Eczema: The itch that rashes

As published in the Washington Observer-Reporter.

When preparing to send her 8-year-old son, Jonathan, to his first day of third grade, Amy Berry had more to worry about than assembling a backback or learning a few teachers’ names.

Jon, who had been diagnosed with eczema – also called atopic dermatitis – just a few months prior, had a breakout of the red, flakey rash all over his face. 

"He didn't want to go to school,” said Berry, a Pancake resident and mother of two. “He was going to be embarrassed, and [he felt like] all the kids were going to stare at him.”

Unfortunately for kids like Jonathan, many misunderstand the habits of eczema, an incurable but non-contagious skin disorder. 

In order to increase awareness, November marks National Eczema Awareness month as promoted by the National Eczema Association (NEA). 

Often recognized in childhood, eczema can lead to a full-body, cracking rash that can sometimes leave children ostracized. It can also result in days of work or school missed and those afflicted feeling isolated.

These individuals, however, couldn't be further from "alone.”

Up to 20 percent of Americans now suffer from eczema – a proportion that has been on the rise since World War II. While the exact mechanism has yet to be discovered, experts have identified oddities in the skin barrier – the fats and oils that protect our skin – as a part of the cause. When this defense is weakened, substances in the environment are able to penetrate the relatively tough outer layers of our largest organ, to reach the more sensitive layers of skin beneath. For those with eczema, this leads to an allergic-type of reaction. 

What happens next is the hallmark of this chronic skin condition. 

"Eczema is 'the itch that rashes' ” explained Dr. Paul Ruschak, a board-certified dermatologist practicing in Monongahela. “Usually, itching precedes the rash, and one induces the eczema by itching and scratching.

“It's imperative to really make the effort not to rub and scratch."

Why are so many more people, both children and adults, suffering from this itchy and sometimes disfiguring disease? The answer might surprise you.

"I think we're too clean," says Dr. Ruschak. "I think we're not being exposed to the entities like cockroaches and fungi early in our life, and, as a result, we are having more incidences of atopic dermatitis."

The theory, referred to as the Hygiene Hypothesis, associates our society's near-obsession with cleanliness and the avoidance of disease – in the form of anti-bacterial wipes, hand sanitizer, vaccines, etc. – with a hypersensitivity of our immune systems. 

In other words, without enough exposure to common "germs" in childhood, our immune system views too many of these substances as threatening. So, when our bodies encounter these germs – however non-threatening – our body mounts a response to fight against them.

Dr. Peter Lio, an eczema researcher and NEA Scientific Advisory Board member, couldn't agree more. 

"I don't want to vilify vaccines because they get vilified for lots of other stuff, but in the best possible way, they've done such a good job of rooting out these illnesses,” Lio said. “Kids don't get sick any more in the same way, and we have these idle immune systems."

Another culprit: Over-bathing.

"The first thing I tell a patient is to avoid over-bathing," says Dr. Ruschak. "Bathe briefly: in and out in 5 minutes."

In fact, a vigilant skin care regimen – to avoid stripping the skin of natural oils and avoiding irritants – Is central to controlling eczema.

After a day out searching for Native American artifacts with his father – a favorite pastime of theirs – Jonathan Berry is forced to have a higher priority than displaying his discoveries. To prevent an outbreak, he has to immediately get into the shower, then slather himself in lotion and steroid cream.

Not exactly a favorite activity for an 8-year-old boy.

Other tips for those with eczema from Dr. Ruschak: Showers should be taken with tepid, not hot, water. Soap should only be used on the body areas that require it, meaning underarms, genitals, etc. Pat yourself dry with a towel – don't rub. Lock in the moisture immediately after a shower with a non-fragranced moisturizer.

When skincare regimens and over-the-counter hydrocortisone creams aren't enough, a visit to a dermatologist or allergist is in order.

But even their recommendations may be on the verge of changing.

"We've never seen so much active research in eczema," said Dr. Lio. "We're going to understand that eczema isn't just one disease. We're going to see subtypes better, and that is going to be huge catalyst for treatment." 

For now, kids like Jonathan can be helped by awareness, understanding and good advice from their mothers.

"I try to explain to him,” Amy Berry said, “ 'It's a part of life, unfortunately, and it could be a lot worse.' "

When the Lack of Sunlight Is More than a Bummer: Identifying Seasonal Affective Disorder

As published in the Washington Observer-Reporter

With another summer of beach vacations and trips to Kennywood in our rearview mirror, sun worshippers joke of the "depression" this time of year brings. While this is meant in jest for many, up to 10% of Americans have a diagnosable depression whose trigger is the unavoidable flip of a calendar.

Seasonal Affective Disorder (or SAD, for short) is the name of this wintertime menace.

As the earth tilts away from the sun – what we commonly call fall and winter – our days shorten. Our bodies are able to sense this decrease in light due to receptors on the top of our heads, in our eyes and on the back of our knees. (Yes, the back of our knees.) This decrease in light can throw off our circadian rhythm (or sleep-wake cycle) and the 24-hour cycle our body is used to, leading to changes in mood, energy, appetite and more.

Apparently, it's like jet lag.

"When people have jet lag it's because their bodies have been operating at a certain circadian rhythm,” said Dr. Michael Franzen, chief psychologist at the West Penn Allegheny Health System with 30 years in practice. “They suddenly go to a different area, the sun is entering receptor areas at a different time than they used to, and they're out of sorts with their circadian rhythm. Those are the same receptors that are probably involved in SAD,"

Dr. Franzen – who, more specifically, is a neurophysiologist and studies the intersection of the psychological with the physiological – explains that the production of chemicals in our bodies such as melatonin and perhaps serotonin and some hormones are dependent upon these light receptors. Ultimately, a change in light means a change in the amount of these chemicals available to our bodies.

Okay, circadian-schmircadian, but what does SAD feel like?

Seasonal Affective Disorder is really just a variant of Major Depressive Disorder and is characterized by sluggishness, loss of interest, lower energy/tiredness, withdrawal from social activities, weight gain (because of carbohydrate cravings), loss of interest in sex, irritability and hopelessness – all symptoms seen in classic depression.

Another similarity between the two disorders: They are both more likely to affect women.

According to Dr. Franzen, "The main thing is, for people who may think they have it, does this tend to increase during the time that the days are shortening – especially mid-to-late fall with peak levels in the dead of winter – and tend to subside as the days get longer?’

“If they have those symptoms, whether they're related to the seasons or not, they should still seek help."

Help in this case isn't a medication you can't pronounce with side-effects you can't tolerate. It's light.

Since a decrease in the shiny rays – as sensed by those eye, head and knee receptors – is the culprit, increasing one's exposure to light is one of the solutions. And, no, you don't have to shine it on the back of your knees.

Sitting two feet in front of a specially made lamp that emits ultraviolet light – called a "light box" – for 20-60 minutes either at the beginning or end of the day is successful treatment for 40% of those suffering from SAD. For the other 60%, a mixture of therapies ranging from light box therapy, to talk therapy to the use of anti-depressants are used to beat the "winter blues".

But that may change.

"Where the research is going now is to try to find the underlying neuro-chemical basis for [SAD] in order to make pharmacological treatment more precise and more effective," said Dr. Franzen.

What might change is the definition of "pharmacological.” As more is discovered about the genetics and naturally-occurring chemicals involved in SAD, don't be surprised if future treatments include vitamins or hormonal supplements.

Bottom line? Be aware. If you recognize these symptoms in yourself or fellow man, remember the importance of seeking treatment from a trained professional.

Also, on a far-less-serious note, be aware that back-of-the-knee light receptor discussions at parties will absolutely label you "quirky.”

Stylish and au Naturale? Bridgeville, PA Salon Fits the Bill

As American women, we often get the short end of the mascara wand when it comes to beauty.

We're bombarded with images of "ideal" women enhanced by time-consuming, expensive and not-so-healthy beauty regimes, but simultaneously we are warned of the cancer-causing and hormone-altering molecules in nearly every beauty product that might elevate all of us to bombshell status.

"Where's the middle ground?" the little voice in our heads might scream.

Newly-remodeled in turquoise and black and celebrating their fifth year in business, Hair 2 Sole Beauty Studio in Bridgeville meets the south-of-Pittsburgh woman right where she is.

With the perfect mixture of traditional beauty services provided with low-toxin and organic products, the mascara wand just got longer.

"We're local, but we're not that stuffy salon where you can't have fun," said salon owner Alana Gibbs, who’s a Chartiers Valley High School graduate

And, it's affordable. While the term "organic" can sometimes imply a devastating price tag, Hair 2 Sole’s prices allow us all to become low-toxin beauties, with women's haircuts starting at $20 and basic facials starting at $35.

While Hair 2 Sole offers services that even the most extreme of earth-lovin'-mothers might seek, Gibbs has created a very accessible atmosphere for the Bridgeville salon. No incense; no PETA advertisements. What you will find, however, are bottles of olive oil, bags of sugar and fresh-ground strawberries--all ingredients for the salon's specialty facials. 

"A lot of the things that are so great for you internally are also great for you externally," says Hair 2 Sole aesthetician and strawberry-grinder, Carrie Sullivan. 

It isn't all fun and games for this civic-minded staff of seven, however. Aside from their environmentally conscious products, the beauty mavens at Hair 2 Sole just spent their fourth year volunteering at Camp Raising Spirits, a retreat for adult cancer patients held each June in Laurelville.

"They do a lot of things to help us out and provide us with their expertise in foot and leg massage,” said Sandra Lee Schafer, Camp Raising Spirits core committee co-chair and H2S open house attendee. “They have the gift to be able to approach people correctly.”

Okay, okay. So they're all-around do-gooders, but what about the quality of these products?

It's definitely time to rid ourselves of the "if it burns, it means it's working" mentality; Hair 2 Sole lacquers nails with Zoya, a non-carcinogenic, low-odor, safe-for-pregnant-women nail polish that’s made in Ohio and usually lasts 7-10 days. At only $8 per bottle, you might consider taking one home with you at the end of your $14 manicure.

That's right, only $14.

And, the hair color is no different. L'Oreal Professional-made Inoa hair color uses an oil delivery system instead of the usual ammonia, which not only pampers your locks but also seals in more of the color.

"Even after the second or third shampoo no color washed out,” said H2S client Randi Kania. “My hair wasn't dry after. I barely need to condition it. It's really nice.”

So, whether you're mainstream and fabulous or a kale-eating queen, Hair 2 Sole on Hickman Street in Bridgeville brings you beauty services conscious of your body, community and wallet.

Who the Hell Kales?: Part II Sauteed Kale

I hate sautéed kale. 

If I were a kid, I'd be left at the table for hours on end, pushing the green bunches of crap around my plate with a fork. 

Or, my uncle might zoom a fork full of the antioxidant antichrist around in the air like an airplane only to land at the pursed lips upon my shaking head. 

Nope. Uh-uh. No way. Put me in time out. 

But, first, let's back up.

I used a recipe from Bobby Flay. (I didn't know he did anything other than grill either.) It simply instructed to heat oil with chopped garlic, add the kale and cook for 10-15 minutes. When finished, add salt, pepper and red wine vinegar to taste. 

I was careful to sauté the kale only long enough to wilt the leaves so as to preserve as much nutritive content as possible. 

And, I believe this was a mistake. 

I couldn't stand the strong, cabbage-y flavor when cooked "al dente", so I threw it back into a pan and cooked the living hell out of it. 

I had an entire conversation, ate lemon cake, made a salad, ate a salad (yes, in that order), screwed around online, and THEN I decided to sample the Kale Part II. 

Boiled down and rather spinach looking, I found the flavor to be just as repulsive. 

It was cabbage but more bitter. It was a brussel sprout that had be left in the sun…in vinegar. And, it was still kind of tough--not nearly the buttery quality of steamed or sautéed spinach. 

It was steamed spinach's ghetto cousin who visits each summer but everyone thinks smells like soup. 

But, you're supposed to love kale. You're supposed to make green smoothies of goodness and talk about how great your skin looks. You're supposed to stare cancer in the face and say, "Bite me, I eat kale."

I'm not sure, but I think my distaste for sautéed kale strips me of the health foodie merit badge that I earned sometime around the purchase of my first jar of tahini. 

Whatever. I was never a Girl Scout, anyway.

Who the Hell Kales? Part I: Kale Chips

Ladies and Gents, 

This is the first in a three-part kale series entitled, "Who the Hell Kales?"

As a ravenous reader of health news and a self-proclaimed down-to-earth foodie, I've been beaten over the head with the advantages of kale, the superhero of superfoods. 

While I have never consumed even one little ruffle on the edge of a kale leaf, I am an equal-opportunity lover of all things green. Everything. Except okra. (Sorry, soul foodies.)

Here it goes, Part I: Kale Chips. 

I've been marinating on this adventure in kale for a few weeks now, and last night--which was, conveniently, Big Farmer's Market Night on route 50--I felt green, leafy and brave. 

Armed with my reusable Trader Joe's bags and an agenda, I searched for the market's best kale deal: $2.00 for a giant, head-banging bundle. 

As an experiment, I asked the lady farmer (larmer?) how she thought I might prepare it since I was a kale virgin. Immediately, she responded, "kale chips." Apparently, she had burnt her first attempt, so I was urged to watch their progress carefully. Another market shopper chimed in and seconded the kale chip love. 

Okay, sold. Kale chips it is. 

I came home, rinsed leaves and took a pretty picture…

After some DIY-goddessing (spray painting outdoor furniture aqua), I took to tearing some kale. 

The technique my fellow kale-purchaser taught me was to tear away front the large center vein, creating chip-sized pieces. I tossed the leaves in canola oil…I'm low on olive oil, okay? Don't judge…and added a little garlic powder, salt and pepper. I spread the leaves across a cookie sheet and baked at 350 for 10 minutes.

And, perfection: not burned but still crispy. 

Big taste test: winner! 

They taste a bit like brussel sprouts with an entirely different texture. They are extremely light and delicate, so storage should be in a hard container, not a bag--how eco-friendly, huh? I wouldn't expect to bounce onto my couch with a bag full of kale chips and an IC Light during the next Steeler game (Sunday night!); although, I've created and consumed far stranger combinations than that. 

Abby tested, Coonhound approved. Yes, our Coonhound, Jerry, is on the kale train--not shocking given his previous affection for edamame, chai tea (accidental taste test there) and Kashi crackers. 

Next time, I can probably go with slightly less oil, since little puddles of canola laid shimmering beneath my chips, but it was a solid--or, light and crispy--first try. Dee-lish!

Next up: Sauteed kale.

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Campbell's Soup Goes Pop...Again

In maybe the ultimate example of life imitating art--particularly pop art which toys with the relationship between fame, advertising and high art--Campbell's Soup's limited edition Andy Warhol soup cans reach the shelves of Target today for an accessible $0.75. 

The trichromatic (baby blue, red, mustard; cobalt, grass green, yellow, etc.) cans seek to celebrate The Factory founder's "32 Campebell's Soup Cans" art exhibit which is celebrating the big 5-0. 

That's right: This is the anniversary of an ART EXHIBIT celebrated at Target. Not the birth of some celebrity bambino; Not the latest in an endless line of a vampire series. We're celebrating pioneering visual art here, people! 

Apparently, Campbell's Soup hasn't been blowing up Wall Street in recent years…shot in the arm to the business…new line of soup in pouches didn't do well… If you're interested in the business angle, this isn't your blog. 

But, if you're here to art ogle, here you go! Get your Pinterest buttons a-ready!

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Mono a Mono: Learning About Mono- and Diglycerides

Each time the phrase "mono- and diglycerides" marches through my mind, I hear it a second time in a child's voice, stumbling through its pronunciation. In a stroke of apparent brilliance (since I am still talking--and blogging!--about it twenty years later), Breyer's demonstrated the natural nature of their ingredients vs. other ice creams by having a child attempt to read the lists in a TV commercial: "cream, sugar, vanilla" pronounced without hesitation versus the strain "mono- and diglycerides, polydextrose and propylene glycol monoesters" have on an eight year old's tongue. 

So, what are these tongue twisters anyway and why should we pit them against the monosyllabic "cream"? 

Mono- and diglycerides are used to combine ingredients containing fats with those containing water. If you've ever made a homemade salad dressing with oil and vinegar, you've noticed how these substances never mix, they only mingle--this is because of the hydrophilic (or water-loving) nature of vinegar versus the hydrophobic (or water-hating) nature of oil. To many consumers, food that settles and separates can be unappetizing: case-in-point the minority market for natural peanut butter, of which I am a proud member. In order to keep these substances mingled, like when you shake a bottle of homemade dressing, food scientists invented mono- and diglycerides to keep the consumer happy and the food product stable. 

Harmless bit of consumer coddling? Not exactly. 

Depending on the food product's treatment, mono-and diglycerides may contain trans fat since they are made up of fatty acids--one (mono) or two (di) fatty acid tails as opposed to three in the media superstar, "triglycerides". For the past several years, trans fats have gained many enemies for their ability to raise LDL ("bad" cholesterol), decrease HDL ("good" cholesterol), and increase the risk of heart disease, stroke and diabetes. This evidence is so widely accepted among even the least health conscious, that the company which supplies McDonalds with its french fries voluntarily removed trans fats from its recipe in 2004, and the FDA began requiring food labels to indicate the presence of these fats in 2006. 

Loophole of loopholes, mono- and diglycerides do not fall under the FDA's labeling requirements despite their propensity for becoming trans fats. 

"Yeah, yeah, just another thing to avoid 'cause it's gonna kill me." 

Well, maybe not. While I am relatively health-conscious, all this fatty acid tail talk inspired me to take a survey of my own cabinets, and the results weren't as upsetting as I had assumed they would be. 

Yes, they're in non-Breyer's ice cream and bread and (my husband's) regular peanut butter. They're also in my International Coffees Suisse Mocha mix, but I'm not exactly looking to cleanse my adrenals when I drink that stuff anyway. I was thrilled to find that store-bought salad dressings are actually free of the substance in favor of xanthan gum, whose level of criminality will be researched at a later time. In truth, however, I found these little suckers in far fewer of my favorite snacks than I expected. 

One last mono-di, "uno, dos, tres, catorce"--sorry, the beginning of U2's Verigo just washed over me--caveat for my vegans and vegetarians: The source of these fats can be plant OR animal-based, and the FDA does not require the source of the mono- and diglycerides to be disclosed; so, buy a bread maker or get to kneading in order to avoid these substances. 

Okay folks, that's it. I'll never advocate extremism, just awareness…

Be aware of where mono- and diglycerides can be found. 

Be aware of how much of these items you consume. 

Be aware of the FDA's partial protection of the public. 

Be aware of commercials featuring super cute kids reading the back of ice cream containers. 

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Welcome and Contact Info

Welcome, one and all, and thank you for checking out The Written Remedy--the blog related to my column in the Washington Observer-Reporter. 

My interests in healthcare range from alternative medicine--yoga, aromatherapy, homeopathic remedies, etc.--to the newest "tech-y" medical advancements, and I intend to share news and thoughts on all of those subjects right here. So, check back frequently!

Have any healthcare related questions gnawing at your noggin? Just send me an email at amackrn23@gmail.com or a Tweet @AbbyMackeyRN, and I'll get you an answer. Who knows, maybe your question will inspire a column!


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