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.

ABCDEs FOR MELANOMA

Melanoma is a type of skin cancer and is the seventh most common cancer in Canadians. Risk factors associated with development of melanoma include ultraviolet (UV) exposure from the sun, indoor tanning, having lots of moles (also called nevi) or strange-looking moles, having fair skin, having a family history of skin cancer, some genetic conditions, and having a weakened immune system.

One way in which you can be proactive in at-home screening for melanoma is by taking a look at your moles using the ABCDE rule (see below). Changes in size, shape, colour and other characteristics of a mole are some of the first warning signs of melanoma. The ABCDE rule is helpful for remembering which signs to look out for:

Asymmetry: The shape of one half of the mole is different from the other.

Border: The edges of the mole are ragged, notched, blurred, uneven or poorly defined.

Colour: Colours, which can be brown, black, grey, pink, tan, red, white or bluish vary within the mole.

Diameter: The mole is larger than 6 mm (bigger than the size of a pencil eraser) or has grown in size.

Evolution: The mole is changing in size, colour, shape, texture, or looks different from surrounding moles.

If you have a mole that has any of these characteristics, you should see your family doctor and get it tested.

Written by Dr. Dana Kolenich ND

References:

[1]https://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2019-EN.pdf?la=en

[2] https://www.aafp.org/afp/2012/0115/p161.html

[3] Parmar, G., Kaczor, T., & Boudreau, E. (2020). Textbook of naturopathic oncology: A desktop guide of integrative cancer care. Medicatrix Holdings Ltd.

SUNSCREEN AND SAFE SUN GUIDELINES

It’s officially summer, and that means lots of sun exposure! A popular topic during this time is the use of sunscreen. This article will cover the benefits and risks of sun exposure, and how we can optimize the benefits while reducing our risks by implementing safe sun practices.

Why do we need to worry about sun protection?

Here’s a quick overview on how the sun affects our health.

The sun emits different kinds of electromagnetic radiation, including ultraviolet (UV) radiation (which is where we will focus our article). UV radiation can be classified as UVA, UVB or UVC. UVC radiation is blocked by the Earth’s atmosphere, so only UVA and UVB radiation reaches the planet’s surface (and us). UVB radiation is the type that plays a role in our body’s ability to make vitamin D.

Maintaining healthy levels of vitamin D is important for overall health, including supporting our immune system, maintaining healthy bones, and supporting mood balance. Since the sun is our main source of vitamin D, why do we need to be careful with sun exposure?

UV radiation is the single greatest risk factor in the development of skin cancers, which are some of the most common cancers in Canadians. UV radiation from the sun can damage the skin, resulting in sunburns, as well as skin aging, wrinkling and loss of elasticity. Therefore, balancing sun exposure to optimize benefits while reducing the risks is ideal! Below are ways to implement safe sun practices for adults, babies and children.

What you can do?

Avoiding the sun at peak times

The sun’s rays are the strongest at midday, between 10 AM and 4 PM, which is when the risks are highest. Avoid getting sunburns and suntans, as these are the result of skin damage from the sun. Emphasize activities in the shade rather than in direct sun, or implement the use of shade from trees or umbrellas.

Use sunscreen

Sunscreen is used to protect the skin from the potential damage of ultraviolet (UV) radiation exposure from the sun. The Canadian Dermatology Association recommends a broad-spectrum (protecting against both UVA and UVB rays) sunscreen with a sun-protection factor (SPF) of 30 or higher. Generally, the higher the SPF, the more effective it is at protecting us from the sun (however, this does not mean that it is foolproof!). Sunscreen should be used on all exposed skin areas and reapplied as per manufacturer's instructions, potentially more often if swimming or sweating. Lip products containing SPF can be used to protect the skin on our lips.

Keep in mind that the skin is one of the body’s largest organs, and may absorb ingredients from the products we use on it. Using the Environmental Working Group’s (EWG’s) Healthy Living app can help you find clean and effective cosmetics and sunscreens. For a more information on “clean” sunscreen options, check out the EWG Sunscreen Guide!

Wear sunglasses and a wide-brimmed hat

Physical barriers to the skin, such as dark clothing, sunglasses and a wide-brimmed hat offer shade options and physical ways to block the sun’s rays. Sunglasses help protect your eyes from potential sun damage, including cataracts. Clothing that has a tight weave, darker in colour, and increased fabric weight and thickness are better clothing options to help protect against the sun’s rays.

Babies need protection too!

Babies’ skin and eyes are particularly sensitive to damage from the sun. Babies should be kept out of direct sun, and should wear hats with a wide brim and be dressed in loose fitting lightweight clothing that covers their arms and legs. These methods are ideal, however you can also use a baby-safe SPF 30 sunscreen. Make sure babies avoid getting tans or sunburns!

Can sunscreen decrease my body’s ability to make vitamin D?

Research suggests that sunscreen, especially when applied correctly and consistently and with a high SPF, can decrease the production of vitamin D, but only by a small amount. This may be because sunscreen does not perfectly block UVB radiation exposure to the skin, and therefore some vitamin D can still be made. If you are worried about not getting enough vitamin D, your naturopathic doctor can test your vitamin D levels and may recommend a vitamin D supplement, which provides a source of vitamin D without the radiation exposure from extended periods of time in the sun.

Written by Dr. Dana Kolenich ND

References:

[1] Queirós, C. S., & Freitas, J. P. (2019). Sun Exposure: Beyond the Risks. Dermatology Practical & Conceptual, 9(4), 249–252. https://doi.org/10.5826/dpc.0904a01

[2] https://dermatology.ca/public-patients/sun-protection/sun-safety-every-day/

[3] Li, H., Colantonio, S., Dawson, A., Lin, X., & Beecker, J. (2019). Sunscreen Application, Safety, and Sun Protection: The Evidence. Journal of Cutaneous Medicine and Surgery, 23(4), 357–369. https://doi.org/10.1177/1203475419856611

[4] https://www.aafp.org/afp/2000/0715/p375.html

[5] https://pubmed.ncbi.nlm.nih.gov/31069788/