I like to think that we are relatively sun smart – I haven’t been sunburnt in a very long time – and I’d like to keep it that way! But when we are walking along St Heliers beach I often cringe as I see so many people not being sun smart. I see them lying on the beach at midday in direct sun with only a bathing suit on. I pray that they have liberally applied sunscreen, but that’s not enough!

So many people think that if they apply sunscreen then they’re good to go. They’re good to be exposed to the powerful midday sun rays for hours, confident that they are protected by the invisible layer of sunscreen, and will not need to worry about being burnt to a crisp. But hang on here! That’s not the case at all!!

While crucial, sunscreen does not guarantee no sunburn. The SPF on sunscreen stands for sun protection factor. An SPF of 15 means that it would take 15 times longer to get burnt than if you did not apply sunscreen at all. At peak hours of the day, burn time can be as little as 11 minutes. Applying SPF 15 sunscreen stretches this to 2 hours 45min. So that means if you use an SPF of 50 then you don’t need to worry, right? Wrong! All sunscreens do not fully block the harmful UV rays and what’s more important to keep in mind is that ALL sunscreens – no matter the SPF, water-resistance claims or brand – need to be reapplied every two hours and after swimming or exercise. This is because the SPF is only fully effective for up to 2 hours after applying it.

As I’ve said, no sunscreen is perfect and UV damage can still occur using sunscreen, SPF 15 sunscreens filter out about 93% of UVB rays, while SPF 30 sunscreens filter out about 97%, SPF 50 sunscreens about 98%. Any exposure to UV rays can lead to skin damage and potentially skin cancer. So the only way to prevent this is to seek shade, wear long sleeves, use a hat and sunglasses in addition to sunscreen. Remember a tan is not healthy – it’s an indicator of sun damage.

Here’s to a sun-smart summer!

The post Sun safe or sun stupid? appeared first on Eastmed Pharmacy.

We had all of our windows open over the weekend, letting in the warm breeze, enjoying the sounds of birds and relaxing. That was until unwelcome intruders arrived!! They were stealthy and I had no idea that they were in the house until later in the evening when we closed everything up. I was innocently sitting on the couch when I sensed another presence…a soft buzzing noise and I knew instantly! Mosquitos!! Surely not! But there they were flying around our warm bodies waiting for an opportune time to strike – I knew we were toast!!

With the warmer weather and doors and windows open all hours it’s inevitable that we are visited by some not so welcome visitors. I thought I would take this opportunity to bust a few myths I commonly hear about mosquitos.

But first, why do we swell and become itchy when bitten by mosquitos? Female mosquitos only feed on human blood – not the males. They are able to find us using a combination of scent, exhaled carbon dioxide and chemicals in sweat. When feeding, their saliva is injected into our skin and it contains more than 100 proteins. Some of these proteins ensure that our blood doesn’t clot while feeding, the mosquito saliva also produces an allergic reaction in our body.

They appear to prefer certain victims such as:
• men
• pregnant women
• people who are overweight or obese
• people with type O blood
• people who have recently exercised
• people who have recently drunk beer

The best way to avoid mosquito bites is to ensure that stagnant water is not around the home e.g emptying children’s pools, unclogging gutters. Also covering up and wearing long sleeves and pants that are light in colour can help (although difficult to do so in this heat!)

Insect repellent can also be useful – but what to look for?
N,N-Diethyl-meta-toluamide, also called DEET or diethyltoluamide, is the most common active ingredient in insect repellents. The chemical was created by USDA chemists in the 1940s for use by the U.S. military and has been commercially available since 1957.
It works to reduce the scents on our skin to reduce mosquito attraction. The concentration of DEET in products may range from less than 10 per cent to nearly 100 per cent. The benefits of DEET reach a peak at a concentration of 30 per cent, the maximum concentration currently recommended for infants and children. DEET should not be used on children under 2 months of age. The different concentrations relate to how long they are effective in repelling mosquitos e.g. 100% lasts 12 hours while 20-30% lasts 3-6 hours.
There has been a lot of concerns over the years about DEET and it’s safety. If used as directed and the product instructions are followed, yes, DEET is safe to use. The majority of cases were people reported toxicity did not used the product correctly. Do not spray it near your eyes and mouth – spray on your hands first and rub on your face. Don’t use a concentration of 100% – 25-30% DEET will work well – especially in NZ. There is not much research about DEET in pregnancy so I would avoid it if you are expecting. There is no reliable information to suggest that it causes cancer according to the CDC.

There are other repellents such as picaridin which has been available since 2005, as it is a newer repellent it doesn’t have as much research about its safety – but what is available says it should be safe and effective (in concentrations of at least 20%). Oil of lemon eucalyptus as another ‘natural’ alternative. It’s not recommended in children less than 3 years old but when used as directed in concentrations of 30% it’s shown to be safe and effective.

That’s how we can prevent these pesky creatures from biting us – but what about treating the bites. I often hear people say to “spit on the bite” to stop it itching – does this actually work though? Or are we being made to look silly by licking our bites! Human saliva has a natural disinfectant which can calm down the bite – however there are also bacteria present in our saliva. There is a risk that by licking or spitting on the bite that we could cause it to become infected. I would advise against doing this! Aloe vera gel or products containing honey could help to calm and promote healing. The cool feeling of aloe vera gel may also soothe the itch. Other products such as steroid creams or antihistamines can help but see me or one of the staff before you use these products to make sure they are right for you.

I think that as we move into the more humid days of summer, mosquitos will become more and more of a problem – especially around dusk. Make sure you cover up and close the windows before they visit you and your family!

To you and your family’s health!

Chris

Pharmacist

The post Have you been visited by these unwelcome guests?! appeared first on Eastmed Pharmacy.

See here if you missed it: https://www.stuff.co.nz/business/117585631/consumer-nz-says-nine-out-of-20-sunscreens-dont-provide-protection-they-claim?rm=a

So what can you do to ensure that you won’t get burned by your sunscreen?

Before I get into that, it’s important to understand what SPF actually is and the different types of sunscreen available. SPF stands for sun protection factor. It is a measure of how well the sunscreen protects our skin from sunburn. A higher SPF means that more ultraviolet (UV) radiation is filtered, however, there is no sunscreen available that can fully block all UV radiation and some will always pass through to our skin.

The Cancer Society recommends using a sunscreen with at least an SPF of 30, this means that 96.7% of UV radiation is filtered, you can purchase higher SPF, for example, SPF 50 filters 98% of UV radiation. Regardless of whether you have SPF 30 or 50, the most important point I must emphasise to you all is to apply your sunscreen correctly (I’ll cover this in detail below).

There are also two main types of sunscreen that you should be aware of – chemical and physical.

Chemical sunscreens contain compounds which work by creating a chemical reaction in the skin that changes UV radiation to heat which is released in the air.

Physical sunscreens contain UV filters which sit on top of the skin to deflect the UV radiation.

If you have sensitive skin, I usually recommend a physical sunscreen as it is less likely to be absorbed into the skin and cause a reaction.

Lastly, it’s important to know what sunscreen brands mean when they advertise their product as “broad spectrum”. This means that it filters both types of UV radiation – UVA and UVB.

UVA can cause ageing and UVB can cause sunburn – but both can cause long term damage.

So when purchasing a sunscreen look for: • A broad-spectrum sunscreen • At least SPF 30 • AS/NZ 2604 standard on the label • If you have sensitive skin, a physical sunscreen containing zinc oxide or titanium dioxide

But beyond this, THE MOST IMPORTANT THING is to know how to apply sunscreen correctly. I have seen many patients over the years complaining that sunscreen doesn’t work for them, only to find out that they have not been using it correctly – this can save you a lot of pain and discomfort!! These are my top tips:

1. Apply sunscreen at least 20 minutes before heading out into the sun – your skin should be dry – give it time to absorb or settle onto your skin.
2. Make sure that you are using enough sunscreen – people often apply much less than they really need. As a general rule of thumb – a teaspoon should be applied to each area of your body – each arm, front of the body, back of the body, each leg, face etc.
3. If you are sweating or in the water, make sure that you reapply the sunscreen often. Brands can advertise 4 hours water resistant but I would recommend reapplying every 2 hours to be sure.
4. I also suggest wearing sunscreen daily to your face as part of a general skincare routine – apply it before any makeup and moisturiser to ensure it is in contact with your skin.

Going back to the media coverage about sunscreen – it is very concerning that some sunscreens may not be meeting the SPF advertised on the packaging, I think it’s important that sunscreens are regulated and are required to adhere to Australian and New Zealand standards – and I hope we see this change coming soon. But regardless of applying it correctly is number 1.

If you would like to know more about sunscreen or need help choosing the one that suits you and your lifestyle, do not hesitate to pop in and ask myself or one of the team.

To a long and sunburn free summer!

Chris Pharmacist

The post Sunscreen or sunburn? appeared first on Eastmed Pharmacy.

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

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