Dry Skin Cause and Treatment

[Dean Pomerleau]

[Note: This is a thread spun off from a post on the Cool Tools" thread about my favorite treatment for dry, cracking skin, discussed below - Dean]

 

Moisturizer: O'Keeffe's Working Hands Cream

 

I know I'm not the only CR Practitioners to suffer on occasion from dry, cracked skin, particularly on the fingers. It seems to happen in the drier months of fall and winter. About a year ago I found a solution that works better than any I've ever tried, and that is O'Keeffe's Working Hands Cream (or in larger size for less per oz). This stuff is amazing, and the 3500+ 5-star reviews on Amazon show that other people feel the same way. Painful hand cracks that I thought I'd be stuck with for a week or more quickly went away after applying this stuff.

 

 

Fortunately I haven't suffered from finger cracks lately, possibly because of regular application of this cream, or possibly because of sufficient healthy fats in my diet. But here is a before/after picture of the kind of cracking I'm talking about (ouch!) that this product can take care of (this is an example after 1-week of use by someone who purchased the cream). 

 

 

Here is a description of the product:

 

O'Keeffe's Working Hands is an odorless unique skin therapy lotion to improve the health of your skin.

 

A water based product that contains no oil -- No Greasy Feel -- the lotion for dry skin, skin repair, cracked skin, skin relief, skin care, and skin moisturizing.

• Absolutely odorless
• No greasy feel
• Hypo-allergenic
• Not tested on animals
• 100% recyclable packaging
• Created by a pharmacist
• 2.7 oz. Jar

The first effective treatment specifically for people who suffer from cracked and split skin. The highly concentrated proprietary formulation stimulates the skin's natural repair process by hydrating the skin, altering pH balance and retaining moisture. Safe and effective on all skin types.

 

But I have to admit, I haven't researched the ingredients, which are:

 

Water, Glycerin, Stearic Acid, Ammonium Stearate, Ammonium Borate, Dimethicone, Paraffin, Hydropropylmethylcellulose, Allantoin, Diazolidinyl Urea, Octyldodecyl Stearate, Iodopropynyl Butylcarbamate 

 

If anyone sees anything they consider toxic (for topical application), please let me know. Otherwise, this hand cream really does the trick and I highly recommend it.

 

--Dean

[Michael R]

I know I'm not the only CR Practitioners to suffer on occasion from dry, cracked skin, particularly on the fingers.

No, but you and your fellow sufferers may largely be suffering from teh effects of a low-fat diet. April and many other people (on CR and not) develop poor hair and dry and cracking skin when their intake of either EFA or total fat declines too much or too long.

[Dean Pomerleau]

... you and your fellow sufferers may largely be suffering from teh effects of a low-fat diet. April and many other people (on CR and not) develop poor hair and dry and cracking skin when their intake of either EFA or total fat declines too much or too long.

 

Yes Michael, I agree. That's why I mentioned in my post "Fortunately I haven't suffered from finger cracks lately, possibly because of regular application of this cream, or possibly because of sufficient healthy fats in my diet."

 

The mention of healthy fats in the post may have been from an edit I did after you read it.

 

--Dean

[nicholson]

FWIW, the symptom I got when, many years ago, the fat content of my diet was too low (way too low probably) was that when I got out of the shower and began to dry off, the itching all over was so intense it was unbearable and I had to get back into the shower to relieve it!  But when I finally got out again the itching returned and it would last for about 20 minutes.  But I never noticed any other symptom - like dry skin or hair - that might have been associated with excessively low fat intake. 

 

Rodney.

[Zeta]

If anyone sees anything they consider toxic (for topical application), please let me know.

 

Well, I'd begin by wondering about your parenthetical qualification. If you check PubMed you'll see evidence that a lot of chemicals pass through the skin into circulation. I didn't research the matter enough to come to any solid conclusions, but I did decide to use coconut oil as my moisturizer (and it works fine for me, though it's greasy).

 

Zeta

[Dean Pomerleau]

 

If anyone sees anything they consider toxic (for topical application), please let me know.

 

Well, I'd begin by wondering about your parenthetical qualification. If you check PubMed you'll see evidence that a lot of chemicals pass through the skin into circulation. I didn't research the matter enough to come to any solid conclusions, but I did decide to use coconut oil as my moisturizer (and it works fine for me, though it's greasy).

 

Zeta,

 

Thanks for making me reconsider my rather indiscriminate & prophylactic use of the O'Keeffe's crack-healing moisturizer. I agree with you that all-things-considered, it is best to avoid using skin products whose ingredients you are unsure about, since they are obviously absorbed through the skin.

 

I've picked up some coconut oil for everyday use, and will reserve the O'Keeffe's for when/if my fingers or heels (the other place I sometimes have gotten cracks) are in real need of healing.

 

Although now that I think about it, I wonder if coconut oil is the best choice. After all, I've chosen not to eat coconut oil due to its saturated fat content. If it gets absorbed when we rub it on our skin, is it any different than eating it?

 

--Dean

[Zeta]

 

Although now that I think about it, I wonder if coconut oil is the best choice. After all, I've chosen not to eat coconut oil due to its saturated fat content. If it gets absorbed when we rub it on our skin, is it any different than eating it?

 

Excellent question which I was going to address until I concluded that the amount I typically use in a day (I use it only on face and hands; and I assume most people are like me: they don't want to get their clothes all greasy, which would happen if you cover your body in coconut oil) is less than a gram, and only a small part of that at most would be absorbed, and that coconut oil is heavy in 12:0, which probably isn't so bad... and, thus, the amount of bad SFAs absorbed would be trivial. But for someone putting it all over his/her body, it could be a problem, but likely a minor one. I've also considered using olive oil.

 

- Zeta

[Dean Pomerleau]

Dean wrote:

     [Paraphrase - what if we absorb the unhealthy saturated fat in the topically-applied coconut oil into our bloodstream?]

 

Excellent question which I was going to address until I concluded that the amount I typically use in a day... is less than a gram, and only a small part of that at most would be absorbed, [etc.]

 

Having just applied the coconut oil to my hands, feet, and bike seat pressure points   for the first time, I realize your are right. The amount I needed to use is negligible. Certainly less than two grams. So given limited absorptions, the doubts about how bad the CO saturated fat actually is, etc, it doesn't seem like skin absorption of saturated fat from topical coconut oil is a legitimate concern.

 

Thanks!

 

--Dean

[nicholson]

Regarding absorption of stuff through your skin:  remember Phisohex?  I recall using it for washing in 1970 in a hospital.  Wonderful stuff.  Wash your hands with it and zero bugs could be detected on the hands immediately afterwards.

 

Then someone detected it on autopsy in the brains of babies just out of the maternity ward.

 

Rodney. 

====================

"The unverified conventional wisdom is almost invariably mistaken."

[Dean Pomerleau]

Rodney,

 

I don't think anyone questions that stuff gets absorbed through the skin. The question is what to use as moisturizer or healing agent for the skin.

 

--Dean

[Saul]

Please see my post on the new subject, Cold Showers.

 

  -- Saul

[Dean Pomerleau]

Zeta,

 

I wanted to thank you for recommending topical coconut oil for dry skin. Having been using it now for a few weeks, I'm pleased to report how well it works as a moisturizer. I've started applying it to a persistent toenail fungus I have, to see if its anti-fungal properties can rid me of it. I know its a long-shot, but heck, seems like it can't hurt. 

 

Here is a recent study [1]  I came across showing that indeed coconut oil is good for skin conditions (atopic dermatitis) and dry skin, although they were just comparing it to mineral oil.

 

--Dean

 

-----------

[1] Int J Dermatol. 2014 Jan;53(1):100-8. doi: 10.1111/ijd.12339. Epub 2013 Dec 10.

The effect of topical virgin coconut oil on SCORAD index, transepidermal water
loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a
randomized, double-blind, clinical trial.

Evangelista MT(1), Abad-Casintahan F, Lopez-Villafuerte L.

Author information:
(1)Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila,
Philippines.

Atopic dermatitis (AD) is a chronic skin disease characterized by defects in the
epidermal barrier function and cutaneous inflammation, in which transepidermal
water loss (TEWL) is increased and the ability of the stratum corneum to hold
water is impaired, causing decreased skin capacitance and hydration. This study
investigated the effects of topical virgin coconut oil (VCO) and mineral oil,
respectively, on SCORAD (SCORing of Atopic Dermatitis) index values, TEWL, and
skin capacitance in pediatric patients with mild to moderate AD, using a
randomized controlled trial design in which participants and investigators were
blinded to the treatments allocated. Patients were evaluated at baseline, and at
2, 4, and 8 weeks. A total of 117 patients were included in the analysis. Mean
SCORAD indices decreased from baseline by 68.23% in the VCO group and by 38.13%
in the mineral oil group (P < 0.001). In the VCO group, 47% (28/59) of patients
achieved moderate improvement and 46% (27/59) showed an excellent response. In
the mineral oil group, 34% (20/58) of patients showed moderate improvement and
19% (11/58) achieved excellent improvement. The VCO group achieved a
post-treatment mean TEWL of 7.09 from a baseline mean of 26.68, whereas the
mineral oil group demonstrated baseline and post-treatment TEWL values of 24.12
and 13.55, respectively. In the VCO group, post-treatment skin capacitance rose
to 42.3 from a baseline mean of 32.0, whereas that in the mineral oil group
increased to 37.49 from a baseline mean of 31.31. Thus, among pediatric patients
with mild to moderate AD, topical application of VCO for eight weeks was superior
to that of mineral oil based on clinical (SCORAD) and instrumental (TEWL, skin
capacitance) assessments.

© 2013 The International Society of Dermatology.

PMID: 24320105

[sirtuin]

 

Dean wrote:

     [Paraphrase - what if we absorb the unhealthy saturated fat in the topically-applied coconut oil into our bloodstream?]

 

Excellent question which I was going to address until I concluded that the amount I typically use in a day... is less than a gram, and only a small part of that at most would be absorbed, [etc.]

 

Having just applied the coconut oil to my hands, feet, and bike seat pressure points   for the first time, I realize your are right. The amount I needed to use is negligible. Certainly less than two grams. So given limited absorptions, the doubts about how bad the CO saturated fat actually is, etc, it doesn't seem like skin absorption of saturated fat from topical coconut oil is a legitimate concern.

 

Thanks!

 

--Dean

 

 

Assuming some of the fat is absorbed from coconut oil (eg. in this study with babies, topical coconut oil raised triglycerides, altered lipid profiles, and was nutritionally bioavailable -- http://www.ncbi.nlm.nih.gov/pubmed/16269830), I wonder what sort of natural body lotion might be more ideal for use in greater quantities.  It looks like a mere 2 spoonfuls of coconut oil provides around 24 grams of saturated fat.  Maybe something like Argan, Shea, or Jojoba?

 

In the past, I've found that switching to cold showers dramatically reduced dry skin.  Although, I think I enjoy hot showers more than I dislike dry skin.

[Dean Pomerleau]

Sirtuin,

 

Assuming some of the fat is absorbed from coconut oil (eg. in this study with babies, topical coconut oil raised triglycerides, altered lipid profiles, and was nutritionally bioavailable -- http://www.ncbi.nlm.nih.gov/pubmed/16269830), I wonder what sort of natural body lotion might be more ideal for use in greater quantities.  It looks like a mere 2 spoonfuls of coconut oil provides around 24 grams of saturated fat.  Maybe something like Argan, Shea, or Jojoba?

 

In the past, I've found that switching to cold showers dramatically reduced dry skin.  Although, I think I enjoy hot showers more than I dislike dry skin.

 

The study you reference [1], the researchers smeared 5g of coconut (or safflower oil) over the entire skin surface of pre-term infants (average weight 4.5lbs, or 2kg), four times per day for five days. That is 20g of coconut oil per day, or 1% of their body weight per day. From Table III of the full text of the study, yes - the total saturated fat in the bloodstream of the coconut oil group rose (from 12 to 26 µg/dL) but the total saturated fat of the control group who didn't receive any oil massage, rose even more (from 7.5 to 27 µg/dL)! So I wouldn't put too much stock in this study, particularly in light of [2] and [3] which found that neonatal oil massage to correct EFA deficits to be ineffective.

 

But let's take this a step further, and assume the serum saturated fat increase seen in the coconut oil babies in [1] was real. Let's compare doses. As I said, they were getting 1% of their body weight of coconut oil massaged into their skin over a span of 40 minutes per day. I just measured amount of coconut oil I use, by weighing the jar before and after application - which I did to my face, fingertips, heals, big toes (w/ fungus) and 'bike seat contact points'. The scale didn't budge - my scale reported the jar weighed 605g after the application, the same as it reported before the application. Obviously I used a little, but certainly less than 2g, and probably closer to 1g. I do this a couple times per day, so lets say it adds up to 2g / day. I've been doing this routine for a few weeks and the jar is still very nearly full, so I think 2g / day is pretty reasonable estimate.

 

So I'm rubbing 10x less coconut oil on my skin per day than the babies in [1]. Plus, I weigh over 25x more than those babies. So I'm getting less than 1/250th the dose per kg body weight as those infants.  What I'm getting is at most 2g of additional saturated fat per day, assuming full transcutaneous absorption which seems extremely unlikely in light of [1], [2] and [3]. That isn't nothing, but it is a quite modest amount.

 

So between the very dubious evidence of transcutaneous absorption of topically applied oils into the bloodstream, the very small amount of oil applied, and the equivocal evidence of harm from ingesting the saturated-fat in coconut oil, and possible benefits of dietary medium chain triglycerides in coconut oil, it doesn't seem to me like a issue worth worrying about. If next week at my yearly physical I see my LDL or triglyceride level has skyrocketed relative to my last check-up, I'll perhaps think twice about it  .

 

--Dean

 

-----------

[1] Indian Pediatr. 2005 Oct;42(10):998-1005.

Transcutaneous absorption of topically massaged oil in neonates.

Solanki K(1), Matnani M, Kale M, Joshi K, Bavdekar A, Bhave S, Pandit A.

Author information:
(1)Department of Pediatrics, KEM Hospital, Pune 411 011, India.

OBJECTIVE: To study the transcutaneous absorption of traditionally massaged oil
in newborns and to specifically compare the effects of (i) essential fatty acid
(EFA) rich - safflower oil and (ii) saturated fat rich coconut oil, on fatty acid
profiles of massaged babies.
DESIGN: A short term randomised controlled study.
SETTING: Tertiary care NICU of a large teaching hospital and a research
laboratory of a University complex.
METHODS: 120 study babies were randomly assigned to three oil groups (i)
safflower oil (n = 40) (ii) coconut oil (n = 40) and (iii) no oil controls (n =
40). In each group, babies were selected in three subsets as per their
gestational ages viz (a) less than 34 weeks, (b) 34-37 weeks, © greater than 37
weeks. 5 mL of the designated oil was massaged four times a day for five days
under controlled conditions of temperature and feeding. Pre and post oil massage
samples of blood were analysed for triglycerides and fatty acid profiles using
gas chromatography.
RESULTS: Post oil triglyceride values were significantly raised in both the oil
groups and also in controls. However, the quantum of rise was significantly
higher in oil groups as compared to controls. Fatty acid profiles (gas
chromatography) showed significant rise in EFAs (linolenic acid and arachidonic
acid) in safflower oil group and saturated fats in coconut oil group. Changes
were more evident in term babies. There were no side effects associated with the
massage.
CONCLUSIONS: This study shows that topically applied oil can be absorbed in
neonates and is probably available for nutritional purposes. The fatty acid
constituents of the oil can influence the changes in the fatty acid profiles of
the massaged babies.

PMID: 16269830

 

-------

[2] J Pediatr. 1978 Apr;92(4):603-7.

Essential fatty acid deficiency in neonates: inability to reverse deficiency by
topical applications of EFA-rich oil.

Hunt CE, Engel RR, Modler S, Hamilton W, Bissen S, Holman RT.

Correction of essential fatty acid deficiency by transcutaneous absorption of
topically applied EFA-rich oil has been reported. We measured serum EFA levels in
two groups of neonates receiving fat-free total parenteral nutrition: nine
control patients after 16 and 25 days of TPN, and six patients before and 12 days
after beginning cutaneous application of 100 mg/kg/day of linoleic acid as
sunflower seed oil. Progressive biochemical EFA deficiency occurred in all but
one of the control patients. Of the six patients receiving 100 mg/kg/day of
linoleic acid, one patient with mild deficiency improved, but progressive EFA
deficiency occurred in the other five patients. Serum EFA levels were also
measured in four patients following 76 days of TPN and daily application of high
doses of topical safflower oil, all of whom had severe biochemical EFA
deficiency. The topical application of EFA-rich oil cannot be assumed to be
uniformly effective in reversing or preventing EFA deficiency. The transcutaneous
absorption of essential fatty acids must be documented by appropriate
measurements of EFA in serum lipids.

PMID: 416194

 

------------

[3] Arch Dis Child. 1993 Jan;68(1 Spec No):27-8.

Transcutaneous application of oil and prevention of essential fatty acid
deficiency in preterm infants.

Lee EJ(1), Gibson RA, Simmer K.

Author information:
(1)Department of Paediatrics and Child Health, Flinders Medical Centre, Bedford
Park, South Australia.

The topical application of vegetable oil was assessed as an alternative means of
providing essential fatty acids (EFA) to parentally fed preterm infants who were
not receiving lipid. Three infant pairs ranging in gestational age from 26-32
weeks were studied. Safflower oil or safflower oil esters (1 g linoleic
acid/kg/day) were applied to available areas daily. All infants rapidly developed
biochemical EFA deficiency. The plasma fatty acid profiles were similar in
infants with or without topical oil, and all returned to normal once parenteral
lipid was introduced. We found no evidence to suggest that the transdermal route
is of use in the nutritional management of preterm infants.

PMCID: PMC1029161
PMID: 8439192

[Guest PravinaSolanki]

 

 

Hi I am a mother of two and recently relocated to London. I had the same problem as yours so I consulted a skin specialist. Normally these kind of problems arise due to change in the weather around us or due to hormonal imbalance. The skin specialist recommended me to use Nyassa products ie Nyassa face moisturizer and Nyassa body lotion. I had my problem solved real quick. Not only did it stop the dryness but also healed my skin. I really recommend Nyassa products. You should surely give them a try

Here is the link where you can buy them nyassabathandbody.com

[Saul]

Hi ALL!

 

The high temperature here in Rochester, NY for today is 11 degrees F.  Nevertheless, after doing my one hour workout on the elliptical cross trainer in my gym, I took my really cold shower.

 

My skin is great (just saw my dermatological NP a week ago -- she said I shouldn't change anything).

 

None of the problems mentioned above.

 

  --  Saul

[mccoy]

Just to add to the sample number: after I started exposure to coldish temps this year (showers plus open atmopsphere) the skin on my knuckles started to crack a little. Gave me some minor concerns, used a cheap cream and now it has just about healed. The fat content in my diet is pretty high, figures from latest week form cronometer (daily averages): 

 

Fat 40% of total energy, 123 g/d, of which 22.5 saturated.

[mccoy]

I have to correct myself on the little hands cut, I lingered a little longer under the shower, the water particularly cold, the cuts were back. Maybe I'll have to change my cheap cream and try a real one, something similar to Nyassa or O'Keefe if Amazon doesn't ship'em here.