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Eczema

Eczema is a term used for many different types of skin inflammation and allergic rashes. In this article we will address the most common type of eczema called atopic dermatitis. This skin concern is increasing in prevalence and is the most common skin condition that dermatologists see. The cause of this condition is not known – it is a result of both hereditary and environmental factors. Most cases start in early childhood. Treatment with conventional drugs is notoriously difficult and usually offers short term relief. There are two main stages of this type of eczema – first the initial irritation of the skin that results in the flareup and then the perpetuation of the rash that generally involves the “itch-scratch cycle”.

Possible causes

Possible causes

  • Soap and harsh detergents
  • Synthetic fabrics
  • Synthetic fragrance or preservatives in cosmetics
  • Cigarette smoke
  • Animal fur
  • Dry weather or temperature extremes
  • Irritants like bleach (chlorine) or ammonia
  • Diet – things to look out for are eggs, peanuts or milk

Important lifestyle considerations

Important lifestyle considerations There are two key factors to address when treating eczema – restoring the skin’s barrier function and interrupting the itch-scratch cycle. This makes treatment sound easy but it requires great discipline on the part of the person that is showing symptoms. The first step is to find a topical application that does not contain irritants that will slow down Trans Epidermal Water Loss so that the skin can restore itself. It is important for this product to be pH balanced. The second step is to stop scratching or making any physical contact with the afflicted area. The use of a handheld counter is suggested – every time you scratch you click the counter. Every contact counts as a scratch. At the end of each day it is not uncommon for the counter to read three figures. This number needs to come down to near zero for the eczema to heal. The “three minute rule” of moisturising within three minutes after a bath or shower is often helpful. In exteme cases of eczema it is recommended that the usual steroidal topical drugs are used to control the condition and the above measures are implemented concurrently.

Keratosis Pilaris

Keratosis Pilaris is a very common skin condition that is often described by clients as “dry patches”. The dry sandpaper like skin lesions are usually white with minimal inflammation. It is medically completely harmless and normally afflicts otherwise healthy people. About 40% of the adult population is affected. This skin disorder results from an excessive build up of keratin in the opening of the hair follicles of the skin and can be described as localized keratinisation. Keratosis Pilaris is unsightly but harmless. It can be itchy and care must be taken that scratching does not lead to secondary infections. This skin condition gets worse after excessive sun exposure or in low humidity environments. It can be hereditary and is commonly associated with a fat free diet with essential fatty acid deficiency. 

Important lifestyle considerations

Important lifestyle considerations

  • Increase essential fatty acid consumption
  • Avoid drying cleansers
  • Use a pH balanced body wash
  • Exfoliate regularly
  • Moisturise with a body lotion which contains EFA’s
  • Increase fluid intake
  • Avoid excessive UV exposure

Rosacea

Rosacea typically occurs on the central zone of the face. Capillaries close to the surface of the skin become dilated resulting in red blotchy areas with small bumps and sometimes pimples. The redness can come and go but may become permanent. The skin tissue can swell and thicken and be tender and sensitive to touch. Swelling of the nose can occur (rhynophyma). The inflammation of rosacea can look like acne but comedones are not present. It can also coexist with acne. The shiny, oily look that this skin has is not due to oil but is due to fast TEWL because the acid mantle is compromised. Rosacea begins with frequent flushing of the face particularly nose and cheeks. The skin often shows extreme sensitivity to cosmetic ingredients such as fragrance and synthetic preservatives. This is most likely due to the impaired barrier function of the skin. Rosacea has been strongly linked to the overgrowth of bacteria in the small intestine. The numbers and type of bacteria in the gut can be managed with probiotics and a diet low in available carbohydrates. In the event that these are not sufficient a ten day course of a non-absorbable antibiotic may be necessary to allow natural gut flora to colonise and proliferate. Hydrogen or methane can be detected in the breath to determine which antibiotic is most appropriate.

Possible causes

Possible causes

  • Drugs which dilate blood vessels (such as those given for asthma and arthiritis, hayfever and allergies)
  • Topical steroid creams
  • Essential fatty acid deficiency
  • Sun exposure
  • Emotional stress
  • Extreme hot or cold weather and indoor heating
  • Alcohol consumption
  • Hot baths
  • Spicy foods
  • Chemicals in skin-care products and cosmetics
  • Medications

Important lifestyle considerations

Important lifestyle considerations

  • The first thing to check is whether the rosacea is due to an imbalance in intestinal flora. Nearly half of all rosacea is directly linked to overgrowth of bacteria in the small intestine. This is easily remedied and can be checked by looking for either hydrogen or methane in the breath.
  • Maintain the acid mantle – use pH balanced skin care products
  • Protect skin cell membranes with antioxidants
  • Topical application and oral consumption of essential fatty acids

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