eczema, exercise and activity, food and nutrition, my journey, pregnancy, women's health

where’s my glow? (pregnancy with eczema)

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Today I decided to dig a bit more into the world of eczema for us pregnant folk.

I started by watching a podcast done by Abby Lai (of Prime Physique Nutrition) in which she talked with Dr. Peter Lio (he’s done a few National Eczema Association webinars). Link to Abby’s podcast is here.

The major points were:

  • It’s not really understood why but about 1/2 of pregnant women have worsened symptoms and 1/2 have bettered symptoms. Dr. Lio likened it to how some women get nausea during pregnancy.
  • You can have a flare in one pregnancy, but not in the next. Also you can have changes in skin between trimesters.
  • Dr. Lio mentioned a few itching conditions that can occur during pregnancy such as cholestasis (when liver and gall bladder slow down their bile flow which causes a terrible itch), atopic eruption of pregnancy, PUPPP (or pruritic urticarial papules and plaques of pregnancy which usually occurs during the 3rd trimester).

He and Abby then talked about treatments used during pregnancy including such as:

  • how topical steroids are okay but not most potent ones. The goal is to keep body surface area that you apply the topical steroids to relatively low (so not WHOLE body), because topical steroids go in blood if they are used long enough or over large surface areas.
  • light/phototherapy
  • Benadryl and other anti-histamines
  • wet wraps, icing, moisturizers (see my post on products I’ve tried here)
  • anti-itch creams in small amounts (such as camphor and menthol)
  • natural oils like coconut and sunflower seed oil (if not allergic)
  • dilute bleach baths (he also mentioned a recent paper shows it’s anti-inflammatory and anti-itch directly, as well as being antibacterial)
  • topical vitamin B 12 (water soluble) – pink magic

The takeaway advice he gave was don’t be afraid to use medicine so long as you have a doctor helping you.

 

I was having trouble finding full access studies but I did stumble across a PDF from the National Eczema Association about getting pregnancy, skin tips during pregnancy, and after pregnancy advice. It also talked about the likelihood of the baby getting eczema and things to hopefully prevent it.

The same study also mentioned that avoiding soap can also help decrease the disruption to the skin barrier.

In regards to when the mothers are postpartum, there can be challenges with breastfeeding if the mother develops eczema around the area. In that case, the study said low to moderate potency topical steroids can be used so long as they are washed off before the next breastfeeding.

 

(NEW) The National Eczema Association posted a new article May 2018 called Oh baby! Eczema from pregnancy to menopause that goes into more detail about why women may experience more incidences of eczema during pregnancy. It mentions how a researcher at the University of California-San Francisco (Dr. Jenny Murase) found that when a woman is pregnant, her body shifts from Th1-dominant to Th2-dominant immunity in order to protect the fetus (because Th1 attacks foreign material that get into our cells, aka it would attack the fetus since they have half of the father’s cells). Th2-dominant immunity means the mom’s body attacks allergens and whatnot that are flowing around outside her cells, protecting the fetus, but not helping when it comes to eczema. The blog post said that the shift from Th1 to Th2 is driven by the surge of estrogen. Perhaps that is also why women generally have higher rates of eczema than men? Unfortunately I couldn’t find the study that the NEA article cited so I can’t follow up with more, though I did find an abstract from Dr. Murase et al, that mentioned how psoriasis tends to improve during pregnancy correlating with those higher estrogen levels… so maybe one of the immunity-linked causes of eczema and psoriasis are opposite in origin?

My personal experience with being pregnant while having eczema has been that I have to be more mindful about how I treat my eczema relative to general lifestyle changes too. For example, no longer can I go and drink tons of kombucha (due to varying alcohol content and the light risk of bacteria), enjoy whatever random herbs I feel will help me heal, go jump into a hot yoga class unprepared (because getting dizzy affects another being besides myself), eat whatever fish I want whenever (I am a tuna fan and enjoy sushi when not pregnant), run and jump into a hot springs all willy nilly, etc. I have to be more mindful about sharing my body and not just jumping into whatever new protocol or thing I want to try out to help my skin. I can’t decide to just go on a particularly aggressive dietary change that involves caloric restrictions or drastic nutritional adjustments.

That being said, being pregnant has also had a lot of changes that might be helping my skin. In my first trimester I was very sugar and meat adverse, so I ended up eating a lot more veggies. Now in my third trimester I tend to crave veggies as a way to keep my guts feeling good, and to keep indigestion at bay. I also eat smaller meals more frequently, and don’t really accidentally binge eat big meals mindlessly, which is great because it means my body isn’t overtaxed in digestion (more time to heal the skin!). Pregnancy has me feeling a bit more tired (and much like with a flare, also avoiding high intensity activities), so I tend to stick to lower impact, longer duration activities like going for walks for miles or remembering to get in 100 modified push-ups a day.

Anyway, I’ll stop there and leave you with a current photo of me. I’m about 31 weeks pregnant now and you can see my arms and hands in particular are especially topically-challenged.

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REFERENCES

Crane, Margaret W. Oh, baby! Eczema from pregnancy to menopause. National Eczema Association, https://nationaleczema.org/oh-baby-eczema/. Accessed 30 Apr 2018.

Lawton, Sandra. “Pregnancy and eczema”. Exchange, https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=20&ved=0ahUKEwj3hO2D-9jaAhWmc98KHRNhAusQFgjGATAT&url=http%3A%2F%2Fwww.eczema.org%2Fdocuments%2F711&usg=AOvVaw2fS6lrX7fvyosOV1imHE4p. Accessed 30 Apr 2018.

Murase JE, Chan KK, Garite TJ, Cooper DM, Weinstein GD. Hormonal effect on psoriasis in pregnancy and post partum. Arch Dermatol. 2015 May;141(5):601-606.

Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health demographic factors: a US population-based study. J Allergy Clin Immunol. 2013 Nov;132(5):1132-1138.

 

Note: Some of the above links are affiliate links. This means that if you click on one and purchase an item, I will receive a small affiliate commission (at no cost to you).

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distraction, eczema, exercise and activity, skin biome, storytime

skin-healing magic dirt

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Here’s little bit of writing for fun that I came up with during a bout of insomnia this week.


My mama always said you need to dig deep to really find yourself. What I didn’t realize was that she meant it literally.

The first warm weekend in New England, I found myself at Home Depot, my eyes scanning along the garden shelves looking for that perfect plant to take home with me. I had finally coaxed myself out into the sunlight and had witnessed what the winter had done to my yard, and knew it was time to help it heal. It didn’t take long for some hardy flower types to catch my eye and I quickly placed a bunch in my cart and wheeled them to the register. On the way I paused to think if I should buy gardening gloves, but then decided again it.

Soon I was at home, kneeling on the lawn scraping away layers of rock and gravel and old stiff mulch from my beds. As I gardened bare-handed I realized the dirt was getting everywhere, in my tiny cuts, stuck along the dry skin flakes, immersing my hands in their loamy fertileness. Though it was nothing like soaking in a warm bath, I felt comforted by the sun beaming down and the dirt encasing my hands. It felt natural and right, even though my hands were no less dry than any other day.

Later that afternoon as I washed the dirt off with soap, I realized my hands were cracking less and less itchy post-wash, unlike my usual discomfort from water and soap encounters. Though I still applied moisturizer, the effects of my gardening had already reduced some of the more persistent symptoms of my stagnant eczema, and I felt good. Obviously it was no cure, but the benefits of getting down and dirty with the dirt seemed to be somewhat relieving from the usual eczema grind.

It was nice to know that my non-flares hands were still down in their under the scrapes and wrinkles and redness and flakes, even if I had to dig down in the dirt to get to re-meet them.

 

eczema, exercise and activity, my journey, topical steroid withdrawal

why do i have wrinkles on my knees?!

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My skin is going through what I believe to be another topical steroid withdrawal. My reasoning? I have excessive wrinkling on the extensor surfaces of my skin (I call this stage of skin my “elephant” phase, and I’m not alone; see the study here), and I was on a moderately potent steroid ointment for most of my body and a lower potent one for my face/crooks of elbows and knees when I found out I was pregnant. What finding out I was pregnant meant for my skin was that, because the more potent one was not necessarily safe for a growing baby, I was taken off of it earlier than planned and told to use just the lower potency one all over my body instead. Unfortunately my thicker skin areas were used to the higher one so the response was less than ideal and I ended up still flaring a lot as I did my low potency taper. I gradually phased out using the lower one despite some discomfort because having to use topical steroids over such a large surface area of skin does increase the risk of it being absorbed into the bloodstream, making it more likely to affect my baby.

So in a nutshell I had a fairly quick taper and now am cold turkey off all topical steroids again. The result has been interesting. This winter has dragged on which means I have been starved for vitamin D, more sluggish from being trapped indoors, and cold. Whenever I have a withdrawal, my skin is hotter to the touch because it is acting as an impaired barrier and letting my core temperature heat go. The result? I am a grouchy popsicle of a human.

Luckily, we have finally seen a break in the northeast chill, and I was able to enjoy the weekend basking in the sun and walking for miles. Hopefully getting outside and playing more will help me get my skin back to its old equilibrium before the baby comes.

Nighttime presents its own problems. Though I am less stressed about losing sleep nowadays (having a remote job helps), I do find that physically sleeping is still a trigger. The last few days I have had hives that appear on my back when I am in bed (but not in the same part of my back each day which would have made me think it was my sheets or  lotion). I also tend to get heat rash-like symptoms on whatever side of my body I am laying on, or even if I roll over to lay on my back for a bit. I haven’t figured out why that is, but it’s extremely irritating and usually affects my IT band area on my legs the most. And naturally since I am awake weird hours, I notice how my skin dries out as the night goes on (but I am usually too tired to actually get up and re-apply another coat of lotion/moisturizer).

My methods of combatting this withdrawal flare are the following:

  1. keeping calm. I have been extraordinarily unfazed by my skin this time round. I am not worried it will never heal, and I am not worried when I miss sleep (I just try to take more cat naps later on or go to bed the next day at crazily early times like 5pm).
  2. diluted bleach baths. I tend to take one many once every one or two weeks just to make sure I keep the potential infections at bay. I usually know when I have had bad scratching bouts or see signs of what I think may be early infections, and I decide when to do these baths by those feelings.
  3. sugar reduction. Yes, despite being a sugar-lover, I am trying to cut down on added sugars. I don’t even put sugar in my oatmeal anymore (instead I cut up a fresh green apple into it or add berries if I have them). I let myself have one treat on Saturday and Sunday, but I make it so I have to work for it (like walk 2 miles to get the treat, then walk back).
  4. finding a good product for the skin presentation. Lately I’m hooked on Exederm’s daily care moisturizer. It doesn’t stop me from still drying out and flaking but it also usually doesn’t burn or cause excessive itching (except sometimes at night, but my skin is an unpredictable animal at night).
  5. living the “motion is lotion” motto. I have been trying to increase my NEAT (non-exercise activity thermogenesis) meaning I have been trying to reduce the time I am a sedentary lump. The warming weather is helping (I will happily walk anywhere in my town even if it is a 1-3 mile walk one way), and I have been doing a 100 push-up challenge every night before bed (I do modified pushups as my belly has been getting bigger!). I also started incorporating more hip workouts and squats/lunges to keep my legs in shape as this baby grows. All in all, “I like to move it, move it”.
  6. showers first thing. When I get up from bed (which sometimes is a struggle in itself), I get into the shower to start my day. One, I find it therapeutic, the feeling of water. Two, it helps me soften the skin and wash off some of the dead skin so that the lotion/moisturizer can be better absorbed. Three, it bases me in a routine.

All in all I feel like I am handling this withdrawal much better than previous ones. My skin has more or less remained skin-colored this time (instead of reddening everywhere). I’ll give updates if it starts to subside or if it gets worse in time.

Oh and here is a photo of what I mean when I say I have elephant skin (this is my right knee):

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REFERENCES

Sheary B. Steroid Withdrawal Effects Following Long-term Topical Corticosteroid Use. Dermatitis. 2018 Jul;29(4):213-218.

distraction, eczema, exercise and activity, flare-up

baby and the beast: caretaking with eczema

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So many searches come up with how to be a caretaker for a person or child with eczema, but I haven’t heard from, or found research more about the challenges and options for when the caretaker is the one with eczema.

This week I am watching my baby cousin. He’s about 7 months old now and his mom leaves him with me starting around 7am until anywhere from 6-8pm. It’s my first time watching an infant and though he is a delight, today required some adjustments to my routine as I overslept. Normally, when I have a rough night, I can sleep from 6-8am and catch up on some of the lost time. And then the first  thing I do when I get out of bed is take a warm shower and then apply lotion (as it helps my skin absorb it better when I shower first. Also for those interested, I am currently using Exederm lotion as my go-to).

Today however, I failed to get up before my cousin had to leave so instead I just rolled out of bed and got the baby, dry flaky skin and all. As I haven’t had enough time to zip off to take my usual shower, because I obviously can’t leave him alone for long periods of time (and I am not familiar enough with his nap schedule to know if I have enough time to shower during one), the day has come down to being a lot of a mind over matter deal about my skin. Yes I still itch, and my hands especially are quite dry, but mostly I’ve focused on the mini wheat, and by doing so I have been able to ignore my own normal tweaks and discomforts. There’s actually a fair amount of studies that show that being able to have a distraction helps decrease the itch sensation due to how itching is perceived via the brain (but more on that in a post coming soon about addiction to scratching).

Though I understand the necessity of taking care of oneself physically and mentally, before others (such as with the oxygen masks on airplanes), I do recognize when handling my skin is less than urgent. Yes, I am dry and theoretically could desperately use some more lotion, but I feel well enough that I can handle waiting to do my usual routine until tonight. That being said, after changing his diaper I did have to wash and soap my hands thoroughly which caused some cracking so I did apply lotion then. The rest of my body is holding up well enough in the meantime.

Plus the advantages of babysitting an infant are that they keep you up and moving. I probably feel relatively good because I haven’t stopped moving around with him, adding validity to the “motion is lotion” mantra. Although sweat-inducing physical activity has been seen as eczema-provoking, overall it seems there still hasn’t been enough research done to figure out what kinds of exercise are the best for people suffering from eczema. Research for moderate, non-sweat-inducing activity helping eczema has been fairly supported by organizations like the National Eczema Association, which encourages trying low-intensity activities such as yoga, tai chi, pilates, walking, and gardening. I’d love to take my cousin out for a walk but it’s currently 45F and down pouring so I’ll settle for doing some squats with the extra baby weight. 🙂

I think one of the most important things when you have a flop day in terms of your care of a chronic (non-fatal) disease is to not get too stressed out. As we all say, life happens, and so sometimes it’s best to just roll with the punches and let that bad day pass on by. So long as it doesn’t become a habit of mis-care to yourself, you’ll most likely be okay.

And so, all in all though I look like a ragamuffin and clearly didn’t take proper care of my skin today, I am not upset and I know I’ll survive one less than ideal day.

Are there any other caretakers (parents, guardians, babysitters, senior home workers, etc) who suffer from eczema and have had to forgo their usual skin care every now and then in order to take care of someone else?

 

REFERENCES

Fuller, John. “Eczema and Exercise: The challenge of enjoying exercise without exacerbating your eczema can be a delicate balancing act.” National Eczema Association, https://nationaleczema.org/eczema-exercise/. Accessed 16 Apr 2018.

Kim A, Silverberg JI. A systematic review of vigorous physical activity in eczema. Br J Dermatol. 2016 Mar; 174(3):660-662.

Mochizuki H, Kakigi R. Itch and brain. The Journal of Dermatology. 2015 Aug 5;42(8):761-767.

eczema, food and nutrition, sugar

skin deep it’s not so sweet: all about sugar

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[For background context: I am currently still interning with EChO-Eradicate Childhood Obesity Foundation, and so I spend a lot of time thinking about and researching sugars].

Ask anyone- I love sweets. I’m pretty indiscriminate about what types (though I tend to prefer baked goods to pure candy). At either rate, one thing I have worried about over the years (and not necessarily due to any scientific reasoning) was that my previously very high sugar consumption as a child/teen had somehow contributed to my global body eczema flares now (despite not eating as much sugar these days). This has led me to be particularly interested in researching more about sugar, and it’s potential links with eczema.

So let’s get into the nitty-gritty about sugar. The term sugar, much like the term bacteria, often gets a bad rep. Sugar is a type of carbohydrate (the others being polysaccharides and oligosaccharides), that is best defined as either monosaccharides or disaccharides (‘saccharide’ means ‘sugar’). Monosaccharides include simple sugars like glucose (dextrose), fructose (levulose), and galactose. Disaccharides includes sucrose (or what we know as table sugar) which is made of glucose and fructose, maltose (a sugar from grains made of 2 glucose molecules), and lactose (a sugar from milk and made of glucose and galactose). You may have heard fructose (the sugar that makes fruit sweet) getting a bad rap, and that’s because the way the brain processes fructose versus glucose differs. Studies done on rats show that when glucose was consumed, a “satiety” response eventually kicks in because glucose triggers the hormone insulin to be released, but when fructose was consumed, there wasn’t enough of an insulin response to cause the same feeling of satiation. What does this mean globally? Well, consuming fructose sugars may take longer for you to feel full or done eating, and so as a result you are more likely to eat/consume more of whatever food/drink it’s in before you feel done. But why are fruits okay to consume (in moderation)? Because they are packaged naturally with fiber and other nutrients and are not just added fructose (think like how many products, like sodas, often have/had high fructose corn syrup, or extra fructose in them but no fiber or other healthier aspects to balance them out).

It is also worth noting about polyols. Some sources consider this to be a type of sugar (such as the World Sugar Research Organization), while others say it is not a sugar, but it is a carbohydrate (Polyols Organization). Polyols can sometimes be called ‘sugar alcohols’ because their structure looks somewhat like a sugar molecule and somewhat like an alcohol molecule. Polyols include: erythritol, hydrogenated starch, hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol. They are seen as a new alternative to sugar because they don’t spike blood glucose levels, and they generally have fewer calories per gram. Currently the warning with them is that they may make still be addictive and cause people to consume larger quantities of foods that contain them and/or start to dislike products that don’t have them. The adverse side effect listed by the FDA of excess consumption of polyols is usually related to digestive issues (gas, bloating, diarrhea, etc). Anyway…

The function of sugar in our bodies is to produce energy. When we eat carbohydrates our body breaks it down into glucose and uses those molecules to do important functions like activating our muscles. However, the rates at which sugar affects our blood sugar levels varies. Simple carbohydrates (like sucrose, or table sugar) increases our blood glucose levels quickly, while complex carbs (whole grains, beans, etc) affect blood glucose levels more slowly. In this case we have another example of how slow and steady wins the health race- fast blood glucose level spikes means insulin is released quickly (insulin is used to help cells take in glucose), as a result, you’ll want more sugar again more quickly after eating a blood glucose spiking diet and also, diseases like diabetes and heart disease are related to blood glucose level spikes.

So why are some sugars considered worse than others? The term “added sugars” is a more recent addition to our nutrition world vocabulary and is used to talk about when products include sugars that are not naturally in food (such as when we add a table sugar to the cake batter we are making for a birthday). For example as mentioned before, fruits contain the sugar fructose, but it is considered a natural sugar because one, it is naturally created by the fruit, and two, because it is packaged in the fruit with a balance of fiber and other micronutrients. The problem is that a lot of our processed foods have more added sugar than we think, and dietary guidelines about how much sugar we should maximally eat in a day are being exceeded (according to the American Heart Association, women should eat no more than a total of 6 teaspoons of added sugar a day, and men no more than 9 teaspoons). So if you had a seasonal tall (aka a small) Starbucks Pumpkin Spice Latte this fall with 2% milk and no whipped cream, you consumed about 37 grams of added sugar, or 7.4 teaspoons, exceeding the max a women should have in a day and getting close to the men’s max as well, with one beverage.

But how does sugar impact skin? It affects it in a few ways: by causing inflammation, by aiding candida infections (people with eczema often have a higher risk of candida infections), via glycation, and by messing up our sleep.

When it comes to inflammation, the issue tends to be that sugar (fructose in particular) as its metabolized by the liver can cause free radicals to be made, which are known to cause inflammation. Inflammation results in cell damage, and with a condition such as eczema where your body is already in hyperdrive of attacking its own cells, increasing cell damage is the last thing you want. Interestingly enough, studies on rats have shown that strength training helps to control inflammation even with a high-fructose diet, but I’ll talk about exercise and activity in another post.

Candida albicans is a type of yeast (or fungus) that many healthy people carry orally, and can be non-pathogenic if there is not an overgrowth of it. When there is too much (or any other type of Candida yeast), the condition is called candidiasis. Though there are many reasons for why we’ve seen an increase in candida infections, some of the major culprits are increases in antibiotic use, use of topical or oral corticosteroids (or other local immune suppressors), as well as refined sugars changing our pH, and allowing for easier growth of this yeast. The problem with candidiasis is it can lead to bloodstream infections, and it can cause increased production of acetaldehyde, a chemical that breaks down DNA and impairs cellular repairs. Now it stands to say again that sugar isn’t the only cause for increased risk of candidiasis, but in tandem with taking corticosteroids and antibiotics, it doesn’t help.

Glycation (or more technically described as advanced glycation end products, or AGEs), are products created by a reaction called the Maillard/browning reaction- a reaction that occurs in normal metabolism, but if too many AGEs are made that’s when it becomes a problem because they can increase inflammation and oxidation stress in the body. Usually, AGEs are released by cooking animal-based foods at high heats, more so than by cooking fruits, veggies, whole grains, etc (unless the fruits/veggies/whole grains are made with added fats, in which case the dietary AGEs are also drastically increased). Increased AGEs can also impact collagen and elastin production (due to the oxidation effects), which would impair wound healing. So how does this relate to sugar? Well sugars such as fructose, in combination with some animal protein components heated together increases the dietary AGE production. A low dietary AGE intake, much like a low sugar diet, can help fix insulin sensitivity and improve wound healing (especially with the subsequent decrease of inflammation that occurs). But if your snack/sweet of choice are baked goods made with animal/protein-rich products and includes fructose, chances are you are upping your AGEs, therefore decreasing wound healing, increasing inflammation, and impairing insulin sensitivity.

And lastly, sleep. Simply put, if you eat a lot of sugar, your body has to spend more time trying to convert it into energy and/or store it as fat, and so if you are eating enough to have the ‘food coma’ effect at night, chances are you are slowing your body’s recuperating abilities as it spends the time trying to handle sugar, instead of focusing on general repairs (such as healing eczema rashes and cuts). When we ultimately hit the sugar crash point, our bodies produce cortisol, which results in a higher heart rate, and subsequently less good sleep. Ironically it’s a cyclical pattern. The more you lose good sleep, the more likely you may be to crave sweets!

So the takeaway? Sugar (and specifically added sugars) definitely don’t help eczema, especially when eaten in excess.

 

REFERENCES

Aubrey, Allison. “Sugar and Sleep: More Rest May Dull Your Sweet Tooth.” National Public Radio: The Salt, https://www.npr.org/sections/thesalt/2018/01/18/578604700/sugar-and-sleep-more-rest-may-dull-your-sweet-tooth. Accessed 12 Apr 2018.

Botezelli JD, Coope A, Ghezzi AC, Cambri LT, Moura LP, Scariot PPM, Gaspar RS, Mekary RA, Ropelle ER, Pauli JR. Strength Training Prevents Hyperinsulinemia, Insulin Resistance, and Inflammation Independent of Weight Loss in Fructose-Fed Animals. Scientific Reports. 2016 Aug 4;6(33106).

Gainze-Cirauqui ML, Nieminen MT, Novak Frazer L, Aguirre-Urizar JM, Moragues MD, Rautemaa R. Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders. J Oral Pathol Med. 2013 Mar;42(3):243-249.

“Healthy Eating Tip of the Month: Does Sugar Feed Cancer?” University of Michigan, https://www.med.umich.edu/pfans/_pdf/hetm-2016/0416-sugarcancer.pdfAccessed 12 Apr 2018.

Lawson M, Jomova K, Poprac P, Kuča K, Musílek K, Valko M. Free Radical and Antioxidants in Human Disease. Nutritional Antioxidant Therapies: Treatments and Perspectives. 2018 Mar 11;283-305.

Ott C, Jacobs K, Haucke E, Santos AN, Grune T, Simm A. Role of advanced glycation end products in cellular signaling. Redox Biology. 2013 Dec 19;2():411-429.

Page KA, Chan OC, Arora J, Belfort-DeAguiar R, Dzuira J, Roehmholdt B, Cline GW, Naik S, Sinha R, Constable T, Sherwin RS. Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved with Appettite and Reward Pathways. JAMA. 2013 Jan 2;309(1):63-70.

Patil S, Rao, RS, Majumdar B, Anil S. Clinical Appearance of Oral Candida Infection and Therapeutic Strategies. Front. Microbiol. 2015 Dec 15.

“Sugar 101.” American Heart Association, https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/sugar-101#.Ws9onWbMzowAccessed 12 Apr 2018.

“Sugar Alcohols.” FDA, https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/sugar-alcohol.html. Accessed 12 Apr 2018.

Uribarri K, Woodruff S, Goodman S, Cia W, Chen X, Pyzik R, Yong A, Striker GE, Vlassara H. Advanced Glycation End Products in Foods and a Practiacl Guide to Their Reduction in the Diet. J Am Diet Assoc. 2010 Jun;110(6):911-916.e12.

“Your Questions Answered.” Polyols, https://polyols.org/frequently-asked-questions/. Accessed 12 Apr 2018.

 

eczema, topicals

eczema product reviews: lotions and moisturizers

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I think one of the universal aspects of having a skin condition is you get used to using a bunch of different topical creams and lotions and ointments. At this point in my life, I am no stranger to the variety of products in the market (though new ones are always being developed) and I’ve formed my own opinions about what works or doesn’t work for my skin (though that also varies depending on what stage my skin is in at the moment).

A+D – First Aid Ointment: Generally, I use this much like I use Neosporin (mostly for cuts and scratches). This does have lanolin which can cause allergic reactions for people. I think this works fine if you don’t have allergies, though it’s too sticky to apply over the whole body. I think Neosporin generally works a bit better (maybe because it usually has a type of antibacterial in it?).

Aquaphor Advanced Healing Therapy Ointment Skin Protectant: I’ve used this brand and the retail store-brand versions. This feels a bit like applying Neosporin to the skin, but more watery. Generally it didn’t feel bad on the skin, but was a bit sticky. Overall, it didn’t really help me enough to keep moisture in to warrant repurchasing it at the time, though I wouldn’t mind using it again if I had another bottle of it lying around.

AveenoActive Naturals Daily Moisturizing Lotion: I find this type to be a bit watery, and it tends to burn a little bit if the skin is raw. To be fair though, I haven’t tried a lot in their line besides this particular product. Apparently their Aveeno Eczema Therapy Moisturizing Cream helps improve the diversity of the skin’s biome.

Avène Eau Thermale Avène Skin Recovery Cream: I actually haven’t tried this brand at all yet, but I have heard good things about it, and this cream I would love to try. Avène has a spring called Saint Odile in France that apparently has very lovely healing properties, and so spas and other treatments have developed there using the water, including hydrotherapy. There is also an Avene company in the USA, which I think also uses the water from France.

Burt’s BeesShea Butter Hand Repair: I’ve been using this along my whole body and generally love it. It is a little thick, but as you spread it, it melds well into the skin and is pretty effective as keeping some moisture in so long as I wear layers over the skin. Downsides is the amount isn’t made for someone using it along their whole body (and technically isn’t made for the whole body as it’s a hand cream!).

Cera Ve Moisturizing Cream: I’ve used a variety of their products. While I have no complaints with them, they are generally a bit too pricey for me for the amount I need and don’t offer as good of benefits as other brands. When I did buy it, I usually went for the bulk size one to get the best price per quantity.

CetaphilMoisturizing Cream for Dry/Sensitive Skin: Generally feels like a watered down Cera Ve. I’m not a huge fan of them. Note: A friend recently told me that Cetaphil products contain almond oil- so for those with a nut allergy, this is not the lotion for you!

(NEW!) Chuckling GoatCalm Down Kefir Lotion: I use these for the inflamed days as it seems to help dry out the excess heat and redness. It doesn’t help keep in moisture so I use it early in the day and then apply something stronger to keep in moisture later on. It goes on fairly gently.

(NEW!) Chuckling GoatSoothing Kefir Lotion: This one smells nice but didn’t feel as good as the Calm Down version.

Coconut Oil (pure) –  Vita Coca Organic Virgin Coconut Oil: I’ve heard great things about the benefits of coconut oil for keeping staph infections at bay and helping to reduce a lot of eczema symptoms. Personally I do like using coconut oil but it feels like it doesn’t absorb as well in to the skin, and it doesn’t really provide lasting moisturizing effects throughout the day so I have to use it with something else. It does seem to help with skin redness though.

ConquererSoothing Dry Skin Balm: This is Abby Lai’s brand (of Prime Physique Nutrition) and lately I am loving it. When my skin is cracking, this is one of the few products that can help calm the skin down, though it does take a while. My only complaints would be the size of the container (I’d love a larger tub of it), and that it is somewhat grainy and so it took a lot of rubbing in to get it to melt into the skin. The latter isn’t a deal breaker though- and I’m not sure if it was just my container from heat or cold transportation that caused it to become so granular.

Curél Ultra Healing Lotion: I have used this product a few times but so intermittently that I can’t really accurate review it. It feels nicer on application than Cera Ve and Cetaphil.

DoveDermaseries Eczema Relief: This is Dove’s new line. I generally like it though it is more on the lighter scale. It’s a bit pricey and also doesn’t last as long if applied after a shower/bath as I would like.

(NEW!) Eczema HoneyHoney Natural Healing Cream: This one tends to provide a better barrier and seal in moisture, plus the honey works as a natural antibiotic. The downside is that it separates from the oil in the mixture pretty quickly so I have to stir it a bit before use. Also, as it is mostly honey, it’s sticky!

EucerinAdvanced Repair Cream: This is one of the lighter types of their line. I liked it because the normal Eucerin was just too thick (and also didn’t absorb well into the skin if the skin was wet/damp). This version however, can tend to burn on application.

(NEW!) Exederm – Eczema Care Daily Lotion: I recently came across this in CVS and gave it a go because it was endorsed by NEA. I found that it really did help relief the intense dry/cracking I have been having, especially with my hands, but it doesn’t last long as a moisturizer (but to be fair, I got the daily lotion, not the daily moisturizer). All together I am using this product almost exclusively now and am pretty happy with it for the dry/cracking/wrinkly skin face (google TSW knee/hand/wrist wrinkles for an idea of what my skin looks like during this phase). The one down side is, this product tends to be hard to find and not in many stores yet (or at least not that I’ve seen).

(NEW!) Exederm Intensive Daily Moisturizer: I’ve been using this product a lot (pretty much exclusively for a few weeks now). It isn’t too watery, and coats my skin nicely and does get absorbed well. I’ve noticed it can cause me a bit of itchiness if I apply it after a hot shower/bath (which I technically should be avoiding anyway), but other than that it’s currently my favorite product.

L’OréalParis Collagen Moisture Filler Day Night Cream: I grabbed this because I was looking for a creme to apply to my skin that contained collagen. This one is okay. It is quite fragrant which I’m not a fan of, and it tends to dry me out after application within a few minutes. Overall I don’t think I’d buy it again, though if I couldn’t find any other collagen-infused creams I might repurchase it.

(NEW!) MG 217 – Eczema Body Cream with 2% Colloidal Oatmeal: This is a newer one I’ve been trying. It has a smell that reminds me a bit of menthol and it feels a bit stickier when it goes on, but it generally doesn’t burn and it dries quickly. I like it because it feels like it coats the skin evenly, but it often is unable to help me stop my drying out when I’m in that aggressive phase of that stage. All things considered I will be getting it again.

NeosporinOriginal First Aid Ointment: I generally only use this for cuts or deeper scratches, and then try to cover them with band-aids to keep in the moisture. Neosporin generally feels good on the skin (no burns or anything- and some types contain pain relievers), but is quite oily and I wouldn’t suggest it for use for the whole body. I do use it overnight a lot when my hands and feet are cracked

Reviva: Collagen Night Creme: I do enjoy this collagen cream, though it only comes in small quantities. It helped reduce a pretty red flare that was starting on my face in two days, which was a great relief. I usually saved it for my face and hands because it does come in so little amounts, but I think it helps overall.

Sunflower Oil (pure) – Spectrum Naturals Organic: Sunflower oil also has studies supporting its use for people with eczema (so long as you don’t develop an allergy to it). It is a bit of a hassle to apply as it is a pure oil, and it does dry pretty quickly, and overall I don’t dislike it. I don’t really use it anymore because I did develop an allergy to it over time.

VanicreamMoisturizing Skin Cream for Sensitive Skin: I received samples of these to try from my phototherapy sessions. They didn’t burn during application which was nice, but they did feel a bit watery and didn’t real help retain moisture.

Vaseline Pure Petroleum Jelly: I have mixed feelings about Vaseline (and in generally petroleum jelly). In general, I hate the feeling of being sticky and having to apply it is a nightmare. When I do use it, I use the pure thick stuff and it used to help keep moisture in my skin but more so when I was on antibiotics and oral steroids. When I’m not on those medications and/or when my skin is not flaring, I find Vaseline to be too much and it often makes me breakout in acne. When my skin is flaring too aggressively, Vaseline tends to trap heat better than it traps moisture. Lately I tried it when my skin was unbearably dry and nothing was working, and Vaseline didn’t help. It just made me feel sticky.

YORO NaturalsOrganic Manuka Skin Soothing Cream: I am loving this product. It feels a little more sticky than the usual culprits (like Exederm), but it keeps my skin hydrated longer. It smells pretty good as well. My only complaint is that it comes in such small amounts.

I’ll add more products to this post as I use more (or remember which ones I’ve used in the past).

 

Note: Some of the above links are affiliate links. This means that if you click on one and purchase an item, I will receive a small affiliate commission (at no cost to you).

eczema, lymphoma

worried about lymphoma?

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One of the most frustrating aspects of having chronic atopic dermatitis is that many of the symptoms overlap with Hodgkin’s lymphoma, but since the latter is rare, it is seemingly unlikely that a person will have it while also being difficult to have enough concrete signs and symptoms that a doctor will feel it warrants further investigation.

For example, the primary symptoms of Hodgkin’s described by the cancer organization are enlarged lymph nodes (especially in the neck, armpit, or groin), intermittent or constant fever, night sweats, weight loss, itchy skin, loss of appetite, and tiredness. Chronic eczema for me has hit virtually all of those but a fever (and I never have fevers even when I am sick… in fact I didn’t even have a fever when I had a staph infection in my lymph nodes some years back!).

The other rub (possibly because of the overlap of symptoms with eczema) is that Hodgkin’s is generally not detected early on, and so unless symptoms changed drastically over a short duration (which I’m not sure this type of cancer does), it would be hard to know if what I had was Hodgkin’s or just another day of swollen lymph nodes, without getting a biopsy of said lymph nodes to confirm. Even then, apparently it can be necessary to need multiple samples to track what’s happening with the lymph node over time.

This is why I believe it is crucial to one, keep track of your own symptoms and body and immediately go in to see someone when something feels off. You are the only person that lives in your body and so it is important for you to be able to track what is going on because no one else will have the lifetime of records that you do. Two, it is so important to find a PCP/provide who you trust and feel able to develop a working relationship with as time goes on. It is necessary to build this relationship over time and feel confident that you are being heard, and always ask questions when you don’t understand or aren’t sure what will happen next. A lot of the preventative care comes from making sure you are ready and informed about what is going on with your body.

I’m currently on that second stage- working towards getting a new PCP (as I recently moved into a new town), in order to establish some kind of plan to understand when my symptoms are just eczema, and when they could be indicative of something more.

Today, I had a check up at my OB/GYN office where they gave me the glucose test (you drink a really sugary drink and they draw your blood an hour later to see if you produce enough insulin to handle the drink). Along with the blood draw testing my insulin levels, I got back data on my WBC, RBC, and the breakdowns. Apparently I have higher than average WBC, and a variation of out-of-range monophil, lymphocyte, esophil, and neutrophil levels that basically make it seem like I am fighting a bacterial/fungal infection or something of the sort, but also still could fall into the realm of someone with lymphoma. So in a nutshell I am still destined to schedule a PCP to try and make sense of all this data and see if there is a cluster of data points that would help more or less clear up the sensitivity or specificity of whether or not I need to get checked for lymphoma.

 

REFERENCES

“Signs and Symptoms of Hodgkins Lymphoma.” American Cancer Society, https://www.cancer.org/cancer/hodgkin-lymphoma/detection-diagnosis-staging/signs-and-symptoms.html. Accessed 4 Apr 2018.