Cleanliness: Can Too Much Cause Dermatitis?

Americans almost seem obsessed with cleanliness. A walk into the local grocery store or department store reveals one or more aisles of products related to personal hygiene. Shoppers often have a wide selection of choices of soaps, facial washes, scrubs, and shampoos. Is it possible for us to be "too clean"?
The outer layer of the skin acts a barrier against potentially dangerous organisms. Normally, the skin maintains a delicate balance of water, fats, pH, and turnover of skin cells. Washing removes the oils in the skin, upsetting the moisture balance, and compromising the protective barrier properties. It's particularly a problem in the cold, dry months of winter. Eventually, too-frequent washing can lead to chronic damage to the outer layer of the skin and cause the development of rough, dry skin and conditions, such as irritant contact dermatitis or eczema. Ironically, while washing is meant to remove germs, research shows dry, damaged skin actually harbors more disease-causing GERMS than healthy skin. In addition, in people with damaged skin, washing is less effective in removing germs. One study found the number of organisms spread by nurses who wash frequently with antimicrobial soap actually increased over time.
There are other reasons to be concerned about over-cleanliness. Not all bacteria are bad. But personal cleaning products don't distinguish between the good and the bad ?washing it all away. In addition, overly clean environments may not be good for infants and children. We need some exposure to GERMS for our immune system to develop antibodies and to learn how to respond to an infection. Some researchers speculate the increase in asthma and other immunological diseases may be related to decreased exposure to GERMS and poorly developed immune systems.
There are some small steps that can be taken to reduce the risk of skin problems from personal hygiene routines. Try to limit washing to one bath or shower a day. Use a mild cleanser and warm (not hot) water. Pat dry the skin with a soft towel. Use a moisturizer immediately after washing to seal moisture in the skin and reduce further moisture loss.

Knowledge Is Power : Know What You Are Applying To Your Skin

Parents risk harming their children because of misinformation about the best treatments for eczema, experts said today.
While some parents turn to herbal lotions of unknown quality to treat their youngsters' skin, others are shunning prescribed steroid creams because of misconceptions about the side effects, a meeting of dermatologists was told.
Dr Sue Lewis-Jones, a specialist in paediatric dermatology from Dundee, said a network of nurses focusing on the management of childhood eczema and other skin problems was urgently needed.
She said that a lack of money and focus on the speciality was to blame for the small number of nurses working in this area.
"These nurses can help parents manage their children's condition, keep an eye on their progress and lead to fewer admissions to hospital. "But there is no money for it.
"It is an obvious thing to do and it would ultimately save the NHS money," Dr Lewis-Jones said.
The consultant dermatologist, speaking at the British Skin Foundation meeting in central London, also highlighted concerns about parents opting for herbal Chinese remedies to treat their children.
She said there were examples of companies springing up promising "wonder cures" for eczema and psoriasis.
"There are lots of reputable companies and there is no reason why some remedies shouldn't work because most medicines originally came from plants.
"But the problem is that we don't know what part of the plant is having the effect and there is less known about the side effects. "With modern medicines much more is known about the side effects.
"Some people out there just want to make money and will dishonestly promote small pots of cream that cost £30 each," Dr Lewis-Jones said. She said that these creams often contained hidden steroids which produced the desired effect and led patients to believe the treatments were working.
But this led to the danger that young children could be exposed to very strong steroids normally only given to adults.
Dr Lewis-Jones said she knew of a case where a parent had used a very strong steroid called Dermovate which was bought from Hong Kong to treat her 12-year-old's psoriasis.
Although the product was clearly labelled, the mother used the cream on her child for 18 months without knowing the dangers of such heavy steroid use.
The girl went on to develop Cushing's Syndrome which leads to weight gain, thinning of the bones and blood pressure problems and is caused by too many steroids.
The condition can cause patients to collapse and die and the child had spent three weeks in hospital while she was treated. But Dr Lewis-Jones said under-treatment was a much more serious concern for children with skin conditions.
She said research had shown that three-quarters of parents were worried about using steroid creams on their children and a quarter stopped using them all together.
They were apparently concerned about products would thinning the skin with some even believing they would lead to muscle development such as that seen in bodybuilders who abuse steroids. "The thing about eczema is that we can get it under control and are not going to have to use steroids for very long.
"There is also widespread ignorance of the public and health professionals about the use of steroids but they are a life-saver for people with eczema," Dr Lewis Jones said.
One in three-children under the age of three-and-a-half suffers from eczema. Psoriasis is also very common, affecting 1.2 million people in the UK.
Dr Colin Holden, trustee of the British Skin Foundation, said: "The number of people suffering from skin disease is increasing every day. "It's vital we keep investing money in life-changing research."

Treating Atopic Dermatitis

More than 15 million Americans are diagnosed with atopic dermatitis, commonly referred to as eczema. There's a new therapy available by prescription.
While many products to treat eczema are currently available, the FDA has recently cleared a new approach in managing the signs and symptoms of eczema called Mimyx cream.
Unlike current prescription therapies, Mimyx is safe enough to be used on patients of any age and there is no limit on the duration of use.
The chronic inflammatory disease that affects 90 percent of patients within the first five years of their lives, is characterized by red, dry, itchy skin that rashes.
This uncomfortable and unpleasant condition largely affects children but can also affect adults and often leads to sleep interruption due to the severity of the itch.

New Drug Application Submitted For Sebazole

"If approved by the FDA, Sebazole may provide an alternative in the non-steroidal management of seborrheic dermatitis, with less risk for irritation and a more convenient treatment regimen as compared to currently available ketoconazole cream products," stated Dr Geert Cauwenbergh, Chairman and CEO of Barrier Therapeutics.Sebazole is a topical formulation consisting of 2% ketoconazole, an antifungal agent, formulated in a waterless gel for once-daily application. The NDA for Sebazole topical gel was submitted to the FDA in September 2005.

The NDA submission for Sebazole was based on the results of a pivotal confirmatory phase III clinical trial in addition to the results from two prior supportive phase III trials. In the confirmatory two arm phase III pivotal study, which enrolled 459 subjects at 24 centers across the US, Sebazole achieved statistical significance at the primary endpoint as compared to the vehicle treated patients.

Sebazole also achieved statistical significance for the same primary efficacy endpoint in both of the prior Phase 3 clinical trials, which enrolled a combined total of 474 patients in the Sebazole and vehicle arms at 47 centers in the United States and Europe.

FDA Issues Warning About Dermatitis Treatment

December 7, 2005
The Food and Drug Administration is advising consumers not to use Miracle II Neutralizer and Miracle II Neutralizer Gel products manufactured by Tedco, Inc., West Monroe, Louisiana because the products are bacterially contaminated and have not been proven to be safe and effective.
The agency says use of these products could pose a risk of serious adverse events such as infections, particularly in children, the elderly, and individuals with weakened immune systems who are particularly susceptible to illness.
"We will not tolerate the marketing of products that use deceptive and untruthful claims to lure consumers into potentially dangerous situations," said Margaret Glavin, FDA's Associate Commissioner for Regulatory Affairs.
"We consider it a significant public health hazard when consumers are deliberately deceived into using potentially dangerous products that promise health benefits but deliver only risk of harm."
The company promotes Miracle II Neutralizer for ophthalmic use in the eyes, including treatment of cataracts and pink eye, and as an eyewash. FDA requires that all ophthalmic products be sterile. Due to the substantial risk posed by non-sterility, Miracle II Neutralizer should never be applied to the eyes.
Tedco, Inc., also markets Miracle II Neutralizer for other unapproved uses, including treatment of AIDS, cancer, Crohn's Disease, dermatitis, diaper rash, diabetes, ear ache, hemorrhoids, hives, gout, herpes, mouth ulcers, psoriasis, skin cancer, and yeast infection.
The firm sells Miracle II Neutralizer Gel for many of the same unapproved uses, including diaper rash, diabetes, gout, psoriasis, and skin cancer.
Tedco, Inc., promotes its Miracle II products with claims such as, "supreme technology has made possible for a perfect soap cleaner, deodorizer, natural insecticide and antibacterial product to be put on the market. This is the only product that is made in the world that can wash a newborn baby or clean up an oil spill and everything in between."
Contrary to such claims, recent FDA testing of Miracle II Neutralizer and Miracle II Neutralizer Gel revealed bacterial contamination and poor manufacturing conditions.
Although Tedco, Inc., has been advised by FDA of the contamination found in its Miracle II Neutralizer and Miracle II Neutralizer Gel products, the firm has declined to voluntarily remove the products from the market.
A number of stores sell Miracle II Neutralizer and Miracle II Neutralizer Gel, and the products are distributed and sold worldwide and sold via the Internet. The products are packaged in 8 oz, 22 oz, and one-gallon size containers.

Dealing With Dermatitis

Try and remove all fragranced items in the house, and replace with fragrance free (not just ‘unscented’, this is not necessarily the same thing).

Replace most if not all artificial cleaning agents and instead use natural products, including vinegar and/or baking soda.

Oatmeal baths are considered invaluable for eczema sufferers; you can put unground oatmeal in a bag made from old pantyhose and soak it in the bath (this method can also be used as a compress on affected areas while in the bath) or you can grind it finely and either put in a bag or directly into the bath.

Use Tea Tree essential oil on affected areas, especially if it may be a fungal-caused reaction (avoid it, however, if it is dry-skin based, as it can dry the skin out even more).

Lavender essential oil is often touted as indispensable for eczema sufferers for its soothing and healing properties.

Emu oil can be invaluable for most skin irritations, eczema included.

Use shea butter and/or camellia oil on affected areas regularly to help with dryness.

Use a good, gentle skin moisturizer (even olive oil will work well for this).

Take a lactobacillus supplement; this can usually be found with other vitamins and supplements... it can even be found in chewable cherry flavored tablets for children.

Take a flaxseed oil supplement, also found in most vitamin/supplement aisles.

Take evening primrose supplements, and/or break open the capsules and apply directly to affected areas, or add to an oil/salve recipe (breaking open the caplets is recommended for children).Take cod liver oil as a supplement (about 3 tbsp daily for an adult).

Consider using a humidifier in winter if it is dry-skin related.

Winter Dandruff

Each year, blizzards of white flakes send millions of men and women rushing to the drugstore — not to get snow shovels or sand — but to try to find relief from the embarrassing itch of dandruff. We all have to learn, though, not to stress out over it. Stress and anxiety, many dermatologists agree, can exacerbate an existing condition.
According to Diane Berson, M.D., a NYC-based dermatologist, "For someone who is already predisposed to developing dandruff, stress can definitely make the condition worse. We don't know why this is so, but, we do know, without question — that dermatological disorders, such as dandruff, are exacerbated by stress."
Dandruff is a mild inflammation of the scalp, and it occurs when the scalp sheds larger than normal amounts of dead skin cells at an excessive rate. Dandruff and seborrheic dermatitis, a more severe form of dandruff, can, according to many dermatologists, increase with stress — regardless of whether the stress is caused by a negative event, such as losing a job, or a positive one, such as getting married.
While dandruff can cause plenty of embarrassment despite routine shampooing, the good news is that the condition responds readily to treatment. And, with a little attention, it's easy to keep it under control, regardless of your stress level.
First line of defense — schedule a visit with your dermatologist who can prescribe a specific medication meant to treat dandruff and seborrheic dermatitis.
According to Dr. Berson, "If you're on a particular dandruff maintenance therapy to prevent flare-ups, and you know you're going to have an especially stressful week, you might want to step up the regimen, just in case."
In addition, dandruff sufferers may want to practice some anti-stress techniques to help keep dandruff flare-ups at bay. "Tapes, books and videos on relaxation may help," suggests Dr. Berson. "Yoga or medication may also help — even a long, hot bath."