Several months ago, on the Solve Eczema User's Forum, a mother in desperation asked, "Are we crazy?!" She was referring to the experience so familiar to all of us on the forum; that is, trying to explain to spouses, extended family, other parents, and even doctors (especially doctors!), this off-the-books approach we have taken to healing our children's eczema. She was also referring to the tendency of those same people to respond as if we were crazy.
I wanted to record here, part of my response to that question: I think this method is just so full of 'new concepts' that are foreign and run completely counter to what most people already understand (or think they understand) about what causes eczema, what causes dry skin, what 'fixes' those things, and even what a detergent is or what soaps are. I can say detergent is the problem, and then even go on to explain everything that contains detergent and detail exactly the process we've had to go through to remove it, and at the end they will still say "Oh, we changed our laundry detergent and only wash our kid with plain water and it didn't help our child, so that's not our problem." (What?! Did you not just hear anything I said??)
...I just honestly think that when you come out and challenge so many pre-conceived ideas and definitions all at once, that's a huge mental leap for people to make!! Also many of these parents have not arrived at the point where they can bring themselves to believe an entire global medical community could be wrong or so far off the mark about something so common as eczema. Many people WANT to trust the "experts", the ones who went to school for 12 years and studied these things. There is security when they feel they can trust their doctors. They might even feel a bit threatened when 'just another mom' comes out and suggest that the experts who are treating their children might be actually making things worse.
Yes, the trouble with AJ Lumsdaine's theory- while brilliant! - is that understanding it requires reframing one's entire paradigm and adopting entirely new definitions for things like detergent, soap, and dryness. So many people will get rid of SLS products and think they've done enough to check off detergent as a potential cause for eczema or skin problems. But they won't realize that detergent goes by a thousand other names (SLS is only the most recognizable) on ingredient labels! They won't realize it is added as an emulsifier or a stabilizer in so many products they would never suspect contain detergents at all. They won't stop to think how detergents are involved in every manufacturing process from clothing to food, that their food is bathed in detergent baths before arriving on the store shelf, and how detergent residues on dishes and utensils on which food is prepared may be as likely a cause for mealtime eczema as food proteins. (Both exist, but my little guy for example, his face would break out red and blotchy at meals, and we could never trace to one food because it was so random. We finally got to the bottom of it when we learned it might be what we were washing the dishes with. It was! No more dish detergent, no more mealtime reactions.)
People will not readily understand that AFTER getting rid of detergent in their products, they will only have barely begun to address the issue. There will be detergent in their dust, their carpets, their furniture. Indeed, detergents coat every surface in an industrial society, and our skin is constantly in contact with them.
They won't understand that detergent residues are stubborn and that water alone will not remove them. So that by removing SLS products and then only washing with water, they are actually forgetting to address all the detergents picked up by the skin from other sources outside the home (or inside the home, but in non-obvious sources like furniture or drapes) and aren't truly removing them from the skin.
They'll have to make another leap to understand why only true soap will remove the detergent residues so ubiquitous in society. Then, in order to get over their fear of using soap, they will have to make the leap to understand that true soap does not cause dry skin as we've all believed. In truth soap making has changed over the past 60 years or so to include detergents, changing the chemical composition of soap so it no longer even qualifies as true soap, chemically! The traditional definition of soap has changed- that is perhaps the biggest problem of all! So they have to learn how to tell if a "soap" at the store is actually soap- and 99% of them aren't. And if its detergent disguised as soap, it will lead to drying (across all skin types!), and for some it will cause eczema. It is the detergent in our soaps today that make us believe "soap is drying, and not good for sensitive skin". They have to understand what constitutes PURE, true soap.... the kind that humans used for thousands of years, without the crazy rates of eczema we exhibit today.
They might then be surprised to learn that the Tide company invented detergent in 1943 and then as it became the preferred laundry product, replacing soap flakes in the 1950's, eczema immediately increased in rate and severity. (I would argue that steroids were introduced at this time as an answer to the demand for a solution to this new predicament- babies weren't handling detergent very well. We never had that problem with soap flakes!) There has to be a reason infantile eczema increased so sharply in the 50's and 60's, causing so many steroid prescriptions to be handed out in the first place. And many researches agree the cases have risen at far too quickly a rate to be explained by ordinary gene mutation (ie, the genetic theory). Many will say it is environmental, as rates are much higher in cities, and industrialized countries over those that are less so. But so far, science has not been pinpoint what it is about the industrialized environment that makes eczema more common. I don't think detergent is the only factor, but I think the factors are fewer than we realize, that whatever the others are they likely all tie in together, and detergent is clearly one of the primary factors.