Keratosis Pilaris – Those annoying tiny bumps that can be found on the back of arms.

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Keratosis Pilaris is a common skin condition that causes patches of small rough raised bumps to appear on the skin. These tiny bumps (that look like pimples) are caused by a buildup of a protein called ‘Keratin’ (and also dead skin cells) at the opening of hair follicles. The condition sometimes gets referred to as ‘chicken skin’.

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The bumps usually appear on the upper arms (most common), thighs, and buttocks. Although less common, they can also show up the face. They are often accompanied with associated redness.

Those with dry skin, are more likely to have Keratosis Pilaris (KP). It may also occur in association with other skin conditions, such as atopic dermatitis / eczema.  KP is usually worse in the winter months, when there’s less moisture in the air. It can often reduce slightly in the summer months.

Although Keratosis Pilaris can occur at any age, it is more common in children and teenagers. It usually reaches its peak prevalence in adolescence and for some, may disappear after the age of 30.

Keratosis Pilaris results from the buildup of keratin which forms a scaly plug that blocks the opening of the hair follicle. Usually many plugs form, causing patches of rough, bumpy skin.

Flare-ups can increase when there is a vitamin A deficiency.

Treatment?

There is generally no 100% cure for this harmless skin condition, however there are ways to greatly reduce the severity and to prevent it from getting worse.

What can help:-

  • Use a gentle soap free body wash (soap can exacerbate dryness). Avoid lathering agents such as sodium lauryl sulphate which dehydrate the skin and strips beneficial lipid layers.
  • Use a ‘gentle’ exfoliator once or twice per week to remove dead skin (without irritating the skin and adding to the problem). A great example is R+F ‘Microdermabrasion Paste’.
  • Topical Retinoids (Vitamin A) help prevent hair follicles from becoming plugged. It also helps with skin cell turnover. However be careful as some Retinol creams are drying. See here for a recommendation.
  • LED or Intense Pulsed Light (ILP).
  • Creams containing salicylic acid, lactic acid, glycolic or urea which help support regular skin-cell proliferation. A good moisturiser will help prevent water loss from the skin (ie dehydration).
  • Laser hair removal
  • Eat anti-inflammatory food such as Omega-3’s found in Salmon, Walnuts, Sea Buckthorn etc
  • Avoid inflammatory foods (non fermented dairy, gluten and sugar).
  • See Gut Health
  • Humidifiers – add moisture to the air, which can maintain the moisture in your skin and prevent itchy flare-ups.
  • Soothe 2 sensitive skin treatment
  • See Skin Supplements
  • Avoid long hot showers which dry the skin out.

More on Vitamin A

Low levels of this vitamin have been associated with inflammation and acne.

Carrots are a source of Vitamin A.  HOWEVER the Beta Carotene (in carrots) needs to be converted into vitamin A in your intestines by gut flora. If you do not have the right gut flora it just won’t happen. See Gut Article. The better absorbed source of vitamin A is from cod liver oil and organ meat, particularly liver.

 

Note:- Women who are pregnant, or breast feeding, or may become pregnant should speak to their treating Doctor or Midwife Before taking Vitamin A supplements or using topical retinoids.

Victoria Isherwood

Registered Nurse

Eczema

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Exactly What Is Eczema?

Eczema (sometimes referred to as atopic dermatitis) is a common condition where patches of skin become inflamed, itchy, red, cracked, and rough. The severity can vary greatly.

Eczema is most common in children and will typically clear as they age. However, they will often continue to have sensitive skin AND eczema will often return again in later life.

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As I’ve explained in previous articles, our skin should act as a protective barrier against external irritants and bacteria. However when the skin is affected by eczema (and the lipid barrier is compromised), external irritants and bacteria are able to penetrate into the skin and moisture is lost . This causes further irritation, inflammation and dryness, which can lead to cracks in the skin, itching, infection etc.

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While the exact cause of eczema is not fully understood, we do know  that;-

Skin hypersensitivity and reactions are often the by-product of hypervigilant immune system skin cells (called Langerhans cells), thrown into overdrive by triggers such as environmental allergens, stress etc.

To put it simply, eczema is caused by inflammation of the skin.

TRIGGERS, which activate and exacerbate episodes of eczema include diet, hormonal, environmental, stress and lifestyle-related factors.

Common triggers include soap, perfume, detergents, stress and change in temperature or weather. Food allergies can also play a part, especially in young children. Individuals will react differently to different triggers.

Other Triggers

  • Hormones: Women can experience increased eczema symptoms at times when their hormone levels are changing, for example during pregnancy and at certain points in the menstrual cycle.
  • Stress: This is not a direct cause of eczema but can make symptoms worse. See mind-skin connection.

Mild cases of eczema can leave the skin irritated, dry, red, scaly and itchy, while the more severe cases can lead to weeping, bleeding and crusting of the skin.

Managing Eczema

For many people, the severity of flare-ups will lessen with maturity, and ‘some’ may completely outgrow it. However, as eczema can come and go throughout life, learning how to manage flare-ups and identifying triggers is the best course of action.

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There are a number of things people with eczema can do to support skin health and alleviate symptoms, such as:

Avoiding external irritants and allergens

Common environmental irritants include:

  • Harsh soaps, bubble baths, some shampoos
  • Wool, nylon
  • Grass and sometimes sand

Common allergens (substances that can aggravate eczema if you are allergic to them) include:

  • pollens;
  • house dust mites;
  • animal dander (small scales from the skin and hair of animals).
  • certain foods.

Note:  an allergy assessment by an allergist will properly identify the allergic triggers.

  • As Overheating can make eczema worse,  therefor try not to have heating too high in winter, bathe in lukewarm water (not too hot), don’t use an electric blanket.
  • Prevent your skin becoming dehydrated and dry (which are two different conditions).
  • Wear cotton and soft fabrics, and avoid rough, scratchy fibers and tight-fitting clothing.
  • Use a mild soap when washing and a non-soap cleanser (such as Soothe gentle cream wash).
  • Gently pat (with a towel) or air dry rather than rubbing the skin dry after bathing.
  • Avoiding rapid changes of temperature and activities (like heated yoga) that make you sweat excessively.
  • learn and avoiding individual eczema triggers
  • Use a humidifier in dry or cold weather.
  • keep childrens fingernails short to prevent breaking the skin when itching.
  • Use an emollient daily to keep the skin moisturised.
  • Wear cool breathable natural fibres.
  • Eczema can get worse when stressed or anxious, so consider relaxation techniques such as meditation. See Mind-Skin-Axis.
  • Check ingredients of skincare products before use.
  • See common skin conditions

Nutrition and skin health

As certain food allergy’s intolerance’s can aggravating eczema, keeping a food diary can help pin point the particular foods that may be causing flare-ups. Speaking to a nutritional professional will point you in the right direction here.

It is important to remember that eczema is an inflammatory skin disorder. Therefore avoiding inflammatory foods can greatly help manage eczema. See gut-skin connection article.

When it comes to healthy eating, certain Vitamins and Nutrients can have a very positive effect on skin health. Some of the key nutrients believed to be essential in maintaining good skin health include; essential fatty acids (EFAs such as salmon, wallnuts or Sea Buckthorn), Zinc, Probiotics, Selenium, Vitamin E (avocados), Vitamin D, Beta-carotene etc. See here for more info.

Everyone is individual and what your body needs, may be different to someone else’s. A nutrition professional can help you understand what foods may be causing your skin issues and guide you in the right direction.

Moisterisers / Emollients

Moisturising is one of the easiest (and most important) measures in protecting the skin barrier. It can also prevent itching and scratching, as well as reduce eczema flare-ups.

As eczema is a chronic condition, it is important to incorporate regular moisturising into your daily skincare routine.  – normally a cream or ointment that softens and soothes the skin. For very dry skin, this should be done twice per day.

  • Avoid moisturisers that contain perfumes which can irritate the skin.
  • Moisturisers should also be applied within 3 minutes of bathing to ‘lock in the moisture’

Rodan + Fields offers dermatologically tested and proven products that are gentle and safe enough to use on childrens delicate skin. Steps 2 & 3 from the Soothe Regimen are two of the products that I recommend. If you are looking for relief and just don’t know where to turn, please feel free to contact me to see if these products are right for you and your family.

Note: emollient is just another word for a moisturiser

Steroid creams and ointments?

Creams or ointments containing corticosteroid are commonly used for flare-ups of eczema. Steroid preparations can relieve itching by reducing inflammation. However it is important to discuss this with a dermatologist as using high-strength steroid ointments or creams over long periods can be associated with  side effects. Short term use intermitted (when required) is a better option.

Anti-itch preparations for eczema

Cold compresses, oatmeal baths, coal tar and pine tar preparations may help to relieve itchy skin.

Antihistamines are occasionally recommended to relieve itching that is disrupting sleep. Their benefit is partially due to the sedating effect – they do not completely suppress the itch. Sedating antihistamines (such as Phenergan) are therefore best taken at night.

The mind-skin connection

Some skin conditions, including eczema, have a psychological component. This is a dynamic is referred to as psychodermatology.  See more information here…

Also see

Light Therapy benefits

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Victoria Isherwood (Registered Nurse)

What Might Be Causing Your Breakouts

To put it simply, acne occurs when the oil glands (pores) in the skin become blocked with oil, dead skin cells and bacteria.

Our sebaceous glands are meant to produce sebum, which is an ‘oil’ designed to keep the skin lubricated and soft. However, when hormonal changes and other factors cause the gland to produce an excess of sebum (OR thicker than normal sebum) the problem arises. The pore becomes blocked and there is a higher chance that bacteria will multiply, leading to inflammation and acne.

Acne usually starts at puberty when increased levels of certain sex hormones (known as androgens) create an increase in the size and oil production of glands.

Hormonal acne can return again in our 30’s, as our levels of androgen hormones increase. Testosterone (an androgen hormone) stimulates sebaceous glands in women to secrete ‘thicker’ sebum. This can cause clogged pores and an increase the likeliness of ‘adult Acne’.

1FFFF33B-BD2C-4E86-96C4-136F24F81D42Underlying acne factors

What else might be going on??

1) Polycystic ovary syndrome (PCOS)

What is PCOS?

Polycystic ovary syndrome (PCOS) is a condition that affects a woman’s hormone levels. The condition usually effects women between the ages of 15 to 44.

Women with PCOS produce higher-than-normal amounts of male hormones (androgens). This hormonal imbalance causes menstrual cycle irregularities (including missed periods) and leads to other unwanted side effects.

The facts-

In PCOS; many small, fluid-filled sacs grow inside the ovaries. The word “polycystic” means “many cysts.” These sacs are actually follicles, each one containing an immature egg. The eggs rarely mature enough to trigger ovulation (making getting pregnant more difficult).

The lack of ovulation results in estrogen and progesterone levels being lower than usual, while androgen levels (masculine hormones) become higher than usual. This causes a disruption of the menstrual cycle and other side effects.

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The increase in testosterone triggers excess oil production in the sebaceous glands, which creates the perfect breeding ground for infection and acne.

PCOS-related acne tends to flare in areas that are usually considered ‘hormonally sensitive’ -especially the lower third of the face. This includes the cheeks, jawline, chin, and upper neck.

Those with PCOS tend to get acne that involves tender knots under the skin, rather than fine surface bumps. Breakouts commonly flare up before menstruation and can take several days to go away.

Other common PCOS symptoms are:

• Unwanted Hair growth: Due to excess testosterone, more than 70 percent of women with this condition grow excess hair on their face and body.

• Thinking of hair on the head – Due to excess testosterone women can also experience male pattern baldness.

• Weight gain

• Darkening of the skin: Dark patches of skin can form in body creases like those on the neck, in the groin, and under the breasts.

• Headaches: Hormone changes can trigger headaches in some women.

What causes it?

Doctors aren’t 100% sure what causes PCOS. They believe that high levels of male hormones prevent the ovaries from producing hormones and making eggs normally.

Genes, insulin resistance, and inflammation have all been linked to excess androgen production.

Women with PCOS often have increased levels of inflammation in their body. Being overweight can also contribute to inflammation. Studies have linked excess inflammation to higher androgen levels.

Treatment

Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise.

https://www.healthline.com/health/pcos-diet

2) Rosacea

For some, Rosacea is actually the problem NOT acne. Click here to find out wether you may actually have rosacea.

3) Hormonal fluctuations

As previously discussed, certain hormones rise during puberty. These hormones cause an increase in the production of sebum. This results in hair follicles becoming blocked, forming comedones or “clogged pores.” These clogged pores then commonly become infected and inflamed – AKA acne!

Hormonal adult acne tends to flare up at predictable times during our menstrual cycle. For many women, this occurs the week leading up to menstruation or during. However the menstrual cycle is the time when symptoms peak. Some women may also experience a breakout during ovulation.

Perimenopause is the period (which can last for several years) prior to menopause. During this time, hormonal fluctuations are increased which can lead to acne.

Acne located on the Lower third of the face and along the jawline is often more likely to be related to hormonal issues than acne across the forehead or the bridge of the nose.

Hormonal adult acne is often deep, cystic, and sensitive to touch.

See link to find out what you can do to help

4) Poor Gut Health

see Gut Article

5) Stress

During times of stress, cortisol (the stress hormone) increases oil production which can stimulate acne. The Skin-Gut connection has been scientifically proven.

6) An Inflammatory diet

A high glycemic (GI) diet

Foods that increase insulin levels have a high ‘glycaemic index’ (GI). The glycaemic index is a measurement of how carbohydrates have an effect on our blood sugar levels. Foods with a high glycaemic index break down super fast in our body causing a rise in blood sugar levels. This then causes a spike in the amount of insulin our body produces (in hope to re balance the blood sugar level). This spike in blood sugar and insulin then leads to inflammation.

High GI foods include white carbohydrates (eg white bread, chips, pasta, white rice, potatoes, processed biscuits etc) and of course sugar.

High GI food and acne

SO ….instead switch to low GI food such as non starchy vegetables (swop potato for sweet potato), some fruit, whole grains, nuts, fermented dairy such as yogurt, meat, poultry, fish and eggs.

Non fermented diary (milk) and gluten also cause inflammation in most people.

Treatment

See adult acne article

See gut health

USA or Canadian readers can click here for clinically proven anti-acne skincare products. Australian readers …check back soon as this great product will be available soon here in Auz.

For severe cases of acne or hormonal imbalances please see your healthcare professional or Dermatologist.

🙂 Victoria Isherwood (Registered Nurse -Dermatology)