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Elias and Williams: The Inside-Out of Skin by dermatologists and skin researchers Peter M. Elias, M.D. and Mary L. Williams, M.D.

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RESEARCH FROM LABS AROUND THE WOLD

Q: Is it true that ‘fast foods’ cause eczema?

May 5, 2018 By Peter M. Elias, M.D. Leave a Comment

Q: Is it true that eating fast foods causes eczema?

A: Evidence is mounting that diet can influence the frequency and severity of eczema and other atopic disorders, like asthma and allergic rhinitis (hay fever). As a whole, these studies suggest that eating a diet enriched the polyphenols found in whole cereals and nuts, as well as one enriched in fruits would have a protective effect. In contrast, the consumption of foods enriched in ‘n-6’ fatty acids, which are abundant in commonly used vegetable oils, like corn or soybean oil, seems to favor the development of eczema and asthma.

To address this issue further, the International Study of Asthma and Allergies in Childhood (ISAAC) obtained information about diet, including the frequency of fast food consumption, obtained via questionnaires sent to almost 800,000 parents and children in over 50 countries. The results of the study support earlier impressions that consumption of fruit is protective, but more importantly, that atopic disorders, including eczema, worsen with high rates of fast food consumption.

We are certainly no fans of fast foods, but a major problem with this study is that excessive fast food consumption clusters with certain cultures and lower socioeconomic classes. These populations tend to live in the most crowded urban settings, with higher exposures to cockroach and dust mite antigens. Therefore, it is possible that the observed dietary effects could reflect where you live, as much or more that what you eat.

Bottom Line: Although the conclusions of this study may not be as clear-cut as the the authors propose, there is no reason not to recommend a diet enriched in fruits and vegetables and with  minimal exposure to fast foods in patients with or predisposed to eczema and other atopic disorders.  In fact, that’s good advice for everyone.

HIghlights of the 2013 IID. Part 8: Sunscreens and Vitamin D

June 10, 2013 By Mary L Williams, M.D. 1 Comment

Dr. Antony Young of the University of King’s College London described how sunscreens, even when used optimally to prevent sunburns, do not prevent the formation of vitamin D in the skin. The study he described in his lecture was remarkable for the stringency of its design.  He and his colleagues recruited lightly pigmented volunteers from Poland to enjoy a week’s winter holiday on the sunny island of Tenerife.

They divided the volunteers into three groups: one (the ‘control group) was advised to enjoy their holiday and to continue to use their sunscreen products as they usually do.  The other two groups were given tubes of sunscreen to use 3 times during the day, and instructed to cover all their sun-exposed skin with it 3 times each day.  The tubes were weighed after applications to measure compliance.  One of the treated groups used a product that primarily screened UV-B (SPF  ~15), while the other applied a product that also screened UV-A, with an SPF >30.  Hours in the sun were clocked for all Tenerife participants using wristband solar chronometers; exposure times did not differ between the 3 groups; all clocked many hours in the sun. A fourth group remained behind in Poland.

Virtually all members of the control group in Tenerife experienced sunburns, indicating that if they did use sunscreens, their practices were ineffective.  In contrast, no one in the two treatment groups developed a sunburn.  But here is the key point: their sunscreen consumption averaged over 3 oz/day (or ~100g/day).  In other words, each day they used the equivalent of a commonly-sized tube of commercial sun screen! It is safe to say that few people probably use this quantity of sunscreen in their sun protection routines, yet this approximates the quantity that is employed when testing laboratories generate the products’ SPF ratings.

Indeed,  numerous earlier clinical studies have shown that, ordinarily, most people apply much less sunscreen than recommended.  In one study, it was estimated that the average quantity of an SPF 15 applied on a sun holiday resulted in a SPF of no more 3(!), affording little protection against sunburn.  Moreover, sunscreen usage was correlated with more time spent in the sun, suggesting little net benefit to the way sunscreens are typically used.

As expected, blood levels of vitamin D in the Tenerife control group – all of whom experienced sunburns – rose dramatically, while those in the control group that stayed behind in the Polish winter, declined.  Both sunscreen-treated groups in Tenerife also experienced a generous bump in the levels of vitamin D in their blood, albeit not quite as high as in the control group.  Yet, this study also demonstrated that even when highly effective sunscreens are used correctly – with quantities that protected these light skinned person from burns even in intense tropical sunlight – vitamin D levels still increased substantially.

Bottom Line:  This study demonstrates that sunscreens can be used to protect the skin from solar toxicity without risking vitamin D deficiency as a side effect.  Moreover, since very few individuals use these quantities of sunscreen in actual practice, it is highly likely that most peoples’ sunscreen usage does not interfere with the skin’s ability to produce vitamin D in other settings.  On the other hand, the way most people use sunscreens is ineffective for sun protection.

 

Highlights of the 2013 IID. Part 5: The microbiome of normal skin and atopic dermatitis

May 28, 2013 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

The gut and its bacterial flora – its ‘microbiome’ – is receiving a lot of attention from scientists and their findings are being closely followed by the lay press.  The skin’s microbiome, too, has become a hot topic among dermatologic researchers, as evidenced by the number of papers and reports dealing with the subject at the 2013 International Investigative Dermatology meeting in Edinburgh.  Of these reports, several dealt with the microbiome in atopic dermatitis (or eczema).  This is of particular importance to clinical dermatology because infections with Staph. aureus is a common trigger of disease flares among atopics. [Read more…] about Highlights of the 2013 IID. Part 5: The microbiome of normal skin and atopic dermatitis

Highlights of the IID 2013. Part 2: Promising New Drug for Atopic Dermatitis

May 16, 2013 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

An important feature of the inflammation in atopic dermatitis (and in the other ‘atopic’ disorders, such as asthma) is the overproduction of ‘bad’ cytokines, such as interleukin 4 (IL-4), by a subgroup of Th2-type lymphocytes. After secretion from Th2 cells, IL-4 percolates up into the epidermis where it decreases the production of both lipids and proteins that are critical for normal barrier function (see our recent series of articles on atopic dermatitis for more information on the link between the barrier and Th2 cytokines).

One would anticipate, therefore, that if one could block the actions of IL-4, the dermatitis might improve. This is just what Lisa Beck’s group at the University of Rochester reported at the recent IID meeting in Edinburgh. [Read more…] about Highlights of the IID 2013. Part 2: Promising New Drug for Atopic Dermatitis

Highlights from the 2013 International Investigative Dermatology (IID) Meeting in Edinburgh: Introduction

May 15, 2013 By Peter M. Elias, M.D. & Mary L. Williams, M.D. 1 Comment

Edinburgh Castle

Every 4 years, the Eurorpean, North American and Japanese dermatologic research societies host a joint meeting. Last week the 2013 International Investigative Dermatology meeting took place in Edinburgh, Scotland. Over the next several days we will summarize some of the highlights of research on the skin barrier that was presented there, alternating posts of research from the Elias group with work coming from other laboratories around the world. [Read more…] about Highlights from the 2013 International Investigative Dermatology (IID) Meeting in Edinburgh: Introduction

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INSIDE THE SKIN BARRIER

The Skin Microbiome: Good Bugs And The Bugs That Bug Us

January 7, 2020 By Peter M. Elias, M.D.

We hear a lot about the multitude and diversity the micro-organisms – especially the bacteria - that … Read More...

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SKIN DISORDERS

Dry Skin: Who Is At Risk and What Can Be Done About It?

December 1, 2019 By Peter M. Elias, M.D. Leave a Comment

Who is at risk? Many people are prone to develop dry skin. Examples include those who have or … Read More...

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REPAIRING THE SKIN BARRIER

The How and Why of Sensitive Skin

November 1, 2018 By Peter M. Elias, M.D. 1 Comment

An alarming percentage (about 60%) of normal adults, mostly women, self-report that they regularly … Read More...

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CLIMATE AND THE SKIN

The Skin’s Many Barriers and Climate Change

October 9, 2020 By Mary L Williams, M.D.

Skin's Many Barriers And How Climate Change May Affect Them Skin has many barriers: it keeps us … Read More...

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Q & A

Q& A: Preventing Dry Skin From COVID-19 Hand Washing And Toxic Hand Sanitizers

December 1, 2020 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

Q: I have developed dry skin from COVID-19 because I have to wash my hands so often. Hand sanitizers … Read More...

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Research: From The Elias Lab

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

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Research: From Labs Around the World

Top 5 Scientific Discoveries About Skin Of The Decade

December 26, 2019 By Peter M. Elias, M.D. & Mary L. Williams, M.D. Leave a Comment

We have learned a lot about skin and its permeability barrier in recent years.  Here are our … Read More...

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