or medication but most of the time, the cause cannot be identified in chronic hives.

Baby Birthmarks

Various Skin Marks (Birthmarks – Haemangiomas, Port Wine Stains, Brown Spots and White Spots) – Various skin marks are present in children, some like port wine stain is present at birth while others like haemangiomas present in about 2-3 weeks of age. The appearance of these spots differ, and generally can be treated by laser.

Baby Milia

Milia are tiny white bumps, common in newborns and appear as cream-coloured papules. It is caused by dead skin that is trapped near the baby’s skin surface. When the surface of the bump wears away, the dead skin is sloughed off and the bump disappears.

Baby Pimples

Pimples – Pimples (whiteheads, blackheads or inflamed red spots), or infantile acne, can also be present in up to 20% of infants and related to blockage, inflammation and breaking of pores from over-production of oil. To prevent scarring, treatment is required. Also for adults having acne, avoid cosmetics, look for powder foundation rather than liquid foundation, and contrary to common belief, chocolate, nuts and oily food does not cause acne.

Next week, I will be posting on the last segment of Dr Lynn’s talk on other skin conditions and grateful to Dr Lynn Chiam for reviewing the above on her talk at Rise and Shine Expo.

Doctor Q&A

Rise and Shine Feature – Seminar with Dr Lynn Chiam on Skin Functions

Dr Lynn Chiam Dermatologist Children Skin Conditions Eczema

Dr Lynn Chiam shared during the Rise and Shine Expo on ‘All about Children’s Skin’. She consults at Children & Adult Skin Hair Laser Clinic and subspecializes in pediatric skin conditions. She was formerly the head of pediatric dermatology at National Skin Centre, Singapore. She has also shared her expertise on Teen Eczema, Hand Eczema and Facial Eczema.

Skin Functions

Dr Lynn shared on the various functions of skin, that the skin is more than a covering but also

  • Acts as a barrier to prevent the penetration of irritants, toxins and harmful organisms
  • Prevents moisture loss
  • Shields the body from harmful UV light
  • Forms part of our immune system
  • Regulates temperature and part of our body’s sensory mechanism (touch)

Baby Skin Functions

The baby’s skin is different from that of adult, being (i) thinner, (ii) less hair, (iii) less oil and (iv) less pigmentation. It is also less equipped to handle temperature changes, sunlight and prevention of moisture loss, and is more vulnerable to toxin, blistering and erosions. A new born baby’s skin is covered by vernix caseosa, a creamy white substance that helps the newborn adjust from being in a womb to outside when delivered. It is lubricating and has anti-bacterial function.

Skin Changes for a Baby

The baby’s skin will undergo changes, gradually getting thicker with less permeability and with more mature sweat and sebaceous glands. There is then less heat and moisture loss.

Care of Baby’s Skin

The newborn baby’s skin does not require much washing, bathing once daily or once in two days is sufficient. Hot water should not be used and avoid showering more than 10 minutes, always taking care to pat dry instead of aggressively rubbing dry. As baby’s skin is more susceptible to sunburn, sun protection with at least SPF 30 and also wearing protective clothing, hats and not going out from 10am to 4pm in direct sunlight is important. Topical creams or lotions can be used in infants but parents must be careful to examine ingredients to ensure no toxicity or irritants.

Diaper Rash

The most common skin irritation by baby is diaper rash, which is a form of irritant contact dermatitis, triggered by faeces (watery stools) and urine. The diaper results in a significant amount of time for which the urine is in contact with the skin, taking into account all the time a newborn spent lying or sitting down. The skin ought to be gently cleansed and lubricants applied.

Next week, I will be posting on the next segment of Dr Lynn’s talk on common baby skin conditions and grateful to Dr Lynn Chiam for reviewing the above on her talk at Rise and Shine Expo.

Doctor Q&A

Doctor Claudia Video – Why Stressed Skin is More Skin Deep

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. Read more about her at

Marcie Mom: Thank you Dr Claudia for taking time to answer questions on the video. In it, you shared that chronic stress is associated with many diseases including diabetes, cardiovascular diseases, autoimmune diseases and even cancer. Stress process begins in hypothalamus, that sends an initial signal to the pituitary gland, adrenal gland and triggers the release of adrenaline, noradrenaline and cortisol that travel through the body for a fight or flight response. Stress is also studied to be able to trigger neurogenic inflammation that can worsen eczema, psoriasis, premature aging, acne and rosacea.

Stress can dehydrate skin, leading to impaired skin barrier that makes the skin more vulnerable to allergens and irritants, and triggers eczema flares. Histamines released also contribute to the itch level experienced in the skin. Stress can also make the skin hypersensitive to allergens. Cortisol boosts oil production, leading to blocked pores and worsening acne.

Doctor Claudia shared that there is a new field Psychodermatology, which is the practice of treating skin disorders using both dermatological and psychiatric techniques. Treatments such as acupuncture, aromatherapy, breathing and massage techniques are also shared in the video.

Dr Claudia, can you share briefly with us how the brain ‘talks’ to the skin and how differently a stressed brain talks to the skin?

Dr Claudia: The brain and the skin share an embryonic origin and are constantly communicating with one another. Think about sensation – your skin, once stroked, sends signals to the brain and the brain determines whether it is being tickled, stroked, or punctured. Of course the picture is more complex than that, as it involves countless nerve fibers, relayed information in the spinal cord and signals from brain to skin. They communicate using electrical impulses and chemical signals for the most part. A stressed brain will send more stress signals, or hormones, throughout the body including the skin.

Dr Claudia Aguirre answers questions on Why Stressed Skin is more than Skin Deep video

MarcieMom: Eczema is a stressful condition to manage, and stress can also trigger eczema – a double whammy situation. For children with eczema, what do you think are some ways to break this vicious cycle?

Dr Claudia: The behavior should be modified to adapt to lifestyle changes early on. In children, this may be teaching them that they can keep their hands busy so they don’t idly scratch their skin. Teaching them to breathe deeply has also been shown to reduce anxiety and stress in children – some therapists put a ball or balloon on the belly of the child and make them move it while breathing deeply, lying on their back. This can help a child understand how to breathe from the belly, which can reduce stress. Maybe when they get particularly itchy, they can call out to mom or caretaker, who will apply a cool compress to relieve the itch without scratching the skin.

MarcieMom: You mentioned about touch being able to relieve stress. Do you think that a mother carrying or sleeping with an eczema baby can help relieve stress and offers the possibility to improve eczema?

Dr Claudia: Absolutely. Holding premature infants allows them to develop faster and carrying a baby or toddler is comforting in more ways than we know. Gently stroking them will also be soothing. As for co-sleeping, there are different viewpoints and it is up to the individual in the end. To relieve from dust mites, wash often with hypoallergenic detergent and vacuum frequently. Although they are a trigger, they are not the cause of eczema, so keeping the skin hydrated and lubricated will allow it to heal and prevent flare-ups.

Thanks Doctor Claudia, as always, very much appreciate your insights into skin.

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!

Doctor Q&A

Skin Health Series – Veins and Bruises and Moles

This is the third 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

This week we are investigating more into what the appearance of our veins, bruises, moles and hair growth tell us about our health.


MarcieMom: I’m looking at my own veins now, and I can see veins on my hands (as I’m typing), on my wrist (so that if I ever need a drip, the (hopefully experienced) nurse knows where to poke, and my feet. There are veins which are swollen with blood in older individuals, such as varicose veins, due to the valve not working and blood gets pooled due to gravity

Apart from varicose veins, are there instances when the skin can get thinner or more transparent, thereby making the veins suddenly more apparent? I’m thinking maybe aged, sun-damaged skin may play a part too.

Dr Verallo-Rowell: You are absolutely right! The thinner the skin, often from photoaging on the more exposed skin of the hands, the easier the veins of the hands appear and wrists. Some people use steroid creams continuously for eczema and other chronic itchy skin conditions. Steroids are notorious for making the skin thin. I have seen so many of these and yes the veins literally pop out in these steroid thinned out skin areas.

Steroids are notorious for making the skin thin.


Brown patches on the skin are characteristic of diabetic dermopathy, where the capillaries are injured from knocks and ‘leaked’ leading to formation of rough, brown patches.  Lines on the palm or soles are also symptom of an endocrine disorder, known as the Addison’s disease.

How long does a bruise take to heal? Could say, having a bruise on a day down with flu cause it to look worse than normal?

Dr Verallo-Rowell: Bruises behave more or less in a certain pattern.  First the extravasation of red blood cells from the damaged or inflamed vessels shows bright red color of blood leaked out into the extra-vascular compartment of skin, often with swelling and warmth of the skin. By about the 5th day the redness gives way to a bluish or purplish color as the red colored hemoglobin breaks down into hemosiderin. By the 7th day billiverdin makes it color greenish, then changes to a yellowish color by the 7th to about the 10th day from the bilirbin in the blood. As these pigments become cleared by our scavenging cells, the area becomes brownish before going back to our regular color. The more intense colors will come from bruising or damage of more superficial skin areas.


When moles take on a different shape, darker color or irregular edges, it can be a sign of skin cancer. I’ve read that hairdressers have spotted changing moles for their clients, and safe them from cancer via prompt consultation with doctor!

Does the presence of the mole itself create the additional risk of skin cancer?

Dr Verallo-Rowell: NOT all moles become skin cancer. The risk factors for moles that may become skin cancer or melanoma are

(1)  many (more than  50)

(2) often with 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

(3) the “ugly duckling sign” – in a field of moles it is the one that looks different from the other;

(4) history of melanoma in the family;

(5) evidence of photoaging.

MarcieMom: Thank you Dr Verallo Rowell, your 5 points for moles are a very good takeaway, at least I would stop warning everyone just because I see a mole on them!

Doctor Q&A

Skin Health Series – Functions of Skin – Dry, Hot/Cold and Collagen

This is the second 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

Understanding Skin & Health – Functions of Skin

The skin has a few important functions, (i) it protects the body from foreign particle, bacteria and it prevents moisture loss, (ii) the skin regulates body temperature, and (iii) the skin gives us a sense of touch.   We understand that in atopic dermatitis, the immune cells in the skin mistook a (harmless) allergen to be harmful, resulting in skin inflammation.

Dry Skin – Eczema or Health Condition?

MarcieMom: Does dry skin indicate possibility of eczema and other skin or health issues?

Will a person’s diet, lifestyle, smoking, drinking (caffeine or alcohol) affects the dryness of skin?

Dr Verallo-Rowell: People with the inherited form of eczema called atopic dermatitis almost always have dry skin but not all people with dry skin have skin or other health issues. Some people just have Congenital Dry Skin while others have Acquired Dry Skin from environmental agents such as too much hot water and strong detergents use; friction from clothing; frequent air travel, pollution, exposure to chemicals at work or play, or frequently staying in highly air-conditioned rooms.

Impact on Diet and Smoking on Skin

Yes definitely – the diet is very important because what we eat forms the structure of our cells, in particular the lipid bi-layer of our cells where a balance of saturated and unsaturated oils, short and long chain fatty acids, omega 3 and omega 6 oils or transfats can contribute to inflammation at the molecular level to eventually manifest itself as skin dryness. Smoking is a strong oxidizing agent. Many studies have now shown it to therefore show much faster aging changes including dryness, wrinkles, toughening of the texture of skin. Too much alcohol affects the liver and caffeine dehydrates.

Smoking is a strong oxidizing agent

Skin being Hot and Cold to Touch

An infected skin patch feels warm to touch. Are there health conditions that affect how cold or hot our skin feels or cause a change in how cold or hot an object feels to us?

Dr Verallo-Rowell: Our skin when compared with skin of others in the same room or under the same environmental circumstances may feel hotter to touch when: febrile from any cause usually infections; in hyperthyroid persons; in rosacea ; when perspiring heavily. The opposite – feel colder to touch may occur in anemic, cachectic, hypothyroid people, or very sedentary people or anyone with lowered metabolism.

A change in how cold or hot an object feels to a person is affected primarily by the condition of the peripheral nerves. One sees this in Hansen’s disease, diabetic neuropathy, metal poisoning, and any other form of neuropathy affecting the peripheral nerves.

Collagen – Consume or Apply on Skin?

MarcieMom: The dermis contains collagen fibers that maintain the elasticity of the skin. In the subcutis, there are fat cells, nerve cells and blood vessels. There are many products that are marketed as containing collagen, be it to be consumed or applied on skin.

How does the collagen from a drink find itself to the skin? And how does the collagen on a skincare product ‘dig’ itself to the collagen fibers of skin? Will it bind with the existing collagen fibers? Are they even the same collagen?

Dr Verallo-Rowell: Collagen are coarser fibers in the dermis that give skin its bulk or structure. Elasticity of the skin is given to it by the elastic fibers. The ingredients in the above products are soluble forms of collagen meant to add bulk, or elastin, meant to give elasticity.  These ingredients are usually from animal or plant proteins with similar bulk forming effects though more likely just texturizing or moisturizing effects. They are extracts that blend into the formulation and not the collagen fibers or fibrils themselves.  Many years ago collagen from cows (called Xyderm or Xyplast) were popular fillers that were what we used to inject into the skin. The molecules of collagen are too large to penetrate the skin and its barriers by topical application.

MarcieMom: Thank you Dr Verallo-Rowell, it is a reminder for me to eat healthily and also understand how our skin interacts with the environment!

Doctor Q&A

What does Your Skin tell you about Your Health?

This is 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

This series is exciting because ever since Laura (Dr Verallo-Rowell’s daughter, CEO of VMV Hypoallergenics) told me during our meeting in Singapore that her mom identified underlying health problems after seeing the skin of her friends, I started to scrutinize everyone’s skin! I became interested in the relationship between skin and health, and discovered through Laura that her mom is very passionate about improving skin and health and also have a nutritionist in her dermatology practice.

So for this series, we are discovering skin, health and health issues that can be identified by changes in skin. Of course, these are not meant to be medical diagnosis and it is always good to look in the mirror and say, ‘Yay! I’m glowing and healthy!’

Understanding Skin and Health – Skin Color

The skin is the largest organ of our body, and has the largest surface area. It consists of 3 layers – the epidermis, the dermis and the hypodermis. The epidermis protects the skin from penetration of foreign matter and also prevents water loss. It has keratinocytes, melanocytes and Langerhans cells. One way to describe skin is its color, for which the melanocytes are responsible for.

How Skin Color Changes during Suntan

MarcieMom: Dr Verallo-Rowell, does a person’s skin stay the same color? For instance:

Sun Tan/ Sun Burn – which layer of skin is affected and how does the skin reverse to its original color?

Dr Verallo-Rowell: Yes. A person’s original, also called constitutive color – under normal/healthy conditions – essentially remains the same throughout one’s life. This is best illustrated by the Fitzpatrick Skin Phototypes I to VI ( from I with very fair, blond or red hair, light colored eyes , often with freckles, thru III with light brown colored skin to VI with black skin). Following a sun tan or sun burn the melanosomes or pre-formed melanin in the epidermis darkens so an immediate pigment darkening occurs – immediately. The radiation reaches the melanocytes in the basal cell layer and stimulates them to form more melanosome which rapidly become melanin granules to contribute to the delayed skin darkening called the tan which in Phototypes I may not happen at all, II, appears and lasts a week, V appears and lasts for 6 months or longer. Once the pigment generated by that sun tan/burn clears up, the color of the skin goes right back to its original – constitutive color.  The tan by the way is called skin’s facultative coloring.

How Skin Changes with Age

From birth to death – does the skin color (assuming good health) stay the same or does the skin color change from an infant to a child, and when entering into old age?

Dr Verallo-Rowell: Even with good health the skin color undergoes natural changes from aging (time on earth) and photoaging ( with the addition of sun/light exposure). Of these two types of aging, photoaging is the one that changes the skin color more.  Notice: the buttocks skin color which most closely resembles the original color throughout life.  Note also the outer arms compared with the inner, the V of the chest up to the neck though sparing the under the chin area which is not exposed to sun/light. Those exposed areas tend to freckle and discolor ( dark and white discolorations) from photoaging effects.

Skin Color as a Reflection of Health Issues

The one some experienced as an infant will be jaundice. Jaundice is the yellow color skin, caused by an accumulation of bilirubin in the newborn’s blood due to the liver not removing it. You may also have heard of babies turning orange after eating too many carrots. This is known as carotenemia due to excess beta-carotene that cannot be processed by the thyroid (hypothyroidism). The skin can also turn blue, a condition called cyanosis, due to lack of oxygen in the blood.

Do the above conditions change the melanocytes of the skin or affect other parts of the skin cells or affect the blood which can be ‘seen through’ the skin? 

Dr Verallo-Rowell: NO. The bilirubin accumulates in the baby who you cited above – whose liver may not be mature enough to remove it. The yellow colored hydrophilic pigment in a sense stains the epidermis and/or its presence in the upper dermis is seen through the epidermis, but it does not affect the melanocytes. Neither does the carotenoids which are lipophilic become prominent in the lipid compartments of the stratum corneum the top most layer of the skin. Melanocytes are unaffected unless for some reason an inflammatory reaction occurs in which case a post-inflammatory hyperpigmentation may occur to temporarily darken the skin from melanocytes reacting to the inflammation.

Pale Skin vs Fair Skin

We know some people like it tanned, but there are others who like it fair. I’ve seen skinny ladies with pale skin, and it doesn’t look healthy to me. There is this condition known as anemia, which is due to iron deficiency for elderly or people without a healthy diet.

How can, say, a lady who is trying for weight loss, be able to spot if it has ‘gone too far’ from observing her skin? Does the same happen for a child (who may for various health reasons not eat well)?

Dr Verallo-Rowell: In ladies (and gentlemen too) who aspire and become successful at losing weight without taking care that they reduce calories but continue to have enough vitamins, minerals and other essential nutrients – iron may become deficient so anemia which gives a pale unhealthy white color develops. Children with poor appetites who likewise lack the above nutritional components also can become pale white from the anemia. Anemia means lowered number of red blood cells hence the pallor.

Thank you Dr Verallo Rowell, I learnt much from your reply! For one, I’ll note my own skin color too as I’m losing weight (and lost quite a fair bit through exercise!)