Thursday, October 31, 2013

Moisturizers - Harmful or Helpful?

I want to talk a little about what I believe is a widespread misguided belief that moisturizers should be used on one's skin. For the purposes of keeping things simple, when I refer to moisturizers I am including emollients, humectants, etc. Here are just a few common things we have all heard many times and have even come to believe ourselves.

"Moisturizing is the protective layer between your skin & factors like pollution, over exposure to sun, harmful effects of sun & wind etc. it enables the skin to preserve its natural moisture & is a must for all skin types, especially for dry skin & aging skin. It is fundamental to all kinds of skin care. Lack of moisturizer increases dryness & speeds up the wrinkling process."

"Moisturizers are proven to help treat dry, damaged skin and improve skin texture. Maintaining a good moisturizing regimen will make you more comfortable, and it will also make you look better because, let's face it, nobody looks their best with skin that is dry and flaky."

"Another reason to use moisturizer is that it can be good for your health."

"If you think your skin is dry, moisturizer is the best thing you can do for it.”

"Wind, cold temperatures and heated houses in the winter can all dehydrate the skin, which can cause eczema to flare up and make the skin itchy and dry. “Prevention of this dryness by moisturizing is the single most important factor in protecting the skin from the elements."

The epidermis is a complicated organ. The epidermis forms the outer layer of skin, creating a tough, renewable, waterproof barrier against the environment. It is a type of epithelium, the tissue that makes up surfaces and linings in the body. Over most of the body the epidermis is relatively thin, while on areas such as the palms of the hands and soles of the feet it is much thicker and hairless. Depending on its location, the epidermis may contain hair follicles, nails, and sweat and sebaceous glands. The study of skin is known as dermatology. For years we've been told to moisturize our skin to keep it hydrated, but now some are calling to question whether this is actually harmful to the skin's natural process. To moisturize or not, that is the question.

Moisturizers work to prevent water loss by coating the skin with a substance to trap moisture - replicating what the healthy sebum balance does normally. Studies show that for dry skin syndromes like xerosis, moisturizers are effective. But some believe that topical hydrators should support the natural hydration process rather than simply supplementing moisture. The moisturizer may offer temporary relief, but the cell disruption must be isolated and corrected for dry skin to actually be alleviated.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2230.1996.tb00118.x/abstract

Regardless, how then, would moisturizers themselves be harmful to the natural hydration process? Many now believe that when cells recognize that an outside source has already hydrated the skin, there's no need for natural hydration to take place. This means that the cells become inactive and stop the moisture production process, which leads to dry skin. They liken it to a moisturizer addiction.

Some advise against using a night cream because regular application interferes with the tasks your skin undergoes at night like regenerating, balancing oil production and expelling impurities. Based on this theory, regular application over time means that the skin becomes less able to care for itself.

Studies do show that over time, moisturizer use has an impact on the skin. A study from the University of Copenhagen confirmed that skin barrier function could be adversely affected by use of moisturizers. In the study, trans-epidermal water loss was significantly higher on the arm treated with moisturizer than on the control arm, which suggests that long-term treatment with moisturizers on normal skin may increase susceptibility to irritants. But, it isn't quite clear if the natural hydration process is quelled because of the moisturizers' regular hydration or if the other ingredients in them are simply damaging the cells and causing irritation.

http://www.ncbi.nlm.nih.gov/pubmed/17300239

A study in the American Journal of Clinical Dermatology suggests that certain types of emulsifiers may weaken the skin barrier.

http://www.ncbi.nlm.nih.gov/pubmed/14572299

Other studies pose questions as to whether moisturizers' inherent capacitance is a source of false positive results.

http://www.ncbi.nlm.nih.gov/pubmed/10859537

Moisturizers also block the skin's natural repair mechanism. If left to its own devices, your skin recovers most of its ability to moisturize itself after a few weeks of feeling dry and tight. So, using moisturizer traps your skin into a vicious cycle. Using too much moisturizer, or all the time makes skin cells lazy and in the presence of exogenous oil (i.e., moisturizers, etc.), they will not need to produce or work to produce the oil necessary. Your skin knows how much to produce and when. Your job is to keep skin clean (not sterile) of old and hardened oil. You don't want to create a 100% sterile surface for yourself. Some of these germs are beneficial for homeostasis of skin and our bodies. After all, we are composed of 70-80% bacteria (by number, not mass). Bio-flora in our bodies, including our skin, are necessary for proper maintenance of our system.

Most of this information pertains to the effects of moisturizers on normal skin. If using moisturizers can damage normal healthy skin, just think of how they can affect already damaged skin. However, it seems moisturizers can be beneficial for damaged skin if used for very short term time periods, depending on the situation. People attempting topical steroid withdrawal face a much longer timeline, so using moisturizers is probably not a good idea to do throughout the process because one must conclude, based on current knowledge and good old fashioned common sense, that moisturizing during tsw can prolong recovery.

There was a recent Japanse conference held this year called "The 24th Lecture Presentation on Atopic Dermatitis in Tokyo". The doctors on the event all agreed that moisturizer withdrawal was 'usually essential' rather than 'encouraged'. They explained that only about 10% of TSW patients healed without moisturiser withdrawal, and they were all mild case patients.  TSW patients who recover well are usually doing moisturiser withdrawal strictly, according to the doctors.

http://skinofrose.blogspot.com/2013/09/tsw-event-report-from-japan.html#comment-form

After hearing about this I exchanged a few emails with Dr. Fukaya. His comments on diet, moisturizer withdrawal, the adrenal glands, etc are very interesting. He says the adrenal glands function normally in most TSA cases, and diet has little effect. He also says he agrees with Dr. Sato in that moisturizer withdrawal speeds up TSW in certain cases. He is careful to point out that some people who try moisturizer withdrawal can’t handle it and go back to using TS, I assume due to the increased pain and suffering going moisturizer free causes in the early stages. He recommends moisturizer withdrawal if one feels strong enough to do it to shorten the TSW period. He also suggests using moisturizers at an older age after TSW is complete. Here is the link to those communications.

http://mototsugufukaya.blogspot.jp/2013/07/a-report-about-biological-product-for.html#comment-form

So should we moisturize? I say yes and no. Yes, very sparingly for short durations ONLY when absolutely needed. And, yes when we are in old age. But, NO for the most part, unless of course, you don't mind lengthening your withdrawal period considerably. I wish I could find statistics on how much longer it takes to recover tsw using moisturizers compared to not using them. I seem to recall reading somewhere that tsw lasted an average of 1-2 years, but can't remember if that was with using moisturizers or not using them.






20 comments:

  1. very informative. thanks Dan.

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  2. You're very welcome Ingrid! That is my intention, to inform and enlighten. To get both sides of the story out there so people aren't seeing just one side only. Currently, information available is too lopsided for my tastes. Everything I say might be bullshit, but it's up to my readers to make that determination. We have all fallen victim to advertising and false claims in one fashion or another about many things. It's time to bring some perspective into the picture. I don't have millions of dollars to advertise, but I do know about the hundredth monkey theory. I also believe we are all connected in the "ethereal soup" of energy via quantum physics. See http://johnassaraf.com/law-of-attraction/why-you-should-be-aware-of-quantum-physics-2 for a quick explanation. I'll be talking in-depth about this subject in future posts.

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  3. So now at 4 days w/o moisturizer I'm dealing with flaking on my ring fingers and tops of both hands. Its unsightly but not quite as red as before when I was using lotions and oils. Hard to bend the fingers and the yellow/honey colored crust is in parts. Just curious what the next stage brings in healing based on your experience. thanks again, no info is too detailed as we forge this path of unknown self-healing!

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  4. Way to go on the MW! My fingers and part of my palms were swollen before I did MW but the swelling went away within a few days or so. But, I also put myself on a week course of antibiotics (Cephalexin 500mg) at the same time, so not sure what part they played. I did this because there were places on my palms that were red, very warm, and swollen, all signs of infection, except I didn't have a fever. I also had many deep fissures and skin breaks that I was concerned about getting infected if they weren't already.

    My second and third days of MW were probably my most difficult. I had to take a strong pain pill one of those days it got so painful. At first when my skin dried out, one finger dried in a half closed position and I had to bathe just to get it to open without breaking the skin so I could get a glove over it after it dried up again. I dried in a straight position which was better than bent because I could get my gloves back on. It did get flexibility back within just a couple days after that. Bathing is a great way to soften the skin in the beginning stages of MW. I looked forward to each daily bath for that reason alone.

    But, I knew I had to keep my skin dry most of the time if I wanted the skin breaks to heal. So, after each bath I would dry out again by not moisturizing. After a few days the skin healed over, and after a few more days the old skin started peeling off revealing new skin. The oozing areas between my fingers started clearing up. They were probbaly the toughest and last to heal. Please keep in mind that I also went straight from my daily baths into the sun for 10-20 minutes. I would get sun before and after each bath when possible. Usually I got sun exposure on my hands about 2-4 times a day. I was fortunate that I ignored the conventional wisdom of staying out of the sun in the initial stages, and that this happened at the beginning of summer. I knew I needed sun exposure and felt that even on raw skin that it would be helpful as long as I kept the exposure time limited. I literally started out for only a few minutes those first few times, and then increased as I went along and could tell it wasn't harming me, but instead helping (despite everything I had read on a certain forum). I am so tanned right now I can't believe it! And who cares? ha ha! I don't. I guess because I'm not at all a very vain person. I rarely even look at myself in the mirror. I check once in a great while just to make sure I haven't changed too much over time :)

    Even if you don't want to expose raw areas to the sun much, it is beneficial to at least expose the other areas of your body as much as possible, since the skin is one large organ and connected to itself. There is nothing one can take to get what your body can get from sun exposure. We can supplement with Vitamin D3 (which I do), but that doesn't give us everything we need like the sun does.

    Now, I know the sun has gone away for awhile but even on cloudy days you get some of what you need from it so do try and get as much sun as possible. I also experimented with using Tea Tree oil diluted with water between my fingers and other oozing areas, only with the idea in mind of keeping infections at bay. I rarely use it now, and mostly just use alcohol and fragrance free witch hazel made by The Homestead Company for any oozy spots that come along.

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    1. I really feel the dead sea salt baths played an important role in this for me as well. While you wait for your salts to come you can try the Epsom salts. You should see a noticeable difference in about two weeks after starting MW. I just had what I thought was the beginning of a flare due to scratching too much and eating too much of the wrong foods. But, after about 2-3 days of dead sea salt baths my skin is much better again. I had slowed down on them and did a bleach bath followed by an ACV bath the next day. My skin was driving me insane so I hit the salt baths hard and today I can tell I'm not going to flare at all. My skin is so much better today! Let us know how you progress. Good luck!

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    2. Again, I am not a doctor and am possibly insane. Do not take what I say as advice. My comments are just my opinions only no matter how they are worded. All content provided on this blog is for informational purposes only. The owner of this blog makes no representations as to the accuracy or completeness of any information on this site or found by following any link on this site. The owner of this site/blog will not be liable for any errors or omissions in this information nor, for the availability of this information. The owner will not be liable for any losses, injuries, or damages from the display or use of this information. Everything I say on this blog is only my opinion and should not be taken as medical advice in any way, shape, or form. Dan

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    3. Ingrid, how are you doing? I hope my posts weren't confusing. Let me know if they are. I know how in the initial stages of MW one questions repeatedly whether they ought to go back to moisturizing. I did go back a couple times but lasted about 3 hours both times. After doing MW the first time and seeing the improvement that follows in about a week to 10 days you won't be able to go back. You will find that moisturizers make you itch much more than being dry does. At least that was my experience. I'm interested in hearing from others who have done this.

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  5. Good morning Dan. Today is ok. My right eyelid was itching like crazy during the night and now im stuck with an inflamed and dry flaky lid :(. Is it normal for the skin to be red and angry after the salt bath? I am drying out still, and it is not quite as itchy. I did one salt hand bath last night and will try again this am. Ive got basically a lot of flakes, smallish with some yellowish spots. All normal at this stage right?! Im going strong with no moisturizer. when ive put it on in the past i definitely get the ZING in my hand and all fingers. It is the craziest feeling in the world. I dont intend to go back down that path. have a good friday. ill keep you posted. I hope some others pipe in with their experiences. I do believe this is the right way (DRY HEALING!)

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    1. Hi Ingrid. I have never done Epsom salt baths but when I need relief I always get it from a dead sea salt bath, and after 20 minutes my skin is very calmed down (always). Unless I scratch during the bath, don't do that! I found that out the hard way. When my skin gets angry I do the baths daily and when it calms down I do them about every other day and sometimes less. It seems to take about two days and my skin calms down a lot and don't need another bath for a couple days. I had a really good day yesterday but the itching set in the evening and I awake after about 3 hours itching like crazy. I knew I should of done a bath yesterday but didn't. I'll do one today and likely will feel great afterwards, and hopefully can skip it tomorrow. Frankly, I'm so sick of taking baths! Has never been my thing.

      The pics of your hands you sent me this morning look really good! I wish mine looked that good. I'll take some pics of mine later today and post them in a new post so you can see how similar the back of my right hand is to yours. It's uncanny. I can't remember if you had those irritating tiny pus filled blisters or not, but after MW you will see those go away pretty quickly. Thanks for updating your condition!

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  6. thanks again dan. look forward to your next post. i know with every day I am closer to healing

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  7. question about the salt baths: how often, and did you rinse with clean water after the salt bath as they recommend on their web site? any exfoliation during the soak when skin was wet? thanks again. even after one soak i can tell the redness is less and some of the trouble spots on my legs are beginning to dry out......hopefully to never return again!

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    1. I do dead sea salt baths once per day and when my skin feels good I cut it back to every other day or so depending on how my skin is doing. I plan to cut my bathing back to once per week eventually when my skin will make it that long without needed help. It's my understanding that bathing rinses all of our natural oils away so would much rather not bathe at all if I could until I'm finished with tsw and my skin is completely healed. Also, soaking in chemicals like chlorine is not the best thing. So, if you can, buy a chlorine filter either for the bathtub, or an expensive one for the water line entering your home.

      I have read everything from rinse immediately afterwards, to getting out of the tub and waiting 30 minutes before rinsing to allow the minerals to absorb more, to don't rinse at all. I have tried all three ways and usually rinse immediately. You are basically trying to mimic being at the dead sea. From what I understand, people who go there go into the water for awhile and then lay on the beach in the sun and dry out, and go back & forth without showering probably until later in the day or evening. I find not rinsing can have more of a drying effect on the skin. I have noticed that when I rinse immediately afterwards, any skin breaks will sting slightly. I figured maybe that was because the bath coated my skin with a thin film from the salt minerals and the rinse washed it off, so I have experimented a little with the other methods and haven't settled on any particular way as of yet. I do rinse immediately for the most part but still experimenting with that.

      I wouldn't suggest exfoliating unless you were done with tsw because when treating our damaged skin we need to allow it to grow and shed naturally so we don't want to inhibit that process by revealing new skin before it's ready. Just soak and allow the dead skin to fall off on it's own when it's ready. You don't want to rush that process.

      Because I don't want any soap at all on my skin due to it's strong ability to strip the oils from the skin so easily, I never use soap and I don't shampoo my hair. When my 20 minutes are up I usually just rinse in the shower briefly and rinse my hair as much as possible. My hair is actually cleaner and healthier looking doing this than when I used to shampoo it. I haven't even washed my face with anything other than water in 5 months. My face is very oily as a result. Not noticeable to the naked eye, but can definitely feel it with my hands. That is why I would like to get my bathing to a minimum eventually, so all my skin can get oily like my face is. My face has had the least water exposure during this whole process.

      I have tsw symptoms on different spots on my face and one ear so I often will lay on one side in the tub with one ear and half my head in the water for the first 10 minutes and then turn to the other side for the remaining 10. Sometimes I will also hold my breath and put my face directly face down into the water several times also. I have a spot on one eyelid, side of my nose, and a couple on my chin. All of these spots have cleared now so I didn't do that as much as I used to. I am always open to any suggestions from others so please don't hesitate to comment. I would love to hear other people's experiences with doing these baths, and what works best for you.

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  8. Help! How do I manage the cracks that are almost healed that break and start bleeding again bc of the excessive dryness? The witch hazel or baths better for itching?

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    1. Ingrid, I tried not rinsing after my bath yesterday made my skin excessively dry, so I plan on sticking to rinsing immediately afterwards. It should take a couple weeks of daily dssb for your skin breaks to heal. I think the baths are better for itching, but they aren't going to keep it away at night. And, you can't do dssb multiple times a day as far as I know. The only thing I know for itching relief is ice, and decreasing foods that are high in histamine from your diet. Hope this helps!

      What is your condition today compared to yesterday? Have you started doing the dssb? If so, how many days so far and much salts did you add? I know I was afraid to use more than a small handful at the beginning...

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  9. Help! How do I manage the dry spots re-splitting?

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  10. I found this to be my most difficult thing as the skin is so thin from the ts. Especially on the areas that received the most ts. I use the witch hazel between baths to control these splits and keep them out of water other then when bathing. If I feel they have been exposed too much and they are turning red and sore I use water diluted Tea Tree oil on them a few times a day. I had a couple of sore blisters pop up over the last couple days and applying undiluted Tea Tree oil made them pop and disappear already. The dead sea salt baths should help those skin splits heal within a few days, but they do tend to pop open again depending on how weak and thin the skin is. I recently had a heck of a time with some on my right hand but they are finally healed again. It feels so good with no skin breaks!

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  11. As always, thanks for your info!

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    1. I thank you as well for your input too!

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  12. Today's rant: how do you deal with basic tasks that use your hands!? Cooking, washing dishes etc!? I am a home chef and LOVE cooking so am trying to adjust to giving my hands a break. I've ordered some cotton lined dish gloves. What kind of gloves have you used?

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    1. I deal with basic daily tasks very gingerly and always wear gloves when I have any open wounds. I buy the cheap xl white cotton gloves and wear xl latex free vinyl gloves over them when I need to get my hands dirty or wet. I don't do this often though as it makes my hands sweat. Having this crap on the hands is probably one of the worst areas to have it. I was buying the Cara brand gloves but found a seller on the web with a large amount, "Magid TouchMaster Cotton Glove, Men's Jumbo (Pack of 60 Pairs)" for $28.83 with shipping. These are thinner but I like them a lot more than the Cara brand. I change my gloves at least 10 times a day so am always washing a load of them. Lately though, I've just had to wear one glove and now I can probably go without it, but want to wait a little longer.

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