Love the Skin You're In

Your skin is the largest organ in your body. It protects and gives you signals from the environment, and regulates temperature and water. We often don’t think about the functions of our skin until it starts to cause us problems – itching, rashes, acne, discoloration, premature aging, etc – all of which can be a signal of something deeper going on in our body. The skin is also a great absorptive surface, for better or for worse. We can use this effect to our benefit for absorbing certain medications or nutrients applied topically (eg. estrogen, testosterone, magnesium), though the absorptive nature of skin also makes us susceptible to adverse effects from environmental exposures that may be allergic or irritant in nature.

ouTSIDE IN VS AND INSIDE OUT

Whether it’s limiting exposures to harmful substances, or increasing exposure to therapeutic agents, both internal and external approaches can, and should, be used in conjunction to promote optimal skin health.

outside in

Skin & The Immune System —> Allergies

An allergic response occurs when the immune system reacts abnormally to a substance found in the environment. The substance that provokes the reaction is called an allergen.

3 Categories of Allergens:

• Ingested allergens - reactions to food or things consumed orally

• Inhaled allergens - reactions to substances we breathe in

• Contact allergens - reactions to substances applied on skin or mucus membranes (lips, mouth, groin)

Skin Allergies

1. Allergic reactions tend to happen after repeated exposure to a substance. The reaction never happens to the first exposure because the immune system must first become sensitized to the chemical.

2. Once you have been sensitizes, you will always be allergic to it.

3. Sudden development of allergies is possible.

4. Even small amounts of allergen can trigger a reaction that can last for several weeks.

5. With each new exposure, the reaction becomes stronger.

6. The reaction can spread beyond the exposure site.

7. A reaction need not happen immediately - it can take hours or days to present.

Allergy Testing

• Prick testing - for allergens ingested or inhaled

• Patch testing - for contact allergens

Top Allergens in Personal Care Products

1. Fragrances

2. Preservatives

3. Hair dyes

4. Lanolin

5. Synthetic detergents

6. Botanicals

7. Nail cosmetics

8. Sunscreens

Skin and The Immune System —> Irritants & Intolerances

Skin irritants elicit non-allergy reactions, that may be immediate, dose-dependent, and/or cumulative.

Irritant Reactions

• Irritation is dose-dependent - the more you are exposed, the more severe the reaction.

• Irritation is cumulative - multiple exposures, multiple chemicals.

• Irritation can happen after a single exposure.

• Irritation does not necessarily happen after every exposure (cumulative exposures impact the outcome).

• An irritant reaction can happen immediately after exposures and can resolve quickly after exposure ends.

Top Irritants in Personal Care Products

1. Water

2. Soap and detergents

3. Fragrances

4. Botanicals

5. Alcohol

6. Abrasive scrubs

7. Vitamin A derivatives and Alpha-Hydroxy Acid (AHA)

8. Shampoos and conditioners

inside out

Your skin is also reflective of what is going on within your body. We see this often with certain conditions that have dermatologic manifestations, such as Celiac disease (dermatitis herpetiformis), systemic lupus erythematosus (malar erythema), PCOS (acne) and many others. Aside from diagnosable pathologies, functional imbalances and other factors can also impact the quality and health of our skin. These may include:

• Inflammation

• Hormonal imbalances

• Diet

• Digestive issues

• Food sensitivities

• Sun exposure

• Stress

• Nutrient deficiencies

• Immune dysfunction

• Medications or supplements

• Smoking

• Infections

Skin problems are often multifactorial, and as such often require a multi-factorial approach. Whether you are addressing the symptoms of chronic disease or looking to improve the appearance and health of your skin overall, optimizing and correcting any one or several of these factors may be necessary to achieve desired results.

THE FIRST STEP TO TREATMENT IS A PROPER ASSESSMENT.

Deciding where to start can be overwhelming. With no shortage of information online, many times patients are confronted with information and option overload. A detailed history taking with a health professional can help to narrow down areas to focus on and get you started on a treatment plan tailored to your individual needs to help you love the skin you’re in.

In health,

Dr. Jacalyn Sieben, ND

PS - for more information about a holistic Outside-In approach I highly recommend the book referenced below.

Reference:

Skotnicki, S. (2018). Beyond soap: The real truth about what you are doing to your skin and how to fix it for a beautiful, healthy glow. Penguin Random House.

Unlocking Relief: How A Naturopathic Approach Can Help Prevent Migraines

Migraines can be debilitating. In Canada alone, 25% of households have someone affected by migraines;[1] as well, migraines are the 2nd most common cause of disability worldwide. [2] This disease can affect people’s quality of life enormously.

As Naturopathic Doctors, our approach is not to treat the migraines – but rather to treat the person living with migraines. This involves considering what may be the root cause(s) of the development of the painful episodes in the brain.

People living with migraines commonly have a genetic predisposition to them. While genetics are the “gun”, environmental factors “pull the trigger” and cause a migraine. These factors include hormonal imbalances, food sensitivities, nutrient deficiencies, mitochondria dysfunction, stress, and suboptimally-functioning pathways of detoxification.

Food Sensitivities vs. Food Triggers

Foods that commonly trigger a migraine for people include caffeine, chocolate (tyramine), MSG (glutamate), processed meat (nitrates), and wine (sulfites).

A food sensitivity does not trigger a migraine to develop, but if you are eating the food regularly and it is creating low-grade inflammation in your body, it is more likely to cause a migraine to develop. These food sensitivities can lead to the development of a migraine when there are additional variables at play such as weather changes OR hormonal decreases before your menstrual flow. If a person can identify foods that cause low-grade inflammation in their system and then avoid them for several weeks, they can reset their levels of inflammation and eat the foods less often. This approach has been helpful for countless patients.

So – how do you know which foods are increasing your likelihood of developing a migraine? There are two ways:

1. If you are unfortunate enough to have migraine attacks daily, or every few days, you can do an elimination diet for 2 weeks to see if the migraines lessen or stop. This involves avoiding the most common food sensitivities including dairy, all grains, egg whites, nuts, and yeast. Often, we can give patients a shorter list of foods to avoid based on what their diet has been comprised of and considering other health concerns they may have.

2. A food sensitivity test is also a very helpful option. Your Naturopathic Doctor can collect a small amount of blood through a finger prick and send the sample to Rocky Mountain Analytical (RMA) – a division of LifeLabs.  RMA can report on IgG antibody levels of between 120-225 foods that our immune systems may react to. A 2007 research study found that 43/65 patients with migraine headaches had complete remission of headaches after one month of eliminating reactive foods. Another study in 2010 found a significant reduction in the number of headache days and migraine attacks with the elimination of reactive foods. [3] [4] [5]

If a food sensitivity is identified, we can provide many options for food substitutions and can guide you on how long to avoid your trigger foods before reintroducing it in small amounts. If food sensitivities exist due to a “leaky gut” – an impaired permeability of the digestive tract – we can develop a plan to heal the lining using simple strategies.

Food sensitivities are not always a factor for patients who have migraine attacks, but it is a common one. When these foods are identified, a patient can experience improved health outcomes in many different areas including digestion, skin, immunity, and metabolism. It’s a win-win all around.

Altering your diet is not always easy, but with some compassionate support and expert guidance, many of our patients have found enormous success. We are here for you with an individualized, multi-faceted approach to help you break free from the cycle of pain.

In good health,

Dr. Darlene Reid, ND

[1] https://migrainecanada.org/wp-content/uploads/2023/05/languageguide-onepager-EN-finalweb.pdf

[2] https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-01208-0

[3] Drisko J, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 2006 Dec;25(6):514-22. doi: 10.1080/07315724.2006.10719567. PMID: 17229899.

[4] Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10. PMID: 20647174; PMCID: PMC2899772.

[5] Arroyave Hernández CM, Echavarría Pinto M, Hernández Montiel HL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8. Erratum in: Rev Alerg Mex. 2010 Mar-Apr;57(2):49. Echevarría Pinto, Mauro [corrected to Echavarría Pinto, Mauro]. PMID: 18693538.