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--- health:dermatology [2019/07/06 13:25]
127.0.0.1 external edit
+++ health:dermatology [2021/11/16 04:03] (current)
marcos
@@ Line 1: / Line 1: @@
-====== Acne, Folliculitis, Keratosis Pilaris, etc ======
+====== Dermatology ======
+===== Acne, Folliculitis, Keratosis Pilaris, etc =====
+\\
 The following video is a great overview of holistic skin care: https://www.youtube.com/watch?v=JhtIyEO011I\\
-I'm trying to cheat and do the minimum necessary, as I don't plan to be vegan.
+I'm trying to cheat and do the minimum necessary.  While I strive to eat healthy, I don't plan to give up some acne causing foods such as milk.
+I found this post to be both funny and intuitively true to me:
+<WRAP center round box 95%>
+Your skin has evolved over millions of years and knows how to regulate itself better than you do. Adding BP or any other chemicals that aren't natural will only cause problems logically because your skin wasn't designed to deal with chemicals.
+Your skin will eventually become dependent and even start to break down after a while, not to mention lose its ability to fight off acne on its own. Notice how sooo many people have problems quitting medication. Do yourself a favor and NOT ruin your skin for the sake of killing a zit.
+Basically eat healthy (Low GI) and exercise daily is the best way to clear up. Also, don't over wash your face; you NEED a lot of the oils your skin produces naturally. You have to understand that there's a reason that Americans have the most acne around the world, they sit on their asses and drink Mountain Dew and then wonder why they look like shit.  Natural selection is brutal.  Everyone isn't genetically supposed to go through acne because of "hormones". [[https://www.acne.org/forums/topic/84907-wash-face-with-water-only |source]]
+</WRAP>
+All the things you keep hearing: diet, exercise, and rest, those things which keep you healthy, these are the best treatment for acne.  There can be all kinds of reasons why you have acne, that are resistant to just being healthy, but trying anything too aggressively will likely cause a backlash.
+DIY products can be more effective than pharmaceuticals or store bought skin care products.  There is lots of advertising and even lots of [[https://lifehacks.science/conflict-of-interest-in-research |research]] that will push society towards artificial products.  Store bought products need to have a long shelf life for companies to gain the most profit, so they will often have less active ingredients (active ingredients tend to be unstable), or will have toxic preservatives to increase shelf life.
+Case in point, rubbing your skin with a lime is more effective than serum products touting 20% Vitamin C.  These store bought products use Sodium Ascorbyl Phophate as a source of Vitamin C, which is effective, but not as effective as the **less-shelf-stable** Citric Acid, as found in a lime.
+Whatever you use, it will likely work for a while and grow less effective with time, so it's good to alternate skin care with healthy options.
 \\
 \\
-===== Diet =====
+==== Diet ====
+One hypothesis is that if you become vegan, your skin will be less inflamed, less acne prone.  Has to do with a lessening of the [[https://en.wikipedia.org/wiki/PI3K/AKT/mTOR_pathway | mtor]] or [[https://en.wikipedia.org/wiki/MTORC1 | mtorc1]] pathway.  A research review [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507494 |here]], with special emphasis on milk.  A healthline article [[https://www.healthline.com/nutrition/foods-that-cause-acne#section3 |here]] showing that higher insulin and IGF-1 increase acne.
-One hypothesis is that if you become vegan, your skin will be less inflamed, less acne prone.  Has to do with a lessening of the [[https://en.wikipedia.org/wiki/PI3K/AKT/mTOR_pathway | mtor]] or [[https://en.wikipedia.org/wiki/MTORC1 | mtorc1]] pathway.
+Cocoa can also affect acne: https://www.healthline.com/health/does-chocolate-cause-acne
 \\
 \\
-===== Stress =====
+==== Stress ====
 Acne is caused by many factors, including [[https://www.ncbi.nlm.nih.gov/pubmed/11479771 |stress]].
@@ Line 18: / Line 42: @@
 \\
-===== Comedogenesis =====
+==== Compulsive Skin Picking ====
+https://www.nbcnews.com/healthmain/when-you-cant-stop-pick-pick-picking-your-skin-777574\\
+Motivational video: https://www.youtube.com/watch?v=rGmKsfA-T28
+What works for me, is to grow my nails long.  I can't feel for bumps, as it's my fingertips that are most sensitive, so I therefore lose the urge to isolate and raise the bump to behead.  I hate long fingernails though.
+\\
+\\
+==== Comedogenesis ====
 Acne may be caused by [[https://onlinelibrary.wiley.com/doi/full/10.1111/j.1473-2165.2009.00437.x | oxidation of sebum]][[https://www.ncbi.nlm.nih.gov/pubmed/21143923 | 2]][[https://www.ncbi.nlm.nih.gov/pubmed/22648222 | 3]][[https://www.ncbi.nlm.nih.gov/pubmed/23325743 | 4]].  Maybe the harsh cleansers cause the sebum to oxidate?  Even [[https://www.ncbi.nlm.nih.gov/pubmed/28579815 | pollution]] has been implicated.  [[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605222 | A higher pH for the skin was associated with acne]].  Consider that harsh cleansers are defined by a high pH.
@@ Line 29: / Line 62: @@
 \\
-===== Skin Care =====
+==== Skin Care ====
 Bacteria are a normal part of your skin.  There is one hypothesis, that says the bacteria cause a problem, when, in the process of "[[https://onlinelibrary.wiley.com/doi/abs/10.1046/j.1468-3083.2002.00527.x |cleaning]]" your skin, you remove the [[https://en.wikipedia.org/wiki/Acid_mantle | acid mantle]].  The acid mantle is a protective barrier, and having removed it by aggressive cleaning, bacteria can enter the hair follicle and sebaceous glands.  Here the bacteria can cause inflammation and produce by-products that leads to blockage of the follicle which leads to acne.
@@ Line 47: / Line 80: @@
 Note: The pads I use are thin, [[https://www.reddit.com/r/SkincareAddiction/comments/2mqa2h/psa_if_you_like_applying_liquid_exfoliants_with_a | waffle weave pads]] [[https://www.acne.org/messageboard/topic/378628-looking-for-exfoliating-rounds-the-kind-that-comes-with-stridex-or-oxy-pads | 2]], made from polypropylene and rayon.  They are hard to come by, but I like them better than cotton rounds.
-Update: I got used to not using soap on my face.  Just washing with water is enough.
+Pharmacological Effects of Rosa Damascena\\
+https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3586833
+Antibacterial Activity of Ethanolic Extract of Cinnamon Bark, Honey, and Their Combination Effects against Acne-Causing Bacteria\\
+https://doi.org/10.3390/scipharm85020019
+\\
+\\
+==== Shower Filters ====
+https://chriskresser.com/is-your-daily-shower-making-you-sick/
+For those that don't have water filtration for the entire home, a shower filter can reduce the amount of chemicals reaching your skin.  The sources I have for information may be biased since they are commercial, but it's what I have for now.
+According to [[https://tappwater.co/en/10-myths-and-facts-about-water-in-your-shower |tappwater.co]], which sells filters, shower filters do not filter chloramines:
+<WRAP center round box 95%>
+Chloramines are used instead of chlorine by some public water suppliers. Many of the shower filter brands and especially vitamin C ones claim that they can also remove chloramines.
+There are no conventional shower filters that will remove more than a small amount of chloramines from your shower water.
+San Francisco Public Utilities Commission states on their website that only Vitamin C can be used to remove chlormaines from municipal water but the test was carried out using 1000 mg of Vitamin C in bath water,
+On the other hand there is plenty of evidence that it will not be as effective for a shower filter. Screw on type of shower filters that claim to eliminate choramines are unlikely to work. While they may reduce chloramines slightly, it is highly dubious that they actually eliminate chloramines because the flow of water through a shower filter is too high to result in contact of the water with the filtering compound for a long enough duration of time.
+Be sure to check out the claims of these chloramine filter manufacturers. Ask for independent research that proves the effectiveness of their shower filters. You probably won’t find it. We haven’t been able to find any. Facts about water in your shower are very important to be known.
+The only way to effectively remove chloramines in your shower is to have a whole house filtration system.
+</WRAP>
+Also on the same page:
+<WRAP center round box 95%>
+. Vitamins C infused shower filters are better for the skin
+Probably false.
+According to Patricia Farris, a doctor that specialises in dermitology Vitamin C has lots of benefits for the skin. It can be absorbed through the skin if it is formulated properly. Vitamin C can soften lines and wrinkles by boosting collagen production, lighten hyperpigmentation, and protect the skin from UV damage.”
+But will it work with a shower filter?
+“Most likely not. While a vitamin C-infused shower sounds good in theory, it will probably provide very little skin benefit,” says Farris. “Vitamin C must be formulated and packaged in a very careful way in order to stabilize it and prevent it from becoming oxidized [which makes it ineffective]. If it’s just sprayed out of the shower, the majority of it will be inactivated rather quickly as it is exposed to air.”
+There is no scientific evidence that Vitamin C showers benefit the skin.
+</WRAP>
+I found a 3 stage shower filter by Pelican that claims to remove chloramines.  On Amazon, in the Q&A, someone tested the chloramine removal and answered that it was only a 50% reduction, which I guess is about as good as it's going to get for a shower filter.
 \\
 \\
-===== Laundry Detergent =====
+==== Laundry Detergent ====
 Do not use standard laundry detergent.  Not only does it add toxins to your clothes that transfer to your skin, it leaves a residue that builds up over time.  I have been using only "washing soda" (I've only found the arm and hammer brand), plus a small amount of laundry detergent (labelled "for sensitive skin" "free of dyes and fragrance").  An approximate ratio of 5 parts washing soda to 1 part laundry detergent.  I use a shout brand stain remover to treat stains before washing (or if I find a stain that didn't come out in the wash).  Stain removers have enzymes to clean other types of stains not covered by washing soda.
@@ Line 59: / Line 137: @@
 " I’ve read over your post with interest, however can I offer my humble opinion. I think you have several unnecessary ingredients here that are actually doing the same thing, which you can see when you consider what they break down to once they are put in water. Let me illustrate. Firstly, the sodium bicarbonate or baking soda, NaHCO3, is just producing a single protonated form of the carbonate ion CO3 which is just acting as a buffer to the alkalinity and counteracting the effect of the washing soda, Na2CO3, which when it hits the water will also form HCO3 by increasing the pH. So unless you really need the pH to be neutral (if you are washing extremely delicate fabrics), you are actually reducing the efficacy of your other washing soda ingredient.
-However, with that removed you are still doubling up on ingredients here because when you add the sodium percarbonate (oxyclean, 2Na2CO3.3H2O2) to the water it decomposes into hydrogen peroxide (oxygen bleach) and washing soda (Na2CO3), so you could leave out the borax (source of oxygen bleach and water softener) and washing soda (anion to lower pH and water softener) since sodium percarbonate decomposes to produce both. Alternately, you could leave out sodium percarbonate and washing soda and use borax (Na2B4O7·10H2O) alone to produce oxygen bleach, lower the pH with the [B4O5(OH)4]2- ion and act as a water softener. Thirdly, you could leave out both the percarbonate and borax and use washing soda (Na2CO3) to get a high pH and soften water if you didn’t want oxygen bleach, or use half the washing soda and half of ONE OF the borax OR percarbonate to get a smaller oxygen bleach effect. It seems to me all you really need is one of these three combined with the actual soap (zota or fels) to get the effect you want, obviously using more to ensure that you still end up with the same effect. Hope this might help anyone tweak their mix to make it simpler. "
+However, with that removed you are still doubling up on ingredients here because when you add the sodium percarbonate (oxyclean, 2Na2CO3.3H2O2) to the water it decomposes into hydrogen peroxide (oxygen bleach) and washing soda (Na2CO3), so you could leave out the borax (source of oxygen bleach and water softener) and washing soda (anion to <del>lower</del> raise pH and water softener) since sodium percarbonate decomposes to produce both. Alternately, you could leave out sodium percarbonate and washing soda and use borax (Na2B4O7·10H2O) alone to produce oxygen bleach, lower the pH with the [B4O5(OH)4]2- ion and act as a water softener. Thirdly, you could leave out both the percarbonate and borax and use washing soda (Na2CO3) to get a high pH and soften water if you didn’t want oxygen bleach, or use half the washing soda and half of ONE OF the borax OR percarbonate to get a smaller oxygen bleach effect. It seems to me all you really need is one of these three combined with the actual soap (zota or fels) to get the effect you want, obviously using more to ensure that you still end up with the same effect. Hope this might help anyone tweak their mix to make it simpler. "
-One thing I haven't considered, upon reading Edward's post more closely, is that washing soda raises the pH, while Borax lowers it.  I imagine some stains would come out better in an acidic environment, while others would come out better in a basic environment?  I don't know.  I chose washing soda to use on all my clothes without worrying about the oxygen bleach in the other two products.  I thought "bleach, oh no!".  I just looked up oxygen bleach: "Oxygen bleach is known as “color-safe” or “all fabric” bleach, since it does not degrade most fabric or strip most color if used correctly, though you must still test colorfastness before using."[[https://sciencing.com/oxygen-bleach-vs-chlorine-bleach-6571838.html |1]]
+I'm confused because [[https://www.20muleteamlaundry.com/compare/borax-vs-washing-soda |both borax and washing soda are alkaline]], so they both raise the pH.
+I chose washing soda to use on all my clothes without worrying about the oxygen bleach in the other two products.  I thought "bleach, oh no!".  I just looked up oxygen bleach: "Oxygen bleach is known as “color-safe” or “all fabric” bleach, since it does not degrade most fabric or strip most color if used correctly, though you must still test colorfastness before using."[[https://sciencing.com/oxygen-bleach-vs-chlorine-bleach-6571838.html |1]]
 There are sites that have sprung up that say DIY laundry detergent creates a buildup of dirt that you may not notice right away.  They show picture examples of how dirty the water looks when they use regular laundry detergent on supposedly clean DIY laundry.  For example, sheets that have been in service and washed in DIY laundry detergent repeatedly for a year.  In this example, the sheets are first washed in the DIY laundry detergent, and then washed with regular store-bought laundry detergent like Tide brand.  During the wash, the water looks dirty even though the sheets should be clean.  I think these sites overlook the fact that they are using shaved bar soap as one of the ingredients, that may not rinse off quickly, and requires and extra rinse cycle.  That they fail to think of this idea makes me suspicious of their motives: maybe these sites are backed by the manufacturers of laundry detergent.  Tide costs a lot more per load than DIY.  As mentioned above, my DIY is not 100% DIY, since I use plain washing soda with a little bit of store bought laundry detergent.  I believe only the bar soap shavings would be hard to rinse off, not the washing soda.  Another reason for a build-up occurring on laundry, is that you are using too much soap, regardless of the type.  To test if this might be the case, after washing your laundry as you normally do, run the washer again without adding any soap, and halting the wash before the first rinse to see if the water looks murky.  On the other hand, maybe the buildup is actually from dirt that cannot be cleaned by the DIY laundry detergent.  Keep in mind, there is no such thing as living without dirt or bacteria, so if it looks clean, that's good enough.  You can still wash with regular washing detergent once in a while, and enjoy the benefit of using less chemicals most of the time.
@@ Line 67: / Line 147: @@
 \\
-===== Personal Log Battling Acne =====
+==== Personal Log Battling Acne ====
-I have finally found a good description of what I have.  It's called "milia", which I think is folliculitis characterized by keratinized plugs (like hard little grains of sand) with little to no inflammation/redness:\\
+I get spots of hardened something, bumps, right under my skin (like hard little grains of sand) with little to no inflammation/redness, and 80% on my scalp.  Like this: https://www.lighttherapydevice.com/hard-white-grains-pores, or this: https://www.dermascope.com/disorders/9481-sebaceous-hyperplasia-gaining-the-upper-hand-on-those-little-lesions
-https://www.theskinnerd.com/milia\\
-https://www.verywellhealth.com/how-to-treat-milia-15668
-<del>I thought maybe if I stop being aggressive on my skin, and only use water, that my skin would return to its blemish-free natural balance, but it seems that the natural state of my skin is with milia.</del>
+I thought maybe if I stop being aggressive on my skin, and only use water, that in an ideal world my skin would return to its blemish-free natural balance, but it seems that the natural state of my skin is with bumps.  I've used accutane in the past, so perhaps I changed the natural state?  Accutane affects epigenetics, or the expression of DNA.  I actually found some support for this idea: [[https://www.ncbi.nlm.nih.gov/pubmed/28940619 |1]][[http://www.jddsjournal.org/article.asp?issn=2352-2410;year=2019;volume=23;issue=1;spage=44;epage=45;aulast=Altalhab |2]][[http://www.ijdvl.com/article.asp?issn=0378-6323;year=2008;volume=74;issue=2;spage=187;epage=187;aulast=Dhir |3]].
-<del>I've used accutane in the past, so perhaps I changed the natural state?  Accutane affects epigenetics, or the expression of DNA.  Maintaining the acid mantle is important, but I can only conclude I need the exfoliation to reduce the formation of keratin plugs.</del>
+I've also been rather aggressive with the acne in the past, having tried to "kill" acne with isopropyl alcohol and hydrogen peroxide.  Because I tear off those hard little bumps whenever I feel one, my scalp often looks like I have chicken pox.
-I wish one of the many dermatologists I've seen could have identified the milia as such.  The answers I've gotten from them have been across the board and incorrect, probably because I tear off those hard little bumps whenever I feel one.  This leads to my scalp looking like I have chicken pox.
+I think I need to exfoliate, but, how to exfoliate, yet keep the supposed beneficial acid mantle?
-So in order to keep milia from forming, I need to exfoliate, but, how to exfoliate, yet keep the supposed beneficial acid mantle?
+=== Washing With Warm Water Three Times a Day ===
-==== My solution was to wash with warm water twice a day ====
+My preventative maintenance is to have consistent and gentle exfoliation.  I wash my hands with soap, and fully rinse them first.  Then I use my hands to wash my entire head with plain warm water.  This keeps some of my natural oils so I don't overdry, without stripping it all off.
-I wash my hands with soap, and fully rinse them first.  Then I use my hands to wash my entire head with plain warm water.  This keeps some of my natural oils so I don't overdry, without stripping it all off.
+If there is inflammation of acne, it is at night.  There appears to be a [[https://thesleepdoctor.com/2019/01/01/5-things-to-know-about-sleep-and-inflammation |relation between fatigue and inflammation]].  I can cause damage by picking at them at night when they are inflamed.  Picking at them when they are *not* inflamed feels more like exfoliation than surgery.
-If there is inflammation of acne, it is at night.  There appears to be a [[https://thesleepdoctor.com/2019/01/01/5-things-to-know-about-sleep-and-inflammation |relation between fatigue and inflammation]].  If I have acne/milia, I can cause damage by picking at them at night when they are inflamed.  Picking at them when they are *not* inflamed feels more like exfoliation than surgery.  Basically I am trying to remove the keratinized plug.
+=== Aloe Vera and Vitamin C Serum ===
 I had always used soap for shaving.  I didn't really want to use anything else, for the sake of simplicity.  My stepfather let me try his shaving cream: Aveeno Therapeutic Shave Gel, and although it is "artificial", it seem gentle.  It's non-messy and convenient.
@@ Line 91: / Line 169: @@
 As an aftershave, I cut off a portion of an aloe vera plant I have in a pot at my window.  Aloe vera naturally has salicylic acid [[https://www.byrdie.com/aloe-acne |1]].
-Alternatively, I use a vitamin C serum, that also contains every other popular ingredient you can think of: Retinol, Niacinamide, Hyaluronic Acid, Salicylic Acid, MSM.  It's strong so I don't use it every day.  In using the [[information-technology:2019-search-engines|search engine Mojeek]], I found one of the top articles was how someone is making there own serum: http://imcelebratinglife.com/skin-care-make-your-own-homemade-vitamin-c-serum
+Alternatively, I use vitamin C serum I buy.  I have tried a vitamin C serum that also contains every other popular ingredient you can think of: Aloe Vera, Retinol, Niacinamide, Hyaluronic Acid, Salicylic Acid, MSM (this one is particularly strong so I didn't use it every day).  I have also bought a vitamin C serum that also contains: Aloe Vera, MSM, Hyaluronic Acid, [[https://en.wikipedia.org/wiki/Arginine |Arginine amino acid]], Vegetable Glycerin, Jojoba Oil.
+In using the [[information-technology:2019-search-engines|search engine Mojeek]], I found one of the top articles was how someone is making there own serum: http://imcelebratinglife.com/skin-care-make-your-own-homemade-vitamin-c-serum
 I dropped the use witch hazel and apple cider vinegar, and the waffle weave pads.  I seem to fulfill the psychological need for rubbing something on my skin by rubbing the aloe vera plant.
 I didn't give the oils or some of the other products a full try, but it seems I don't have to, as I prefer the aloe vera plant or the aloe-based vitamin C serum.
+I found the following article after the strategy that I settled into, over time.  It also describes a balance between exfoliation and gentleness: https://www.healthline.com/health/skin-disorders/how-to-get-rid-of-milia
+=== Sebaceous Hyperplasia ===
+I've been trying to figure out what my acne is exactly.  First I thought it was folliculitis, then I thought it was milia, and now I think it may be sebaceous hyperplasia.  Hints this might be the right conclusion:\\
+Some of the recommended treatments on [[https://www.quora.com/What-are-some-of-the-best-treatments-for-sebaceous-hyperplasia |Quora]] are similar to what I've been trying.\\
+The explanation that it starts deeply in the skin, and can reform in the same spot sounds familiar.\\
+That it happens for older people.\\
+That a history of sun exposure is a cofactor.
+[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4507494 |Linking diet to acne metabolomics, inflammation, and comedogenesis: an update]]\\
+[[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371670 |Sebaceous hyperplasia: systemic treatment with isotretinoin]]\\
+[[https://link.springer.com/article/10.1007/s13555-017-0185-2 |Why Topical Retinoids Are Mainstay of Therapy for Acne]]
+=== Sebum Plugs ===
+https://www.healthline.com/health/beauty-skin-care/sebum-plugs
 \\
 \\
-==== Logs lacking beneficial conclusions ====
+=== Logs lacking beneficial conclusions ===
 <del>20180707: I've been traveling and forgot to pack oil.  So I have been using, exclusively, the witch hazel, apple cider vinegar, and salicylic acid (ACV+WH+SA) pads.  The pads are too drying for my skin, so I'm trying to figure out something else.  The witch hazel I'm using has 14% alcohol, but perhaps even the use of an alcohol free witch hazel may be too harsh, since it is still an astringent [[https://gressaskin.com/blogs/blog/dont-f-with-your-skin | 1]].  I may just go full paleo and use only water.  That would be the simplest solution.  I can wash my face and head with water as much as I please.  For shaving, face cream or even hair conditioner as a lubricant seems to work best.  I will use the pads as an aftershave.  From my experience, aftershave is very necessary, even if it is drying.  The shaving tears up the acid mantle, so a disinfectant/astringent is called for, followed by adding a layer of oil on the newly unprotected skin.  My original plan to use both the pads and the oil as moisturizer could still work, like it did for [[https://www.acne.org/messageboard/topic/360599-how-apple-cider-vinegar-and-coconut-oil-resolved-my-cystic-acne | her]].  Aha, I didn't pack oil, but I packed a vitamin C serum which I will start using pronto!</del>

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