Skin Stories | Eczema with Hayley Fogarty
What are the biggest challenges people with eczema face when it comes to skincare?
The majority of skincare, SPF and makeup on the market will exacerbate their eczema due to damaging ingredients that disrupt the barrier and its processes, or they may be too active for this condition such as vitamin A or C. That’s why it’s important to seek out help from a professional who specialises in this area to guide you on what you should and shouldn’t be putting on your skin.
How can someone tell if their eczema is being triggered by a specific product or ingredient?
A pretty good indication would be how the product feels when you first put it on the skin. If there is a burning sensation then stop using the product immediately. If your skin turns red on application and stays red that would be another indication and if you notice your condition getting worse over the next few days whilst using the product. If your skin improves when you stop the product then voila we’ve found a common denominator.
Are there any surprising treatments or lifestyle changes that can help manage eczema?
Washing your face and body with filtered water! It’s my first recommendation for anyone who wants better skin and hair but especially for eczema/dermatitis prone clients. Tap water is incredibly stripping and irritating to the skin due to the chlorine and fluoride content as well as other heavy metals. I recommend shower and bath filters OR the gold standard would be to get your whole water system filtered in your home. Also drinking tap water lowers IQ and we don’t need that do we.
What’s your best advice for parents managing eczema in children?
We love working with babies and children who have eczema so we can implement some simple things to prevent them from going down the topical steroid route. The two main areas we focus on internally is diet and the gut as well as supporting their overactive immune response. Dairy and gluten can be the main dietary triggers to avoid and implementing a probiotic with strains specific for eczema as well as fish oil omegas. I recommend a therapeutic bath dead sea salts (1/2 cup), apple cider vinegar (1 tablespoon) and a dash bentonite clay if their skin can tolerate it as well as a specific skincare prescription. Adults just double the recipe.
What’s happening beneath the skin when someone experiences an eczema flare-up?
The science-y answer is:
Skin barrier dysfunction. Mutations in the filaggrin gene is inherited from one or both parents that results in a poor skin integrity and reduced hydration making that person more susceptible to eczema which leads to increase water loss (TEWL).
Immune dysregulation occurs wherein Th-2 is overactive resulting in inflammation.
Microbiome dysbiosis – increase is staphylococcus aureus which worsens inflammation by triggering an immune response.
pH within the skin increases to an alkaline state making it harder to defend pathogens and increases risk of infections.
Our skin is a protective shield from the outside world and when the above concoction is happening we see red, inflamed, irritated skin!
How does the skin’s microbiome play a role in eczema management, and how can we support it?
Our skin’s microbiome is made up of bacteria, yeast, fungi and viruses. They all have their roles to play within the skin. When the environment on the skin changes then this microbiome can become disturbed, in eczema it’s an increase in the bacteria - staphylococcus aureus that results in inflammation, infection and disruption to the skin barrier. Applying ingredients that support the skin microbiome such as zinc oxide and probiotics helps a lot. The gut and skin microbiome are intrinsically linked ensuring the gut is supported will directly impact the skin’s microbiome.
What’s the science behind why mineral SPF is less irritating for eczema-prone skin?
When I recommend Mother SPF which contains zinc oxide to my eczema clients not only is it protecting their fragile skin from UV damage it’s actually helping to heal and calm the skin too.
Zinc oxide is one of the main ingredients I get my eczema clients applying to their skin.
Zinc oxide is an immunomodulator that helps to regulate the immune system), as well as having wound healing and anti-inflammatory benefits. It helps to reduce itch and is antibacterial so it’s supports the skin’s microbiome which is essential for reducing the staph aureus bacteria. Most eczema clients will be suffering from an overactive immune response so zinc helps to reduce allergen induced skin inflammation. Zinc has a powerful re-epithelisation benefit and supports skin cell communication. A great hack for bubs and kids is to apply nappy rash balm to the eczema as it has a high dose of zinc in it – or your Mother SPF! The majority of eczema sufferers are zinc deficient, so topical and internal supplementation is key.
How does water loss (TEWL) contribute to eczema severity, and what helps lock in moisture?
If we think of our skin barrier like a roof of a house. Imagine your skin cells are the tiles and ceramides are the glue that holds those tiles together. In an eczema prone skin you have tiles missing from your skin roof. This means water escapes rapidly (TEWL) from the skin due to a dodgy roof! To counter this we need essential fatty acids externally and internally. We can provide a protection barrier with a fat rich balm to help lock in that water until our skin roof is rebuilt as well as taking fish oils internally and upping good fats in the diet.
Are there any dietary links to eczema that people should be aware of?
The following can potentially exacerbate eczema - dairy, gluten, sugar, alcohol, coffee, inflammatory foods such as heated seed oils, fried and processed food), additives and preservatives, high histamine foods and some common allergen foods are – egg, shellfish, citrus and strawberries.
What’s the biggest myth about eczema treatments that you’d like to debunk?
‘Antibiotics and bleach baths are the only options to combat skin infections’
The studies are weak to show internal antibiotics and bleach baths are effective for reducing infections and can have negative side effects. If a skin infection is aggressive or persistent, I would recommend topical antibiotics over the above as it’s more localised. However, since introducing a particular spray our clients infection rate has dramatically dropped off without harmful side effects!
‘Eczema is hereditary and untreatable without topical steroids’
We specialise in topical steroid withdrawal at our clinic so we see the effects topical steroids can have on the skin long term and unfortunately it can be an extremely severe drug induced skin condition. Getting to the root cause of your eczema is KEY to treating this condition and keeping it at bay.
How do you approach treatment for clients struggling with skin barrier protection?
My motto is GO LOW AND SLOW when it comes to eczema/dermatitis. Filtered water cleanses, a customised Dermaviduals serum and an oleogel balm layered with a zinc oxide SPF is my first point of call for the face and a simple yet effective protocol for the body skin. I recommend LED light sessions if the skin is ready for it. I would be cautious of any other skin treatments unless it’s a very gentle, express facial that we offer. It’s important to seek out professional as each case is different and requires a slightly different approach.
What role does sun protection play in managing skin barrier issues?
If the barrier is impaired, then it’s going to be more susceptible to UV damage. Most SPFs on the market will exacerbate eczema so I always recommend a gentle zinc based SPF such as MOTHER for my clients and of course other sun protection methods such as a hat. I do however believe 20 mins of sun exposure is beneficial in non-peak times as it encourages a healthy microbiome and increase vitamin D levels. I am a big fan of grounding to help reduce eczema/skin conditions such as ocean swims, putting your feet in the grass, being out in nature and I recommend grounding mats to go on your bed.
Note: This article was originally published on Mother SPF.