We currently maintain Sam's clear skin by consistently doing three things:
- We avoid all obvious detergents and all products containing less obvious detergent ingredients.
- We use only pure, true soap products for all household and personal care needs. (Water is not sufficient, and I will explain why in a moment).
- We protect his skin from the environmental detergent residues outside our control by using clothing or ointment barriers to minimize exposure and maintain healing.
Since Sam's skin is now a blank slate, I am able to experiment with products and situations and then judge the effects more easily than I could when his skin was red and broken. This process of trying new things, and making connections from repeat observations, is fascinating to me. I am learning so much about contact eczema.
Several weeks ago, I purposely allowed Sam to break out in eczema. I did this by allowing him to walk around the house without pants or socks on for an entire day. He spent twelve hours in direct contact with our ancient, detergent-saturated carpet. This is significant because last year, in the months immediately following his miraculous healing, even 30 minutes in contact with our carpet was enough to cause relapse of what looked like large red burns on his skin. I wanted to find out if, after 10 solid months of detergent-free healing, Sam's eczema would look and present differently due to a much stronger and improved skin barrier.
The Hypothesis My thinking was that steroid creams and environmental detergent residues each magnify the damaging effects of the other, playing off one another in cyclical fashion to increase skin barrier deterioration and skin permeability, thus increasing susceptibility to eczema over time. However, in the long term absence of both damaging sources (steroids and detergents), the skin barrier could begin the work of repairing itself, become stronger, less permeable, and therefore less susceptible to severe breakouts. If this was the case, then the resulting eczema from spending a day in contact with the carpet should be much less than it was with the same exposure time last summer or fall.
(*I must credit the ideas and foundation for this hypothesis to AJ Lumsdaine who said the skin barrier will strengthen over time when spared detergent exposure, and also naturally over time, with age. I suppose I am actually putting her hypothesis to the test and applying it to a slightly different situation where steroids were a factor.)
How It All Went Down
I didn't think to take a "before" photo but I can assure you his legs were completely clear, with the exception of a faint hint of redness around the knees (the ever persistent remnants of skin candida which must run really deep because I've yet to be able to get rid of that last little bit! At least its under control).
And here is the result of twelve hours of bare-skinned exposure to a ten-year-old detergent saturated carpet:
Not bad at all! I was surprised how limited the eczema was. This eczema presentation falls more closely in line with what I remember his eczema looking like pre- steroids; spotty, faint, with lots of clear skin in between. The worst spot, as you can see, was on his left knee where he still has a bit of yeast infection. The detergent exposure seems to have really aggravated the infection, and caused it to flare and spread far beyond what it was the day before. Interesting! So it seems that while steroids definitely play a major role in creating ideal conditions for infection to take hold, detergent exposure plays its roll in exacerbating infections as well.
I think I can safely say that Sam's skin barrier has improved and that there has been much reparation these past ten months. I wanted to share my observations to encourage others going through this process that in the absence of steroids and detergents, the skin barrier can in fact bounce back from the damage. While Sam will probably always be susceptible to detergent reactive eczema because of his skin type, in the continued absence of steroid treatment and constant detergent exposure I feel confident that he will never again have to deal with the same severity of eczema that he faced in his first two years of life.
Getting It All Cleared Up: The Miracle of Soap Washing
I also wanted to demonstrate, in practice, how we regularly eliminate eczema (sometimes before it can even manifest) and just how swiftly healing can occur by washing the skin with simple bar of unadulterated soap.
Just to reiterate (forgive me if I come across as patronizing, some people just don't get this or believe it!) if I had only rinsed Sam's skin with water, the eczema would have remained, because the detergent would have remained, deep in the tissue. I wash Sam with soap every single night and that is one of the primary reasons his skin can stay clear!
The effect of soap washing is not always immediate. Right after his bath, his skin did not look noticeably improved. However, 48 hours later you can see the drastic improvement:
Day 2: After 2 Soap Washings
The eczema spots are still visible, but just barely. They have faded considerably! His flare on his knees is all but gone.
Day 4: After 4 Soap Washings
The eczema is pretty much gone and all the itch and discomfort has long since vanished. I've found that the itching can typically be stopped right away, actually, even before rashes are visibly healed, with the first bath.
The Importance of Barriers
One more thing, because this is very important too: After each nightly soap bath, I always clothe Sam from wrist to toe. The clothing acts as a barrier so that the skin remains in a perpetual state of healing. Soap-washing the skin and following up with a barrier prevents future detergent exposures and thus prevents the return of eczema. For exposed skin on hands and face, that cannot be clothed, a thick barrier ointment like Aquaphor or Vaseline can be applied to create an artificial shield and give the skin healing time throughout the day. For outings where it is not prudent to clothe the entire body, Sam wears regular summer clothing and then if he has a break out it can still be managed quite well or at least eliminated quickly by washing the skin and re-clothing after arriving home.
Note: The same children who have detergent reactive eczema may also have food allergies, and/ or infection as factors in their eczema. Eczema caused by infection or food allergies will not respond directly to soap washing. However, if food allergies or infection are addressed and the treatment only partially improves the eczema, it is likely that detergent is a dual factor and the remaining eczema might be eliminated completely by following principles of detergent removal and soap washing. See solveeczema.org for the complete theory and to understand why this method is so effective.
Does your child have any of the Signs of Detergent Reactive Eczema?