Three Types of People
There are the women who stay attuned to the latest trends in beauty and fashion. They’re always on the lookout for new products to use. They spend time in salons. They troll the mall for interesting new makeup or other products. And they feel a little frisson of excitement whenever a stylist, retail clerk or social media maven suggests something new. At home, this type has a vanity somewhere that’s full of old products—half-used shampoos and conditioners, exfoliating masks, chemical peels. The author calls this sort of patient the aforementioned product junkie.
Another classic type is something like the opposite. Usually men, these are frequent exercisers who need to look good at work. Maybe they’re in finance, or in sales. Probably they wear suits to the office. And at some point through the course of the day, they’re exercising. And showering after the workout. Even though they may use only a handful of beauty products—soap and shampoo, conditioner, deodorant and maybe a hair gel—these people are showering around a dozen times a week, and likely soaping all over their bodies when they do. Over time, this consistent assault on the external layers leads to a rash, or some kind of worse skin reaction.
A third type is the organic friend of the earth. Male or female, these are people who may have already experienced skin reactions to beauty products, possibly due to a pre-existing skin condition. Their history has made them suspicious of anything that has an ingredient with a chemical-sounding name. They opt for natural products often created by alternative beauty companies, avoiding things like parabens or such chemical surfactants as sodium lauryl sulphate. But although opting for natural and organic is a smart strategy when it comes to the food you put in your mouth, it’s not always best for the things you put on your skin, particularly when natural fragrances are among some of the most allergenic and irritating substances out there.
Damaging Our Body’s Natural Armour
We take care of our skin. We’re washing too much. We’re also using far too many skincare products. Daily washing of our babies and children is now thought to have contributed to the steep rise in cases of eczema, asthma and hay fever. And then, in adulthood, our incessant washing, moisturizing, exfoliating, cleansing and polishing is damaging the skin. The numerous actions we take every day to protect and care for our skin can actually end up doing the opposite. All the products we’re using can instead compromise the skin’s barrier function, damaging its ability to work the way it should.
Skin Basics: Nature’s Most Sophisticated Membrane
To understand how overwashing and overfrequent product use may be damaging the skin, we need to understand how skin works. The body’s largest organ has evolved over the course of millions of years to be one of the most sophisticated membranes nature ever invented. The skin functions as our body’s armour, protecting our muscles and internal organs from things like sunlight, harmful germs and substances the body might find toxic. Skin insulates our internal organs from extremes of cold and heat, allows nerves to convey information to the brain about the external world and just in general works like the perfect permeable barrier—keeping good stuff like water in and bad stuff like toxins and allergens out.
Skin actually consists of three layers. The deepest layer is the hypodermis, which includes fat tissue as well as larger blood vessels and nerves. It’s also where you’ll find the roots of hair follicles and some glands. Closer to the surface is the dermis, which contains your collagen and elastin. Sweat glands live in the dermis—they emit moisture to cool the skin and the rest of the body. The skin’s outermost layer—the epidermis—which functions a bit like a brick-and-mortar wall, protecting us from the outside world. This brick-and-mortar concept is one of the most important in the book. It’s integral to understanding what overwashing is doing to our skin.
It’s hard to break habits we’ve been taught. It’s in our DNA to want to be clean. But we have to realize that contemporary beauty practices go too far. That soaping our entire body daily is likely damaging what we’re trying to protect.
There are two main pathways to sensitive skin. The first is associated with a pre-existing skin condition, such as rosacea, seborrheic dermatitis and atopic eczema. The second is linked to the disturbance of the skin’s natural equilibrium, the disruption of the skin barrier and of the microbiome. Both pathways can be activated by the too-frequent use of harsh cleansers and other beauty products.
What should you do about that? Read on.
Getting Skeptical About Marketing
Three points to remember the next time you’re standing in a pharmacy aisle and considering whether to buy yet another beauty product:
- Less is more.
Every new product you buy and use is another product that could come with more ingredients, more fragrances, more botanicals and more preservatives, each of which poses an incremental additional likelihood of causing you a reaction. So the next time you’re in your pharmacy beauty aisle, remember the principle of less is more when it comes to skincare, and ask yourself—Do I really need this?
- Watch the product-ingredient lists of recently acquired companies.
Whoa, that’s some wordy advice. But listen: There’s a product cycle in the personal-care industry. A little upstart competitor will spy an unoccupied niche in the market and generate some sales with an outsider brand that stands for consumer-focused products. And then a bigger, more corporate competitor swallows the niche brand and takes it mainstream. When that happens, the new company will often change the ingredient lists—without telling consumers. So when a small and respected personal-care products company gets purchased by a larger competitor, keep an eye on the ingredient lists and be wary of any new, problematic substances.
- Remember that this is a business.
The personal-care products companies tend to serve two masters: Wall Street and Main Street. They want to give Wall Street growing sales—and give Main Street age-defying, fully moisturized skin. But sometimes Main Street and Wall Street head in different directions. Behavioural economics shows that, within certain parameters, more choice equals more sales. So when you’re paying attention to product marketing, try to stay skeptical.
Problem Ingredients
Read product labels carefully. The following are the sorts of terms found on an increasing number of skincare product labels these days. And yet, few of them actually mean anything.
- dermatologist recommended
- for sensitive skin
- free and gentle
- hypoallergenic
- non-sensitizing
- ophthalmologist-tested
- safe for kids
- tear-free
The one term that carries some weight is “fragrance-free.” If you see that on a label, it’s supposed to mean that the product doesn’t contain any ingredients considered a fragrance under the International Nomenclature of Cosmetic Ingredients system. However manufacturers have begun to use a loophole. They call something fragrance-free but include an odiferous botanical ingredient, such as lavender or calendula, orange or mint. Many of these botanical fragrances are potential allergens. Also bear in mind that “unscented” does not mean the same thing as “fragrance-free.” Unscented products can contain fragranced ingredients.
Skin Allergy Basics
- Allergic reactions tend to happen after repeated exposure to a substance. The reaction never happens with the first exposure because the immune system must first become sensitized to the chemical.
- Once you’ve been sensitized to a substance, you will always be allergic to it. Once allergic, always allergic. You can’t be allergic some days and not others. If you find yourself reacting only sometimes to a substance, then you’re likely not allergic to that substance.
- It’s possible to use a product for years, without incident, and then suddenly develop an allergy to it.
- Even a small amount of allergen can trigger a reaction, and the resultant rash usually lasts several weeks.
- With each new exposure the reactions can become stronger.
- The reaction can spread beyond the exposure site.
- A reaction need not happen immediately. Rather, it can take hours or even days to present.
Skin Irritation: Smoke For Your Skin
- Irritation is dose dependent. The more you’re exposed, the more severe the reaction.
- Irritation is cumulative, typically requiring multiple exposures, or multiple chemicals acting together. However, unlike an allergic reaction, irritation can happen after a single exposure.
- Irritation doesn’t necessarily occur after every exposure. Some days you may be okay with the chemical. Other times, you’ll get a reaction. It all depends on what else you did or put on that day.
- An irritant reaction can happen immediately after exposure, and can go away quickly after the exposure ends.
Top Allergenic Ingredients in Personal-Care Products
- Fragrances
- Preservatives
- Hair dyes
- Lanolin
- Synthetic detergents
- Botanicals
- Nail cosmetics
- Sunscreens
A Common-Sense Guide to Cleansing the Skin
Showers Are Better Than Baths
Water is known as the “universal solvent” because so many things dissolve in it.
Lounging in a bath too long gives the water an opportunity to dissolve those lipids, opening up the skin membrane to potential irritants—like bath salts or the ingredients in bubble baths. This happens all the time with toddlers. A parent will bring in an 18-month-old with an itchy rash on his skin.
“Well,” the parent will say, “I wash his hair with baby shampoo and then soap up his body, rinse him off and then we play for a while.”
But that’s exactly the wrong order. You don’t want your child sitting in potentially irritating soapsuds. Instead the parent should reverse things—playtime happens first, in clean water, and then comes the skin- and hair-washing. Rinse off the toddler’s skin and hair afterward, and then it’s right out of the bath. Don’t let the child sit in the bath suds. Another, even better approach to bathing a child is to use a hand-held shower wand. After playtime is over, let the water drain out; as it’s draining, wash with minimal syndet cleanser and fragrance-free shampoo, then rinse with the shower wand.
But Showers Aren’t So Great Either
What showers do remove, especially when they involve steaming hot water, is the skin’s natural lipids. Which impedes the skin’s barrier function, and in turn can create a vicious cycle that sees soap causing more damage, stripping out even more lipids from the epidermis and worsening the chapping caused by overfrequent and overlong showers. Which also alters our microbiome. So instead, limit the time you spend beneath that overhead nozzle. Keep it under 10 to 15 minutes, and because hot water strips more lipids than cold, reduce the temperature. Finally, try to avoid showering every day. How much is enough? There’s no study on that, and everyone is different. But think about it—if all you do is go to work and sit in an office building and go home and relax, are you dirty? Do you really need a shower?
Toss That Traditional Soap in the Trash
A newer invention than conventional soap is the so-called syndet or beauty bars, which combine around 10 percent real soap with what’s typically a milder synthetic detergent.
Most of the cleansing bars you buy in your pharmacy, with names like Dove, Cetaphil, Aveeno and CeraVe, are actually syndet bars. These damage the skin less.
Be Careful with Foaming Body Washes
Possibly the worst thing about body washes is implied in the name: They’re meant to be used on the body. The entire body. Which by now you know isn’t necessary to wash. Some would say that adding moisturizers to body washes helps counteract their tendency to irritate. But why bother to do it at all? It’s a vicious cycle—irritate with overwashing, then moisturize to compensate. Instead, just wash your bits. If they called the stuff bits wash, maybe I’d like it better.
Avoid Antibacterial Soaps and Cleansers
Recall how important bacteria is to the skin’s normal functioning. Maybe it grosses you out to think about a million microbes crawling around on a single square centimetre of your skin, but those creepy-crawlies help the immune system in numerous ways. We need them on the skin. And we need to quit wiping them out with antibacterial agents.
Use Alternative Cleansers Instead
The holy grail of skin cleansing would be something that gets rid of the grease and dirt that accumulate on the skin through the course of a normal day while leaving behind the natural lipids of the stratum corneum. Beauty bars (Dove, Aveeno, Cetaphil, CeraVe) are the first step toward this. They’re milder synthetic detergents with a small amount of soap in them. Even gentler are lipid-free cleansers, which don’t have any soap at all. They use substances like propylene glycol or cetyl alcohol to cleanse the skin. With names like Cetaphil or CeraVe cleanser, they’re what you should be using in the shower.
Post-Workout Showers Should Be Quick and as Soap-Free as Possible
There’s salty sweat all over my body—I need to wash that off, don’t I?
No way! It’s a fact of biochemistry that salt dissolves in water. That means salt rinses. All you have to do to get rid of that sweat is get under an overhead faucet and let it sluice off your skin. Condition yourself to avoid feeling as if you have to soap up your whole body. You don’t.
That’s not good for your skin, either. To limit the number of showers you require in a week, consider skipping the one you take in the morning if you’re going to get in a lunchtime workout and plan to shower after that.
Most of Us Don’t Have to Exfoliate
Our skin is exfoliating itself all the time, naturally. You don’t have to help the process along. As we age the exfoliation process can slow down a little bit. So if you’re older, you may want to pursue some sort of physical exfoliation. That entails taking a loofah, a natural sea sponge, and rubbing it over the arms and legs in the shower. This can also be done as a dry rub, or what’s called dry brushing. Don’t use exfoliating scrubs—you don’t need them, and they may actually exfoliate too much, irritating the skin.
Use “Simple” Shampoos and Conditioners
The more ingredients in anything, the more likely something is going to be allergenic and irritating to the skin. All that stuff is going all over your body. Down the drain, too. And the organic shampoos tend to contain a lot of botanical ingredients—things like mint and citrus, which can be just as irritating to skin as chemical fragrances.
Technically speaking, the hair is a dead protein. It doesn’t need to be cleansed. I like the way dermatologist Zoe Draelos puts it: “Hair does not really need to be washed. It is nonliving and does not produce sebum or sweat. It is the scalp that produces these materials that are then wicked from the scalp down the hair. Certainly, if the hair gets full of environmental dirt or food, it needs to be washed, but this is rare in adults.”
COMMON-SENSE HAIR CARE TIPS
- If your hair isn’t dirty or greasy, don’t shampoo it every day.
- If your hair is long, wash your scalp, not your hair. The oil is near the scalp, and the surfactants will damage the ends.
- Avoid sulphates, fragrances and botanicals if you have a dry, irritated scalp.
- Use dry shampoo several times a week to decrease the amount of shampooing.
- Use co-washes or non-detergent hair cleansers more frequently than shampoos. Be careful, though, as many contain fragrances and botanicals, which could irritate.
Cleanse Your Face with a Non-Foaming Facial Wash
If you don’t like the lipid-free cleansers, try their foaming facial variants.
- CeraVe Foaming Facial Cleanser
- Cetaphil Foaming Facial Wash
- La Roche-Posay Toleriane Purifying Foaming Cream
When trying out cleansers, take a less-is-more approach: no fragrance, dyes or allergenic botanicals. Whether you choose a cream, lotion or gel, as long as it’s water soluble, the product will be either light or high foaming—and remember, the more it foams, the more drying it tends to be. Creams and oil cleansers tend to be less drying than gels. Consider the latest cleanser, micellar water, which is a great way to clean without water. Apply it with a makeup pad. Some patients like to use micellar water after their lipid-free cleansers.
When you do go from a lipid-free to a water-soluble cleanser, try to keep all your other skincare routines the same. That way, if you do react, you’ll know for certain that the cause is the switch in cleansers—and it’ll be easy to treat the reaction by returning to your lipid-free cleanser.
Handwashing Can Cause Problems
Hands feature several different environments. The palms are thick, for example, while the tops of the hands have thinner skin. Once the skin on the fingertips or palms is compromised by overfrequent handwashing, it takes a long time for it to heal. Why? Because the skin on our hands never gets a break. We use our hands all day long—to clean ourselves, prepare food, open doors, move paper. All this exposure to constant irritation prevents the skin from healing.
Here are some of the times the CDC suggests it’s a good idea to wash the hands:
- Before, during and after preparing food
- Before eating food
- Before and after caring for someone who is sick
- Before and after treating a cut or wound
- After using the toilet
- After changing diapers
- After blowing your nose, coughing or sneezing
- After touching an animal
- After handling pet food or pet treats
- After touching garbage
However, following these suggestions to the letter could require that people in some professions wash their hands dozens of times a day. That kind of washing frequency can lead to skin dryness and cracking, which can in turn lead to infection, ironically bringing about a scenario that sees handwashing actually increasing germ transmission.
The author’s advice is to use a cleanser and water if your hands are visibly dirty. That is, covered with mud, grease, paint, ink or any of the other substances that can get on the fingers and palms through the course of the day.
But if your hands aren’t visibly dirty—if you’re simply concerned with germs and disease transmission—then using an alcohol-based hand sanitizer is better. Such sanitizers have the added advantage of being less likely to dry out and irritate the skin.