Thursday, February 1, 2018

Treating skin conditions: Part 1 - Topical (lotion/cream) help

Troublesome skin has been a huge part of my life. My mom will tell baby stories of me with more than the average diaper rash: angry, red eczema covering huge portions of my body. She changed detergents, could only buy very specific brands of wipes and diapers, using "hypoallergenic" lotions and creams... but everything made my skin angry. I grew up with eczema and dry skin in general; always patchy, but it always came back.

The most troublesome spot was the inside of my elbows, and it was awful seeing as how everyone in gym class and at school in general could see it. Sometimes it would move to the backs of my hands and knuckles, to my stomach, under my arms. It was unrelenting.

Steroid creams like hydrocortisone definitely helped. Of course they should! They suppress inflammation. So after 2 days the patches would be gone, but just a few days later and we'd be starting all over again with itchiness, redness, dry, scaly and patchy skin, and then it was back to the steroids.

This is something I see often in practice and the problem is how we treat the skin. We think because skin is on the "outside" that we should treat skin conditions solely with topical treatments, but this isn't the case. In fact, more than 90% of the cases of acne and eczema that come into the clinic are not due to any external irritant. These eruptions of inflammation are telling us that something is wrong on the INSIDE (I'll talk more about this next week in "Part 2").

Of course, changing your detergent and body products can still have a big impact, and that's in part because some of these chemicals and substances can be absorbed through the skin and get into our bodies (and blood streams). Sometimes we forget that all of these things are linked: what we expose our bodies to (internally, like food, and externally, such as body products), can affect our hormones and elicit immune responses like inflammation.

What should you avoid in skin care products?

  • I tend to toss away any product that has a high amount of alcohol in it. Alcohol is drying and on eczema, it can cause burning and stinging. Eczema is already a dry skin condition, no need to dry things out even more. 
    • Avoid products that have any type of alcohol listed in the first 5 ingredients. This is more common in lotions, as opposed to creams. 
  • Fragrance and Parfum/parfumes: these tend to be chemical irritants. Look out for them in body products and try to pick fragrance-free products, or those that only contain natural essential oils 
    • Side note on essential oils: There are some that can still be irritating for skin, especially in concentrated forms. Avoid oils that have a "pine" scent as these can be more irritating and astringent. 
  • Parabens ( including methylparaben, ethylparaben, propylparaben, and butylparaben: These are known hormone disruptors. 
  • Propylene glycol: can be a skin irritant
  • Triclosan: a skin irritant that also may disrupt hormones
Growing up with this type of inflammation, it's an understatement to say that I've tried out a LOT of products. I found I had to rotate my moisturizers on a continual basis. From all of that experimenting I have come to the conclusion that: 

Products with the most "natural" ingredients and oils seem to give way better results than those that are "dermatologist recommended" or "pharmaceutically designed" --> Even if it says "hypoallergenic" on the label. 

All the Cetaphil, Aveeno, and Vaseline in the world couldn't help me and instead my skin just burned and itched even more. 

Look to the following helpful ingredients either on their own or in combination:
  • Shea butter
  • Cocoa butter
  • Vitamin E oil
  • Aloe vera
  • Avocado oil
  • Olive oil
  • Coconut oil
  • Vegetable Glycerin (especially for soaps - I've gone back to Natural bar soaps!)
  • Avena sativa (oat) extracts
My favourite products at the moment are Scentuals Scent-free Hand & Body Lotion, and Aleva's Daily Soothing Moisturizer (pictured below):

For my face and hands, I primarily use oils. This is also a great added treatment for eczema lesions. As often as you can, apply small amounts of coconut oil, shea butter, vitamin E oil to damaged and itching skin. Oftentimes I'll even incorporate a natural diaper rash cream (something with Zinc Oxide and Calendula) for skin healing and the zinc to decrease itching. 

These ingredients are meant to heal skin, provide anti-inflammatory support, and nourish damaged tissue. While we nourish our skin from the outside, we must treat it on the inside (see Part 2 next week).

The goal is to be consistent, and often I'll have patients apply these products as often as they can throughout the day (at least twice daily, but up to 4 times can give better results).

For an individualized plan and prescribing, I suggest seeing a licensed naturopathic doctor as not all of these options will be right for everyone (especially in the case of allergies or sensitivities).

In "Part 2" of Treating Skin Conditions, we'll review treating the body from the inside out for both acne and eczema. Check in next week!