A regular customer of ours came in last week seeking advice on how to manage her long-standing eczema on her face.

Customer: Hey, Chris. My eczema (pointing to her cheeks) has been getting worse lately. It’s very itchy and irritating, and I don’t know what to do about it.

Chris: Have you been doing anything different to your skin lately?

Customer: Not really…All I have been doing was using this facial exfoliant which I brought from my beauty therapist 2 weeks ago. Also, she suggested using a facial cleanser every morning before putting on my make-up.

Chris: Umm… that could probably explain why your eczema got worse…

Chris: I think your skin might be sensitive to the cleanser and exfoliant that you’re using. The fact that you have eczema makes you more prone to react to the ingredients used in common skincare products.

Chris: Also, the two products that you’re using can disrupt your natural lipid barrier on the surface of your skin. Your skin’s lipid barrier is responsible for keeping water in and keeps out any irritants and harsh chemicals. People with eczema usually have a thin lipid barrier. Using products that can strip away this thin lipid layer could potentially make the skin underneath more reactive and susceptible to dryness. Hence, exacerbating your eczema problem.

Customer: So, do you reckon I should stop using the cleanser and exfoliant?

Chris: Bingo! You can still use exfoliating and skin cleansing products, but make sure they are free from alcohol or any fragrance to minimise irritation. One of my favourite DIY recipes to exfoliate sensitive skin is to use oats. Oats are a natural exfoliator and are known for reducing inflammation and soothing to the skin.

Chris: In fact, you could make an at-home gentle face scrub by mixing oats, honey, and banana. However, always remember no matter which method of exfoliation you choose, start by using the product only once a week and slowly increase frequency. For people with eczema and sensitive skin, I generally wouldn’t recommend exfoliating more than twice a week.

Chris: In terms of your facial cleanser, make sure it does not contain any alcohol as it can potentially dry up your skin and making your skin more sensitive to allergens or irritants. I would recommend using only warm water to clean your face in the morning.

Customer: Thanks, Chris! I’ll give it a go.

Chris: In the meantime, I suggest you use the corticosteroid cream that your doctor prescribed to you on your last visit to reduce the flare-up. At the same time, keep up with the use of a moisturiser because it can help you restore moisture in your skin and form a protective barrier to keep any irritants out.

I come across this all the time where customers and patients are using skincare products that they thought might fix their skin problem but in fact, it’s what makes the problem worse. When you have sensitive skin or eczema, your immune system goes into overdrive mode to fight off a perceived threat. If your skin is repeatedly exposed to a certain irritant like a fragrance or preservative, you can also develop a skin allergy even though you may have been exposed to it for years.

Here is a list of ingredients that you should avoid in any skin-care products when you have sensitive skin or eczema.

1) Fragrance – Choose ‘Fragrance-Free’ products. Fragrance-free usually means that no extra fragrances were added to the product. On the other hand, a ‘fragrance’ product could contain 200 or more different chemical and your skin could react to any one of them.

2) Preservatives – Preservatives are necessary for keeping any product stable. Some preservatives, such as parabens, can cause an allergic reaction in certain people. Parabens are more likely to irritate those who already have skin problems like eczema.

3) Botanical extracts or essential oils – Just because a product is classified as natural or organic does not mean it won’t cause a reaction to sensitive skin.

The following are the 3 things I recommend doing if you have sensitive skin:

1) Do not wash your face too often (especially with harsh cleanser)
– Over-washing with soap and hot water or cleanser strips away your skin protective lipid barrier. Instead, wash your face with cool or lukewarm water no more than twice daily.

2) Use products with simple ingredients
– Avoid harsh ingredients such as alcohol, sulfates, and fragrances in cleansers

3) Perform a patch test before commencing any new products.
– Apply a small amount to your inner arm first, wait for 24 hours to see if there is a reaction.

If you have any questions about skin problems please do not hesitate to contact me or one of our team.

To your health,

Chris
Pharmacist

The post Why is my eczema getting worse??? appeared first on Eastmed Pharmacy.

As much as I would like to keep this inner circle only to a selected few like yourself (I consider you all my inner circle of friends) – if you know anyone that could benefit from my emails, by all means, let me know so I could add them to this group.

Anyway, I had a long weekend with my wife celebrating her birthday across the ditch in Sydney. We got back from Sydney on Monday. While I was away, one of my regular customers emailed me after reading my last email regarding vitamin C and wondered if a high dose of it could help with her eczema skin problem that she has been suffering from for years. Particularly, she mentioned how heavy use of steroid creams have left her skin more prone to bruising and bleeding.

Now, before finding out whether vitamin C could help with eczema condition. It is important to understand what eczema is.

There are several different types of eczema. One of the most common types of eczema is called “Atopic dermatitis”. “Atopic” refers to the body’s increased sensitivity to allergens or irritants. “Dermatitis” refers to the inflamed skin.

Eczema happens when our top layer of skin is essentially sleeping on the job. Normally that layer should keep your skin hydrated by locking in moisture and warding off bacteria, irritants, allergens and other substances that can cause aggravation.

If you have eczema, your top layer of skin is not upholding this duty. As a result, you may experience inflammation of the skin because the disrupted skin layer exposes your immune system to irritants. Your immune response can overreact, causing inflammation underneath your skin, which may lead to frequent flare-ups. So those rashes on the surface, together with the symptoms of itchiness, redness, dry and scaly skin are just the signs of a deeper inflammatory disease.

One of the facts about eczema that I found most people are not aware of, is that topical steroids are only effective in reducing the severity of skin inflammation during an exacerbation. It does not prevent eczema from occurring. The long-term management of eczema that I always suggest is moisturisation. Moisturising your skin will do two things:

1) Help form a protective barrier above your skin to ward off irritants and allergens

2) It will hydrate your skin by locking in moisture.

Hence, it is crucial to find a moisturiser that can moisturise your skin and help you restore the disrupted skin layer.

I will go deeper in the next few emails about the best approach in managing eczema (so stay tuned!)

Now, going back to your question: “Would taking a large dose of vitamin C help with eczema?”

It is important to understand how our body transports and stores vitamin C. As I mentioned in my last email, our body does not have the mechanism to store vitamin C. Hence, we need to replenish it daily. Vitamin C in the skin is normally transported from the bloodstream (it can also be delivered through a topical formulation – which I’m a bit skeptical of).

Transport proteins specific for vitamin C are found on cells in all layers of the skin. Oral vitamin C effectively increases vitamin C levels in the skin. However, when vitamin C levels in the blood are saturated, skin vitamin C concentrations no longer increase. In other words, taking high dose vitamin C may not necessarily strengthen the skin barrier compared to a normal dosage. When we have reached a saturated level of vitamin C in our bloodstream, the excess amount will be excreted through the kidneys in the urine rather than being absorbed further.

In terms of whether vitamin C could improve eczema, I have done some research and could not find any journal articles suggesting clinical evidence to support its use. However, vitamin C may have a role in wound healing which could potentially indirectly assist in the healing of inflamed eczema sites. Vitamin C is necessary for collagen synthesis and the demand for it usually increases during the wound healing process. Some studies have suggested that vitamin C deficiency may result in poor wound healing, and supplementation with vitamin C in people with a deficiency may be beneficial.

If you were to give vitamin C a try, I would suggest not taking more than 2000mg daily. Any dose beyond that could potentially be excreted from the body without added benefit to our health. Too much vitamin C may also cause gastrointestinal symptoms such as diarrhoea and nausea.

Anyway, have a great long weekend everyone!

To your health,

Chris

Pharmacist

The post Can vitamin C work magic on eczema? appeared first on Eastmed Pharmacy.