The Impact of Hyperhidrosis

Life’s worries

Sweat is something that most people hardly think about.  It’s just something that happens when it’s hot, when your working out, or sometimes when feeling a strong emotion. But for people suffering from hyperhidrosis, there is a constant worry about sweat. It pervades all aspects of their lives, to a degree that may seem shocking to those not afflicted with the condition. 

Here are some of the many ways that hyperhidrosis can impact one’s quality of life.

Difficulty accomplishing simple tasks

Hyperhidrosis, especially in the palms, can make day-to-day activities more difficult. When your hands are slippery with sweat, keeping a grip on anything is challenging. Ditto for navigating touch screens and turning doorknobs. It can even be dangerous for jobs that require tools, such as handling hot pans and knives for cooks and hospital staff, using sharp and heavy equipment for technicians and engineers, conducting fine laboratory work for those in the science and medical fields, handling paper and money for office workers, among others.

People who sweat from their head can also find it difficult to see from time to time as the sweat drips down their forehead into their eyes. They need to constantly wipe away the sweat, or else wear something that will absorb the moisture. These distractions can make driving dangerous.

Those that suffer from armpit sweating (or axillary hyperhidrosis) often find it very embarrassing and constantly fear inadvertently putting up their arms up in case someone sees their sweat marks.  They often report needing to be very choosy about the clothes they wear and activities they partake in.

Physical discomfort and inconvenience

With hyperhidrosis, even mild physical activity can cause one to sweat as if they’ve run a marathon. Arriving to work or school sticky and wet after a commute is uncomfortable and embarrassing. Many lug around spare clothes, towels, handkerchiefs, antiperspirants, and deodorants to make the rest of the day more bearable. 

Accumulation of moisture in the armpits or in the groin area can lead to chafing, pain, and irritation to the skin. It is also a predisposing factor for bacterial growths that cause unpleasant odours at best and inflammation at worst. To prevent this from happening, many people who suffer from hyperhidrosis need to think of workarounds. These take time and resources, which lowers their quality of life considerably.

Limitations on lifestyle

Studies on the effect of hyperhidrosis on patients show that the condition dictates many aspects of their lifestyle.

This is particularly obvious in choosing what they wear. People with hyperhidrosis gravitate towards darker colours that help make sweat marks less obvious. They would rather opt for breathable fabrics and fits. People who sweat from their feet do not wear flip flops or sandals to avoid slipping out of them. Those who perspire from their head will avoid wearing make-up because it slides off. This hampers their self-confidence and ability to express themselves.

Hyperhidrosis can also affect the activities patients choose to engage in. Since heat and physical exercise can trigger sweating, those with hyperhidrosis tend to minimise working out or going outdoors, especially when it involves other people. It is also a factor to consider when choosing a career, with some hyperhidrosis patients opting for office jobs in air-conditioned rooms just so they can avoid physical excursions.

Fear of touch-related social interactions

Touching is a normal part of building relationships, but it is something that hyperhidrosis patients dread. This fear usually stems from previous social interactions when they have been on the receiving end of awkwardness and disgust for their sweat. People with palmar sweating avoid shaking hands and giving high fives, while those with generalised sweating shy away from hugs and crowded places. Fear of other people seeing their perspiration leads many to avoid social gatherings altogether, affecting interpersonal relationships with both family and friends. This is particularly an issue when attempting to build romantic relationships, as intimate physical contact is expected.

Unhealthy levels of stress

People with hyperhidrosis worry all the time about their condition. It’s the little things, like stressing about the smell of their socks when they take off their shoes in public, handing sweat-soaked money when paying for purchase, leaving noticeable sweat marks on surfaces. These small worries add up over time and drastically affect their self-esteem. This can have a pervasive effect on everything from social life to career opportunities.

In addition, a good number of people who have hyperhidrosis do not know that treatment is available. There is not much attention given to the condition even among healthcare providers. This can lead to a feeling of hopelessness at the situation, and resignation to spend the rest of their life sweating excessively and suffering for it.  However, modern medical treatments can improve the lives of sufferers of hyperhidrosis drastically, and in most cases, back to normal levels of sweating. 

Conclusion

Hyperhidrosis can have a negative impact on patients’ lives. However, seeking care from a dermatologist to learn about options for treatments is the first step to overcoming this otherwise troubling condition.  Seeking therapy for mental health impacts may also be appropriate for some. This can help lessen the anxiety they feel about sweating. 

If you are experiencing any mental health concerns, please see your GP or mental health professional.  

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

 

References

 

Kamudoni, P., Mueller, B., Halford, J. et al. The impact of hyperhidrosis on patients’ daily life and quality of life: a qualitative investigation. Health Qual Life Outcomes 15, 121 (2017). https://doi.org/10.1186/s12955-017-0693-x

 

Strutton, D. R., Kowalski, J. W., Glaser, D. A., & Stang, P. E. (2004). US prevalence of hyperhidrosis and impact on individuals with axillary hyperhidrosis: results from a national survey. Journal of the American Academy of Dermatology, 51(2), 241–248. https://doi.org/10.1016/j.jaad.2003.12.040

 

Botox injections hyperhidrosis

Botulinum Toxin for Hyperhidrosis

One of the many uses of botulinum toxin

 

Botulinum toxins may have a scary-sounding name, but it’s just the umbrella term for the famous anti-wrinkle treatment. This injection has long been used by the rich and famous to slow down the passage of time. But there are many other uses for botulinum toxins, and one of them is hyperhidrosis. 

 

So if you’re suffering from excessive sweating, this is one treatment for consideration.

What is botulinum toxin?

Botulinum toxin is a substance produced by Clostridium botulinum. When this bacteria enters the body through contaminated food, through an open wound, or through inhalation, the toxin it produces attacks the nervous system, leading to a disease called botulism. This is characterised by paralysis of muscles and even organs. It does not take a high amount of toxins to cause morbidity and mortality.

 

It is a testament to humankind’s ingenuity to use this dangerous substance as a treatment for various conditions. In extremely diluted amounts and with processing, botulinum toxins can be used to control conditions that result in involuntary muscle contractions, repetitive eye movements, and neuromuscular dysfunction. But perhaps botulinum toxin is best known for its ability to achieve tight, wrinkle-free, youthful-looking skin. 

 

There are two TGA-approved botulinum toxin formulations, both of which exert their effects through blocking the release of an important neurotransmitter, acetylcholine. The binding of acetylcholine to nerve receptors is crucial for many processes, including muscle movement and glandular secretions. 

How does botulinum toxin help with hyperhidrosis?

We have two kinds of sweat glands. Eccrine sweat glands are the most numerous and are found all over the body. Their primary function is to regulate temperature. When the body feels like it’s getting a little too hot, the nervous system produces acetylcholine, which in turn is the chemical trigger for eccrine glands to start producing sweat. 

 

On the other hand, we have apocrine sweat glands. These are much fewer in number, and are concentrated in the axillary (armpits), groin area, and breast area. Instead of responding to acetylcholine, they are triggered by noradrenaline. Noradrenaline is produced when the body feels strong emotions such as distress, fear, pain, and sexual stimulation. The sweat they produce is more viscous, and has a tendency to smell when in contact with bacteria.

 

What are the advantages and disadvantages of using botulinum toxin for hyperhidrosis?

Botulinum toxin has been used as a treatment for hyperhidrosis for over 25 years. Its safety and efficacy have long been established through numerous studies. Patients have consistently reported a significant decrease in sweat production and an increase in quality of life within 2 weeks of treatment.

 

Though botulinum toxin injections are more expensive than topical antiperspirants, the first line of treatment against hyperhidrosis, they are much more convenient. The effect of a single session can last from 3-9 months, whereas topical antiperspirants will require at least weekly, if not daily application. 

 

Botulinum toxin is particularly effective for focal hyperhidrosis, or excessive sweating in select parts of the body. Patients with profuse perspiration in the armpits, palms of the hands, soles of the feet, and face or head area stand to benefit the most from this treatment.

 

Using botulinum toxin may have side effects, although studies show that it occurs in a minority of patients. When used for axillary hyperhidrosis, there may be temporary itchiness or bruising. When used for palmar hyperhidrosis, there may be temporary weakening of the hand-grip.

How is botulinum toxin used for hyperhidrosis?

Botulinum toxin can only be administered by a licensed medical professional. Always consult your doctor before pushing through with this treatment, as some medical conditions may contraindicate its use, even at such a miniscule amount. 

 

When injected by dermatologists, there is a Medicare subsidy that applies making the treatment more affordable.  Certain criteria need to be met however, so its best to make an appointment to check your suitability.

 

The area is first cleansed and then marked appropriately.  Various pain-reduction techniques are used at Melbourne Skin & Dermatology to ensure a comfortable treatment.  Multiple injections are then applied to the treatment area.  The markings are then washed off and the patient is good to go back immediately to unrestricted activities.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

References

 

de Almeida, A. R., & Montagner, S. (2014). Botulinum toxin for axillary hyperhidrosis. Dermatologic clinics, 32(4), 495–504. https://doi.org/10.1016/j.det.2014.06.013

 

Doft, M. A., Hardy, K. L., & Ascherman, J. A. (2012). Treatment of hyperhidrosis with botulinum toxin. Aesthetic surgery journal, 32(2), 238–244. https://doi.org/10.1177/1090820X11434506

 

Hodge BD, Sanvictores T, Brodell RT. Anatomy, Skin Sweat Glands. [Updated 2021 Aug 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482278/

 

Nigam, P. K., & Nigam, A. (2010). Botulinum toxin. Indian journal of dermatology, 55(1), 8–14. https://doi.org/10.4103/0019-5154.60343

 

https://dermnetnz.org/topics/hyperhidrosis#:~:text=Botulinum%20toxin%20injections%20are%20approved,other%20sites%20such%20as%20palms.

 

Excessive Sweating image

Why am I sweating so much?

The 101 on hyperhidrosis

 

If you are self-conscious about how much you sweat, you could be suffering from a condition called hyperhidrosis. Many people who live with it do not even know that it is a medical phenomenon; they just think it is an unfortunate and frequent occurrence that they need to work around. While hyperhidrosis is not a life-threatening disease, anyone who has it can attest to the fact it is very inconvenient, embarrassing, and can be a great impact on daily school, work and social activities. 

 

So if you’re one of them, you’ll be pleased to know that hyperhidrosis has long been given attention by the medical community. There are options available to help better manage, or, in some cases, completely eliminate this condition.

 

But before you go in search of a cure, it’s important to get a better understanding of hyperhidrosis.

What causes us to sweat?

To understand the causes of excessive sweating, it is first important to consider what causes normal sweating. And at the centre of that conversation is the hypothalamus.

 

The hypothalamus wants to keep our bodies at a constant temperature of 37 degrees Celsius. When the body appears to be getting a little too hot for comfort, temperature sensors in the skin and internal organs send messages to the hypothalamus to do something about it. Among the many ways to cool the body down, releasing sweat through the sweat glands is one of the most effective responses. This is called “thermoregulatory sweat”.

 

However, it’s not just increased heat or exertion that causes us to sweat. Strong emotions and stress can cause us to break out in what is commonly known as “cold sweat”. Whereas thermoregulatory sweat is usually excreted throughout the body, emotional sweat is typically concentrated in the armpits, face, palms, and feet. 

 

It is important to consider that these two general types of sweating are interrelated. It is likely that one process influences the other.

What causes excessive sweating?

There are two general kinds of hyperhidrosis. Usually, it is easy to differentiate the two based on onset of the disease, family history, and symmetry of affected areas, but in some cases, further tests may need to be done to confirm the diagnosis.

 

Primary hyperhidrosis

Primary hyperhidrosis can run in families. Though the exact gene that controls this has not been identified, it appears to be autosomally inherited with incomplete penetrance.  This is a fancy way of saying that it can be passed on to both males and females of the family, and can manifest with different severity and presentation among family members. So if you have primary hyperhidrosis, there’s a good chance you’re not the only sweaty one in the family.

 

This condition usually appears in childhood or puberty, and can continue into adulthood. There are some who report a period of quiescence or remission, but for some, it’s something they live with for most of their adult lives.

 

Primary hyperhidrosis can be focal (meaning only in one area such as the armpits) or generalised (head and trunk). A hallmark of focal primary hyperhidrosis is that it presents symmetrically.  So in these cases, if the right armpit sweats a lot, you can expect the left to do the same. You can have it in one or more areas of the body. For some, they may even present with both focal and generalised primary hyperhidrosis.

Secondary hyperhidrosis

Secondary hyperhidrosis can be caused by hormonal imbalances, neurological or endocrine diseases, or certain types of drugs.  Pregnancy and menopause have been associated with periods of excessive sweating that may extend for months up to years. Some people develop hyperhidrosis as a side effect of conditions that affect the brain, spine, and peripheral nerves, while others start to notice increased perspiration after taking cholinergic drugs, antidepressants, and opioid painkillers.

 

Sudden onset of increased volume and frequency of sweating in people who have no prior history of sweatiness is a potential sign of secondary hyperhidrosis. 

 

Like primary hyperhidrosis, secondary hyperhidrosis can be both focal and generalised. The difference is that when it does manifest focally, it tends to occur on one side. This is usually because of a compensatory mechanism, ie, it is possible that the nerves supplying the right side of the body have been damaged and no longer produce sweat, so the nerves on the left side work extra hard to make up for it. Generalised secondary hyperhidrosis can be difficult to differentiate from generalised primary hyperhidrosis, but that’s what a visit to the dermatologist is for! 

 

For some, it is easy to identify the trigger. But for others, it may not be so clear-cut. Usually, secondary hyperhidrosis is accompanied by other red flags that something is wrong in the endocrine or nervous system. If there are no other signs, doctors will usually prescribe a battery of diagnostic tests in an attempt to find out what’s causing it.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

 

References:

 

Rystedt A, Brismar K, Aquilonius SM, Naver H, Swartling C. (2016). Hyperhidrosis – an unknown widespread “silent” disorder. Journal of Neurology and Neuromedicine, 1(4): 25-33.

 

Schlereth, Tanja & Dieterich, Marianne & Birklein, Frank. (2009). Hyperhidrosis-Causes and Treatment of Enhanced Sweating. Deutsches Ärzteblatt international. 106. 32-7. 10.3238/arztebl.2009.0032. 

 

https://dermnetnz.org/topics/hyperhidrosis

 

Oral and topical niacinamide for rosacea

Rosacea can be a challenging condition to live with. The unpredictable flushing, uncomfortable dryness, random pimples, and the frustrating sensitivity of the skin would make anyone desperate to find a cure.

 

While there is no treatment that can permanently correct rosacea, there are many treatments, skincare, and lifestyle measures that can help decrease flare-ups. One that is gaining popularity is a vitamin called niacinamide. With its high safety profile, economic accessibility, and ease of use, it has earned a place in many a rosacea patient’s routines.

 

What is niacinamide?

Niacinamide, also known as nicotinamide, is none other than Vitamin B3. Specifically, it is the form of Vitamin B3 that is actively used by the body for various processes; the most basic of which is cellular metabolism. Each and every cell in our body requires NAD(H) and NADP(H) to use and harness energy. In fact, the “n” in the acronym stands for nicotinamide. Without these molecules, cells will not be able to function normally. These also have antioxidative properties that help repair damage to cells.

 

The entire body benefits from this vitamin, but let’s take a closer look at what it does for the skin. Studies suggest that niacinamide plays an important role in maintaining the skin barrier by upregulating the production of ceramides and collagen. Ceramides are lipids that prevent transepidermal water loss, helping keep the skin soft and supple. Meanwhile, collagen is a structural protein that provides for elasticity and tensile strength.

 

In addition, niacinamide has potent immunomodulatory properties. It inhibits the production of some cytokines, the chemical messengers that trigger inflammation. In fact, niacinamide has been used to successfully treat inflammatory dermatoses, including bullous pemphigoid and is sometimes used as part of acne treatments.

 

How does niacinamide help rosacea patients?

 

The skin of rosacea patients is much more sensitive than those of people who do not suffer from the condition. Flare-ups are triggered by anything from sunlight to windburn, spicy food to alcohol, cosmetics to strong emotions. The skin reacts disproportionately to the perceived threat, becoming red, blotchy, rough, and swollen. Unfortunately, angry skin is not great at protecting itself from further irritation, and so the cycle continues.

 

Niacinamide throws a wrench into this process by making the skin more resilient against threats. It does this by improving the structure of the epidermis to prevent moisture loss, improve tensile strength and suppleness. With niacinamide, the cells that make up the layers of the skin have the sufficient building blocks to produce NAD(H) and NADP(H), allowing them to do their jobs optimally. It also helps to modulate the overactive immune response associated with rosacea.

 

Topical use

With niacinamide’s many mechanisms of action for improving skin condition and texture, many products have begun to incorporate this vitamin into their formulas. Serums, moisturisers, foundations, creams–you name it.

 

However, if it is used as a supportive treatment for rosacea, you should pay attention to the concentration. Using a moisturiser containing 2% niacinamide was shown to decrease blotchiness, flakiness, and bumps in rosacea patients after 4 weeks of use. Other studies that focus on this vitamin’s effect on other skin conditions like acne, wrinkles, and pigmentation use products that have up to 10% niacinamide.

 

Discuss with your practitioner what product they would recommend for your condition. Always be sure to patch-test before applying on your whole face to see how your skin will react to it. Many rosacea patients love niacinamide and most skin types will tolerate it well, but each body is different. It’s better to err on the side of caution and check first, especially if you have sensitive, rosacea-prone skin.

 

Oral use

In the quest for the ultimate cure to rosacea, oral treatments have been considered. These include low-dose antibiotics and isotretinoin. Initial studies on oral niacinamide for rosacea show promise, though there is still much research needed to find out exactly how it works. Likely, its effect has something to do with the vitamin’s ability to inhibit the chemical triggers for vasodilation, provide energy for cellular repair, and modulate inflammation.  This translates to a decreased likelihood of flare-ups and improved ability of the skin to regenerate after irritation.

 

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

References

Draelos, Z. D., Ertel, K., & Berge, C. (2005). Niacinamide-containing facial moisturizer improves skin barrier and benefits subjects with rosacea. Cutis, 76(2), 135–141.

 

Fivenson D. P. (2006). The mechanisms of action of nicotinamide and zinc in inflammatory skin disease. Cutis, 77(1 Suppl), 5–10.

 

Levin, J., & Momin, S. B. (2010). How much do we really know about our favorite cosmeceutical ingredients?. The Journal of clinical and aesthetic dermatology, 3(2), 22–41.

 

Matts, Paul & Oblong, John & Bissett, D.L.. (2002). A Review of the range of effects of niacinamide in human skin. Int Fed Soc Cosmet Chem Mag. 5. 285-289.

 

Niren N. M. (2006). Pharmacologic doses of nicotinamide in the treatment of inflammatory skin conditions: a review. Cutis, 77(1 Suppl), 11–16.

 

https://dermnetnz.org/topics/nicotinamide

 

https://dermnetnz.org/topics/rosacea

 

 

 

Green Light Vascular Laser

Vascular Laser Therapy for Rosacea

Some sufferers of rosacea may have agonised in front of the mirror about the diffuse redness and prominent blood vessels on their face. Thankfully, advances in medicine and technology have resulted in numerous treatments that can help improve the appearance of red-blotchy skin.

 

Among the treatments stirring up a lot of buzz is the Excel V 532nm vascular laser therapy. If you’re considering this procedure, it’s important to get a general idea of what it is, how it works, and the factors that affect its efficacy and safety. Armed with this knowledge, you can make better decisions for your skin.

 

What is vascular laser therapy?

The term “laser” actually started out as an acronym for “light amplification by the stimulated emission of radiation”. It sounds like a handful, but translated into layman’s terms, it basically refers to high-intensity light produced through excitation of specific molecules. The wavelength of the light that is produced depends on what molecules are used to create them. If the wavelength is between 400 to 700nm, you’ll be able to see it as within the spectrum of visible light. There are also lasers that produce wavelengths greater than 700nm, which fall into the range of infrared light.

 

Laser light is very different from the light coming from your lamp. It contains large amounts of energy contained in a very narrow beam, allowing it to change the objects it’s pointed towards. Because it’s so precise, you can target it at a specific spot on skin while minimising collateral damage.

 

How does it work?

The goal of vascular laser therapy is to destroy the small blood vessels that have dilated so much that they are visible through the skin. We know that blood that fills it contains oxygenated hemoglobin, and we also know that oxygenated hemoglobin strongly absorbs light at around the range of 418, 542, and 577nm.

 

Vascular laser therapy delivers a concentrated beam of light in an absorbable wavelength into a blood vessel. The light energy is converted into heat, and that causes the destruction of the offending blood vessel. The surrounding structures are not damaged because they do not absorb the wavelength of the laser light, they just reflect it. Plus, the beam of the laser is so narrow, it can target a small area.

 

This is great for people diagnosed with rosacea. It can greatly reduce telangiectasia (the visible red blood vessels) and overall redness within a few sessions, depending on the depth and size of the lesions. Many people report being satisfied with the relatively quick, long-lasting, and obvious improvement in their skin.

 

Considerations before opting for laser therapy

By this time, you might be ready to start looking for the nearest clinic that offers vascular laser therapy. But before you do that, there are things you have to consider finding out if this is the right procedure for you.

 

Firstly, laser therapy is generally considered supportive to medical therapy for rosacea. In other words, a few sessions will not magically make the skin condition go away. Following a good skincare regimen, avoiding triggers, and using any prescribed treatments are just as important to managing rosacea.

 

Laser therapy may also have different effects on different types of skin. This may cause a reaction to skin that burns easily or is sensitive to light and heat. Those with darker skin tones should be especially careful as not all laser are suitable in such cases.

 

It is important to note the change is not instantaneous. There may be discomfort, increased redness, and swelling on the face a few days after the procedure. Sessions are usually spaced a few weeks apart to allow the inflammation to settle down. There is also an increased risk of sun sensitivity, so be ready to slather on the sunscreen, wear a hat, and avoid the sun as much as you can.

 

But the most important factor to consider is where you plan to get vascular laser treatments done. Not all lasers are the same, not all laser clinics are the same, and not everyone should be operating a laser device.

Not all lasers are the same, not all laser clinics are the same, and not everyone should be operating a laser device.

Conclusion

Rosacea can be a difficult condition to live with, but there are therapies that can help improve the appearance of the skin. With proper medical advice and research, you can get the help you need to not just look better but feel better about yourself.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

References

Carniol, P. J., Price, J., & Olive, A. (2005). Treatment of telangiectasias with the 532-nm and the 532/940-nm diode laser. Facial plastic surgery : FPS, 21(2), 117–119. https://doi.org/10.1055/s-2005-872412

 

https://dermnetnz.org/topics/lasers-in-dermatology/

 

https://www.aad.org/public/diseases/rosacea/treatment/lasers-lights

 

https://dermnetnz.org/topics/rosacea/

 

https://dermnetnz.org/topics/facial-red-vein-and-vascular-birthmark-treatments/

 

 

Learn more about Vascular Laser & Download our brochure here: Vascular Laser Excel V

 

Winter Tips for Rosacea Patients

Rosacea patients are well-aware that the heat is their enemy. Staying out of the hot gaze of the sun and keeping cool with shade and water are basic tenets of rosacea control. So, it’s no wonder that rosacea patients breathe a sigh of relief at winter’s arrival.

 

But just because the weather is cool does not mean rosacea patients can slack off on their routine. If you live with this condition, you have to adjust to the new set of challenges this season brings. The triggers may come in different forms but learning how to recognise and act on them is the key to managing rosacea. Here are some tips to help rosacea patients have healthy winter skin.

Protection from sudden changes in temperature

With the temperature drop, it’s easier to go outdoors without worrying too much about flare-ups. But when it’s cold, people seek warmth. Whether it’s turning up the thermostat, taking a steaming bath, or sipping on a hot drink, that abrupt change from cold to hot could be bad for sensitive, rosacea-prone skin.

 

To protect against this, refrain from going overboard with the heat. Keep the thermostat at a temperature that is not drastically different from the outdoors or give your skin time to adjust to the different temperatures. Avoid hot water, whether drinking it or bathing in it.   To easily adjust to the temperature changes as you go to work, school, or errands, wear layered clothing.

 

Protection from the sun

The heat of the sun may not be as aggravating as it is in the summer, but the risk of its UV rays is still there. Be especially mindful of this if you are lucky enough to visit the snow.  UV can be worse in the snow as snow absorbs only about 10% of UV radiation, unlike grass and soil that absorbs roughly 90% of it. The bulk is then reflected towards things on the snow, including unsuspecting people. The result is not only a UV burn but a flare in your rosacea.

 

That’s why slathering on sunscreen should be done all throughout the year, regardless of season. Choose a broad-spectrum, waterproof sunscreen with at least SPF30. You might want to shift to a creamier formulation than the one you use in warmer seasons for longer-lasting moisturising effects. Make sure to apply it on every part of your face and reapply at least every two hours for maximal protection.

 

Protection from the wind

The cold gusts of wind can really do a number on rosacea-prone skin. It strips away at the protective barrier and irritates the skin, potentially causing flare-ups. To protect against this, wear a scarf or ski mask when spending a long time outdoors.

Protection from dryness

The low humidity is yet another reason why winter is bad for rosacea patients. Dry skin is not as good as protecting our bodies as well-hydrated skin and doesn’t look as good either. Moisturising is a crucial part of any rosacea skin regimen, but you’ll have to up your game if you’re fighting against an already dry atmosphere.

 

You can change your formulation to something heavier and creamier for the winter. Keep a bottle with you at all times so you can reapply as often as needed.

 

Conclusion

Winter brings its own set of challenges to rosacea-prone skin, but there are ways to manage it. As long as you adjust your products and habits to minimise triggers and stick to your doctor’s orders on rosacea treatments, you can minimise the flare-ups and achieve healthy skin during the winter months.

 

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

 

 

Gentle Skincare in Rosacea

Gentle is the way in Rosacea Management

 

Rosacea is a skin condition that causes various types of sensitivity and inflammation of the skin. These hallmarks of inflammation need to be soothed and calmed, and to do that, one must practice gentle skincare.

Gentle skincare is all about minimising irritation that otherwise can cause the skin to flare up. It’s important to remember that this includes avoiding both chemical and mechanical irritants. It’s not just the products you use, but also how you apply them.

 

Here are some tips to help you practice gentle skincare.

 

Look at the ingredient list.

You can tell which products are more likely to irritate your skin by checking its formulation. Avoid those that have ingredients such as menthol, alcohol, camphor, fragrances and sodium lauryl sulfate. Now here is something that may shock you.  Avoid essential oils! Dermatologist Dr Chris Jalilian says to avoid ingredients that contain ‘botanicals’.  “These are more likely to do more harm than good”.  Go for products that are labelled as “mild”, “gentle”, “non-irritating”, or “for sensitive skin”. Run away from toners, even if it’s suggested that they may be OK to use in sensitive skin. Rosacea needs no toning!

 

You should apply these guidelines to anything that touches your face. For example, sodium lauryl sulfate is often found in shampoos and toothpaste. The residue from these products could cause redness in the forehead or around the mouth for example.

 

  “Avoid menthol, alcohol, camphor, fragrances, sodium lauryl sulfate and essential oils. These are more likely to do more harm than good”.

 

For more product suggestions, you can check out the rosacea products page of our partner pharmacy.

 

Consider the two staple ingredients for rosacea skincare, Vitamin B3 (niacinamide) and Vitamin A (retinols). Our favourites are Propaira Skin Defence serum with 10% niacinamide and The Skincare Company’s Vitamin A which glides on the skin so elegantly.  As for a gentle moisturiser, our pick is La Roche Posay Toleriane Ultra Light Sensitive Moisturiser.

 

Do a patch test

Each person’s skin is different from the next. So what will work for one person may not necessarily work for you. To make sure that the product you are purchasing is right for your skin, do a patch test first. Place a small amount on your jawline or somewhere that is not so obvious. Leave it on for 5-10 minutes to see if it will cause a reaction. If it causes redness, itching, or dryness, best leave it on the shelf.

 

Cleanse twice a day

To complement your prescribed rosacea treatment, it is important to cleanse twice a day. It’s best to use products that have a slightly acidic or neutral pH to mimic the skin’s natural state.

 

“Blot your skin dry rather than rubbing and use a soft towel to dry your skin then allow your face to air dry for a further 5 to 10 minutes before you put on your creams”.

 

The goal is to remove oil and residue from the face as gently as possible. Avoid using washcloths or face brushes as they can be abrasive. Instead, use your fingertips and gently move it against your face in circular motions using a light touch. Wash away the cleanser with lukewarm water as temperature extremes can trigger rosacea. “Blot your skin dry rather than rubbing and use a soft towel to dry your skin” says Dr Chris Jalilian.  “Then allow your face to air dry for a further 5 to 10 minutes before you put on your creams”.

 

 

Moisturise regularly

People who suffer from rosacea have skin that is sensitive and easily damaged. Proper moisturisation helps repair that barrier and protect the skin, which results in improved skin appearance and increased comfort.

 

When you find a gentle, non-irritating moisturiser that works for you, apply it as often as you want. With clean hands, dab it gently onto your face and enjoy the relief from dryness.  You don’t need a lot of moisturiser to cover your face, just enough for a thin coat.

 

 

Apply sunscreen everyday

Sunscreen is one of the cornerstones of rosacea management. Use a broad-spectrum product with at least SPF 30+. Physical filters such as zinc oxide and titanium dioxide may not be easy to blend into the face, but these are less likely to irritate the face, making them the active ingredients to look out for when shopping for sunscreen.

 

Make sure to apply every 2-3 hours during the day when outdoors, regardless of the weather or your location.

 

Conclusion

Combining gentle products with gentle application can significantly improve the effectiveness of medical rosacea treatments. But as with any skincare routine, consistency is key. Make it a habit to take care of your skin by cleansing, moisturising, and applying sunscreen, and you’re sure to see (and feel!) the results.

 

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

 

References

 

https://www.aad.org/public/diseases/rosacea/triggers/tips

 

https://www.rosacea.org/patients/skin-care/facial-cleansing-for-rosacea

 

Levin, Jacquelyn & Miller, Richard. (2011). A Guide to the Ingredients and Potential Benefits of Over-the-Counter Cleansers and Moisturizers for Rosacea Patients. The Journal of clinical and aesthetic dermatology. 4. 31-49.

 

Santoro, F., Lachmann, N. An Open-Label, Intra-Individual Study to Evaluate a Regimen of Three Cosmetic Products Combined with Medical Treatment of Rosacea: Cutaneous Tolerability and Effect on Hydration. Dermatol Ther (Heidelb) 9, 775–784 (2019). https://doi.org/10.1007/s13555-019-00331-4

 

 

 

 

 

 

 

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Dietary Do’s and Don’ts for Rosacea Patients

Dietary Do’s and Don’ts for Rosacea Patients

 

One of the key tenets of rosacea management is the avoidance of triggers. The majority of these involve being choosy about what you put on your skin, but it seems that there is value in also choosing what you put in your mouth.

A significant number of rosacea patients report intensified flare-ups after being exposed to certain types of food. These experiences have piqued the interest of researchers. They are now trying to understand the pathogenesis of flares in signs and symptoms of rosacea following ingestion of certain types of food. Following this through could lead to further breakthroughs in understanding and treatment of this condition.

Rosacea and the gut

Anecdotal evidence suggests a link between rosacea and issues in the gastrointestinal tract. Based on initial studies, gut microbiome disruptions appear to play a role in the pathogenesis of rosacea flare-ups.

Several scientific papers have reported higher prevalence of Helicobacter pylori infections (HPI) and small intestinal bacterial overgrowth (SIBO) in people with rosacea compared to people who don’t. This may mean that imbalances in the microbial environment of our digestive system play a role in rosacea.

Inflammatory bowel disease also appears to be associated with rosacea. The factors influencing the guts immune response may also be the same factors setting off flare-ups.

Dietary management for Rosacea patients 

Doctors and researchers have compiled information from thousands of rosacea patients over the years to find out which food most commonly causes their skin to flush. Though not all rosacea patients react the same way, you can use this list as a general guide on what to eat and what not to eat if you’re trying to avoid an episode.

  1. Don’t drink too much alcohol

    Celebrations often call for a bottle of champagne or a glass of wine, but rosacea patients best beware of the effects of alcohol on the skin.  When alcohol is processed inside our body, one by-product is acetaldehyde. This compound triggers the release of histamine, which in turn promotes a pro-inflammatory response. Combined with alcohol’s vasodilatory effect (ie opening of blood vessels), it’s no wonder drinking causes redness and increased body heat. This happens to people without rosacea, so you can just imagine its effect on those suffering from it.

  2. Avoid foods containing capsaicin

    Capsaicin is the compound from chili that gives the mouth that hot, tingly feeling. While many people enjoy a little spice in their meal, rosacea patients are better off without it. Capsaicin binds to a cell receptor called TRPV1, which leads to a cascade of neurovascular activities that promote blood vessel dilation and redness.

  3. Don’t consume piping hot food or drinks

    Sometimes it’s not the food itself, but the temperature it’s served at. Remember that increased body temperature can set off a blushing bonanza.  Many rosacea patients find that drinking hot coffee and tea can trigger an episode, so they opt for iced drinks instead.

  4. Don’t eat food that contains cinnamaldehyde

    Cinnamaldehye is a compound found in several kinds of food that people may not think to group together. Mustard oil, chocolate, tomatoes, cinnamon, and citrus fruits all have it. Like capsaicin, it binds to a cell receptor, specifically TRPA1, which promotes vasodilation and redness.

  5. Do eat sources containing prebiotics and probiotics

    Given that rosacea has been associated with the overgrowth of pathogenic bacteria in the gut, giving the beneficial bacteria a leg-up could help mitigate the effects long-term. Prebiotics are foods that promote the activity and regulate the growth of beneficial bacteria in the stomach. Fiber-rich foods are considered prebiotics, so consider increasing uptake of barley, green peas, lentils, dried dates, pasta, pistachios, and others.

    On the other hand, probiotics are foods that deliver beneficial bacteria to the GIT. Yogurt, kefir, kimchi, sauerkraut, and miso are some options.

    While the effect of prebiotics and probiotics on rosacea symptoms have not been demonstrated scientifically, some patients report an improvement in their condition. Aside from that, there are a lot of other health benefits to incorporating fiber and probiotics into your meals. But as always, seek specific advice from your doctor or dietician for a tailored eating plan.

  6. Consider supplements

    The skin barrier function of the skin can be compromised in patients suffering from rosacea.  To help with this, supplements like zinc and omega-3 fatty acids have been suggested to be beneficial. They may have anti-inflammatory properties that can keep the swelling and redness down. Omega-3 fatty acids are important for skin health and integrity, so if your not getting enough of this in your diet, consider supplementation.

Conclusion

Rosacea patients should make use of all avenues to keep their condition from flaring up. Knowing which foods to avoid and which foods to incorporate may help decrease the frequency and intensity of flare-ups in the long term.

Purpose of this information

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

References:

Buddenkotte, J., & Steinhoff, M. (2018). Recent advances in understanding and managing rosacea. F1000Research, 7, F1000 Faculty Rev-1885. https://doi.org/10.12688/f1000research.16537.1

Weiss, E., & Katta, R. (2017). Diet and rosacea: the role of dietary change in the management of rosacea. Dermatology practical & conceptual, 7(4), 31–37. https://doi.org/10.5826/dpc.0704a08

https://dermnetnz.org/topics/cutaneous-adverse-effects-of-alcohol/3

SLIP, SLOP, What?

SLIP, SLOP, What?

Effective Methods of Sunscreen Application

If you ask any dermatologist what the secret is behind healthy, beautiful skin, it’s practically guaranteed that they’ll mention sunscreen. But this skincare product doesn’t just protect us from fine lines, an uneven complexion, or sunburn – it also is a key component to manageing skin conditions such as rosacea and mostly importantly, protects us from potentially life-threatening skin cancers like melanoma.

However, the effectiveness of sunscreen is not just based on the product itself, but on how you use it. Simply put, using the best, most expensive, most dermatologically-recommended sunscreen in the world won’t be able to protect your skin from the sun unless you apply it correctly. 

So if you want to maximise the benefits of your sunscreen, make sure you’re putting it on the way it should be. Here we list 5 methods for effective sunscreen application.

 

Apply it on all exposed areas of the body

Everything the sunlight touches should be covered by sunscreen. The face, legs, and arms get a lot of attention. But how about the ears, lips, eyelids? How about feet and toes if you’re wearing sandals? How about the backs of your hands? If you don’t cover all your bases, you might find one area aging a lot faster than the rest. 

For the eyes, UV-protection sunglasses in wrap-around style are best for those spending time outdoors. For the lips, use lip balm that offers at least SPF 15 and reapply every few hours and after meal times as it can get wiped away while talking or eating.

 

Apply a shot glass’ worth of sunscreen

One of the main reasons that people don’t get the full benefits of sunscreen is because they apply too little of it. On average, the majority of people put 20% to 50% less product than they should. 

According to studies, each square centimetre on your body should be covered with 2mg of sunscreen. But that’s pretty difficult to measure on the field. A good rule of thumb is to dispense a shot glass-worth of sunscreen (around 45mL) on your body. If you’re into baking or cooking, it can also be thought of as 2-3 tablespoons for the body and 1-2 teaspoons from the neck and face.

It may sound like a lot, but applying sunscreen in the right amounts will allow you more effective protection for a longer period of time.

 

Apply 20 minutes before sun exposure

Sunscreen doesn’t provide instantaneous sun protection the way clothes or shade would. You need to give it time to get absorbed into the skin where it will do its magic. Apply your sunscreen 20 to 30 minutes before leaving your home. 

It is very important to follow this rule before you go for a swim or engage in strenuous physical activity. The water and sweat can easily wash off freshly-applied sunscreen, and leave you vulnerable to the effects of the sun.

 

Know when to reapply sunscreen

Sunscreen loses effectiveness over time and as it gets wiped away. If you slather on the appropriate amount in the morning and have minimal sweating done during the day, you’re probably good for the next 3-4 hours.

But if you’re doing anything to remove that layer of sunscreen protection, you will have to reapply more often. Activities that wipe sunscreen off include sweating, exposure to water, and rubbing motions such as towel drying. In this case, you should apply after you dry yourself off, and ideally wait 20 minutes before exposing yourself to the sun again.

 

Conclusion

Observing the proper method of sunscreen application will give you the full protection of the product you’re using. But remember, sunscreen is supposed to be used in conjunction with other sun defence measures, including wearing sun-protective clothing, and seeking shade. 

A combination of these methods will give you the best protection against the sun, and afford you healthier, happier skin.

References

Li, H., Colantonio, S., Dawson, A., Lin, X., & Beecker, J. (2019). Sunscreen Application, Safety, and Sun Protection: The Evidence. Journal of cutaneous medicine and surgery, 23(4), 357–369. https://doi.org/10.1177/1203475419856611

 

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

What is melasma?

What is melasma?

Melasma is a pigmentation disorder of the skin that causes brown patches mostly commonly seen on the cheeks and forehead. It is essentially caused by the pigment producing cells (melanocytes) going into overdrive and producing excessive amounts of melanin (the pigment molecule).  Melanin is deposited in the skin and tends to just hang around, causing an uneven complexion. 

Melasma may cause sufferers feeling self-conscious and can have other psychosocial impacts.

 

What causes melasma?

There is no one certain cause of melasma.  It is known however that 3 main contributing factors are at play; 

  1. Genetics 
  2. Hormones 
  3. Light/UV exposure.

Those with darker skin and from Middle Eastern and Asian backgrounds seem to be more prone to this condition.  Approximately 60% of sufferers state that at least one relative also has similar patches on the face.  This alone signifies a genetic component.

About 90% of patients with melasma are female. Hence, sex hormones (for example oestrogens) are likely to play a role. If you have heard the term “mask of pregnancy”, then you already know about melasma. Melasma can occur in pregnant women commonly, particularly those in the latter half of gestation. Melasma is also seen in some women who are on hormonal contraception. 

One of the most important contributors to melasma is sun and light exposure. Ultraviolet (UV) radiation has long been established to contribute to melasma.  UV rays stimulate melanocyte growth and increase production of melanin, the pigment molecule. More attention has also been given to visible light causing worsening of melasma.  Hence it’s not just the sun that can worsen melasma, but also light emitted from your TV, light bulbs and possibly even the screen on your mobile devices! 

 

How is melasma treated?

Melasma can be treated using different medicaments which decrease the activity of melanocytes. Sun and light protection are also essential. A combination of different active treatments is often used for a quicker and more predictable result.

Hydroquinone is the gold standard ingredient compounded in most anti-pigmentation creams. It is often combined with other ingredients such as tretinoin and corticosteroids to enhance the effect and reduce side-effects. Other ingredients that have anti-pigmentation properties include azelaic acid, ascorbic acid, kojic acid, licorice extract and glutathione.

More recently, dermatologists have also started using oral tranexamic acid.  This is a medication that is prescribed to help improve melasma patches.  Glutathione and Polypodium leucotomos are also options, however these agents are less commonly used due to more limited experience and scientific research. 

Sunscreen and sun-smart behaviour are essential components of treatment of melasma.  Tinted sunscreens are always advisable for patients with melasma as they contain iron oxide pigments that block visible light which, as we have learnt, also contributes to melasma..

 

Procedures such as chemical peels and laser treatments are also utilised in some situations to reduce or remove the melanin on the surface of the skin. When not performed correctly however, post-inflammatory hyperpigmentation may occur and worsen melasma.  Having such procedures performed at reputable clinics is a must.  

Melasma is a chronic condition, so maintenance treatment is essential.  Episodic flares, especially in summer or with lapses of treatment, are seen often.  It can take months to see an initial improvement and sometimes the condition can be very challenging to treat. 

Having a good grasp of melasma and understanding the basic causes and principles of treatment is as important as finding the right treatment that works for a specific patient.

 

 

References

https://www.aad.org/public/diseases/a-z/melasma-treatment

https://dermnetnz.org/topics/melasma/

Ogbechie-Godec, O. A., & Elbuluk, N. (2017). Melasma: an Up-to-Date Comprehensive Review. Dermatology and therapy, 7(3), 305–318. https://doi.org/10.1007/s13555-017-0194-1

Sarkar, R., Arora, P., Garg, V. K., Sonthalia, S., & Gokhale, N. (2014). Melasma update. Indian dermatology online journal, 5(4), 426–435. https://doi.org/10.4103/2229-5178.142484

 

 

The information presented on this website and in this article is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.