Why is my eczema getting worse???

Here is a real-life case that I wanted to share with all of you.

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