Thursday, April 18, 2013

An Eczema Experiment: Measuring Skin Barrier Reparation

Sam's skin has been clear and soft for so long now that I feel quite confident recognizing exposure and healing patterns, as well as the distinct difference between detergent-reactive eczema and infection. He rarely has issues, but when he does, it is a relief to know just what to do to quickly eliminate his eczema.

We currently maintain Sam's clear skin by consistently doing three things:  
  1.  We avoid all obvious detergents and all products containing less obvious detergent ingredients.
  2. 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).
  3. 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.


The Experiment


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.


Conclusion


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.

That night of our experiment, after taking the above photos, I scoured Sam's body and legs with soap. An important principle of the SEO (SolveEczema.Org) method for healing eczema is that water alone can not remove detergent residues from skin. Whatever detergent residues Sam picks up during his day, outside the home, (and in an industrial society every space is literally coated in detergent!) those residues remain in the skin unless we wash them out with something other than water. According to AJ Lumsdaine, the best thing to remove traces of detergent residue from skin and clothing is a true, pure soap.  True or pure soap refers to the kind of soap humans used for hundreds of thousands of years to wash clothing, hair, and skin, long before the invention of detergents and without the widespread skin problems we face globally today.  

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.

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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?




21 comments:

  1. My daughter has all the signs of detergent related eczema. Your pictures of Sam (before) look so similar to her skin. She is 5 years old now, and we are on week 9 of ridding detergents according to solveeczema.org. At first, her skin improved dramatically in the first few weeks. However, for the past month her whole body has broken out in a spotty rash. I'm getting discouraged since this started working at first and she's still miserable. I also noticed her clothing that has soaked up some of the aquaphor irritates her skin when she wears them for long periods of time. (Can aquaphor cause soap to stick to the fabric like unwashed detergent does?) I'm still sticking with it though. Praying for similar results!

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    1. Hi Sarah. I'm sorry to hear about your setback. Is her skin still improved overall? Or are there areas that are still obviously improved? What do you mean by "spotty"? There was about a 4 week period of time, in the beginning, where Sam's back and belly had broken out in a rash, small dots, almost like pimples. I concluded it was heat rash because of slathering his core with Aquaphor after a warm bath... then layering with clothing... his body was having a hard time ridding itself of the heat. I solved this by no longer applying the Aquaphor to his trunk. After that I only applied it to his arms and legs and it did take time but eventually that rash went away. So maybe it was heat rash? Anyway, the idea is just to have some kind of barrier, so for most of her body, soap-washing and then just putting clothes on top might be enough. Is her skin especially dry? I found that by using a moisturizing soap, after time, Sam didn't even need a moisturizer, in the absence of drying detergents his skin could maintain its own moisture and felt great. Maybe you can just apply the Aquaphor to exposed areas of skin and see if that helps?
      It might also help the problem with her clothes!

      Do you have hard water?

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    2. Her skin has improved a lot overall. Her neck used to be solid red and leathery. That's mostly cleared up. Every 1-2 weeks her skin will have a flare-up and she'll develop a speckled underlying rash over her entire body with patches of skin where it's really bad (back and belly are the worst). There are random pimple-like bumps too - mostly on her hands. Her skin does flake where she's been scratching alot. The worst areas are where her clothes sit directly on her skin (waist, sock line, etc) which made me question if the aquaphor had something to do with attracting soap.
      We do have hard water where we live and high levels of chlorine which we've bought a shower head filter for. I'm hoping it's not an infection or something. It just comes and goes so sporadically. It's hard to figure out! I'll try your suggestion of putting the aquaphor only on the exposed areas. There's been enough improvement from when we first started that I'm confident this will work in the long run!

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    3. That's really interesting Sarah, I'm sorry to hear about the challenges. I honestly can't think why that would be, except maybe she is sensitive to an ingredient in Aquaphor? Or one of the ingredients in a soap you are using? Have you super washed all her clothing and bedding? It took up to 12 washes until Sam stopped reacting to some of his clothes. I have no medical background, but in all my experiences with infection it stays put, does not really come and go. If its not heat rash, could she have a food allergy? Although that would be odd if its not showing up on her face.

      You have a great attitude, I'm glad you are willing to keep going. I also had a gut instinct about following SEO, I just knew it would help in the long run even though the first two months were really slow going. There were moments where I wondered if he was getting worse. Especially since his eczema always appeared worse at night and under flourescent lighting- much better in the morning when natural cortisol levels went up. Good luck. Wish I could be of more help! Have you joined the Solve Eczema User's forum yet?

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    4. So, now I'm thinking maybe she is sensitive to Aquaphor itself. I tried applying only on her exposed areas, and that's the areas she's scratching and the rest of her skin appears to be healing. Wow!
      I initially super-washed all her clothes (and ours) and bedding 5 times and they've been washed several times since then. But I do notice certain clothes irritate her more than others. This whole process is so interesting! I did join the Solve Eczema User forum a while back but I need to jump back on there.
      Thank you for blogging your journey with Sam's skin. It really has been the "proof" I needed to try this myself. And so far it's been so worth it. :)

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  2. What a great experiment! With interesting results. I see Sam's sporting his Kumfy Cotton shirt to protect his skin. So glad it helps him.

    Curious, which soap do you use?

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    1. Hi Jennifer, yes we really love the Kumfy Cotton clothing. I wish there were more options available for eczema clothing in the US. More colors, designs, etc. The UK has some great clothing lines but expense prevents my family from being able to purchase them. Did you know that DermaSilk clothes are treated with a "permanent anti-microbial" shield which contains a harsh detergent? I was recently looking for gloves for my little guy, because the only problem area we really have left is his hands, which quite frequently are red from detergent exposure. Mittens are really too restrictive for him, limiting his play, since he is almost 3. We need something that allows for separate fingers! Any way I had looked at the DermaSilk line and discovered the detergent ingredient.

      There are so many great soaps, my personal favorite that we use for everything (bodies, faces, hands, etc) is Sappo Hill Natural Unscented. I love this bar! In fact I've spent a life time tormented by horribly itchy dry skin, and I never thought I could live without lotions or moisturizers. For the past 10 months the ONLY product I use on my body, face, and hands is this soap bar. Nothing else, and it is so gentle and effective at cleaning out the day's irritating, drying toxins that my skin has been able to regain its natural moisture balance.

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  3. hello cj,

    thank you so much for posting this. i have read all your post numerous times. sammy's eczema look a lot like my twins boys. the pictures i see of your son's eczema comes closest to any pictures that i've seen or researched online. my boys are now 2. i have done everything to pinpoint the cause and for the last 2 years i have been challenging myself to their diet. while they do have true food allergies to certain food, a part of me was telling me that there is something underlying with their eczema. their diet now is on consist of 4 or 5 food, milk, chicken, apples, millet, and avocado. the blood and skin prick test showed negative for dairy so i really dont think it's the dairy or any of the other 4 foods that im giving them. i have switched from dreft to all free and clear and that's what ive been using on their laundry since birth. after coming across your post and aj lumsdine, i am beginning to suspect that it might be detergent related. they are both miserable and even now at age 2, one of them is up all night scratching away, it's really hear breaking and i feel very hopeless. i have kept them in pajamas since birth and at night i have special mits sewned on to their pajamas to prevent scratching but still they find a way to rip their clothes apart. their rash has been consistently bad on their legs. it started at 3 mo on the face and spread to their body and legs. for the past year, the face, arms and torso seem to be clear most of the time, but especially dry. however thier leg is what im confused by. it's not exactly the typical hallmark eczema patches. it's more of a lacy faint to red rash thats covered their entire leg. better in the mornings and worse in the evening. looked just like sams in all his pictures. im starting to suspect yeast. while waiting for my cal ben products to arrived, i quickly went to the store to pick up a bottle of dr bronners and immediately started the detergent removal process. i also ordered the braggs vinegar that you use on sam. i started the vinegar in bath yesterday and today their skin seem especially dry. did you have this issue with sam while first starting him on the vinegar bath? i did not have any soap to wash him with after and therefore only used water. my sappo hill soap is also on it way! i have not used any soap on them ever and am worried that once i will when my sappo hill bars arrive that it may dry the skin out even more. did you experience any dryness on sams while using the vinegar bath and sappo hill soap before you began to see results? i do feel that im on the right path regardless and hope my boys will come to achieve positive results. btw, your kids are lucky to have you as mom and sam is a handsome little guy =)

    mary

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    1. Hi Mary,

      I'm glad you were able to find AJ's website. Obviously it has saved our quality of life and I hope it will do so for you and your boys as well.

      Sam's eczema was always the worst on his legs, and it is possiblyeyour boys may have a bit of infection there, especially if you used medication on their legs for a prolonged period of time. Keep in mind with the ACV baths, they have to be consistent and it will probably take a good while to see results. This is not an overnight cure, but it can be a lifelong solution if you're willing to get past the difficulty in the beginning. It is a lot of work! I bathed Sam in ACV almost every day (probably 6 days out of a week most weeks) for a minimum of 20 minutes each bath, and it took doing that for two straight months before I could really see that it was in fact working. It can be so hard to be patient, but I have known too many to go down this road only to give up after a few weeks or unwilling to put in the effort that is required, and then they will say this didn't work for them when it is very clear they didn't give it a fair chance.

      As for the dryness, I don't recall having a dryness issue from the ACV baths, although Sam's skin was already alligator-dry to start with. Also you haven't been using soap products long enough to see the difference in moisture. Actually you said some of them are still on their way! It is a myth that all soaps are drying. I'm going to write a more in depth post on this soon but for now you should know that detergents are drying, pure soaps have properties more closely matched to the human skin barrier and when they are made well they do NOT dry the skin, they in fact can totally remedy dryness and result in natural moisture being restored. Within two weeks of using Sappo Hill soap on Sam every night, followed with a thin layer of Aquaphor, the dryness was gone and has never returned. Now he doesn't even need the Aquaphor most of the time, or any moisturizers at all, just using the soap is enough. It is very gentle on the skin. It is the soaps that have detergent added, that are drying and give "soap" a bad name. I think you will be surprised.

      Take care!
      Carrie

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  4. hello carrie,

    thank you for your response. so the dr. bronners soap clearly made things worse. it definitely dried their skin out more than it normally would be and their legs broke out in another bad rash. their eczema doesn't really follow a normal pattern and this is why it's so hard for me to pinpoint things or what exactly they could be allergic to. there would be days when i would do nothing different and it would get better or worse?! it could just be that this isn't the right product for them as im anxiously awaiting the arrival of my cal bens and sappo hill soap. ive done washes with the dr. bronner and will immediately switch over to cal ben once i have it. you mentioned that you are using the cal ben sea foam for laundry, is it the powder or liquid one that you have?

    as for the possiblity of yeast, i filled a prescription for the perrigo brand nystatin ointment that you mentioned. even on a good day when their legs are better, it's never "clear" with supple skin. there would still be a faint lacy underneath rash covering the entire leg(i hope this makes sense) and the rash would always be more defined and angry at night.

    twins awake and screaming now.. will keep you posted.

    mary

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    1. Hi Mary,

      I have the powder laundry soap from Cal Ben. We bought the large economy size, I only use 1 TBS (or less) per load. It has almost been a full year and I still have almost a full quarter of a box left.

      How are things going with the new soap?

      It sounds like they might have some infection going on. Either that, or if their eczema is not responding to soap washing, it is possible you live in a very hard water area which leads to a much slower healing time.

      I hope things are improving for you.

      Carrie

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  5. Hello CJ,

    Your boy's pictures of eczema looks like my kids' conditions.

    My wife and I both suspect the detergent as well but weren't sure. We are going to experiment to wash their clothes without detergent and use soap instead.

    Instead of handwashing all their clothes with soap, how much liquid soap should I use for the washing machine? I'm thinking of using Dove Sensitive skin liquid soap.

    I look forward to your reply!

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    1. Dove Sensitive Liquid is not the best choice! It still contains detergent. Many products labeled for sensitive skin are just marketing gimmicks. You need a true soap product like pure Soap flakes, Cal Ben Seafoam, or something similar.

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  6. Hello, CJ- your son's and my son's skin seems to be very similar, I wanted to follow up with you and see where you were in your son's process with no detergents, is he is still doing good?

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  7. Hi, CJ!
    I wonder how about your son's skin? Is he totally ok now? Does the soap still work well for him?
    Is it possible for you to post his new photo?
    Thanks!

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    1. I posted an update Nancy. I apologize for the looooong delay. Admittedly, I forgot about this blog for awhile, because Sam has been doing so well!

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  8. Thank you so much for all of the information that you have provided. We are at the beginning stages of healing my sons eczema, but I am hopeful we will get there. Are you familiar with The Honest Company? Any comments on their detergents, soaps...etc... They have the ingredients listed on their website

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    1. I have never tried Honest Company products. Did you try them out? What did you think?

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  9. When I read this story I realized just how similar it was to my eczema.
    I was so desperate that I tried every thick, smelly cream and goopy ointment I could get my hands on. Nothing really worked permanently and the eczema always came back.
    I knew that there had to be another way. I searched long and hard and finally came across some simple natural remedies that finally made my embarrassing eczema disappear for good...to the amazement of my doctor.

    In fact, you might want to check out this article, it really helped me a lot:
    http://www.journalofnaturalhealth.com/eczemaremedy

    Hope it helps anyone reading this!

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  10. Very informative post on Eczema. Last month, while teaching us, my teacher told us about Urtikaria. I was wondering if I could see a patient suffering with it to know how it looks/feels, but unfortunately or interestingly, my cousin itself suffered with it. Glad he got well soon.

    ReplyDelete

Thank you for your comment. I will do my best to reply as soon as possible, but there are often delays as this blog is only a side project to share what I have learned with others. Life goes on with three busy little ones and homeschooling so I ask for your patience. If you want to make sure you do not miss my reply, include your email in "emailaddress at dot com" form and I will email you directly.

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