OH LOOK, it’s the return of The Other Sarah with a fascinating and helpful screed on eczema! WOO!
Are you rashy, patchy, scaly, and itchy? Bumpy, lumpy, red, and inflamed? Do you find your hands get red bumps from the rando-soap at work, school, or, I don’t know, a Target restroom? Do you sometimes get weird dry patches around your lips? Are you dehydrated? Maybe you’re dying? Is it cancer? It’s probably cancer, right, Healthline? Do you carry around hydrocortisone and Benadryl just in case you’re overtaken by a random uncontrollably itchy dry scaly rash or peeling mystery chemical burn that feels like a thousand tiny paper cuts? Doesn’t everyone?
Maybe you don’t. Some people have normal, tolerant skin that can put up with sulfate interaction. But I don’t. This used to be the regular state of my existence. Now it’s less so! HERE IS MY STORY.
Hey ya’ll. I’m Sarah. Not, like… Cool Friend Sarah. A less-cool casual acquaintance Sarah? Maybe Awkward Sarah? Anyway. I’m Sarah, and I have eczema, and I’m allergic to sulfates. And latex. And like… a million other ingredients. And, if you were nodding along with the above symptomatology, you may be too. Well, it could really be a number of things. Some people are allergic to tap water, so I’m lucky it’s just stuff commonly found in skincare products.
I am not a doctor and I would highly recommend you see one about any suspected allergy. I did not. It took me a long time to recognize what was actually causing my skin reactions, even though I’ve always had eczema and topical dermatitis. For a while, I was once so convinced that my topical dermatitis and eczema was ringworm that I rounded up my poor cats and took them to the vet, convinced they were infested with fungal spores and were giving it to me in an endless cycle (but not Mr. Beara, for whatever reason, even though they sleep on his face). Mostly because it had gotten so bad on my hands that even hydrocortisone stopped helping. I washed all of my bedding and even refused to hold hands with Mr. Beara. Yeah, it was irrational, but I swear it seemed incredibly cogent at the time. Long, embarrassing story short : never diagnose yourself. See a doctor if you can! When see Dr. Google, you are suddenly awake at 3am, wide-eyed with dark under-eye circles looking like a ghoul shopping for sulfur soaps and buying bulk boxes of cloramitizole and salves made for farm animals on Amazon Prime. $400 in vet bills later (and about $70 spent at Amazon for things I didn’t need and will never use), the cat was diagnosed with eczema from food allergies. BUT NOW, I know my problems are from sulfate allergies … and now I read all of the labels on all of my soaps.
(I swear I’m not a hypochondriac; I just act like one sometimes.)
So, what is a sulfate, and what does it do?
Sulfates, for us less-science-y people, are detergents / surfactants made from mineral sodium that contains sulfur. They first came on the market around the 1930s and revolutionized the way we envision cleanliness. They make water feel more water-y, they create that rich lather we feel makes us clean, they break through grease and oil (sometimes to the point of stripping your skin of its moisture barrier or natural anti-microbial peptides, proteins, and oils that keep our skin happy and healthy). When we think of something getting us clean, for the most part we imagine thick luxurious bubbles. Sulfates are also, like, dirt-cheap to produce, so they’re in basically everything to give us that oh-so-squeaky clean feel at minimum cost to manufacturers.
Because of this low cost and our modern association of lather = cleanliness, sulfates are in everything. They’re in your mouthwash (hi, lip eczema!). They’re in your toothpaste (hi, again, lip eczema and gum sensitivity!). The most aggressive of sulfates is SLS — Sodium Lauryl Sulfate. I would suggest eliminating this at the very least if you’re an itchy person. It has a lot of “cousins” (Sodium Lauryl Sulfoacetate, Sodium Lauroyl Isoethionate, Sodium Lauroyl Taurate, Sodium Cocoyl Isoethionate and Sodium Lauroyl Methyl Isoethionate, to name a few), some of which may cause reactions, some of which may not, depending on your skin. I would recommend evicting SLS from your bathroom, kitchen, and laundry room — as well Sodium Laureth Sulfate (SLeS) — as they’re the ones that tend to be more harsh and aggressive.
But is it REALLY sulfate-free?
A lot of brands tout the sulfate-free label, but are really only SLS- and SLES-free. If you’re also sensitive to coconut-derived products, be aware of anything with “coco” in the name (coco-caprylate/caprate, sodium cocoyl glycinate, disodium coco glutamate, sodium cocoyl glutamate … you get the idea). If you’re desperate and just starting out and have no sensitivity to coconut oil I would suggest you go here. It’s a pretty good resource, but if I were to wager a guess, about 85% of the products either use coconut-derived sulfate replacements or just contain plain coconut oil, and not everyone’s skin tolerates those ingredients well. In my experience, sometimes a few concessions are a necessary evil. These concessions are things like dish soaps, where it’s extremely hard to find something sulfate-free. (So, please wear gloves. But if you’re like me, and the “latex-free” gloves are somehow cut with latex, giving you a rash anyway, double it up with some exam gloves under there, or look for some made of pure Niltrile. Wear these gloves when you clean and use detergents, like laundry soap or kitchen and bath cleaners — wear them EVERY TIME. I know it’s a pain, but it’s worth it.)
Besides looking like the cashier at Trader Joe’s you used to roll your eyes at and wearing exam gloves all the time (sorry, bro, I get it now), there are a few practical things I can suggest when it comes to body care (and facial, but to be honest, I have a completely different facial routine that I could happily share):
- Purge your products that contain known irritants (but maybe don’t throw it away if it’s expensive…? What if you find out it isn’t that ingredient but another one? I’m not a hoarder—YOU’RE a hoarder).
- Get ye to the supermarket and buy ye-self (yer-self?) some National Eczema Association approved lotions.
- While ye be browsin’ through them thar aisles (should I stop this? I feel like I’ve committed…) grab some of their approved hydrocortisone.
- Realize that yeah, sometimes just “soap” is super irritating and you should probably avoid soap as it’s often very drying, and then scuttle yer way to the Isle o’ Babes (baby aisle, I am so sorry) and find some nice baby soap that uses more gentle ingredients like the Aveeno Baby Cleansing Therapy or the Dove Tip to Toe Sensitive which, although Dove contains Lauric Acid and some other stuff, the fact that it is mainly glycerin based makes my skin super happy. And the Aveeno is alright but kind of smells like what I imagine an oatmeal fart smells like.
- Look at your shampoo and conditioner labels. I use Living Proof No Frizz. Living Proof comes with kind of mixed reviews here but I love the fact that nothing in this makes me scratchy. It also keeps me down to washing once or twice a week (low maintenance fo’ life).
- Oil it up. Rub it up. Glove it up. Forgive me, that sounds gross. I promise this didn’t just turn into a softcore porno. You’ll want to get some cotton gloves or socks depending on where eczema strikes. You will also want to make sure that you moisturize. I use rosehip seed oil basically everywhere once I finish showering and put on some lotion (what I use and love).
- If it’s a product that goes on your face, you’ll definitely want to check the labels. Does it have alcohol? Harsh sulfates? I would recommend CeraVe Hydrating Cleanser. It doesn’t lather and it’s amazing. Also, I can’t stress how important moisturizing is. I personally use the Korean 10-Step program, but this is not for everyone. Regardless of how many steps you use, make sure to work some hydration in there, ideally including an oil. Fresh Seaberry Oil is amazing for me, particularly since sea buckthorn oil is supposed to be great for eczema. (You can get sea buckthorn/seaberry that isn’t like $50 a pop for body care. I won’t tell you to put freaking fifty-dollar oil on your body.) The Ordinary Rosehip oil is also beloved by many, and at a pretty reasonable price point.
- I don’t want to scare you with more steps, but you should consider sealing that face with an occlusive. I personally like sleeping packs like Too Cool For School’s and I have CosRX’s Rice on order. Obviously, this isn’t prescriptive. Check ingredients and be aware of what your triggers are. ALWAYS patch test. Some people like to use their oil after the occlusive, btw. I tend to do it before, but experiment and pay attention to what works for you.
- Lastly, carry your own soap with you. I don’t care if people think you’re weird. When have you ever cared if anyone thinks you’re weird? That’s not you! What IS you : not wanting to scratch various bodily extremities off due to eczema or sulfate-related irritation. What I use is just some oatmeal glycerin based soap I found at Fred Meyer. It had no label and I found it in the natural granola-crunchy section. Don’t get a soap-based one, and unless you know it doesn’t irritate you, I wouldn’t recommend castile soap (sorry, Dr. Bronner, you crazy scamp!) (but, for real, have you read that bottle? It is fascinating and there is a cool documentary about him on Netflix).
- Also carry lotion with you. Just do it. Decant it if you must; because I am classy, I carry that whole 8oz bottle with me.
Wishing you an un-scratchy future!
Got eczema? Got any favorite products that make you less miserable? Share!