alternative/holistic medicine, books, career, eczema, flare-up, my journey, skin care, sugar, topical steroid withdrawal, wounds and infections

“and now for something completely different”

mountains nature arrow guide
Photo by Jens Johnsson on Pexels.com

Remember how I did a post yesterday about my skin care regime? Yeah ignore that. Much like how lives change, the way I take care of my skin is almost as fluid as my skin itself. Let me explain.

Yesterday I was talking about how I was using two products (Eczema Honey Co.’s Nut-Free Natural Healing Cream and Chuckling Goat’s Calm Down Kefir Lotion), and talked a little about them both. Well last night, Fi was fighting the sleep hard and I couldn’t get her down until around 11pm (after trying for 3 hours!), which meant that I didn’t get to catch up on the massive sleep deprivation from the night before. While I was trying to get her to calm down and sleep through various means, I was using the Chuckling Goat lotion on some dry areas (hands, feet, knees) to help work through some light itching. Finally, the little piglet stayed asleep when I put her down and I thankfully succumbed to my own exhaustion, only to be woken up around midnight by myself scratching the sh*t out of my hands, arms, and feet. It was so bad I could feel my skin starting to weep. Here’s a picture of the aftermath on my hand:

2018-10-17 20.21.01.jpg

When I woke up enough to realize what I was doing, I took some Benadryl and waited for it to kick in and knock me out. But then I had to wake up at around 3am because Fi has been big into not sleeping through more than 4 hours at a time lately, which was rough (I don’t know if you’ve ever tried to cut your sleep short when taking Benadryl, but it is hard to mentally function afterwards).

Today I started the day off (once the Fi routine was completed) with another bleach bath to help level out my skin, followed by rinsing off using the Chuckling Goat Calm Down soap bar, and then using the Eczema Honey Co cream again. I am still very much enjoying it, in fact, it’s time for a mini review!

Eczema Honey Co is a company where the founders live with eczema themselves (always a plus because you know they are actually experiencing the condition they are treating). They currently have 4 products: their original cream, their nut-free (no almond oil) version, an oatmeal scrub, and cotton gloves, and the cool thing about their line is that they have a monthly subscription, which is lovely because when you have eczema all over your body, you know that you’ll need a lot of product. The one I am using is there nut-free cream and so far I love it. It’s only got a few ingredients (Organic Pure Honey, Grapeseed Oil, Organic Grated Beeswax, Organic Sunflower Oil, Colloidal Oatmeal, Pure Spring Water, and Optiphen), which makes it easier to understand what I’m putting on my body (aka looking up the studies on how specific ingredients affect skin). This is an important factor to consider because our skin is quite absorbent and things we put on it can end up in our hypodermis and/or our blood stream (and this is even more true for people with compromised skin like those of us with eczema). Of note: optiphen is a chemical made of Phenoxyethanol, Caprylyl Glycol, and Sorbic Acid, and the biggest concern with it seems to be that it can be a skin irritant according to EWG Skin Deep Cosmetics Database. My opinion on the product overall is that it seems to be the best thing I have tried up to now. I put it on after baths or showers and it tends to hold in the moisture best like I mentioned in my post yesterday, and it smells nice and seems to be helping reduce the major TSW signs: the redness, the dryness, etc. Jury’s still out as to whether it is helping with the itch (currently it seems my itching is worst 11pm-4am and nothing can fix that minus taking Benadryl to knock me out). All in all I think for now, especially given that I have only used it for a few days now, this is the product I am going to stick with and see where it takes me and my skin. The only less than positive comment I have is that it is a bit sticky, but it’s mostly made of honey, so that’s expected. All in all I’m giving it two thumbs up so far.

Now why do I think I am enjoying this Eczema Honey Co product? It may jusr be because their first ingredient is honey, and honey historically has been used topically to treat wounds. The evidence is still a bit iffy on how effective honey really is on wounds other than partial thickness burns, with some studies toting the antibacterial properties when used for wounds (studied on the wound of a stumptail macaque), and other saying that honey can slow healing (of venous ulcers in particular). But all in all, as with most things, I think it comes down to using what you feel is comfortable (and consulting an open-minded medical professional who you can discuss your concerns and questions) to determine what you want to use for your care.

Speaking of skin (which I almost always am), I am currently reading The Little Book of Skin Care: Korean Beauty Secrets for Healthy, Glowing Skin by Charlotte Cho. So far I’m enjoying it immensely, as it goes into detail about how the Korean skincare regiment works in a nutshell, as well as how the mentality of it differs (Cho says that Koreans enjoy their skin care and don’t think of it as a chore). I am trying to think about how those of us living with eczema/TSW could learn to love our skincare regimes. It feels like such a foreign concept, but I can see how it would be an immensely helpful part of healing. So, I am thinking about how to apply what I’m reading in the book to myself and if it works, subsequently to the eczema/TSW community. Keep your eyes posted for that in a bit!

I also wondered if there are estheticians that specialize in eczema/TSW, because that would be awesome. Another idea I had was that if in some world I could learn Korean, it would be awesome to go to South Korea (with my sister who has been studying Korean for years) and experience their skin care ways for myself. But that’s a pipe dream.

On a complete and utter tangent, all I dream about lately is eating That’s It Bites, the blueberry ones in particular. But actually. I go to sleep wanting them, I wake up wanting them, and then when I am sitting around during the day, especially if I get a little bit hungry, I crave them so badly. I think I’ve latched onto them because:

  1. That’s It bars are so good
  2. blueberries are some of my favorite berries
  3. the chocolate truffle version is delicious, particularly the blueberry one
  4. they don’t have any other ingredients in them besides blueberries, apples, and dark chocolate (cocoa, cane sugar  and cocoa butter), and I’m not eating sweets with ingredients I can’t track

So basically if you are ever feeling like you want to send me something nice… send me those – insert winking face here – !

Anyway, in regards to the title of today’s post, what I meant by taking a new direction is that I am trying to figure out what my focus, both hobby and career-wise, will be. I am accepting that my skin is going to be the limiting factor for a while to come and in that interim I am trying to figure out what I can do, not just in the meantime, but potentially forever. I want to be able to start to commit to things again and know that I’ll still be able to do them even with the worst of flares. I know I’ve dabbled with writing for a while, but now I am thinking of taking it seriously (Glob help me!). If you know of any opportunities, let me know (this is my desperate reach out to the universe)!

Tangential parting thoughts: Did anyome know the reference I made with the post’s title? I credit my dad for why things like that are still stuck in my head today.

 

REFERENCES

Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for acute and chronic wounds. Cochrane Database of Systematic Reviews. 2015 Mar 6;(3):CD005083.

Jull AM, Walker N, Deshpande S. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD005083.

“Optiphen.” EWS Skin Deep Cosmetics Database, https://www.ewg.org/skindeep/ingredient/732140/OPTIPHEN/. Accessed 17 Oct 2018.

Staunton CJ, Halliday LC, Garcia KD. The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides). Contemp Top Lab Anim Sci. 2005 Jul;44(4):43-45.

 

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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alternative/holistic medicine, eczema, exercise and activity, flare-up, food and nutrition, my journey, NEA, pregnancy, relationships, skin biome, skin care, sugar, topical steroid withdrawal, topical steroids, topicals, women's health, wounds and infections

how my skin made me take the road less traveled

gray pathway surrounded by green tress
Photo by Skitterphoto on Pexels.com

Today’s post is all about trying to convey what life with eczema is like for me. The first thing I need to stress is that my condition was not always this severe. I can remember a “before”, as my condition didn’t start affecting my skin globally until I was 21 or 22.

So how has eczema affected me?

  • insomnia – Some nights I was unable to sleep until 6am. More recently off and on I have difficulty sleeping from midnight to about 6am.
  • food paranoia – Given that I have legitimate food allergies to peanuts, pistachios and cashews, I know how to deal with food allergies that cause anaphylaxis. What I don’t know how to deal with is the thought that some common food might have developed into being the cause for the severity of my skin issues. Also sometimes I’ll eat something that is usually fine for consumption, and I’ll break out in hives in my mouth inexplicably and the next time I consume said food, it won’t happen.
  • many different diets – I have tried the gambit of elimination diets, auto-immune diets, vegetarianism, paleo diets, sugar-free diets, low-carb diets, detox diets, etc).
  • food-related social repercussion – You have no idea how frustrating it is to have people think I am “just being picky” when I am avoiding certain foods or diets. It’s usually when I’m avoiding gluten, dairy, or soy or other common American-diet staples. What I don’t understand is why people think I enjoy avoiding these foods… do they not know my undying love for pizza and ice cream?
  • intimacy issues – picture not being able to cuddle on the couch while watching a scary movie without covering myself in a blanket to make sure my skin doesn’t touch my husbands. Long drawn out hugs? Nope.
  • skin-to-skin with baby issues – I have adapted to the lifestyle of needing to put a barrier between me and my baby’s skin. When I feed her, I throw a cloth on or wear long sleeves before I put her head on my arms. When I have her in a carrier, I try to put a layer between her face and my chest, or else I know I’ll have to take her out earlier as my chest will start turning red, flushing, and itching.
  • exercise limitations – Up until my junior year of college I was doing many different sports and activities including soccer, track and field, long runs on my own, ultimate frisbee, generically running around like an idiot, etc. Post-eczema life, unless I can get a flare to calm down for months, cardio is a nightmare. Hell, at this point in time, just going for a long walk in the summer induces itching everywhere that takes at least 10 minutes in an air-conditioned building to relieve.
  • summer nightmare – See what I mentioned about walking above and now just add that to general life in the summer. I do well if I don’t move, and if I avoid direct sunlight. Though I also need sunlight for vitamin D (and in my previous life I loved the sun) so I’ll pop outside for a few minutes to bask in the sun’s warm embrace and then I’ll overheat and have to come inside. At least the itching only starts if I sweat.
  • pain (cracked skin) – During certain stages of a flare I dry out (especially at night or after washing my hands or other random times) and my skin will crack. The worst areas are my hands (which will fissure all over) and my ears, as well as sometimes under my eyes.
  • obsession – I spend so much time thinking about my skin and worrying over if I am doing something to make it worse, or not doing enough. It gets exhausting really.
  • career switching – I dropped out of my physical therapy doctorate program because I just couldn’t deal with my skin. I wasn’t sleeping, I was uncomfortable sitting (more on that in a bit), and I couldn’t stand being in an air-conditioned room (see below), or being touched or coming in contact with another’s skin, which made it incredibly difficult to practice the hands on aspects of PT. I am now still in a stage of making my own career, which while exciting, is stressful when I have to talk about it because it’s not a clear cut “oh, yeah, I do X” anymore.
  • fear of infections – As my skin barrier is compromised so often, the risk of infections, primarily Staph, is high. I spend a lot of time wondering if I am infected and worrying when I catch a cold or something that I have contracted Staph (again).
  • hand washing (pain/itching) – Imagine how many times you have to wash your hands or use hand sani when you are a PT student working in a clinic. Doing dishes is irritating enough. Sometimes even just taking a shower will irritate my skin.
  • cleaning frequency – Given that I shed skin faster than the average human, I spend a lot of time cleaning to try to not live in my own skin dust filth.
  • social situation aversion – When I am flaring, I have no desire to go out, not only because I worry about the stares I get for physical appearances, but also because it takes so much energy to deal with varying temperatures, varying foods, varying stressors, usually a lot of sitting, the inability to play/dance without itching, etc.
  • general discomfort (pain, itch, smell) – Eczema this severe is uncomfortable. The obvious is that it itches, and not like a “I have a random little itch” but more on the level of if a swam of mosquitoes bite you all over your body but instead of having angry welt-y bite marks externally, they are all inside your body and not visible to anyone. The pain comes from the cracking I mentioned above, as well as the pain of the self-inflicted wounds from scratching too hard. When I have a bad flare, I develop this scent that I call the burning rubber skin that I loathe.
  • depression and anxiety – It’s no surprise that aggressive and long lasting flares take an emotional toll. As I spend time in pain, itching, paranoid about foods I eat, avoiding people, and unable to exercise and play as I normally would, sometimes my moods take a nose dive.
  • money spent – From skin care lotions and moisturizers, general soaps, bath products (bleach, epsom salt, apple cider vinegar), natural house cleaning products, dry brushes, the rebounder, to the doctors’ visits, etc, this condition isn’t cheap.
  • doctor visits (dermatologists, endocrinologists, neurologists) – There is something very frustrating about seeing many doctors and still getting no relief. I have moved a few times in the last past 4 years and as a result have an even larger number of individual doctor visits under my belt. The general consensus? I am fine (as in no underlying crazy cause of my skin issues like cancer), but I have eczema. Oh and have I tried using steroids creams? -.-
  • hormone imbalances – Since I spent so much time inflamed, I usually have a highly elevated level of immune stuff, like my white blood cell count. When my skin first started going haywire, I also have high cortisol level, which made doctors think I had a hormonal imbalance and first order an MRI of my brain.
  • forever fielding questions – “Have you tried X??” “What’s wrong with your skin?” “Do you use lotion?”
  • excoriation disorder (dermatillomania) – Due to very often having flaky skin, I have developed a picking disorder where I spend inordinate amounts of time trying to remove dead skin from my body. It’s become partially therapeutic and partially me trying to exert control over my uncontrollable presentation.
  • scratching OCD – I scratch all the time. In my sleep, when I’m stressed, when I’m relaxing. I don’t even notice I’m doing it sometimes.
  • scarring – Go figure from all that scratching I’d have scars.
  • ring wearing/jewelry/piercings – I no longer wear my wedding band on my left hand because the ring finger on that side is usually swollen. I wear it on my right now. I also had to take out my belly button piercing, my nose piercing, and all ear piercings except tragus one because the skin started itching so badly around them all.
  • hot inflamed skin with cold chills/shivering – One of the worst stages of a flare is when my skin is constantly wet and weeping and heated, but I’m losing so much heat that I am internal freezing and will shiver uncontrollably.
  • winter is bad – It’s hard enough to regulate my body temperature without the weather outside being frigid.
  • sensitivity to pressure contact (sitting/laying down) – This made PT school very trying. Hell, going to a doctors office and laying on the table, or sitting on a chair for too long made my skin feel terrible and heat up and start itching. This is even through wearing long sleeves and pants.
  • nervousness = flares – Some nervousness is good for keeping our brains alert. Unfortunately, any little bit of social nervousness (like before a practical or talking to new people) would cause me to start to flare and itch.
  • wrinkly, swollen skin – Still not sure why this happens (maybe it’s a product of topical steroid withdrawal) but the skin around my joints especially, on the extensor side, starts to look like that of an elephant.
  • discoloration – From redness to drying out gray/white, I am a veritable human mood ring.

And since people love me and will forever want to help, here is a list of what I have already tried:

  • topical steroids (for a good 20 years as this was the main accepted solution to eczema for decades)
  • topical medicines that are not steroids (Elidel/protopic, etc)
  • oral steroids
  • lotions/moisturizers (cetaphil, cera ve, aquaphor, dove eczema line, exederm, burt’s bees, obscurely-named-other-ones, etc)
  • going moisturizer free (actually does help with the red/weeping stage)
  • ocean water
  • chlorinated pools
  • naturopathy
  • acupuncture (including herbs, cupping, and massage)
  • diet (gluten free, soy free, dairy free, vegetarian, sugar free)
  • phototherapy (clinically done in light boxes, and just being in the sun)
  • antihistamines
  • sleep aid pills
  • yoga, meditation, and deep breathing
  • coconut and sunflower oil
  • bleach, epsom, and apple cider vinegar baths
  • antibiotics
  • collagen powder (edible)
  • collagen cream
  • wound care
  • probiotics

Update: I have not tried any biologics because I have been pregnant and am now nursing.

Despite all the shit that comes with eczema, there have been some silver linings in my experience including:

  • Having to deal with eczema year round has made me live much more seasonally. In the warmer months I try to take advantage of being able to walk outside for hours and garden to get vitamin D and get exposed to bacteria in the soil (and as stress relievers). In the colder months I turn to herbal teas and nourishing soups, and bundle up well to go on walks to get fresh air. I pay a lot more attention to what can grow when, and try to eat accordingly (like lighter foods in the summertime).
  • Having dealt with the difficulties of eczema for so long, in juxtaposition pregnancy wasn’t half bad (though to be fair my belly was small and I didn’t have morning sickness… but discomfort with sleeping? Aversions to certain foods? Tired randomly? Feeling generally uncomfortable? Yep, I was used to that all already).
  • In effort to control my flares, I am constantly open to trying new things (though my wallet isn’t!).
  • When I first came up to visit Jake, before we were dating, we had an honest conversation about eczema and I told him how bad it gets for me, and he still wanted to be with me. To this day, I’ve never had insecurity about my skin around him.
  • I have learned to really appreciate the good days. As a result, I’m generally even happier of a person.
alternative/holistic medicine, eczema, food and nutrition, my journey, sugar, women's health

the magic of medicinal ideologies

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Something that has always fascinated me has been the underlying ideologies behind medicine of different regions/cultures, be it modern western science, naturopathic medicine (which can blend a lot of the holistic and western medicine practices), traditional Chinese medicine, Ayurveda, or yoga.

As western medicine is the most familiar, I will talk about that briefly at the end.

The other day I went to a Qi Gong and Tai Chi school where I talked with one of the instructors about the concepts behind medical Qi Gong. We talked a little bit about my skin and the instructor mentioned how the skin and the liver are connected in the Chinese ideology and so if the skin is showing lots of signs of disease, there may be an issue with the liver’s digestion. She also mentioned that I would be a person expected to have an imbalance of yang over yin. Yin and yang are seen as complimentary energies that keep the body in balance, with yin being the cooler, more feminine energy, and yang being a hotter, more masculine one.

In regards to nutrition, when I was seeing an acupuncturist a few years ago, she also talked about the dietary components that might be causing my skin issues. She also believed that I had an imbalance of yin and yang, (in that again I had more yang), hence the inflammation. Her advice to me was to eat less spicy food, avoid sugars, and have more bitter herbs in my diet, as well as continuing the treatments I was getting from her in acupuncture, cupping, and massage.

The National Eczema Associate interviewed Dr. Xiu-Min Li (a Professor of Pediatrics in the Division of Pediatric Allergy and Immunology at the Icahn School of Medicine at Mount Sinai) who studies asthma and allergies (including AD) and went on to explain about traditional Chinese medicine and how it fits into the treatment of eczema. The article provides more insight into how TCM is starting to be incorporating into mainstream western medicine, with the goal of having an alternative to use before topical steroids. It would seem that many people currently turn to try traditional Chinese medicine when standard western medicine practices of topical/oral steroids and other topical medications don’t do the trick.

When I was doing my yoga teacher training a while back they talked about chakras. Chakras are energetic points of the subtle body and there are 7 of them that line the spinal column, and they each are meant to represent a basic level of human consciousness. According to what I learned during the training, when the third chakra (Manipura) is unbalanced, one can expect to see eczema and other stress-related skin conditions. This may be because the third chakra is connected to the detox related organs (like the liver) as well as the abdominals, obliques, etc.

Nutrition based in the Ayurvedic ideology talks about balancing the Pitta dosa (doshas are energies that control how we act, think, move, etc), and to do that they advise avoiding eggs, wheat, milk, nightshades, spicy foods, corn, shellfish, and overly sugary foods. Eczema is seen to be more of an excess of Pitta dosha, or more fire, hence trying to eliminate inflammatory foods.

Here’s an anecdotal story published by the National Eczema Association a while back about a family that turned to Ayurveda when the western medicine wasn’t helping their daughter’s eczema.

In regards to modern western medicine practices, a few comparison points are developing that reflect the more holistic ideals in the ideologies mentioned above. For example, added sugar is more or less nationally seen as being inflammatory, and many doctors will caution against having a diet that includes too much of it. There are also more practices such as taking bleach baths to help reduce infection risk and other treatments that can be done at home without a prescription that a western doctor will recommend now. And the recommendations around lotions and moisturizers (over the counter) are more prevalent, though the brands which are suggested still vary. Light therapy/phototherapy is also recommended to help increase vitamin D exposure, and more and more doctors are also advising getting moving more to help with healing, as well as different solutions to try at night to help with sleep- from stress relieving techniques like meditation or taking a bath at night, to antihistamines.

I personally however, have not yet had a doctor who engaged me in a conversation that got more specifically into nutrition (minus not eating a lot of sugar or junk food). I am not sure if it is out of their scope of practice, but it has not come up in 26 years of seeing doctors, which surprises me. Many doctors, as far as I can tell, still think eczema is not really related to food, but as I do have food allergies I was born with, I would probably be a prime candidate to test for new allergies. The rub there is that generally doctors will prescribe getting a patch test done- but you have to have cleared up skin for the test results to be more or less accurate, and you can’t be on steroids at the time (and I haven’t had clear enough skin in about 3 years).

There is also the holistic medicine movement we see that is not specifically tied to any of the above ideologies. It includes more of western herbalism, often crossed with different nutrition changes and protocols, like the autoimmune protocol, or the elimination diet, or other variations to help with what is called the “leaky gut” syndrome. There are tons of resources from bloggers, nutritionists, doctors, etc about how to go about a nutritional change to heal whatever ailments you are undergoing with food, and I’ve also noticed a lot of sufferers of eczema have gone into nutrition after having success controlling their conditions with their dietary changes (one example being Prime Physique Nutrition). There are also movements to changing the whole lifestyle to be more holistic (like making your own cleaning products as well as skin creams, moisturizers, body wash products. A lot of this new movement is grounded in taking control of your health, often after having tried working with doctors in modern western practices for long periods of time unsuccessfully.

A health resurgence in America has been in herbalism. Some famous members of the community include Rosemary Gladstar (author of Herbal Healing for Women), Susan Weed (author of Wise Woman Herbal for the Childbearing Year), Aviva Romm, Mark Blumenthal (founder of the American Botanical Council), Christopher Hobbs, and many, many others. [Of note, I am usually deep into researching about women’s health, hence the references above. Gladstar does have a book on men’s health called Herbal Healing for Men].

From Gladstar’s book Herbal Recipes for Vibrant Health (which I own) she briefly talks about her general advice as an herbalist for how women can keep balance in the bodies by doing “good living practices”, which she notes as having proper nutrition, ample enough rest, joyful exercise, self connection, and tonic herbs. Delving deeper into nutrition she says to eat foods close to their natural states (which also means eat what grows seasonally), pay attention to how you feel while eating and afterwards, eat organic when you can, and eat  alkalizing foods. She notes about the latter that a lot of the disorders women have thrive in acidic conditions (aka when we eat too many sweets and carbs).

Personally, I have found relief from the most extreme symptoms by modifying my diet (I usually avoid eating wheat products and sugar because I tend to over consume foods containing them), and by using products approved by the NEA that avoid parabens, alcohol, and other chemicals that can be irritants for people with eczema. Acupuncture did seem to help- though I can’t say it was in isolation, since I did get massaged each time (which is also known for helping eczema). I tend to only bathe in a diluted bleach bath when I feel like my skin is getting close to infection (not sure how to explain how I know when that point is), otherwise this winter I did take a lot of baths with either apple cider vinegar (works similarly to bleach) or epsom salt (tends to calm me down and works well for helping me get through the dry out phase of TSW faster). I generally avoid using topical steroids when I can because I have gone through withdrawals before, and because I don’t like the reliance on something that doesn’t fix my issue (usually starting on steroids means I have to stay on them because I flare back up as soon as I start a taper).

All in all it does feel like there are more overlaps occurring over time in these differing ideologies, and we are seeing them sort of blend together in effort to figure out how to deal with chronic non-fatal diseases such as eczema. Whether or not they work still mostly seems to comes down to a person-by-person basis.

 

REFERENCES

“Ayurvedic Medicine and Eczema.” National Eczema Association, https://nationaleczema.org/ayurvedic-medicine-eczema/. Accessed 14 May 2018.

Berzin, Robin. “The Simple Elimination Diet that Could Change Your Life Forever.” Mind Body Green, https://www.mindbodygreen.com/0-12540/the-simple-elimination-diet-that-could-change-your-life-forever.html. Accessed 14 May 2018.

“The Effects of Traditional Chinese Medicine on Eczema.” Pacific College of Oriental Medicine, https://www.pacificcollege.edu/news/blog/2016/08/19/effects-traditional-chinese-medicine-eczema. Accessed 14 May 2018.

Ehrlich, Henry. “Traditional Chinese Medicine and Eczema: An Interview with Xiu-Min Li, M.D.” National Eczema Association, https://nationaleczema.org/traditional-chinese-medicine-and-eczema/. Accessed 14 May 2018.

Gottfried, Sara “Is the Autoimmune Protocol Necessary?” Sara Gottfried MD, https://www.saragottfriedmd.com/is-the-autoimmune-protocol-necessary/. Accessed 14 May 2018.

“The Three Doshas: The Keys to Your Individual Nature.” Eat Taste Heal, http://www.eattasteheal.com/ayurveda101/eth_bodytypes.htm. Accessed 14 May 2018.

“Yoga for Skin Diseases”, Yoga India, http://yoga-india.net/wp-content/uploads/2014/04/Yoga-for-Skin-Diseases-Anna-Mayer.pdf. Accessed 14 May 2018.

 

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, 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.