Nobody likes flying these days. The bag fees, the lines, the security, the delays. But flying is a special hell for those of us with eczema. Each of us has his or her personal pharmacy at home, containing moisturizers, various grades of steroids, and special soaps, shampoos, and shaving creams that cost a lot of money and are difficult to find in stores. When you travel, first of all you have to select what to take with you. Airlines lose bags, so you want to put your vitals in your carryon—but regulations now say that everything has to fit into a quart-size Ziploc, so you have to fill small plastic containers with a few days’ worth of this or that. And if you’re not careful—as happened to me recently—a zealous airline employee can “gate-check” your carryon because the plane’s already full of other passengers’ necessities. You last see your precious mini-pharmacy sitting forlornly on the jet way as you board Untied Airlines 1234 for Topeka.
Untied Airlines. (I don’t want to embarrass the airline, so I’ve given them a pseudonym.)
I’ll never fly Untied again. They made my trip back from my summer family vacation a personal indignity. The worst thing is that it wasn’t the Untied staff, who were almost all truly helpful and pleasant. It was the airline’s system, which was clearly to blame for all the problems. So no free vouchers or drinks will convince me to fly with them again, because the experience would surely be no better next time.
Our trips out and back were two-stage: San Francisco to Chicago to Halifax, and Halifax to Newark to San Francisco. On the way out, both flights were delayed by two hours—but the delays were of the rolling variety, in which the airline tells you the plane’s going to take off in half an hour, but it doesn’t; then they announce it will take off in another half hour, but it doesn’t; etc.
But these delays were peanuts. The real trouble started on the second leg of our return, as you will see.
My mistake was in bringing along on the trip only just enough moisturizers and steroids to last the planned duration. Because the vacation was stressful (my extended family, ten of us, in a small house for two weeks) and heavily air-conditioned, my skin had been especially dry and inflamed—so much so that my dad assumed the redness was sunburn. I ran out of Eucerin two days before our return, and bought a cheap substitute that didn’t really do the job. I squeezed the last microgram of steroids out of a flattened tube, and willed myself not to scratch. You can imagine how that worked out.
I packed my pathetic remaining moisturizer into a small Tupperware container and shoved it into my carryon. As we left Halifax for San Francisco, where my eczema stash awaited, I felt like a nomad in the desert making his way back to a beloved oasis.
We barely made a tight connection in Newark. An Untied employee gate-checked my bag, and I watched my moisturizer disappear into the distance. Untied gave us seats in four different locations throughout the plane, so we had to beg random strangers to let us sit next to our kids. It was 2:00 in the afternoon.
Two hours pass on the tarmac. Then the pilot tells us the flight has been canceled because of mechanical difficulties.
We disembark in confusion. Eventually we get booked on a flight leaving at 8:00 pm. We get food vouchers and search the airport for something that my daughter, who has dairy and nut allergies, can eat. We find essentially nothing. (She doesn’t have known anaphylactic problems, but who wants to gamble?) She's eaten all her snacks already. This is going to be a hungry day for her. We board at 8:00 and, because we have seats in four different locations, beg random strangers to take our cramped middle seats so that we can sit next to our kids.
Three hours pass on the tarmac. The kids fall asleep. Then the pilot tells us the flight has been canceled because of mechanical difficulties.
Someone in the back of the plane yells “Goddamn!”
We all get free drink vouchers and coupons for 10% off our next flight on Untied.
And we get to stay overnight at the Newark Ramada. “Overnight” in this case means four hours, since it’s now midnight and we have to be back at the airport to go through security again for our new 7:00 am flight.
By the morning, my skin is so dry it makes the Dead Sea Scrolls look supple. I introduce myself to my seatmate, but can’t shake hands with her because it would be too painful and disgusting. I look at myself in the mirror of the airplane bathroom. My face is falling off.
Eighteen hours after we were supposed to arrive, we land in San Francisco. The final farce: our bags aren’t on the plane and we have to go searching for them. My wife finds them in a special long-term holding location.
The first thing I do at home is to take a long shower with Dove soap and tar shampoo and cover myself in a thick layer of Eucerin. The second thing: rip all the Untied tags off our baggage.
The moral to this story, I guess, is that you have to plan for the worst when you fly. And I will next time. You have to go into survival mode, and make absolutely sure that you have small containers of your eczema essentials on your person where you can’t possibly lose them. Otherwise, you run the risk of a hellish experience.
Showing posts with label moisturizers. Show all posts
Showing posts with label moisturizers. Show all posts
Wednesday, August 22, 2012
Thursday, December 9, 2010
Moisturizer alcohol burn bad; acid moisturizer good
Voov had another dermatology appointment today. Nothing urgent; just a checkup to see how she's doing on her restricted diet. The new development is that we are not to apply steroids unless she's having a significant flare. Hidden B has, it turns out, been putting Derma-Smoothe on Voov every second night (Hidden B and I trade kid duties on alternate nights) and every morning. "I can't tell what's a significant flare," she says. "They all look significant to me."
I, on the other hand, don't think Voov's skin has been bad for quite some time. So, on my shifts, I haven't been putting any Derma-Smoothe on. This is what happens even in a two-doctorate family: we don't know exactly what we're supposed to be doing with our kid.
I mentioned that recently I got suckered into buying some generic moisturizing "creme" at CVS. It sits right next to the Eucerin, comes in the same kind of jar, and costs half as much. Why do I have to learn this lesson over and over again? The CVS creme sucks. It's slippery and actually burns my skin, although the ingredient list is virtually identical to Eucerin's. (Not perfectly identical, though, and I'd guess that the CVS version has more alcohol.)
Anyway, Hidden B found Eucerin on sale at Target and got me two jars. So I chucked out the CVS stuff. Burn begone.
This month's Journal of Allergy and Clinical Immunology has an article you'd find interesting. (Editor's summary here.) Let me recap it for you.
Two amino acids that naturally occur on normal human skin can slow the growth and reduce the infectious potential of the bacterial pathogen Staphylococcus aureus, a group of Irish scientists have shown in laboratory experiments.
S. aureus colonizes the skin of 5% of people without eczema, and 90% of people with eczema; it infects broken skin and secretes molecules that cause and prolong inflammation.
Normal skin controls S. aureus with antimicrobial agents and an acidic pH (about pH 5.5, compared to normal cellular pH of about 7.4). I am not sure what acids are responsible for this low pH; however, two products of the breakdown of the molecule filaggrin (see here and here), "UCA" and "PCA," are amino acid components of "natural moisturizing factor" known to hydrate the skin and possibly contribute to its acidity.
The scientists explored whether UCA and PCA could, in a test tube, inhibit the growth of S. aureus. The answer was yes. UCA and PCA also reduced bacterial production of proteins necessary for S. aureus to colonize skin and evade the immune system. The interesting thing is that the scientists found the same inhibitory effects when they used hydrochloric acid instead of UCA and PCA. So the acidity of amino acids, rather than some other chemical property, is responsible for much of the bacteria-controlling effect.
However, there is one area in which UCA and PCA appear to have special properties: they greatly reduce bacterial production of one iron-sensing protein that helps S. aureus stick to skin cells. Hydrochloric acid does not do this.
If anything from this research might prove useful in the future to eczema patients, it would be that chemists might consider adding UCA and PCA to moisturizers to provide antibacterial control. There is evidence (referenced in the paper) that acidic moisturizers help suppress S. aureus.
I, on the other hand, don't think Voov's skin has been bad for quite some time. So, on my shifts, I haven't been putting any Derma-Smoothe on. This is what happens even in a two-doctorate family: we don't know exactly what we're supposed to be doing with our kid.
I mentioned that recently I got suckered into buying some generic moisturizing "creme" at CVS. It sits right next to the Eucerin, comes in the same kind of jar, and costs half as much. Why do I have to learn this lesson over and over again? The CVS creme sucks. It's slippery and actually burns my skin, although the ingredient list is virtually identical to Eucerin's. (Not perfectly identical, though, and I'd guess that the CVS version has more alcohol.)
Anyway, Hidden B found Eucerin on sale at Target and got me two jars. So I chucked out the CVS stuff. Burn begone.
This month's Journal of Allergy and Clinical Immunology has an article you'd find interesting. (Editor's summary here.) Let me recap it for you.
Two amino acids that naturally occur on normal human skin can slow the growth and reduce the infectious potential of the bacterial pathogen Staphylococcus aureus, a group of Irish scientists have shown in laboratory experiments.
S. aureus colonizes the skin of 5% of people without eczema, and 90% of people with eczema; it infects broken skin and secretes molecules that cause and prolong inflammation.
Normal skin controls S. aureus with antimicrobial agents and an acidic pH (about pH 5.5, compared to normal cellular pH of about 7.4). I am not sure what acids are responsible for this low pH; however, two products of the breakdown of the molecule filaggrin (see here and here), "UCA" and "PCA," are amino acid components of "natural moisturizing factor" known to hydrate the skin and possibly contribute to its acidity.
The scientists explored whether UCA and PCA could, in a test tube, inhibit the growth of S. aureus. The answer was yes. UCA and PCA also reduced bacterial production of proteins necessary for S. aureus to colonize skin and evade the immune system. The interesting thing is that the scientists found the same inhibitory effects when they used hydrochloric acid instead of UCA and PCA. So the acidity of amino acids, rather than some other chemical property, is responsible for much of the bacteria-controlling effect.
However, there is one area in which UCA and PCA appear to have special properties: they greatly reduce bacterial production of one iron-sensing protein that helps S. aureus stick to skin cells. Hydrochloric acid does not do this.
If anything from this research might prove useful in the future to eczema patients, it would be that chemists might consider adding UCA and PCA to moisturizers to provide antibacterial control. There is evidence (referenced in the paper) that acidic moisturizers help suppress S. aureus.
Tuesday, November 30, 2010
Immunotherapy: a history of histamines
"Winter" here in the San Francisco Bay Area may not be severe by anyone's standards, but there's a definite change in the air that has flipped some sort of switch for me and Voov. It's always been this way, mysterious: changing weather makes eczema worse. Toward winter, it's probably reduced humidity in the air; in spring, there's probably pollen. Can't do much about either! Slather on more moisturizer after November, maybe, but it's not a 100% remedy. And as far as antihistamines go for pollen: completely useless, in my experience.
So here we are, skin suddenly tighter and drier, the red excoriations on our hands and wrists. But neither of us is going through an extreme flare.
I ran out of Eucerin on the weekend, and picked up a jar of generic moisturizer at CVS. You know the kind. It's the store brand stuff stacked next to the Eucerin, and the price tags read "Eucerin: $15.99" "CVS Moisturizing Creme: $9.99." You get what you pay for. The problem is, the cheap stuff may LOOK the same as Eucerin, but it sucks. It's thinner and slippery and wears off fast. I have to relearn this the hard way every six months or so.
The review is only eight pages including two of references, but it's encyclopedic. It follows immunotherapy all the way from its inception in 1911 (Leonard Noon's paper in the Lancet on injecting hay fever patients with grass pollen extract) to the current day. The authors explain how the therapy has remained essentially the same, but our understanding of how it works has evolved to become ever more complex as scientists have laid bare the secrets of the immune system.
In short: in the 1930s, scientists realized that patients given immunotherapy develop "blocking antibodies" that hinder the overeager allergic response. In the late 1960s, they learned that immunotherapy stabilizes mast cells and basophils and reduces the quantity of histamine released when patients encounter allergenic triggers. In the 1990s, after the discovery that there are at least two subtypes of helper T cells, scientists realized that immunotherapy partially shifts the T cell population in allergic patients from the allergy-related type 2 to the infection-related type 1. And in the mid-2000s, regulatory T cells were discovered; immunotherapy apparently increases the number of regulatory T cells that inhibit type 2 helper T cells.
Over time, immunotherapy has been refined. With greater understanding of how the mucosal membranes process allergens, scientists developed sublingual immunotherapy, in which the allergens are placed under the tongue and absorbed into the tissue, where they are taken up by dendritic cells. (Straight-up oral immunotherapy, where the patient swallows the substances, is a bust.)
And, for asthma patients at risk of severe allergic reactions, doctors now administer immunotherapy along with the monoclonal anti-IgE antibody "omalizumab." Which is produced by Genentech, naturally, and costs $10,000 to $30,000 a year. I wonder, within the US, which insurance plans cover this, and whether the product is available outside the US. It's relevant to eczema because it appears to be quite effective-- it might become cheaper over time (e.g. after the patent expires) or other companies might develop alternatives to take excess IgE out of our systems.
So here we are, skin suddenly tighter and drier, the red excoriations on our hands and wrists. But neither of us is going through an extreme flare.
I ran out of Eucerin on the weekend, and picked up a jar of generic moisturizer at CVS. You know the kind. It's the store brand stuff stacked next to the Eucerin, and the price tags read "Eucerin: $15.99" "CVS Moisturizing Creme: $9.99." You get what you pay for. The problem is, the cheap stuff may LOOK the same as Eucerin, but it sucks. It's thinner and slippery and wears off fast. I have to relearn this the hard way every six months or so.
* * *
I want to share this review with you. It covers the history of our understanding of how immunotherapy works. The senior author is Mitchell Grayson, the scientist from the Medical College of Wisconsin who gave a presentation on eosinophils at the recent annual meeting of the American College of Allergy, Asthma, and Immunology.The review is only eight pages including two of references, but it's encyclopedic. It follows immunotherapy all the way from its inception in 1911 (Leonard Noon's paper in the Lancet on injecting hay fever patients with grass pollen extract) to the current day. The authors explain how the therapy has remained essentially the same, but our understanding of how it works has evolved to become ever more complex as scientists have laid bare the secrets of the immune system.
In short: in the 1930s, scientists realized that patients given immunotherapy develop "blocking antibodies" that hinder the overeager allergic response. In the late 1960s, they learned that immunotherapy stabilizes mast cells and basophils and reduces the quantity of histamine released when patients encounter allergenic triggers. In the 1990s, after the discovery that there are at least two subtypes of helper T cells, scientists realized that immunotherapy partially shifts the T cell population in allergic patients from the allergy-related type 2 to the infection-related type 1. And in the mid-2000s, regulatory T cells were discovered; immunotherapy apparently increases the number of regulatory T cells that inhibit type 2 helper T cells.
Over time, immunotherapy has been refined. With greater understanding of how the mucosal membranes process allergens, scientists developed sublingual immunotherapy, in which the allergens are placed under the tongue and absorbed into the tissue, where they are taken up by dendritic cells. (Straight-up oral immunotherapy, where the patient swallows the substances, is a bust.)
And, for asthma patients at risk of severe allergic reactions, doctors now administer immunotherapy along with the monoclonal anti-IgE antibody "omalizumab." Which is produced by Genentech, naturally, and costs $10,000 to $30,000 a year. I wonder, within the US, which insurance plans cover this, and whether the product is available outside the US. It's relevant to eczema because it appears to be quite effective-- it might become cheaper over time (e.g. after the patent expires) or other companies might develop alternatives to take excess IgE out of our systems.
Thursday, November 18, 2010
Aveeno rolls out new line of eczema moisturizers
In my newsfeed today I got a press release from Aveeno-- apparently they have just rolled out a new line of moisturizers especially for kids and adults with eczema. In fact, you can find a promo video on Facebook. In the video, Suzy Deprizio, a brand manager for Aveeno, talks about how she's been involved in developing the moisturizers (or developing the marketing strategy? Not entirely clear to me) for five years, and how she found out that her young daughter had eczema. She also offers a few tips, none of which will surprise you if you live with eczema: clip fingernails, etc. It is interesting to know that there are people at Aveeno who have a personal stake in the products. Aveeno's definitely an example of a company whose products benefit society. Looking forward to trying out the new creams!
On the topic of moisturizers & skin barrier, there is a good article in The Advocate, basically a transcript of a presentation by Peter Lio, MD, at the 2010 NEA Patient Conference in Chicago. Lio makes a few interesting points. One is that traditional soaps-- say, Ivory, or something that you might make yourself from lye and rendered fat if you're under the impression that "pure" or "simple" equals better--are harsh on the skin. Quite apart from their surfactant properties, when mixed with water, they increase the pH, making a strong alkaline solution. Why is alkalinity bad? Because the skin's natural pH is slightly acidic.
When the skin becomes more alkaline, the conditions favor the action of natural enzymes called serine proteases, which break down the bonds between skin cells and chew up other enzymes that produce fatty molecules called ceramides. Ceramides, in the right balance, are essential in creating a good skin barrier. So traditional soap not only removes these lipids from the skin, but reduces the skin's ability to replenish itself. You can find a good review of the skin barrier in eczema here.
Lio also discusses commercial moisturizers. He says (and I've found) that pure petroleum barriers such as Vaseline aren't very useful. They do indeed keep water in the skin, but as soon as they rub off, they don't. When I put Vaseline on eczematous skin, the benefit seems to wear off within minutes. "Right now I would say it's nice to look for something that contains ceramides," Lio says.* We're using CeraVe on Voov--it contains ceramides--and it seems to be working very well. The stuff is hella expensive though. It makes Eucerin look cheap. But I am going to start trying it out on my hands to see if it makes any difference. (I know, I know, Eczema Mom, you advised me to try it a while ago. But we all get attached to our daily routine and it's hard to change.)
*So do these Aveeno products have ceramides? If not, why is colloidal oatmeal so good for skin? Will investigate.
On the topic of moisturizers & skin barrier, there is a good article in The Advocate, basically a transcript of a presentation by Peter Lio, MD, at the 2010 NEA Patient Conference in Chicago. Lio makes a few interesting points. One is that traditional soaps-- say, Ivory, or something that you might make yourself from lye and rendered fat if you're under the impression that "pure" or "simple" equals better--are harsh on the skin. Quite apart from their surfactant properties, when mixed with water, they increase the pH, making a strong alkaline solution. Why is alkalinity bad? Because the skin's natural pH is slightly acidic.
When the skin becomes more alkaline, the conditions favor the action of natural enzymes called serine proteases, which break down the bonds between skin cells and chew up other enzymes that produce fatty molecules called ceramides. Ceramides, in the right balance, are essential in creating a good skin barrier. So traditional soap not only removes these lipids from the skin, but reduces the skin's ability to replenish itself. You can find a good review of the skin barrier in eczema here.
Lio also discusses commercial moisturizers. He says (and I've found) that pure petroleum barriers such as Vaseline aren't very useful. They do indeed keep water in the skin, but as soon as they rub off, they don't. When I put Vaseline on eczematous skin, the benefit seems to wear off within minutes. "Right now I would say it's nice to look for something that contains ceramides," Lio says.* We're using CeraVe on Voov--it contains ceramides--and it seems to be working very well. The stuff is hella expensive though. It makes Eucerin look cheap. But I am going to start trying it out on my hands to see if it makes any difference. (I know, I know, Eczema Mom, you advised me to try it a while ago. But we all get attached to our daily routine and it's hard to change.)
*So do these Aveeno products have ceramides? If not, why is colloidal oatmeal so good for skin? Will investigate.
Wednesday, November 10, 2010
Eczema Haul!!!
An End Eczema first today: let's look at a video. As I've said before, this blog is going to be light on photos and such because eczema doesn't make the most attractive visuals. And video? Well, this one is an exception. It's kind of fun. The girl has decided to show us all the panoply or arsenal or whatever of the products that she uses daily to treat her eczema. She's titled her video "Eczema Haul!!!" --must be some new slang term I haven't heard of.
Easy to tell that she's American: well, first, her accent, but if you hadn't registered that, "I don't have insurance" is a dead giveaway. Let me be perfectly clear. I live in the U.S., but I think it's barbaric that this is the only first-world country without universal health insurance. Imagine having eczema and getting a staph infection and wondering whether you ought to go see a doctor because it might cost too much. For one thing, every infection that unnecessarily goes too far puts other people at risk of being infected.
Here's the video (she's disabled embedding).
A couple interesting points. She's obviously very keen on Aveeno. So am I. It's a great company with great products, and the Daily Moisturizing Lotion with dimethicone (a rubbery sealant) is almost the best I've found. The shaving gel is awesome, although a while back they were having manufacturing problems and you couldn't find it in stores, so I've been using some fragrance-free Edge. But you can't go completely Aveeno. I tried Aveeno shampoo and found it little better than ordinary shampoo, leaving my scalp drier than the Mojave. Here's my secret: tar shampoo, rinse, and then, rubbed into the scalp, some jojoba oil.
Ironically, jojoba grows in the Mojave.
Toward the end she pulls out a bottle of vitamin E capsules and touts its benefits to people with skin diseases. "Vitamins are good for you, period, people." I am not so sure. I confess to taking a daily multivitamin (mostly for the potassium-- I get muscle cramps sometimes), but all that I read about eczema tells me that the way to a happier you is to avoid problem foods rather than take any miracle nostrums.
To quote an impeccable authority, Wikipedia:
Something I forgot to relate after my trip east to the science writers' conference this past weekend: there is a new book just out on MRSA. Superbug: The Fatal Menace of MRSA. (The author, Maryn McKenna, was on a panel discussing how to publish a popular science book.) I'm not saying you should read it--even the website gives me the willies--but it sure looks like the comprehensive resource on the emergence of this medical hazard that is of concern to everyone with eczema. Perhaps Dr. Sib can give us her perspective on MRSA, what it's like to deal with it in the hospital.
Easy to tell that she's American: well, first, her accent, but if you hadn't registered that, "I don't have insurance" is a dead giveaway. Let me be perfectly clear. I live in the U.S., but I think it's barbaric that this is the only first-world country without universal health insurance. Imagine having eczema and getting a staph infection and wondering whether you ought to go see a doctor because it might cost too much. For one thing, every infection that unnecessarily goes too far puts other people at risk of being infected.
Here's the video (she's disabled embedding).
A couple interesting points. She's obviously very keen on Aveeno. So am I. It's a great company with great products, and the Daily Moisturizing Lotion with dimethicone (a rubbery sealant) is almost the best I've found. The shaving gel is awesome, although a while back they were having manufacturing problems and you couldn't find it in stores, so I've been using some fragrance-free Edge. But you can't go completely Aveeno. I tried Aveeno shampoo and found it little better than ordinary shampoo, leaving my scalp drier than the Mojave. Here's my secret: tar shampoo, rinse, and then, rubbed into the scalp, some jojoba oil.
Ironically, jojoba grows in the Mojave.
Toward the end she pulls out a bottle of vitamin E capsules and touts its benefits to people with skin diseases. "Vitamins are good for you, period, people." I am not so sure. I confess to taking a daily multivitamin (mostly for the potassium-- I get muscle cramps sometimes), but all that I read about eczema tells me that the way to a happier you is to avoid problem foods rather than take any miracle nostrums.
To quote an impeccable authority, Wikipedia:
The consensus in the medical community is that there is no good evidence to support health benefits from vitamin E supplementation, yet there is strong evidence that taking more than 400 IU of vitamin E per day for extended periods increases the risk of death.I like to avoid death, myself. It's something that, according to the prophet Mohammed, even black cumin can't cure.
Something I forgot to relate after my trip east to the science writers' conference this past weekend: there is a new book just out on MRSA. Superbug: The Fatal Menace of MRSA. (The author, Maryn McKenna, was on a panel discussing how to publish a popular science book.) I'm not saying you should read it--even the website gives me the willies--but it sure looks like the comprehensive resource on the emergence of this medical hazard that is of concern to everyone with eczema. Perhaps Dr. Sib can give us her perspective on MRSA, what it's like to deal with it in the hospital.
Monday, October 18, 2010
A moisturizer to steer clear of, for you Brits
Today, along with an avalanche of the usual news of perfidy and perversion this world produces, was a note from the BBC describing some research at the University of Bath. In short: putting some stuff called Aqueous Cream BP on the skin of even healthy subjects is a bad idea. (Original article here.)
Aqueous Cream BP must be a British thing-- never seen it here. Apparently the manufacturers' original intent was for it to be used as a kind of gentle cleanser, to be washed off, but doctors started telling people with eczema that they should leave it on and use it as a moisturizer. It contains 1% w/v sodium lauryl sulfate, a detergent, and people, especially kids, have for years been complaining about it stinging. Big surprise: you shouldn't use it.
I'm not sure I buy the researchers' data on how this cream thins the stratum corneum--the topmost layer of skin--but they seem to show that when you start stripping off healthy skin that has been treated with the cream, its rate of water loss increases faster than that of untreated healthy skin. (The researchers' advanced tool for stratum corneum stripping: Scotch no. 845 book tape (St. Paul, MN, U.S.A.)
The authors say that most likely the detergent is breaking down lipids between cells in the stratum corneum, and making the skin more permeable.
This is cheap, easy research. It also proves something everyone already knew was true. So it's not the kind of work I propose to fund.
But it does let me ramble about moisturizers. I grew up in Canada, where doctors always prescribed Glaxal Base for my eczema. Let it be known: although Glaxal Base contains not a molecule of sodium lauryl sulfate, it completely sucks as a moisturizer. The best stuff I've found is Eucerin, or one of its generic analogs that you can find in CVS or Longs (but not Walgreens--their version is terrible). Eucerin, like a good mayonnaise, combines awesome greasiness with light fluffiness. OK, I'm exaggerating: it goes on like cream cheese. There's a science to moisturizers and Beiersdorf, the makers of Eucerin, have got it right.
No surprise, Beiersdorf is a German company. The Germans, in my personal experience, are a step ahead in eczema treatment.
Aqueous Cream BP must be a British thing-- never seen it here. Apparently the manufacturers' original intent was for it to be used as a kind of gentle cleanser, to be washed off, but doctors started telling people with eczema that they should leave it on and use it as a moisturizer. It contains 1% w/v sodium lauryl sulfate, a detergent, and people, especially kids, have for years been complaining about it stinging. Big surprise: you shouldn't use it.
I'm not sure I buy the researchers' data on how this cream thins the stratum corneum--the topmost layer of skin--but they seem to show that when you start stripping off healthy skin that has been treated with the cream, its rate of water loss increases faster than that of untreated healthy skin. (The researchers' advanced tool for stratum corneum stripping: Scotch no. 845 book tape (St. Paul, MN, U.S.A.)
The authors say that most likely the detergent is breaking down lipids between cells in the stratum corneum, and making the skin more permeable.
This is cheap, easy research. It also proves something everyone already knew was true. So it's not the kind of work I propose to fund.
But it does let me ramble about moisturizers. I grew up in Canada, where doctors always prescribed Glaxal Base for my eczema. Let it be known: although Glaxal Base contains not a molecule of sodium lauryl sulfate, it completely sucks as a moisturizer. The best stuff I've found is Eucerin, or one of its generic analogs that you can find in CVS or Longs (but not Walgreens--their version is terrible). Eucerin, like a good mayonnaise, combines awesome greasiness with light fluffiness. OK, I'm exaggerating: it goes on like cream cheese. There's a science to moisturizers and Beiersdorf, the makers of Eucerin, have got it right.
No surprise, Beiersdorf is a German company. The Germans, in my personal experience, are a step ahead in eczema treatment.
Saturday, October 2, 2010
Eeyore, terrorism, and moisturizers
I said last post that I was going to announce the lucky winner(s) of the second Mark Twain Steel Trap Award.
An optimist. The pessimist doesn't want to reach higher. He's enjoying it too much feeling sorry for himself and taking it out on others.
To quote A. A. Milne:
I'm nearly done with being Eeyore. Indulge me this once. The second Mark Twain Steel Trap Award goes to the terrorists who, in 2006, plotted to bring liquid explosives on airliners flying from the UK to North America. The British police, bless 'em, foiled these men and put them in irons. But since that day--at least in North America, which is what my experience has been limited to in the last four years--you can't bring any sizeable quantity of moisturizer in your carry-on. And anything in your checked bag comes under suspicion. (Myself, I like to travel without checked baggage if I can, especially since United started charging for bags.)
The inconvenience is non-lethal, I grant you, but several times I've had to chuck out large tubs of Eucerin at security checkpoints. Eucerin is the only moisturizer I've found to do the job, and it's not cheap--depending where you get it, anything from $13 to $17 a pop. And you can't necessarily get it at your destination. So there you are stuck on an airplane getting stressed and dehydrated, and at the far end the first thing on your mind is where the nearest pharmacy is. When you find one, it may be open, or not, and may or may not carry Eucerin, at a reasonable or exorbitant price.
Messrs. Ali, Sarwar, Hussain, Savant, Khan, Zaman, and any I may have omitted: your prize, sirs.
(No succor for you.)
I'm done awarding prizes for now, but can't rule it out absolutely in the future, should I come across a deserving honoree.
The silver lining from one of these Eucerin-chucking incidents was that I ended up in San Francisco (having flown from DC where I was living at the time) on a Sunday, when all Walgreens pharmacies are inexplicably closed, and was forced to pick some random moisturizer from an aisle in Safeway. It turned out to be a winner. Aveeno Daily Moisturizing Lotion with dimethicone is pretty good stuff, even if it's not in the same league as Eucerin. The dimethicone is a rubbery sealant that leaves you with a pleasant plasticky feeling. If you're into that kind of thing.
(From Twain's autobiography, to be released this November by UC Berkeley Press; the quote refers to a man who borrowed and lost a large amount of Twain's money: "if I had his nuts in a steel trap, I would shut out all human succor and watch that trap until he died.")Well, here's the thing. I've been reading a few of my earlier posts, and I'm not sure the tone is what I want to aim for. The aim of this blog is to raise at least $1 million for eczema research, whether that means creating a foundation or funneling major contributions to a worthy, effective organization that already exists. I want to inspire philanthropists to invest in research that leads to a cure (or cures; eczema's a many-headed beast). Would you invest with a pessimist or an optimist?
An optimist. The pessimist doesn't want to reach higher. He's enjoying it too much feeling sorry for himself and taking it out on others.
To quote A. A. Milne:
"I'm not asking anybody," said Eeyore. "I'm just telling everybody. We can look for the North Pole, or we can play 'Here we go gathering Nuts in May' with the end part of an ants' nest. It's all the same to me."If Eeyore had eczema--which could well be the explanation for his poor attitude--he'd not be the one you'd give $1 million to in the expectation he'd find a cure.
I'm nearly done with being Eeyore. Indulge me this once. The second Mark Twain Steel Trap Award goes to the terrorists who, in 2006, plotted to bring liquid explosives on airliners flying from the UK to North America. The British police, bless 'em, foiled these men and put them in irons. But since that day--at least in North America, which is what my experience has been limited to in the last four years--you can't bring any sizeable quantity of moisturizer in your carry-on. And anything in your checked bag comes under suspicion. (Myself, I like to travel without checked baggage if I can, especially since United started charging for bags.)
The inconvenience is non-lethal, I grant you, but several times I've had to chuck out large tubs of Eucerin at security checkpoints. Eucerin is the only moisturizer I've found to do the job, and it's not cheap--depending where you get it, anything from $13 to $17 a pop. And you can't necessarily get it at your destination. So there you are stuck on an airplane getting stressed and dehydrated, and at the far end the first thing on your mind is where the nearest pharmacy is. When you find one, it may be open, or not, and may or may not carry Eucerin, at a reasonable or exorbitant price.
Messrs. Ali, Sarwar, Hussain, Savant, Khan, Zaman, and any I may have omitted: your prize, sirs.
(No succor for you.)I'm done awarding prizes for now, but can't rule it out absolutely in the future, should I come across a deserving honoree.
The silver lining from one of these Eucerin-chucking incidents was that I ended up in San Francisco (having flown from DC where I was living at the time) on a Sunday, when all Walgreens pharmacies are inexplicably closed, and was forced to pick some random moisturizer from an aisle in Safeway. It turned out to be a winner. Aveeno Daily Moisturizing Lotion with dimethicone is pretty good stuff, even if it's not in the same league as Eucerin. The dimethicone is a rubbery sealant that leaves you with a pleasant plasticky feeling. If you're into that kind of thing.
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