Common Recommendations
Everyone's body is different
Before you begin
I appreciate that everyone's body and experience of TSW are different. This isn't intended to be an exhaustive list or provide the ultimate list of solutions. My hope is that there might be something new in here that you haven't tried before and that it may help.
Take what resonates with you and leave the rest.
Nutrition & Gut Health
GUT/SKIN AXIS
The gut and skin are connected through the gut-skin axis, a system where imbalances in gut bacteria (or microbiome) can affect skin health.
INFLAMMATORY TRIGGERS
We started by focusing on whole foods and avoiding sugar and processed ingredients, which can trigger inflammation. Some common culprits for inflammation can be:
- sugar
- artificial colours
- gluten
- dairy and
- salicylates (here's a link to a food guide from St. Joseph's Health Care London in a PDF)
Going through elimination diets, one at a time, can help identify if any of these triggers are causing your skin to flare. For each one, we trialed it for 6 weeks as it takes time for your body to adjust and your skin's cells to renew.
The cleaner you can eat, the better. Avoid sugar, artificial dyes, and processed foods as much as possible. Several studies indicate a Mediterranean diet was associated with reduced symptoms. BUT it's not all about food!!! This is only one component.
RE-BALANCING YOUR MICROFLORA
Support gut health with probiotics, which will help re-populate your gut with the bacteria you need. There are many studies on the Rhamnosus bacterial strain (1) where people with skin conditions have seen improvements. We recommend a good probiotic with a delayed release so that it doesn't dissolve in the stomach.
SOURCE
(1) https://pubmed.ncbi.nlm.nih.gov/?term=rhamnosus%2C+eczema&page=1
BLOODS
As part of the process Tony had his bloods done to check various levels - thyroid, liver function, vitamin D, iron etc. Although it didn't give us a full picture we wanted to check this to ensure the baseline levels were in an okay place.
Skincare
CLEANSES GENTLY
Use a mild cleanser and lukewarm water to avoid stripping the skin's natural oils. Soap-free options are the best (see fragrance-free products below for suggestions).
PROTECT YOUR SKIN FROM THE SUN
Since your skin barrier has been broken, you want to stay out of the sun as much as possible to avoid getting burned. If you need to wear sunscreen, select a clean, zinc-based product.
USE FRAGRANCE-FREE PRODUCTS
Avoid products with fragrances, including those from essential oils, which can be irritating or trigger allergic reactions. We used Dr Bonner's soap-free products for a long time. We tried several laundry powders including Molly's Suds and soap nuts that we got shipped in from the US. They were better than the traditional options in the supermarket.
USE PRODUCTS WITH CLEAN INGREDIENTS
The Think Dirty, Shop Clean app is a fantastic app for checking how toxic the ingredients are in various beauty products. You can download it for free here: www.thinkdirtyapp.com
TEST NEW PRODUCTS
Test all new skincare products before using them.
TAKE SHORT SHOWERS
Keep showers short and lukewarm to avoid prolonged exposure to heat, which can cause more water to evaporate from your skin.
BATHS
Oat Baths
Some people (including my husband) find relief from putting oats in a muslin cloth and soaking it in the bath. The baths were always short, though.
Activated Cider Vinegar
Bear in mind that secondary infections can be common. If you suspect an infection, consult a doctor. Add 1-2 cups of activated apple cider vinegar to a warm bath. Soak for about 20 minutes, allowing your skin to absorb the benefits.
Bleach Baths
An alternative to ACV is bleach baths. A doctor recommend a diluted bleach bath as a treatment option. We were told to use the pure budget bleach without any foaming agents. The ratio is 1/2 cup for half a bath full of water.
EPSOM SALT BATHS
Epsom salt baths provided some relief during severe flare-ups by soothing inflammation and delivering magnesium through the skin. It also helped with improving sleep.
CLOTHING
Choose clothing and laundry detergent that are eczema-friendly. My husband would go to bed with tubular bandages and cotton gloves to help keep the moisture in and to help stop him from breaking his skin when he scratched in the night.
MOISTURISE
There are two schools of thought here. Some people go moisturiser-free. My husband tried this and it didn't work for him, unfortunately.
He tried Aloe Vera, Kawakawa balm, Emu oil, Aveeno (which we later discovered wasn't a very clean formulation) and Aqueous cream to name a few with little or no effect.
He found using Sudocrem (for baby's nappy rash) helpful overnight under his bandages. Whatever you choose, ensure it is fragrance-free and hypoallergenic. Other options he tried were Kawakawa cream and Urea 10% cream.
However, there is others in the community who found going moisturiser-free as the key way to get their skin back in balance. We concluded it was a trial and error based on everyone's body and condition were different.
SUDOCREAM
My husband would put sudocream under his tubular bandages at night time. It would provide great relief, especially on the wounds that were open and weeping.
RED LIGHT THERAPY
My husband got a red light pad so he could use it on large areas - he was covered heat to toe. It may have helped marginally, but it certainly wasn't the treatment that fixed his condition.
However, there are others in the community who have seen great results from this. I've followed @tswkidd on Instagram who shares a lot of research no it.
- - - SOURCES - - - -
1) https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional
2) https://pubmed.ncbi.nlm.nih.gov/39275147/
Helpful Nutritional Supports
Key things that we found made a significant difference:
VITAMIN D
Enhances overall mitochondrial function and immune health. Growing research indicates an association of lower vitamin D levels with worsening eczema severity and it's also been shown to help improve mitochondrial dysfunction.
Ensure you get some time out in the sun at short intervals and not at the height of heat during the day. The recommended dosage of vitamin D ranges from 10-20mg per day, depending on age
(1). Fatty fish (such as trout, salmon, tuna, and mackerel) and fish liver oils have among the best sources of Vitamin D
OMEGA
Research shows that eczema sufferers tend to have significantly lower levels of omega-3 fatty acids, EPA and DHA, in their systems (2). If you choose to supplement, ensure you select a high-quality product that has stringent testing for toxicity.
PROBIOTICS
As per the previous section, gut health is imperative for helping improve the gut/skin axis.
BOOSTING ANTIOXIDANTS & HELPING CELLULAR
In 2021, we learned about nutrigenomics—how specific nutrients can positively impact your genes. This was the turning point for Tony's skin. See the What Worked page for more info.
- - - SOURCES - - - -
(1) https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional
Additional Tools
EASTERN MEDICINE
Tony tried an array of Chinese herbs early on. Unfortunately, it didn't provide significant relief for him but we tried it because we knew of friends who had tried it for their children and it had worked for really well.
MINDFULNESS PRACTICES
I know this is hard to do when your body is in so much discomfort, but any type of mindfulness, even for a small amount of time is helpful. Meditation, yoga, or deep breathing exercises help to lower cortisol levels. High cortisol can negatively impact mitochondrial health.
CLOTHING & BEDDING
Natural materials against your skin will cause less irritation. We found light cotton clothing and bedding best.
GROWING AWARENESS & RESEARCH
I'll continue to add to this section over time:
- Briana Banos (another TSW sufferer) created a documentary called Still Preventable.
- Dr Ian Myles is also doing research around this as well.
- Corticosteroid exposure and cumulative effects in patients with eczema: Results from a patient survey