Eczema and detergents

 

The first and primary recommendation is that people suffering from eczema shouldn't use detergents of any kind unless absolutely necessary. Current medical thought is that people wash too much and that eczema sufferers should use cleansers only when water is not sufficient to remove dirt from skin.

Another point of view is that detergents are so ubiquitous in modern environments and so persistent in tissues and surfaces, safe soaps are necessary to remove them in order to eliminate the eczema in a percentage of cases. Although most recommendations use the terms "detergents" and "soaps" interchangeably, and tell eczema sufferers to avoid both, detergents and soaps are not the same and are not equally problematic to eczema sufferers. Detergents increase the permeability of skin membranes in a way that soaps and water alone do not. Sodium lauryl sulfate, the most common household detergent, has been shown to amplify the allergenicity of other substances ("increase antigen penetration").^[2]

The use of detergents in recent decades has increased dramatically, while the use of soaps began to decline when detergents were invented, and leveled off to a constant around the '60s. Complicating this picture is the recent development of mild plant-based detergents for the natural products sector.

Unfortunately there is no one agreed-upon best kind of cleanser for eczema sufferers. Different clinical tests, sponsored by different personal product companies, unsurprisingly tout various brands as the most skin friendly based on specific properties of various products and different underlying assumptions as to what really determines skin friendliness. The terms "hypoallergenic" and "doctor tested" are not regulated,^[3] and no research has been done showing that products labeled "hypoallergenic" are in fact less problematic than any others.

Dermatological recommendations in choosing a soap generally include:

• Avoid harsh detergents or drying soaps.
• Choose a soap that has an oil or fat base; a "superfatted" soap is best.
• Use an unscented soap.
• Patch test your soap choice, by using it only on a chosen area until you are sure of its results.
• Use a non-soap based cleanser.

How to use soap when one must

• Use soap sparingly
• Avoid using washcloths, sponges, or loofahs
• Use soap only on areas where it is necessary
• Soap up only at the very end of your bath
• Use a fragrance-free barrier type moisturizer such as vaseline or aquaphor before drying off
• Use care when selecting lotion, soap, or fragrance, avoiding suspected allergens. Ask your doctor for recommendations.
• Never rub your skin dry, or else your skin's oil/moisture will be on the towel and not your body

High-Trauma Fractures in Older Men and Women Linked to Osteoporosis

Here is a article about High-Trauma Fractures

http://www.niams.nih.gov/News_and_Events/Press_Releases/2007/11_28.asp

Researchers at the California Pacific Medical Center (CPMC) Research Institute are challenging a widely held belief that fractures resulting from major trauma, such as automobile accidents, are not related to osteoporosis, the common disease that makes bones weak and prone to fracture. Their study, published in the November 28 issue of the Journal of the American Medical Association , was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), and the National Institute on Aging (NIA). NIAMS and NIA are components of the National Institutes of Health.

People with osteoporosis, a condition of low bone mineral density, experience fractures from a level of force that would not break a healthy bone. Although clinicians often recognize fractures resulting from minimal trauma as osteoporotic, those related to more substantial injury are rarely given the same consideration. "We know that too many clinicians pass on any follow-up of many fracture patients because, in their minds, the patient 'earned' their fracture," says Joan A. McGowan, Ph.D., director of the Division of Musculoskeletal Diseases at NIAMS. "These missed opportunities can have a devastating impact on these men and women, who, without proper management, are at increased risk for subsequent fracture."

CPMC's Steven R. Cummings, M.D., and his colleagues analyzed data from two large prospective cohort studies: the Study of Osteoporotic Fractures (SOF) in women and the Osteoporotic Fractures in Men Study (Mr. OS). The SOF followed 8,022 women for nine years and Mr. OS tracked 5,995 men for five years. Bone mineral density (BMD) was assessed by dual-energy X-ray absorptiometry (DXA). Study participants were contacted every four months to determine whether they experienced a fracture in the previous four-month period.

When a fracture was reported, clinical staff interviewed the participant to learn how it occurred. Without knowledge of the participant's BMD, staff classified each fracture as high-trauma or low-trauma. High-trauma fractures were defined as those caused by motor vehicle crashes and falls from greater than standing height, and low-trauma fractures were defined as those resulting from falls from standing height and less severe trauma.

Cummings and his team discovered that the relationship between BMD and fracture risk was similar for high-trauma and low-trauma fractures. They also found that women who experienced a high-trauma fracture were at increased risk for future fractures. (A similar analysis was not conducted in men because of the shorter follow-up time.) "It is becoming increasingly clear that any fracture experienced by an older individual is worthy of an osteoporosis evaluation," says Sheryl S. Sherman, Ph.D., Geriatrics and Clinical Gerontology Branch, NIA.

"We believe that this study changes the definition of osteoporotic fracture and expands the number of fractures that should be considered as such," Cummings says. "Moreover, it is critical that fractures that occur as a result of high trauma be included as outcomes in future studies, so that we may fully understand the impact of these fractures and develop strategies to prevent them."

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, a part of the Department of Health and Human Services' National Institutes of Health, is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, call the information clearinghouse at (301) 495-4484 or (877) 22-NIAMS (free call) or visit the NIAMS Web site at http://www.niams.nih.gov . Information on osteoporosis and other bone disorders is available from the NIH Osteoporosis and Related Bone Diseases~National Resource Center; phone toll-free 800-624-BONE (2663), or visit www.niams.nih.gov/bone .

NIA leads the federal effort supporting and conducting research on aging and the medical, social and behavioral issues of older people, including Alzheimer's disease and age-related cognitive change. For information on dementia and aging, please visit NIA's Alzheimer's Disease Education and Referral Center at www.nia.nih.gov/alzheimers , or call 1-800-438-4380. For more general information on research and aging, go to www.nia.nih.gov . Please visit the Web sites to sign up for e-mail notification of new information and publications about aging and about age-related cognitive change.

The National Institutes of Health (NIH) - The Nation's Medical Research Agency - includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov .

 

Understanding Skin Cancer... - Part 2

Risk Factors

Doctors cannot explain why one person develops skin cancer and another does not. However, we do know that skin cancer is not contagious. You cannot "catch" it from another person.

Research has shown that people with certain risk factors are more likely than others to develop skin cancer. A risk factor is something that may increase the chance of developing a disease.

Studies have found the following risk factors for skin cancer:

• Ultraviolet (UV) radiation: UV radiation comes from the sun, sunlamps, tanning beds, or tanning booths. A person's risk of skin cancer is related to lifetime exposure to UV radiation. Most skin cancer appears after age 50, but the sun damages the skin from an early age.

  UV radiation affects everyone. But people who have fair skin that freckles or burns easily are at greater risk. These people often also have red or blond hair and light-colored eyes. But even people who tan can get skin cancer.

  People who live in areas that get high levels of UV radiation have a higher risk of skin cancer. In the United States, areas in the south (such as Texas and Florida) get more UV radiation than areas in the north (such as Minnesota). Also, people who live in the mountains get high levels of UV radiation.

  UV radiation is present even in cold weather or on a cloudy day.

• Scars or burns on the skin
• Infection with certain human papillomaviruses
• Exposure to arsenic at work
• Chronic skin inflammation or skin ulcers
• Diseases that make the skin sensitive to the sun, such as xeroderma pigmentosum, albinism, and basal cell nevus syndrome
• Radiation therapy
• Medical conditions or drugs that suppress the immune system
• Personal history of one or more skin cancers
• Family history of skin cancer
• Actinic keratosis: Actinic keratosis is a type of flat, scaly growth on the skin. It is most often found on areas exposed to the sun, especially the face and the backs of the hands. The growths may appear as rough red or brown patches on the skin. They may also appear as cracking or peeling of the lower lip that does not heal. Without treatment, a small number of these scaly growths may turn into squamous cell cancer.
• Bowen's disease: Bowen's disease is a type of scaly or thickened patch on the skin. It may turn into squamous cell skin cancer.

If you think you may be at risk for skin cancer, you should discuss this concern with your doctor. Your doctor may be able to suggest ways to reduce your risk and can plan a schedule for checkups.

Source: http://www.cancer.gov

 

Blood and Lymph Diseases

As most of the cells in the human body are not in direct contact with the external environment, the circulatory system acts as a transport system for these cells. Two distinct fluids move through the circulatory system: blood and lymph. Blood carries oxygen and nutrients to the body's cells, and carries waste materials away. Blood also carries hormones, which control body processes, and antibodies, to fight invading germs. The heart is the pump that keeps this transport system moving. Together, the blood, heart, and blood vessels form the circulatory system.

The lymphatic system (lymph, lymph nodes and lymph vessels) supports the circulatory system by draining excess fluids and proteins from tissues back into the bloodstream, thereby preventing tissue swelling. It also serves as a defense system for the body, filtering out organisms that cause disease, producing white blood cells, and generating antibodies.

The biochemical make up of lymph — the fluid found in the lymphatic vessels — varies with the site of origin. For example, lymph from bone marrow, spleen, and thymus have high concentrations of white blood cells for fighting infection, while lymph from intestines is high in fat that has been absorbed during digestion. Damage to the lymphatic and circulatory systems leaves the body more susceptible to sickness and infection, as well as to serious conditions such as cancer.

 

Skin and Connective Tissue

The skin is the largest organ in the body — both in weight and in surface area — and separates the body's internal environment from the external environment. The skin has many diverse roles. It acts as a channel of communication with the outside world; protects the body from water loss; uses specialized pigment cells, called melanocytes, to protect the body from ultraviolet radiation; participates in calcium homeostasis by contributing to the body's supply of vitamin D; and helps regulate body temperature and metabolism.

Elastic tissues such as the skin require a strong and resilient structural framework. This framework is called the extracellular matrix, or connective tissue. The orientation of the connective tissues — adipose (fat cells), cartilage, bone, tendons, and ligaments — found beneath the skin are also key for tissue appearance and function. All connective tissue is composed of three major classes of biomolecules: structural proteins (collagen and elastin), specialized proteins (fibrillin, fibronectin, and laminin), and proteoglycans.

Some skin and connective tissue diseases, such as those discussed in this section of genes and disease, are due strictly to genetic inheritance, while others do not have specific gene abnormalities as their sole cause. Many features of skin and connective tissue disorders overlap with each other, and with other disorders, even though they have unique genetic causes.

 

Misoprostol

 

Misoprostol is a drug that is FDA-approved in the United States for the prevention of NSAID-induced gastric ulcers. It is also used (and approved in other countries) to induce labor and as an abortifacient. It was invented and marketed by G.D. Searle & Company (now Pfizer) under the trade name Cytotec, but other brand-name and generic formulations are now available as well.

Chemically, misoprostol is a synthetic prostaglandin E₁ (PGE₁) analogue.

 

Indicated use

Misoprostol stimulates increased secretion of the protective mucus that lines the gastrointestinal tract and increases mucosal blood flow, thereby increasing mucosal integrity. It is sometimes co-prescribed with non-steroidal anti-inflammatory drugs to prevent their common adverse effect of gastric ulceration

Off label uses

Obstetric and gynecological

Labor Induction

Misoprostol is commonly prescribed off-label to cause birth induction by uterine contractions and the ripening (effacement or thinning) of the cervix. Misoprostol is highly effective and much less expensive than pitocin and dinoprostone, the FDA-approved drugs for medically necessary labor induction. Trial meta-analysis by the Cochrane Collaboration demonstrates no difference in efficacy or side effects between inductions undertaken with dinoprostone or misoprostol.

Concern has been expressed about the overuse or misuse of misoprostol for labor induction. High doses can cause uterine rupture (especially in women who have previously had a caesarean section), fetal death and severe fetal brain damage, according to a CBS Evening News story by correspondent Sharyn Alfonsi. All induction agents cause uterine contractions – this can affect the blood supply to the fetus, especially if contractions become very frequent. Induction agents therefore need to be used with great care and with close fetal monitoring. One of the problems with induction using prostaglandins (either cervidil or misoprostol) is that once given, the process is difficult to reverse. In contrast, Pitocin (oxytocin, a hormone that also causes contractions) has a half-life of about 10 minutes and is administered via intravenous drip, which can be stopped immediately in the event of adverse reaction, according to a Salon.com webzine article by midwife Ina May Gaskin. A clinical trial is currently underway to establish a controlled delivery method for misoprostol.

The manufacturers of misoprostol have never sought to license misoprostol for labor induction. Recently, however, generic forms of misoprostol have become available, and it is now licensed for labor induction in Egypt and Brazil, and a licensed induction product is expected in the UK in 2008.

The American College of Obstetricians and Gynecologists advocates misoprostol for labor inductions, and it is on the WHO essential drug list for labour induction. Other agencies await more evidence as to its safety, including obstetric organizations in Britain, Canada and Scandinavia, according to a Midwifery Today magazine article by neonatologist Marsden Wagner.

Abortion

Misoprostol is one of the drugs used for medical abortions. In many countries it is used in conjunction with mifepristone (RU-486). After mifepristone is taken orally, misoprostol is taken 24–72 hours later causing the expulsion of the fetus and associated matter in approximately 92% of the cases. No large studies have established a protocol for the use of misoprostol alone, and the range of efficacy is 65%–93% depending on sample size, gestational age, and other test variables; Misoprostol alone may be more effective in earlier gestation. The side effects associated with the misoprostol-only regimen are generally much more severe than those associated with the combined regimens. Misoprostol is used for self-induced abortions in Brazil, where black market prices exceed US $100 per dose. Illegal medically-unsupervised misoprostol abortions in Brazil are associated with a lower complication rate than other forms of illegal self-induced abortion, but are still associated with a higher complication rate than legal, medically supervised surgical and chemical abortions. Failed misoprostol abortions are associated with birth defects in some cases. Poor immigrant populations in New York have also been observed to use self-administered misoprostol to induce abortions, as this method is much cheaper than a surgical abortion.

Misoprostol is sometimes used to treat early fetal death in the absence of spontaneous miscarriage, but further research is needed to establish a a safe, effective protocol. It can also be used to dilate the cervix in preparation for a surgical abortion. Misoprostol is also used to prevent and treat post-partum hemorrhage, but it has more side effects and is less effective than oxytocin for this purpose.

 

Symptoms of skin cancer

 

Following is a list of symptoms of skin cancer...

Most basal cell and squamous cell skin cancers can be cured if found and treated early.

A change on the skin is the most common sign of skin cancer. This may be a new growth, a sore that doesn't heal, or a change in an old growth. Not all skin cancers look the same. Skin changes to watch for:

• Small, smooth, shiny, pale, or waxy lump

• Firm, red lump

• Sore or lump that bleeds or develops a crust or a scab

• Flat red spot that is rough, dry, or scaly and may become itchy or tender

• Red or brown patch that is rough and scaly

Sometimes skin cancer is painful, but usually it is not.

Checking your skin for new growths or other changes is a good idea. Keep in mind that changes are not a sure sign of skin cancer. Still, you should report any changes to your health care provider right away. You may need to see a doctor who has special training in the diagnosis and treatment of skin problems.

This is a copy of the original http://www.cancer.gov/cancertopics/wyntk/skin/page6

 

Understanding Skin Cancer

Skin cancer begins in cells, the building blocks that make up the skin. Normally, skin cells grow and divide to form new cells. Every day skin cells grow old and die, and new cells take their place.

Sometimes, this orderly process goes wrong. New cells form when the skin does not need them, and old cells do not die when they should. These extra cells can form a mass of tissue called a growth or tumor.

Growths or tumors can be benign or malignant.

• Benign growths are not cancer:
  • Benign growths are rarely life-threatening.
  • Generally, benign growths can be removed. They usually do not grow back.
  • Cells from benign growths do not invade the tissues around them.
  • Cells from benign growths do not spread to other parts of the body.
• Malignant growths are cancer:
  • Malignant growths are generally more serious than benign growths. They may be life-threatening. However, the two most common types of skin cancer cause only about one out of every thousand deaths from cancer.
  • Malignant growths often can be removed. But sometimes they grow back.
  • Cells from malignant growths can invade and damage nearby tissues and organs.
  • Cells from some malignant growths can spread to other parts of the body. The spread of cancer is called metastasis.

Types of Skin Cancer

Skin cancers are named for the type of cells that become cancerous.

The two most common types of skin cancer are basal cell cancer and squamous cell cancer. These cancers usually form on the head, face, neck, hands, and arms. These areas are exposed to the sun. But skin cancer can occur anywhere.

• Basal cell skin cancer grows slowly. It usually occurs on areas of the skin that have been in the sun. It is most common on the face. Basal cell cancer rarely spreads to other parts of the body.
• Squamous cell skin cancer also occurs on parts of the skin that have been in the sun. But it also may be in places that are not in the sun. Squamous cell cancer sometimes spreads to lymph nodes and organs inside the body.

If skin cancer spreads from its original place to another part of the body, the new growth has the same kind of abnormal cells and the same name as the primary growth. It is still called skin cancer.

 

Skin Cancer

What is skin cancer?

Cancer that forms in tissues of the skin. When cancer forms in cells that make pigment, it is called melanoma. When cancer forms in cells that do not make pigment it may begin in basal cells (small, round cells in the base of the outer layer of skin) or squamous cells (flat cells that form the surface of the skin). Both types of skin cancer usually occur in skin that has been exposed to sunlight, such as the skin on the face, neck, hands, and arms.

Estimated new cases and deaths from skin (nonmelanoma) cancer in the United States in 2007:

  New cases: more than 1,000,000
  Deaths: less than 2,000

Source: http://www.cancer.gov

 

 

Methotrexate

Methotrexate may cause very serious side effects. Some side effects of methotrexate may cause death. You should only use methotrexate to treat life-threatening cancer, or certain other conditions that are very severe and that cannot be treated with other medications. Talk to your doctor about the risks of taking methotrexate for your condition.

Tell your doctor if you have or have ever had excess fluid in your stomach area or in the space around your lungs and if you have or have ever had kidney disease. Also tell your doctor if you are taking aspirin or other nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) or are being treated with radiation therapy. These conditions and treatments may increase the risk that you will develop serious side effects of methotrexate. Your doctor will monitor you more carefully and may need to change the doses of your medications.

Methotrexate may cause liver damage. Tell your doctor if you are taking any of the following medications: acitretin (Soriatane), azathioprine (Imuran), isotretinoin (Accutane), sulfasalazine (Azulfidine), or tretinoin (Vesanoid), Tell your doctor if you drink or have ever drunk large amounts of alcohol and if you have or have ever had liver disease, Your doctor may tell you that you should not take methotrexate unless you have a life-threatening cancer. Also tell your doctor if you have diabetes. Do not drink alcohol while you are taking methotrexate. Call your doctor immediately if you experience any of the following symptoms: nausea, extreme tiredness, lack of energy, loss of appetite, pain in the upper right part of the stomach, yellowing of the skin or eyes, or flu-like symptoms.

Methotrexate may cause lung damage. Tell your doctor if you have or have ever had lung disease. Call your doctor immediately if you experience any of the following symptoms: dry cough, fever, or shortness of breath.

Methotrexate may cause kidney damage. Be sure to drink plenty of fluids during your treatment with methotrexate, especially if you exercise or are physically active. Call your doctor if you think you might be dehydrated (do not have enough fluid in your body). You may become dehydrated if you sweat excessively or if you vomit, have diarrhea, or have a fever.

Methotrexate may cause a decrease in the number of blood cells made by your bone marrow. Tell your doctor if you have or have ever had a low blood count (decrease in the number of blood cells in your body), anemia (red blood cells do not bring enough oxygen to all parts of the body), or any other problem with your blood cells. Your doctor may tell you not to take methotrexate unless you have a life-threatening cancer. Call your doctor immediately if you experience any of the following symptoms: sore throat, chills, fever, or other signs of infection; unusual bruising or bleeding; excessive tiredness; weakness; pale skin; dizziness; confusion; fast heartbeat; shortness of breath; or difficulty falling asleep or staying asleep.

Methotrexate may cause damage to your intestines. Tell your doctor if you have or have ever had stomach ulcers or ulcerative colitis (condition in which part or all of the lining of the intestine is swollen or worn away). If you develop sores in your mouth or diarrhea, stop taking methotrexate and call your doctor immediately.

Methotrexate may cause a severe rash that may be life-threatening. If you develop a rash, blisters, or a fever, call your doctor immediately.

Methotrexate may decrease the activity of your immune system, and you may develop serious infections. Tell your doctor if you have any type of infection and if you have or have ever had any condition that affects your immune system such as human immunodeficiency syndrome (HIV) or acquired immunodeficiency syndrome (AIDS). Your doctor may tell you that you should not take methotrexate unless you have a life-threatening cancer. If you experience signs of infection such as a sore throat, cough, fever, or chills, call your doctor immediately.

Taking methotrexate may increase the risk that you will develop lymphoma (cancer that begins in the cells of the immune system). If you do develop lymphoma, it might go away without treatment when you stop taking methotrexate, or it might need to be treated with chemotherapy.

If you are taking methotrexate to treat cancer, you may develop certain complications as methotrexate works to destroy the cancer cells. Your doctor will monitor you carefully and treat these complications if they occur.

Keep all appointments with your doctor and the laboratory. Your doctor will order lab tests before, during, and after your treatment to check your body's response to methotrexate and to treat side effects before they become severe.

Women who are taking methotrexate, or whose male partners are taking methotrexate are less likely to become pregnant than women who are not taking methotrexate or whose partners are not taking the medication. However, you should not assume that you or your partner cannot become pregnant while you are taking methotrexate. Tell your doctor if you or your partner is pregnant or plan to become pregnant. If you are female, you will need to take a pregnancy test before you begin taking methotrexate. Use a reliable method of birth control so that you or your partner will not become pregnant during or shortly after your treatment. If you are male, you and your female partner should continue to use birth control for 3 months after you stop taking methotrexate. If you are female, you should continue to use birth control until you have had one menstrual period that began after you stopped taking methotrexate. If you or your partner become pregnant, call your doctor immediately. Methotrexate may harm the fetus.

 

Natural skin care with EPA

Incredible though it sounds, fish oil containing eicosapentaenoic acid or EPA, appears to slow down the ageing process and help us to look younger by protecting the skin and inhibiting the chemical processes that take place when our skin is exposed to damage-inducing stimuli, like the sun for example. Evidence suggests that aside from all the other documented health benefits of EPA, it can make our skin more resistant to sunburn, improve skin elasticity and tone and helps to prevent saggy skin and wrinkles from forming.

Most of us know that UV radiation from the sun is public enemy number one as far as the skin is concerned. Overexposure results in premature ageing and wrinkles as well as reduced immunity to disease, and possibly even skin cancer. When our skin is exposed to a lot of sunlight we produce abnormal elastin that causes the skin to stretch and collagen fibres begin to break down. In response to this we produce a large number of enzymes called metalloproteinases or MMPS. This would normally be a good thing as these enzymes try to repair the damage, but it is inefficient and over time, MMPS produced as a result of UV radiation actually results in a break down of collagen and finally wrinkles appear.

A study published in 2005 in the Journal for Lipid Research investigated the effect that EPA had on MMPS arising as a result of ultra violet radiation from the sun in human skin and found that EPA inhibited overproduction of MMPS and reduced the amount of damage to the skin. The researchers Kim et al concluded that EPA could possibly prevent as well as treat skin ageing. Then more recently in 2006, Drs Black and Rhodes found that EPA offers protection against sun-induced damage to skin cells by making the skin more resistant to the sun's rays in the first place. Participants taking fish oil showed a higher "minimal erythemal dose". This basically means that the lowest amount of radiation needed to produce erythema (an inflammatory effect on the skin or sunburn) was higher for those taking fish oil. These studies show that EPA not only protects the skin, it limits the damage too, but these are not the only benefits of EPA.

The properties of EPA

EPA is known to have powerful anti-inflammatory and anti-thrombotic properties, both of which help to slow down and minimise the effects of ageing and wear and tear on the body. From the moment we are born, we are subjected to a number of environmental pollutants that put pressure on our skin. Oxygen-free radicals from pollution, for example, are everywhere and result in a process known as oxidation. Oxidation leads to an increase in inflammatory responses and too much can cause premature ageing and wrinkles as well as contribute to the development of many skin conditions. The anti-inflammatory properties of EPA can inhibit the production of pro-inflammatory chemical messengers responsible for these inflammatory responses.

Increasingly as we grow older, our skin starts to thin out and stretch as collagen fibres lose their elasticity, the skin starts to lose its ability to repair itself and can no longer retain moisture as well as it did. Consequently, many people begin to rely on external lotions and potions to keep the skin moist and supple. EPA can help the blood to flow more efficiently throughout the body and contribute to healthy and radiant looking skin. It is interesting that a lack of Omega 3 fatty acids in the diet manifests itself most noticeably as skin problems.

Signs of Omega 3 fatty acid deficiency

• Dry and flaky skin
• Dandruff
• Hard and cracked skin
• Eczema
• Psoriasis
• Acne
• Poor wound healing
• Dull and lifeless looking skin

Most of us are also well aware that stress and anxiety can speed up the ageing process resulting in 'worry lines' as well as more serious conditions and threats to our health. The amazing thing is that EPA has demonstrated considerable success in alleviating depression, anxiety and stress so not only does it help us to remain healthy and look younger with better skin and fewer wrinkles, but it has a 'feel-good' factor too which helps keep those worry lines at bay.

Conclusion

All this is very exciting, particularly when we consider the amount of time, money and effort spent on the ever-increasing number of products available to help keep us healthy, young and beautiful. The implications are that we can do the same job naturally through diet by taking fish oil supplements containing EPA and benefit not only from healthy more youthful looking skin and all the other documented health-giving properties of EPA but possibly gain a new lease of life too.

By: David McEvoy

Dave McEvoy is an expert in Omega 3 and fish oil for more information about fish oil and EPA come and visit his site which is packed full of information.

Article Source: http://articles.drbonomi.com/

Skin Care Basics

The only four products you need.

With new creams and ingredients being launched seemingly every day, it's easy to get confused by all the options. And unless you're willing to spend hours on your skin care routine every day by incorporating all of these different lotions, you'll need to pick and choose which basics are right for you.

Here, the bare minimum that you need:

Sunscreen:

It's a must, essential for preventing sun damage and lowering your risk of developing skin cancer.

Eye cream:

It's wise to invest in an eye cream, which treats the eye area with more emollient moisturizers. Some eye creams even claim to minimize dark circles and temporarily tighten fine lines.

Retinols:

If you're concerned with wrinkles and pigmentation spots, a face cream with retinol (a derivative of vitamin A) can help.

Body lotion with alpha-hydroxy acids:

A lotion with skin-sloughing AHAs smoothes your whole body, including hands, feet, arms, and legs. For tough dry spots, apply extra lotion before bed and let it soak in while you sleep.

This is a summary of the article, Read the complete article here...
http://ww4.lhj.com/lhj/story.jhtml?storyid=/templatedata/lhj/story/data/skincarebasics_03152002.xml

Skin and Body Care - Fact and Fiction

The world of skin and body care is slathered with misapprehensions, says a company that has prospered in the field. Perhaps wearing tight pants will stop consumers gaining weight? ◆ I don't need body lotion in summer, right? Because the skin is hot and sticky, if you don't provide it with moisture and nourishment, it loses its vitality. The changes in the season and climate can spell trouble due to dry skin. ◆ If I wrap myself in cling film, will I lose weight? If you wrap yourself in plastic wrap or wear tight-fitting jeans, you might feel like you've become slimmer. But all that has happened is that the fat on your abdomen has now been pushed to a different place. The real fact is that if you put too much pressure on fat, it can cause circulation problems and block toxin removal and the supply of oxygen, harming your overall health including skin and figure. ◆ If you massage your forearm fat, it goes away. Massages do not break up fat. But they can help in reducing fat caused by edema by improving capillary and lymph circulation in the region. ◆ Is gooseflesh genetic? The formal name of gooseflesh is "keratosis pilaris." It is partially genetic in that it usually happens to people with dry-skin conditions like atopy, but there are also other causes. Moisturizing liberally can help prevent the condition. ◆ Does everyone get cellulite when they gain weight? Lumpy cellulite on thighs and forearms is known to form when fat globs push through thin skin layers or when pressure is put on circulation. Besides fat, however, cellulite can be caused by hormonal changes, genetic factors and excessive dieting.

Skin

 

What's the biggest organ in our body?

You might be surprised to find out it's the skin, which you might not think of as an organ, Do You?

No matter how you think of it, your skin is very important and of course a very important organ of your body. It covers and protects everything inside your body. Without skin, people's muscles, bones, and organs would be hanging out all over the place. Skin holds everything together. It also:

• protects our bodies
  
• helps keep our bodies at just the right temperature
  
• allows us to have the sense of touch

Don't Miss Your Epidermis
The skin is made up of three layers, each with its own important parts. The layer on the outside is called the epidermis (say: eh-puh-dur-mis). The epidermis is the part of your skin you can see.

Look down at your hands for a minute. Even though you can't see anything happening, your epidermis is hard at work. At the bottom of the epidermis, new skin cells are forming.

These old cells are tough and strong, just right for covering your body and protecting it. But they only stick around for a little while. Soon, they'll flake off. Though you can't see it happening, every minute of the day we lose about 30,000 to 40,000 dead skin cells off the surface of our skin.

So just in the time it took you to read this far, you've probably lost about 40,000 cells. That's almost 9 pounds (4 kilograms) of cells every year! But don't think your skin might wear out someday. Your epidermis is always making new skin cells that rise to the top to replace the old ones. Most of the cells in your epidermis (95%) work to make new skin cells.

And what about the other 5%? They make a substance called melanin (say: meh-luh-nin). Melanin gives skin its color. The darker your skin is, the more melanin you have. When you go out into the sun, these cells make extra melanin to protect you from getting burned by the sun's ultraviolet, or UV, rays.

The Dermis Is Under the Epidermis
The next layer down is the dermis (say: dur-mis). You can't see your dermis because it's hidden under your epidermis. The dermis contains nerve endings, blood vessels, oil glands, and sweat glands. It also contains collagen and elastin, which are tough and stretchy.

The nerve endings in your dermis tell you how things feel when you touch them. They work with your brain and nervous system, so that your brain gets the message about what you're touching. Is it the soft fur of a cat or the rough surface of your skateboard?

Your dermis is also full of tiny blood vessels. These keep your skin cells healthy by bringing them the oxygen and nutrients they need and by taking away waste. These blood vessels are hard to see in kids, but you might get a better look if you check out your grandparents' skin. As the dermis gets older, it gets thinner and easier to see through.

The dermis is home to the oil glands, too. These are also called sebaceous (say: sih-bay-shus) glands, and they are always producing sebum (say: see-bum). Sebum is your skin's own natural oil. It rises to the surface of your epidermis to keep your skin lubricated and protected. It also makes your skin waterproof - as long as sebum's on the scene, your skin won't absorb water and get soggy.

You also have sweat glands on your epidermis. Even though you can't feel it, you actually sweat a tiny bit all the time. The sweat comes up through pores (say: pors), tiny holes in the skin that allow it to escape. When the sebum meets the sweat, they form a protective film that's a bit sticky.

An easy way to see this film in action is to pick up a pin with your fingers. Then wash your hands well with soap and water and dry them off completely. Now try to pick up that pin again. It won't be so easy because your sticky layer is gone! Don't worry - it will be back soon, as your sebaceous and sweat glands create more sticky stuff.

The Third Layer Is Subcutaneous Fat
The third and bottom layer of the skin is called the subcutaneous (say: sub-kyoo-tay-nee-us) layer. It is made mostly of fat and helps your body stay warm and absorb shocks, like if you bang into something or fall down. The subcutaneous layer also helps hold your skin to all the tissues underneath it.

This layer is where you'll find the start of hair, too. Each hair on your body grows out of a tiny tube in the skin called a follicle (say: fah-lih-kul). Every follicle has its roots way down in the subcutaneous layer and continues up through the dermis.

You have hair follicles all over your body, except on your lips, the palms of your hands, and the soles of your feet. And you have more hair follicles in some places than in others - there are more than 100,000 follicles on your head alone!

Skin Can Warm and Cool You
Your skin can help if you're feeling too hot or too cold. Your blood vessels, hair, and sweat glands cooperate to keep your body at just the right temperature. If you were to run around in the heat, you could get overheated. If you play outside when it's cold, your inner temperature could drop. Either way, your skin can help.

To cool you down, sweat glands also swing into action by making lots of sweat to release body heat into the air. The hotter you are, the more sweat your glands make! Once the sweat hits the air, it evaporates (this means that it changes from a liquid to a vapor) off your skin, and you cool down.

What about when you're ice-skating or sledding? When you're cold, your blood vessels keep your body from losing heat by narrowing as much as possible and keeping the warm blood away from the skin's surface. You might notice tiny bumps on your skin. Most kids call these goosebumps, but the fancy name for them is the pilomotor (say: pie-low-mo-tur) reflex. The reflex makes special tiny muscles called the erector pili (say: ee-rek-tur pie-lie) muscles pull on your hairs so they stand up very straight.

Keep It Clean!
Unlike other organs (like your lungs, heart, and brain), your skin likes a good washing. When you wash your skin, use water and a mild soap. And don't forget to cover scrapes and cuts with gauze or a bandage. This keeps the dirt out and helps prevent infections. It's just one way to be kind to the skin you're in!

 

Atopic Dermatitis - Part 2

Continued form part 1- Atopic Dermatitis - Part 1

How Is Atopic Dermatitis Treated?

Treatment works best when the patient, family members, and doctor work together. Treatment plans are based on:

Age

Symptoms

General health.

You need to carefully follow the treatment plan. Try to notice what is or isn’t helpful. Symptoms usually improve with the right skin care and lifestyle changes.

Atopic dermatitis treatment goals are to heal the skin and prevent flares. Your doctor will help you:

Develop a good skin care routine

Avoid things that lead to flares

Treat symptoms when they occur.

You and your family members should watch for changes in the skin to find out what treatments help the most.

Medications for atopic dermatitis include:

Skin creams or ointments that control swelling and lower allergic reactions

Corticosteroids

Antibiotics to treat infections caused by bacteria

Antihistamines that make people sleepy to help stop nighttime scratching

Drugs that suppress the immune system.

Other treatments include:

Light therapy

A mix of light therapy and a drug called psoralen

Skin care that helps heal the skin and keep it healthy

Protection from allergens.

Atopic Dermatitis and Vaccination Against Smallpox

People with atopic dermatitis should not get the smallpox vaccine. It may cause serious problems in people with atopic dermatitis.

What Research Is Being Done on Atopic Dermatitis?

Research is being done into what causes atopic dermatitis, and how it can be managed, treated, and prevented.

Research includes:

Genetics

Biochemical changes in skin and white blood cells

Immune factors

Light therapy

A bacterium called Staphylococcus aureus

Drug research

 

Atopic Dermatitis - Part 1

What Is Atopic Dermatitis?

Atopic dermatitis is a long-term skin disease. “Atopic” refers to a tendency to develop allergy conditions. “Dermatitis” means swelling of the skin.

The most common symptoms of atopic dermatitis are:

Dry and itchy skin

Rashes on the face, inside the elbows, behind the knees, and on the hands and feet.

Scratching the skin can cause:

Redness

Swelling

Cracking

“Weeping” clear fluid

Crusting

Thick skin

Scaling.

Often, the skin gets worse (flares), then it improves or clears up (remissions).

Who Gets Atopic Dermatitis?

Atopic dermatitis is most common in babies and children. But it can happen to anyone. People who live in cities and dry climates may be more likely to get this disease.

When children with atopic dermatitis grow older, this problem can improve or go away. But the skin may stay dry and easy to irritate. At other times, atopic dermatitis is a problem in adulthood.

You can’t “catch” the disease or give it to other people.

Other Types of Skin Problems

Atopic dermatitis is often called eczema. “Eczema” is a term for many kinds of skin problems. Atopic dermatitis is the most common kind of eczema. Other types include:

• Allergic contact eczema. The skin gets red, itchy, and weepy because it touches something that the immune system knows is foreign, like poison ivy.
• Contact eczema. The skin has redness, itching, and burning in one spot because it has touched something allergy-causing, like an acid, cleaner, or other chemical.
• Dyshidrotic eczema. The skin on the palms of hands and soles of the feet is irritated and has clear, deep blisters that itch and burn.
• Neurodermatitis. Scaly patches on the head, lower legs, wrists, or forearms are caused by a localized itch (such as an insect bite).
• Nummular eczema. The skin has coin-shaped spots of irritation. The spots can be crusted, scaling, and very itchy.
• Seborrheic eczema. This skin has yellowish, oily, scaly patches on the scalp, face, and sometimes other parts of the body.
• Stasis dermatitis. The skin is irritated on the lower legs, most often from a blood flow problem.

What Causes Atopic Dermatitis?

The cause of atopic dermatitis is not known. It is likely caused by both genetic (runs in the family) and environmental factors. People with this disease often have other atopic conditions, like hay fever and asthma.

How Is Atopic Dermatitis Diagnosed?

Diagnosis is based on the symptoms. Each person has his or her own mix of symptoms that can change over time. Doctors will ask for a medical history to:

Learn about your symptoms

Know when symptoms occur

Rule out other diseases

Look for causes of symptoms.

Doctors also may ask about:

Other family members with allergies

Whether you have conditions such as hay fever or asthma

Whether you have been around something that might bother the skin

Sleep problems

Foods that may lead to skin flares

Treatments you have had for other skin problems

Use of steroids or medicine.

There isn’t a certain test that can be used to check for this disease. But you may be tested for allergies by a dermatologist (skin doctor) or allergist (allergy doctor).

Things That Make Atopic Dermatitis Worse

Irritants and allergens can make atopic dermatitis worse.

Irritants are things that may cause the skin to be red and itchy or to burn. They include:

Wool or man-made fibers

Soaps and cleaners

Some perfumes and makeup

Substances such as chlorine, mineral oil, or solvents

Dust or sand

Cigarette smoke.

Allergens are allergy-causing substances from foods, plants, animals, or the air. Common allergens are:

Eggs, peanuts, milk, fish, soy products, and wheat

Dust mites

Mold

Pollen

Dog or cat dander.

Stress, anger, and frustration can make atopic dermatitis worse, but they haven’t been shown to cause it. Skin infections, temperature, and climate can also lead to skin flares. Other things that can lead to flares are:

Not using enough moisturizer after a bath

Low humidity in winter

Dry year-round climate

Long or hot baths and showers

Going from sweating to being chilled

Bacterial infections.

 

..... to be continued

Antioxidants to the Skin

Mannatech Inc. develops nutritional supplements, topical products, and weight-management products.

Its products are designed to support cell-to-cell communication, the immune system, the endocrine system, skin, and health, as well as nutritional support during weight loss.

It provides various nutritional supplements for overall health and wellness; wellness management products to support and maintain specific areas of the body; lifestyle solutions to further support specific physiological functions that need additional nutritional support; sports performance nutrition products that provide nutrition to support physical performance and maintain muscle mass; a body system that focuses on various aspects of nutrition and weight management; skin care solutions, which are designed to strengthen the skin's own natural texture, softness, and elasticity, as well as to deliver vital antioxidants to the skin; and children's growth essentials for their overall health and wellness.

Mannatech Inc. contain glyconutrients giving optimal health and wellbeing.

Avocados - Full of Antioxidants

Avocados are one of nature's best super foods packed with essential vitamins and minerals, cholesterol and sodium free. They contain more than fourteen essential vitamins and minerals, including vitamins A, C and E, B6, niacin and riboflavin as well as copper, potassium and magnesium.

They are a great source of folate, vital for expectant mums. They are also rich in heart-healthy monounsaturated fats, making them an excellent alternative to foods containing saturated fats, such as spreads and dips. In fact, they're so good for you they carry the National Heart Foundation's Tick of Approval, so there is really no reason not to buy avocado and use it in your favourite recipes.

These suggestions were appreciated:

1) Roughly mash an avocado with finely diced tomato, red onion and chilli, as well as a little lime juice, for a quick and tasty guacamole.
2) Spread avocado on toasted Turkish bread with sliced tomato, torn basil leaves and a little olive oil, or add to cheese on toast for extra taste.
3) Mix avocado with a little lime juice and chopped dill. Spread over bagel halves and top with smoked salmon, rocket leaves and capers.
4) Slice and add to homemade pizzas. Try teaming with seafood, crispy prosciutto, bacon, grilled chicken, corn kernels, capsicum or fetta.
5) Make a quick winter salad by tossing together cubed avocado and pear, crushed macadamia pieces and a little lime juice.

GlycoMatrix produced by Mannatech provides greater absorption of nutrients than other existing supplement technologies.

Glowing Complextions...

Mostly it is a roller coaster time for teenagers when it comes to having a glowing complexion.
There are many things that teenagers can do to help retain or increase their clear, radiant skin.

The best way to a smooth, clear bacteria-free skin is to drink plenty of water a day.

At least 7 glasses; we see recommendation coming from most researchers and medical facilities.

Water keeps the skin well hydrated, improves texture and appearance as well as flushing out toxins.

Not using too much make up as a teenager will also do wonders as cosmetics such as foundation
can clog the pores causing blemishes and pimples. Touching your face can cause break-outs as you touch all sorts of germs during the day.

Another critical factor is to clease excess oil and dead skin cells before they clog pores as well as eating well. Skin-friendly foods include those rich in omega-3 fats, such as oily fish, avocado and walnuts, as well as omega-9 fats, found in olive oil and almonds. Of course it is necessary to avoid sugary and highly processed foods and refined carbohydrates.

Mannatech understands that health begins at the celluar level. With their nutritional glyconutrients they have now the technology for optimal health technology to the cells of your skin.

 

 

Diseases - Atopic Dermatitis - Part 2

 

Major and Minor Features of Atopic Dermatitis

Major Features

• Intense itching
  
• Characteristic rash in locations typical of the disease
  
• Chronic or repeatedly occurring symptoms
  
• Personal or family history of atopic disorders (eczema, hay fever, asthma)

Some Minor Features

• Early age of onset
  
• Dry, rough skin
  
• High levels of immunoglobulin E (IgE), an antibody, in the blood
  
• Ichthyosis
  
• Hyperlinear palms
  
• Keratosis pilaris
  
• Hand or foot dermatitis
  
• Cheilitis
  
• Nipple eczema
  
• Susceptibility to skin infection
  
• Positive allergy skin tests

What factors can aggravate atopic dermatitis?

Many factors or conditions can intensify the symptoms of atopic dermatitis, which can trigger the following cycle: further stimulating the already overactive immune system in the skin; aggravating the itch-scratch cycle; and increasing damage to the skin. These exacerbating elements can be broken down into two main categories; irritants and allergens. Emotional factors and some infections can also influence atopic dermatitis.

What are skin irritants in patients with atopic dermatitis?

Irritants are substances that directly affect the skin, and when used in high enough concentrations with long enough contact, cause the skin to become red and itchy or to burn. Specific irritants affect people with atopic dermatitis to different degrees. Over time, many patients and their families learn to identify the irritants that are most troublesome to them. For example, wool or synthetic fibers may affect some patients. Rough or poorly fitting clothing can rub the skin, trigger inflammation, and prompt the beginning of the itch- scratch cycle. Soaps and detergents may have a drying effect and worsen itching, and some perfumes and cosmetics may irritate the skin. Exposure to certain elements, such as chlorine, mineral oil, or solvents, or to irritants, such as dust or sand, may also aggravate the condition. Cigarette smoke may irritate the eyelids. Because irritants vary from one person to another, each person has to determine for himself or herself what substances or circumstances cause the disease to flare.

Common Irritants

• Wool or synthetic fibers
  
• Soaps and detergents
  
• Some perfumes and cosmetics
  
• Substances such as chlorine, mineral oil, or solvents
  
• Dust or sand
  
• Cigarette smoke

What are allergens?

Allergens are substances from foods, plants, or animals that provoke an overreaction of the immune system and cause inflammation (in this case, the skin). Inflammation can occur even when the person is exposed to small amounts of the allergen for a limited time. Some examples of allergens are pollen and dog or cat dander (tiny particles from the animal's skin or hair). When people with atopic dermatitis come into contact with an irritant or allergen to which they are sensitive, inflammation- producing cells permeate the skin from elsewhere in the body. These cells release chemicals that cause itching and redness. As the person scratches and rubs the skin in response, further damage occurs.

Certain foods act as allergens and may trigger atopic dermatitis or exacerbate it (cause it to become worse). Food allergens clearly play a role in a number of cases of atopic dermatitis, primarily in infants and children. An allergic reaction to food can cause skin inflammation (generally hives), gastrointestinal symptoms (vomiting, diarrhea), upper respiratory tract symptoms (congestion, sneezing), and wheezing. The most common allergy-causing (allergenic) foods are eggs, peanuts, milk, fish, soy products, and wheat. Although the data remain inconclusive, some studies suggest that mothers of children with a family history of atopic diseases should avoid eating commonly allergenic foods themselves during late pregnancy and (if breast feeding) while they are breast feeding the baby. Although not all researchers agree, most experts think that breast feeding the infant for at least 4 months may have a protective effect for the child.

If a food allergy is suspected, it may be helpful to keep a careful diary of everything the patient eats, noting any reactions. Identifying the food allergen may be difficult if the patient is also being exposed to other allergens, and may require supervision by an allergist. One helpful way to explore the possibility of a food allergy is to eliminate the suspected food and then, if improvement is noticed, reintroduce it into the diet under carefully controlled conditions. A two week trial is usually sufficient for each food. If the food being tested causes no symptoms after two weeks, a different food can be tested in like manner afterwards. Likewise, if the elimination of a food does not result in improvement after 2 weeks, other foods may be eliminated in turn.

Changing the diet of a person who has atopic dermatitis may not always relieve symptoms. A change may be helpful, however, when a patient's medical history and specific symptoms strongly suggest a food allergy. It is up to the patient and his or her family and physician to judge whether the dietary restrictions outweigh the impact of the disease itself. Restricted diets often are emotionally and financially difficult for patients and their families to follow. Unless properly monitored, diets with many restrictions can also contribute to nutritional problems in children.

What are aeroallergens?

Some allergens are called aeroallergens because they are present in the air. They may also play a role in atopic dermatitis. Common aeroallergens are dust mites, pollens, molds, and dander from animal hair or skin. These aeroallergens, particularly the house dust mite, may worsen the symptoms of atopic dermatitis in some people. Although some researchers think that aeroallergens are an important contributing factor to atopic dermatitis, others believe that they are insignificant. Scientists also don't understand the way in which aeroallergens affect the skin; whether the aeroallergen affects the person internally after being inhaled, or whether the aeroallergen actually penetrates the patient's skin.

No reliable test is available that determines whether a specific aeroallergen is an exacerbating factor in any given individual. If the doctor suspects that an aeroallergen is contributing to a patient's symptoms, the doctor may recommend ways to reduce exposure to the offending agents. For example, the presence of the house dust mite can be limited by encasing mattresses and pillows in special dust-proof covers, frequently washing bedding in hot water, and removing carpeting. However, there is no way to completely rid the environment of aeroallergens.

What other factors may play a role in atopic dermatitis?

In addition to irritants and allergens, other factors, such as emotional issues, temperature and climate, and skin infections can affect atopic dermatitis. Although the disease itself is not caused by emotional factors or personality, it can be exacerbated by stress, anger, and frustration. Interpersonal problems or major life changes, such as divorce, job changes, or the death of a loved one, can also make the disease worse. Often, emotional stress seems to prompt a flare of the disease.

Bathing without proper moisturizing afterward is a common factor that triggers a flare of atopic dermatitis. The low humidity of winter or the dry year-round climate of some geographic areas can intensify the disease, as can overheated indoor areas and long or hot baths and showers. Alternately sweating and chilling can induce an attack in some people. Bacterial infections can also prompt or increase the severity of atopic dermatitis. If a patient experiences a sudden onset of illness, the doctor may check for a viral infection (such as herpes simplex) or fungal infection (such as ringworm or athlete's foot).

How is atopic dermatitis treated?

Treatment involves a partnership between the doctor and the patient and his or her family members. The doctor will suggest a treatment plan based on the patient's age, symptoms, and general health. The patient and family members play a large role in the success of the treatment plan by carefully following the doctor's instructions. Some of the primary components of treatment programs are described below. Most patients can be successfully managed with proper skin care and lifestyle changes and do not require the more intensive treatments discussed.

The doctor has three main goals in treating atopic dermatitis: healing the skin and keeping it healthy; preventing flares; and treating symptoms when they do occur. Much of caring for the skin involves developing skin care routines, identifying exacerbating factors, and avoiding circumstances that stimulate the skin's immune system and the itch-scratch cycle. It is important for the patient and family members to note any changes in skin condition in response to treatment, and to be persistent in identifying the most effective treatment strategy.

Skin Care: Healing the skin and keeping it healthy are of primary importance both in preventing further damage and enhancing the patient's quality of life. Developing and following a daily skin care routine is critical to preventing recurrent episodes of symptoms. Key factors are proper bathing and the application of lubricants, such as creams or ointments, within 3 minutes of bathing. People with atopic dermatitis should avoid hot or long (more than 10 to 15 minutes) baths and showers. A lukewarm bath helps to cleanse and moisturize the skin without drying it excessively. The doctor may recommend limited use of a mild bar soap or non-soap cleanser because soaps can be drying to the skin. Bath oils are not usually helpful.

Once the bath is finished, the patient should air-dry the skin, or pat it dry gently (avoiding rubbing or brisk drying), and apply a lubricant immediately. Lubrication restores the skin's moisture, increases the rate of healing, and establishes a barrier against further drying and irritation. Several kinds of lubricants can be used. Lotions generally are not the best choice because they have a high water or alcohol content and evaporate quickly. Creams and ointments work better at healing the skin. Tar preparations can be very helpful in healing very dry, lichenified areas. Whatever preparation is chosen, it should be as free of fragrances and chemicals as possible.

Another key to protecting and restoring the skin is taking steps to avoid repeated skin infections. Although it may not be possible to avoid infections altogether, the effects of an infection may be minimized if they are identified and treated early. Patients and their families should learn to recognize the signs of skin infections, including tiny pustules (pus-filled bumps) on the arms and legs, appearance of oozing areas, or crusty yellow blisters. If symptoms of a skin infection develop, the doctor should be consulted to begin treatment as soon as possible.

Treating Atopic Dermatitis in Infants and Children

• Give brief, lukewarm baths.
  
• Apply lubricant immediately following the bath.
  
• Keep child's fingernails filed short.
  
• Select soft cotton fabrics when choosing clothing.
  
• Consider using antihistamines to reduce scratching at night.
  
• Keep the child cool; avoid situations where overheating occurs.
  
• Learn to recognize skin infections and seek treatment promptly.
  
• Attempt to distract the child with activities to keep him or her from scratching.

Medications and Phototherapy: If a recurrence of atopic dermatitis occurs, several methods can be used to treat the symptoms. With proper treatment, most symptoms can be brought under control within 3 weeks. If symptoms fail to respond, this may be due to a flare that is stronger than the medication can handle, a treatment program that is not fully effective for a particular individual, or the presence of trigger factors that were not addressed in the initial treatment program. These factors can include a reaction to a medication, infection, or emotional stress. Continued symptoms may also occur because the patient is not following the treatment program instructions.

Corticosteroid creams and ointments are the most frequently used treatment. Sometimes, over-the-counter preparations are used, but in many cases, the doctor will prescribe a stronger corticosteroid cream or ointment. Occasionally, the base used in certain brands of corticosteroid creams and ointments is irritating for a particular patient and a different brand is required. Side effects of repeated or long-term use of topical corticosteroids can include thinning of the skin, infections, growth suppression (in children), and stretch marks on the skin.

Tacrolimus (Protopic) and pimecrolimus (Elidel) ointments are powerful topical medicated creams (drugs that are applied to the skin) that is used for the treatment of atopic dermatitis. These new drugs are referred to as "immune modulators." They were first used internally to help patients with kidney and liver transplants avoid rejecting the organs they received. They work by suppressing the immune system. When these drugs are used externally to treat the skin, however, they do not weaken or change the body's immune system. Also, unlike topical steroids (cortisone creams), these new medications don't cause thinning of the skin and breaking of superficial blood vessels (atrophy).

Some treatments reduce specific symptoms of the disease. Antibiotics to treat skin infections may be applied directly to the skin in an ointment, but are usually more effective when taken by mouth in pill form. Certain antihistamines that cause drowsiness can reduce nighttime scratching and allow more restful sleep when taken at bedtime. This effect can be particularly helpful for patients whose nighttime scratching aggravates the disease. If viral or fungal infections are present, the doctor may also prescribe medications to treat those infections.

Phototherapy is treatment with light that uses ultraviolet A or B light waves, or a combination of both. This treatment can be an effective treatment for mild to moderate dermatitis in older children (over 12 years old) and adults. Photochemotherapy, a combination of ultraviolet light therapy and a drug called psoralen, can also be used in cases that are resistant to phototherapy alone. Possible long-term side effects of this treatment include premature skin aging and skin cancer. If the doctor thinks that phototherapy may be useful in treating the symptoms of atopic dermatitis, he or she will use the minimum exposure n Glossary content Copyright © 1996-2002 MedicineNet, Inc. All rights reserved.

Diseases - Atopic Dermatitis - Part 1

 

What is atopic dermatitis?

Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. The word "dermatitis" means inflammation of the skin. "Atopic" refers to diseases that are hereditary, tend to run in families, and often occur together. These diseases include asthma, hay fever, and atopic dermatitis. In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, cracking, weeping, crusting, and scaling.

Atopic dermatitis most often affects infants and young children, but it can continue into adulthood or first show up later in life. In most cases, there are periods of time when the disease is worse, called exacerbations or flares, which are followed by periods when the skin improves or clears up entirely, called remissions. Many children with atopic dermatitis enter into a permanent remission of the disease when they get older, although their skin often remains dry and easily irritated. Environmental factors can activate symptoms of atopic dermatitis at any time in the lives of individuals who have inherited the atopic disease trait.

What is the difference between atopic dermatitis and eczema?

Eczema is a general term for many types of skin inflammation (dermatitis). Atopic dermatitis is the most common of the many types of eczema. Several other forms have very similar symptoms. The diverse types of eczema are listed and briefly described below.

Types of Eczema

• Atopic dermatitis: a chronic skin disease characterized by itchy, inflamed skin
  
• Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical
  
• Allergic contact eczema: a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions
  
• Seborrheic eczema: a form of skin inflammation of unknown cause that presents as yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body
  
• Nummular eczema: coin-shaped patches of irritated skin-most commonly on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy
  
• Neurodermatitis: scaly patches of skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that becomes intensely irritated when scratched
  
• Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems
  
• Dyshidrotic eczema: irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn

How common is atopic dermatitis?

Atopic dermatitis is very common. It affects males and females equally and accounts for 10 to 20 % of all referrals to dermatologists (doctors who specialize in the care and treatment of skin diseases). Atopic dermatitis occurs most often in infants and children and its onset decreases substantially with age. Scientists estimate that 65 percent of patients develop symptoms in the first year of life, and 90 percent develop symptoms before the age of 5. Onset after age 30 is less common and often occurs after exposure of the skin to harsh conditions. People who live in urban areas and in climates with low humidity seem to be at an increased risk for developing atopic dermatitis.

About 10% of all infants and young children experience symptoms of the disease. Roughly 60 percent of these infants continue to have one or more symptoms of atopic dermatitis even after they reach adulthood. This means that more than 15 million people in the United States have symptoms of the disease.

What causes atopic dermatitis?

The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors. Evidence suggests that the disease is associated with other so-called atopic disorders such as hay fever and asthma, which many people with atopic dermatitis also have. In addition, many children who outgrow the symptoms of atopic dermatitis go on to develop hay fever or asthma. Although one disorder does not cause another, they may be related, thereby giving researchers clues to understanding atopic dermatitis.

In the past, it was thought that atopic dermatitis was caused by an emotional disorder. We now know that emotional factors such as stress can exacerbate, but do not cause the condition.

Is atopic dermatitis contagious?

No. Atopic dermatitis is definitely not contagious; it cannot be passed from one person to another. There is no cause for concern in being around someone with even an active case of atopic dermatitis.

What are the symptoms of atopic dermatitis?

Symptoms vary from person to person. The most common symptoms are dry, itchy skin, cracks behind the ears, and rashes on the cheeks, arms, and legs. The itchy feeling is an important factor in atopic dermatitis, because scratching and rubbing in response to itching worsen the skin inflammation that is characteristic of this disease. People with atopic dermatitis seem to be more sensitive to itching and feel the need to scratch longer in response. They develop what is referred to as the "itch-scratch" cycle. The extreme itchiness of the skin causes the person to scratch, which in turn worsens the itch, and so on. Itching is particularly a problem during sleep, when conscious control of scratching decreases and the absence of other outside stimuli makes the itchiness more noticeable.

How atopic dermatitis affects the skin can be changed by patterns of scratching and resulting skin infections. Some people with the disease develop red, scaling skin where the immune system in the skin becomes very activated. Others develop thick and leathery skin as a result of constant scratching and rubbing. This condition is called lichenification. Still others develop papules, or small raised bumps, on their skin. When the papules are scratched, they may open (excoriations) and become crusty and infected. The box below lists common skin features of the disease. These conditions can also be found in people without atopic dermatitis or with other types of skin disorders.

Can atopic dermatitis affect the face?

Yes. Atopic dermatitis may affect the skin around the eyes, the eyelids, and the eyebrows and lashes. Scratching and rubbing the eye area can cause the skin to change in appearance. Some people with atopic dermatitis develop an extra fold of skin under their eyes, called an atopic pleat or Dennie-Morgan fold. Other people may have hyperpigmented eyelids, meaning that the skin on their eyelids darkens from the inflammation or hay fever (allergic shiners). Patchy eyebrows and eyelashes may also result from scratching or rubbing.

Is the sufferer's skin type important?

Yes. Differences in the skin of people with atopic dermatitis may contribute to the symptoms of the disease. The epidermis, which is the outermost layer of skin, is divided into two parts: the inner part, which contains moist, living cells; and the outer part, which consists of dry, flattened, dead cells. Under normal conditions, the outer layer of skin acts as a barrier, keeping the rest of the skin from drying out and protecting other layers of skin from damage caused by irritants and infections. When this barrier is damaged or is naturally thin, irritants act more intensely on the skin.

The skin of a person with atopic dermatitis loses too much moisture from the epidermal layer. This allows the skin to become very dry, which reduces its protective abilities. In addition, the skin is very susceptible to recurring disorders, such as staphylococcal and streptococcal bacterial skin infections, warts, herpes simplex, and molluscum contagiosum (which is caused by a virus).

Skin Features of Atopic Dermatitis

• Lichenification: thick, leathery skin resulting from constant scratching and rubbing
  
• Papules: small raised bumps that may open when scratched, becoming crusty and infected
  
• Ichthyosis: dry, rectangular scales on the skin
  
• Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs
  
• Hyperlinear palms: increased number of skin creases on the palms
  
• Urticaria: hives (red, raised bumps), often after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath
  
• Cheilitis: inflammation of the skin on and around the lips
  
• Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
  
• Hyperpigmented eyelids: eyelids that have become darker in color from inflammation or hay fever

What are the stages of atopic dermatitis?

Atopic dermatitis affects each child differently, both in terms of onset and severity of symptoms. In infants, atopic dermatitis typically begins around 6 to 12 weeks of age. It may first appear around the cheeks and chin as a patchy facial rash, which can progress to red, scaling, oozing skin. The skin may become infected. Once the infant becomes more mobile and begins crawling, exposed areas such as the knees and elbows may also be affected. An infant with atopic dermatitis may be restless and irritable because of the itching and discomfort. Many infants improve by 18 months of age, although they remain at greater than normal risk for dry skin or hand eczema later in life.

In childhood, the rash tends to occur behind the knees and inside the elbows, on the sides of the neck, and on the wrists, ankles, and hands. Often, the rash begins with papules that become hard and scaly when scratched. The skin around the lips may be inflamed, and constant licking of the area may lead to small, painful cracks. Severe cases of atopic dermatitis may affect growth, and the child may be shorter than average.

The disease may go into remission. The length of a remission varies, and it may last months or even years. In some children, the disease gets better for a long time only to come back at the onset of puberty when hormones, stress, and the use of irritating skin care products or cosmetics may cause the condition to flare.

Although a number of people who developed atopic dermatitis as children also experience symptoms as adults, it is unusual (but possible) for the disease to show up first in adulthood. The pattern in adults is similar to that seen in children; that is, the disease may be widespread or limited. In some adults, only the hands or feet may be affected and become dry, itchy, red, and cracked. Sleep patterns and work performance may be affected, and long-term use of medications to treat the condition may cause complications. Adults with atopic dermatitis also have a predisposition toward irritant contact dermatitis, especially if they are in occupations involving frequent hand wetting, hand washing, or exposure to chemicals. Some people develop a rash around their nipples. These localized symptoms are difficult to treat, and people often do not tell their doctor because of modesty or embarrassment. Adults may also develop cataracts that are difficult to detect because they cause no symptoms. Therefore, the doctor may recommend regular eye exams.

How is atopic dermatitis diagnosed?

Currently, there is no single test that says unequivocally "this is atopic dermatitis" and there is no single symptom or feature that can be used to identify the disease. Each patient experiences a unique combination of symptoms, and the symptoms and severity of the disease may vary over time. The doctor bases the diagnosis on the individual's symptoms and may need to see the patient several times to make an accurate diagnosis. It is important for the doctor to rule out other diseases and conditions that might cause skin irritation. In some cases, the family doctor or pediatrician may refer the patient to a dermatologist or allergist (allergy specialist) for further evaluation.

A valuable diagnostic tool is a thorough medical history, which provides important clues as to the possible causes of the patient's ailment. The doctor may ask about all of the following: a family history of allergic disease; whether the patient also has diseases such as hay fever or asthma; exposure to irritants; sleep disturbances; any foods that seem to be related to skin flares; previous treatments for skin-related symptoms; use of steroids; and the effects of symptoms on schoolwork, career, or social life. Sometimes, it is necessary to do a biopsy of the skin or patch testing to determine if the skin's immune system overreacts to certain chemicals or preservatives in skin creams. A preliminary diagnosis of atopic dermatitis can be made if the patient has three or more characteristics from each of two categories: major features and minor features. Some of these characteristics are listed in the box below.

Skin scratch/prick tests (which involve scratching or pricking the skin with a needle that contains a small amount of a suspected allergen) and blood tests for airborne allergens generally are not as useful in diagnosing atopic dermatitis as a medical history and careful observation of symptoms. However, they may occasionally help the doctor rule out or confirm a specific allergen that might be considered important in the diagnosis. Negative results on skin tests are reliable and may help rule out the possibility that certain substances are causing skin inflammation in the patient. However, positive skin scratch/prick test results are difficult to interpret in people with atopic dermatitis and are often inaccurate. In some cases, where the type of dermatitis is unclear, blood tests to check the level of eosinophils (a type of white blood cell) or IgE (an antibody whose levels are often high in atopic dermatitis) are helpful.

... to be continued