This is Part II of a four-part “Our Story” article. In this part, I share the results for every member of our family after implementing the environmental changes, problem-solving heuristic, and switching to using soap products as discussed on the solveeczema.org site. In other parts, I discuss:
Our Story, Part I: Finding and Believing solveeczema.org
Our Story, Part II: Results After Switching to Soap
Our Story, Part III: How Eczema Made Me a Granola Mom
Our Story, Part IV: What’s this Blog About?
What We Changed
Before I share the results for every member of our family, I need to give a short summary of what changed in our environment. We implemented the solveeczema site’s suggestions and problem-solving heuristic. In a nutshell, we switched the following products to soap, soap-based product, or non-detergent-containing product:
- what we wash our hands, faces, bodies and hair with
- what we wash our dishes with
- what we wash our clothes with
- what we clean our house with (e.g. countertops, floors, windows, walls, sinks, tubs, toilets, etc.)
- what we use for personal care, i.e. toothpaste, underarm deodorant, moisturizers, lip balm, diaper cream/wipes, etc.
- bought a good vacuum with a HEPA filter
- installed a water softener (imperative because of our city’s very hard water at measurement of 15 GPG) and ensured we are using softener salt that does not contain detergents or other additives like anti-rusting compounds
- removed our previously detergent-washed carpet and replaced with hardwood
- superwashed all clothes and bedding with soap to remove detergent traces
- cleaned our floors, surfaces, windows and blinds with soap or otherwise non-detergent products to remove detergent residues left from our previous products
- avoid foods that are likely to contain food-grade detergents as per heuristic described on solveeczema
You Can Start Small and Make Incremental Changes!
I want to highlight that it doesn’t need to be an arduous, back-breaking task to make the switch. You can start small and work at making incremental changes if you are tolerant that it will take longer to fully see results (though based on discussion with friends who have done partial implementations and done what they can, I think you will see some small changes initially!). I don’t want anyone to be scared away by hearing our story of how much we changed immediately and how long it took for the final hold-outs to be elucidated; we were operating under complicated conditions which included food allergy among other things, and the severity of my children’s eczema and depth of my heartbreak drove my particularly intense efforts!
See the page listing what exactly we use, and where we get it if interested.
Something changed for every member of our family, so for the rest of this article, I’ve devoted a section to each family member. The article reads best if you read the family members in order, but if you want to jump to a specific family member, click the quick links below.
Our Daughter’s Results
- Eczema fully cleared without steroids and constant moisturizing.
- Eczema better, asthma development delayed and/or severity reduced.
- Lifelong asthma cleared without steroid inhalers, lungs so clear I felt like I didn’t have asthma. Asthma returned after re-entering detergent-y environments.
- Less severe environmental allergies.
Our Daughter’s Results
Our daughter had the most dramatic change in our family. Her experience alone would be enough to convince me the solveeczema is valid. Our daughter went from having severe and extensive eczema to being completely eczema-free without drugs nor need to constantly apply moisturizers. Before we made the changes, she had significant blistering and puffy red eczema on her cheeks, chin and neck, and patches of broken skin on the backs of her calves, front of her wrist, and parts of her belly and back when it was really bad. Now, she has soft, supple, porcelain-like, eczema-free skin on every part of her body.
When our daughter’s skin was at its worst prior to implementing solveeczema, she needed upwards of five daily applications of 1% hydrocortisone cream for her skin to appear clear, though even at those times, she still had the faint red-tinged skin that betrays topical steroid use. Today, she does not require topical steroids or the recommended regimen of multiple daily applications of moisturizer, and her skin is no longer very reactive in detergent-y environments. Additionally, though she has a number of food allergies, she seems to be quite robust and shows little reaction when coming into skin contact with trace particles of some of her food allergens.
We found solveeczema and started to implement the site when our daughter was 3 months old. She has been steroid-free since she was 10 months old, though her eczema continued until she was about 21 months, and required further sleuthing and problem-solving to fully clear up.
It’s important to point out that, true to the information about eczema types on solveeczema, food allergy and microbial involvement seemed to contribute to my daughter’s eczema. Both had to be dealt with in addition to detergent removal for her eczema to go away completely. We had to remove the offending food allergens from her diet (also consistent with our pediatrician’s beliefs) and treat for microbial involvement using both pharmaceuticals and home remedies (e.g. topical anti-fungal and anti-bacterial ointments, and alternating dilute apple cider vinegar vs. dilute bleach baths). It turns out that we also had to get rid of our carpet, which we are pretty sure had been detergent-washed by the previous owners, for her eczema to finally go away. Our observations indicate the detergent-washed carpet was a problem even though she did not come into direct skin contact with it. This was likely due to detergent-laden dust or lint particles being released from the carpet and landing on her exposed skin.
It is important to note that everything we needed to do, the length of time it took, and the observations we made along the way indicated to me that our daughter’s results were not coincidental with her just getting older and “growing out of her eczema”. Her eczema persisted even after initial detergent and food allergen removal, and some of it then started to retreat in direct correlation with our efforts to deal with microbial involvement. But, there was a low-level of stubborn eczema that persisted on her exposed skin (face and neck) until we removed our carpet, which was likely a hidden source of detergent-laden dust.
Within 2 weeks of removing the carpet, the eczema was completely gone. If her eczema retreat was simply due to “growing out of it”, a basic understanding about probability theory intuitively suggests that it would be highly unlikely that the “outgrowing” would have coincided exactly with the timing of the removal of the carpet. Add to this that the eczema disappeared suddenly (within 2 weeks vs. the 4 months it had been simmering after everything else except the hold-out detergent source had been removed), and it seems even more likely that our results were due to our problem-solving steps and not coincidental with age.
Believe it or not, the above few paragraphs are just a summary of what we did. If there is enough interest, I will write a more detailed recounting of our problem-solving with her.
All told, it took about 1.5 years of steady problem-solving. I understand that there have been some solveeczema site users who have seen dramatic changes in as little as 2 weeks if there aren’t complicating factors like we had. I do now understand so well why the solveeczema site recommends that the best time to make the switch to soaps is before a baby arrives. I wonder how much of the snowball effect of open skin leading to microbial colonization and potential contribution to development of food allergy, which were two things we needed to deal with even after detergents were removed, could have been prevented if detergents hadn’t been present at the outset.
During the times I felt most hopeless, when I was frustrated that we’d made so much progress but yet the eczema wasn’t completely gone, it greatly helped me to have the help and encouragement of A.J. Lumsdaine along the way. Her guidance helped me apply the problem-solving heuristic and gave me anecdotal evidence and facts to consider. It was also helpful to have a voice in my life who gently but so confidently believed that the solveeczema principles were valid, who could share the stories and positive results of many others who’d had success before us. She never wavered, even once; she helped me get to freedom from eczema.
There is now a huge relief in knowing that I’ve freed my daughter from a potential life long reliance on steroids and moisturizing regimens. And freed her fully from eczema, too — not just settling for a decreased severity of eczema that would nonetheless flare periodically but inexplicably for the rest of her life. By removing the detergents that increase membrane permeability and disrupt the skin barrier, I believe we have fundamentally changed her threshold of having a skin reaction when encountering spurious detergents. I would dare say we have gone a long way to returning that threshold back to a “normal”, protective state. We have targeted the cause and we have control back, as opposed to forever being a slave merely to eczema triggers (like dryness/low humidity).
In our daughter’s life we’ve seen what we believe is evidence of the “bucket analogy” of allergy in action, because our daughter now seems significantly more robust than she was before, even at her young age. She is no longer very reactive in detergent-y environments and when she does get somewhat red, the skin rarely blisters and never breaks. It may be that she isn’t in detergent-y environments for very long (she’s not in school yet). When her skin does react, it clears up very quickly after being removed from the detergent environment, washing with soap, and applying some Aquaphor. It usually takes a few hours to overnight at the longest, to clear up. Although she has a number of food allergies, she seems generally less reactive and sensitive to trace amounts of her food allergens (such as if others are eating things she’s allergic to in her presence) than her brother. His story follows below and you’ll see why I think her results show support for the “bucket analogy” of allergy.
Our Son’s Results
We had great, almost miraculous, success with our daughter. Our son is a different story. While my daughter’s results might alone be enough to convince me of solveeczema’s validity, my son’s might have been enough to convince me solveeczema didn’t apply to him, that his eczema was due to some other mysterious cause — might have been, that is, IF I mistakenly concluded that solveeczema was only about detergents. But, it’s not just about detergents. There is a theme running through the solveeczema site around the connection between atopic dermatitis and microbial interaction, particularly mold and other fungal organisms, as well as a general framework about eczema resulting from the interplay between detergent exposure and allergen impact on the immune system. At this point, I find these larger frameworks on solveeczema equally (if not more) useful than the very specific direction about detergent removal.
Our son’s skin got better overall after making our lifestyle and environment changes, which included detergent removal as well as avoiding / limiting foods containing detergents. Of course, he also benefitted from the same measures aimed at dealing with microbial colonization (pharmaceuticals and the dilute apple cider and dilute bleach bathing routine) that we employed for our daughter.
Avoiding detergents in foods is not an exact science; there’s a lot of guesswork involved because knowing 100% for sure whether there are detergent residues in your food requires having intimate knowledge of how every food is processed before it gets to your table, something most food suppliers won’t divulge, even to a careful consumer who lays out her rationale for asking. (See my article “How Eczema Made Me a Granola Mom” if you’re interested in this angle).
I believe that for our son, we’ve been able to reduce the severity of asthma in the best case, and delay its onset in the best case. We can now predict and take steps to avoid superficial eczema flares (e.g. red cheeks that persist for a few days) which used to seem to occur randomly and be of unknown origin. We’ve also noticed that he seems more robust that he used to be, less generally sensitive and manifesting fewer or less severe allergic reactions both at home and outside. This increase in robustness has occurred even as he’s developed more environmental allergies as he’s aged.
However, he still struggles with unusual, atypical eczema flares on some parts of his body. By atypical I mean the eczema is sometimes raised and rough, sometimes puffy and smooth, not just at the surface level of the skin. My science-based-mama’s intuition, borne from my formal education and years of observation of my son, makes me feel that some of these areas of persistent flare are caused by microbial interaction whereas others seem to be caused by ingestion of detergents in food. These areas don’t seem to be due to direct contact with detergents and don’t “wash off” with soap as solveeczema indicates.
When these areas get really bad and our problem-solving efforts haven’t been able to resolve them, we do reluctantly use topical steroids to control them. It’s important to note that the steroid is compounded in Aquaphor and not in a cream base, so there are no emulsifiers / synthetic detergents in the actual drug. There is always a balance between what I believe to be one of the larger risks of topical steroids (i.e. side effects of immunosuppression, e.g. potentially allowing a dermal-layer microbial colonization to get worse) vs. the risks of unbearably itchy, painful and open skin (both from a psychological perspective and increased risk of infection).
We want to get to the place with our son where he doesn’t need any topical steroids and we think it’s possible given what we’ve seen with our daughter. But, we have discovered through painful experience that if the root issue hasn’t been figured out and resolved despite all the hard work you’re putting in, allowing the eczema to get out of control is both miserable and cruel, and can inevitably lead to much larger issues. These larger issues can be dangerous at worst, and at best, still complicate the situation, threatening to hopelessly derail any further problem-solving efforts. I can say the latter because I’ve lived it with our son. We barely managed to claw our way back from being nearly literally “in survival mode” with his skin and his misery, to considering problem-solving again.
What’s interesting is that our son’s experience prior to about age 3 was vastly different than our daughter’s. He spent the first 5 months of his life in a moldy home, with the open skin of eczema and body rashes (food allergy) unhealed by detergent-removal or steroids. Once we were prescribed steroids, he used them (ones containing detergents), for a much longer time than our daughter — on the scale of years vs. months. The ones he used were stronger than the 1% and 2% hydrocortisone that our daughter used. And he lived in an environment full of detergents for a much longer time than our daughter, too. Who can say whether longer-term immunosuppression, coupled with detergents weakening the skin barrier (increasing risks of allergens crossing the skin), coupled with exposure to environmental mold could explain why his results are so significantly different than our daugther’s, and why his remaining eczema is so much more stubborn to problem-solve?
See this post to read more about our continued problem-solving for our son and why we think the “bucket analogy of allergy” is a significant factor in the persistence of his eczema, as well as observations that led me to believe we’ve either delayed the onset, or reduced the severity, of potential future asthma development.
So where are we left now? As disheartening as it is to not have solved his problems fully, I often need to remind myself to celebrate the relatively large victories along the way and count our blessings. To have delayed the onset of asthma or potentially reduced its severity if it finally shows up, to be less reliant upon steroids than we used to be, and to have reduced his allergen load enough at home so that he is generally more robust than he used to be — those are all big successes in their own right. Figuratively, we are at the same place with him now as we were with our daughter when she still had that cheek and neck eczema despite having cleaned up most everything else. Something else is going on with him, something which might be informed by his differential exposures and history compared to his sister. We continue to problem-solve and sleuth with the hope that we can get him to the place where his eczema is clear and he is less allergically-reactive in detergent-y and high allergen environments without any use of drugs.
My results are a bit of a departure from those of my children. While their stories are primarily about their eczema, mine is about the resolution of asthma, unbearably dry skin, and a form of eczema of the tongue.
Despite the fact I’ve never suffered from eczema, I used to have chronically dry skin that needed daily moisturizing, and I had come to (mistakenly) believe it was solely due to living in such a dry climate. After detergent removal, I saw the skin on my whole body heal gradually but completely, and a clear correlation between detergent and the periodic eczema-like flares on my tongue (that my dentist called geographic tongue). Today in the areas most problematic in the past (hands, cheeks, feet, shins, arms), I have soft, healthy looking, comfortable skin without constant application of moisturizers, and I realize that this is the way it’s supposed to be — I’m not doomed because I live in a dry climate.
But, it was how detergent removal positively affected my asthma which was truly astonishing and unexpected. My asthma completely disappeared during my maternity leave with my daughter during which time I spent 9 months primarily at home in a detergent-free environment. My asthma disappeared despite the fact that I had not used any inhalers or other allergy drugs during that time. My story is about how my asthma got better, what happened when I returned to work and regularly entered the detergent-filled world, and what it’s like today. I now realize that my dry skin, tongue irritation, and the severity of my asthma resulted primarily from exposure to a damaging class of chemicals in our modern world, and that I have control over my well-being in a way I never would have thought possible.
My Asthma History
I have had asthma since I was in my early teens. My asthma started out being primarily exercise-induced and was particularly bad if I was physically active in cold weather. If I got sick with a bad cold, my wheezing and shortness of breath would be constant until I got over the cold.
Around my late teens, and especially after university, my asthma became more severe. I would start to wheeze even if I was around the environmental allergens that in the past had caused me only the “typical” allergy symptoms like itchy eyes, runny nose, and sneezing. I was still also reactive to exercise, but with diligent physical training and good physical fitness during my late 20’s and early 30’s, my body seemed to adapt. That is, the more fit I was and the more consistently I trained, the more I could tolerate longer periods of exercise and higher intensities of physical activity before I would start to wheeze and need my short-acting inhaler for relief.
After university ended, my new family doctor told me the conventionally-accepted wisdom that my asthma was not under control if I had to use my short-acting inhaler more than 4 times a week, amongst other signs. I was prescribed a steroid inhaler that I was to take daily in order to keep my asthma under control. I was to use my short-acting inhaler only when necessary and taught how to tell if my steroid usage was insufficient, which included signs to watch for.
I started out being a conforming patient in that I took my steroid inhalers regularly and at an appropriately high dose. Over many years, I started to feel generally better. While feeling better was obviously partly due to taking steroids properly, like many steroid users in general, I felt uneasy about taking so much steroid. I constantly tried to wean myself off steroids, or use as little as possible.
At the same time, I was becoming become more choosey about the places I would go, becoming generally less willing to put myself through the misery of allergic reactions and asthma. This means I sometimes opted out of attending a party if that party was at a house with lots of cats and carpet, for instance. The seeming adaptation and raised thresholds for having an attack during physical activity because of my physical fitness also played a significant role in tricking me into believing my asthma wasn’t that big a deal (and certainly nowhere near as severe as some asthmatics that needed to be hospitalized periodically). I began, almost subconsciously, ramping down both the dosage and frequency of my steroid inhaler use.
I would not typically experience attacks or wheezing unless something unusual happened, like spending time around my allergens or exercising past my adapted threshold. In those cases, a shot or two of short-acting inhaler and eventual removal of the offending allergen or finishing my workout, would typically get my breathing back to normal. But periodically I would get sick with a bad cold and my asthma would flare up with a vengeance: I would be constantly wheezing, and the short-acting inhaler wouldn’t provide relief.
In my early 30’s I finally learned with the help of another new doctor that my asthma becoming truly unmanageable when fighting a cold was evidence that my asthma was not under good drug control. Whenever I had the constant wheezing brought on by being sick, I learned to ramp up my steroid inhaler use, and needed to take it consistently for at least 2 weeks before I would see my wheezing subside. This was more evidence that trying to use as little drug as possible meant my asthma was notunder good drug control.
When I found solveeczema, I considered that I personally, and not just my children, might actually benefit from the changes we were committing to in our household. I thought my asthma might get better, but I wasn’t holding my breath (pun intended!). At the time I found solveeczema, I’d had asthma for more than half my life. It was something to which I had become accustomed, had learned to manage and live with, and had resigned myself to having. It was a disease that was theoretically due to my genetic profile — even though no one else in my extended family has asthma!
Partly because I’ve been uneasy about using and being constantly reliant upon steroids for years, partly because I was already always ramping my steroid usage down to as little as possible, and partly because I was somewhat curious whether detergent removal would have a positive effect on my asthma (due to similar suggestion on solveeczema), I stopped taking my steroid inhalers altogether, almost subconsciously, at the same time we started detergent removal in our home.
My Asthma Disappears!
Within 4 months of starting detergent removal, I started feeling like I might not be experiencing the same depth or sensitivity of asthma as I used to. I started tentatively telling a few people. I always told them I thought I still had asthma, but it seemed to be better. I seemed less likely to start wheezing, or it took more physical exertion to have the asthma show up, and when it did, it didn’t linger as long, and didn’t seem to need the short-acting inhaler to resolve. However, I remained cautious in drawing any conclusions or doing anything more to test the state of my asthma. I did, after all, have my hands full problem-solving my children’s eczema.
7 months after starting detergent removal, I was invited on a snoeshowing trip in the mountains. The trip was in an area in which I used to cross-country ski frequently a number of years ago, and so my body was generally familiar with the terrain, conditions and weather. Back when I was cross-country skiing regularly, I was exceptionally fit — and as already mentioned, this seemed to also help mitigate the asthma, raising the threshold of physical exertion before wheezing. However, I always got asthma while skiing, and I always had to stop and take 2 puffs of my short-acting inhaler, typically within 5 minutes of starting to ski, and often at later times during my 4-6 hour workout, too.
At the time of this present snowshoeing trip, for reasons related to the physical fitness adaptation alone, I had reason to expect my asthma would be more severe than in the past. After all, I had had 2 babies and become relatively out of shape. I hadn’t been exercising regularly for more than 6 years (!) at this point, so I didn’t expect I would be able to tolerate much physical activity before wheezing. And also at this point, I hadn’t taken any steroid inhaler for 7 months, and hadn’t taken enough to control my asthma for at least 11 months. In short, I had every reason to expect to be wheezy on this trip.
I brought my inhaler along just in case. After the initial steps, getting into the groove, I listened to my body, tentatively, half expecting to need my inhaler. No wheezing, not too much tightness in the chest. So far so good. I kept on. And on. And on. 2.5 hours into the trip, I suddenly realized, that despite climbing up and down a canyon, breaking through undisturbed snow at times, and talking while walking, I hadn’t needed my inhaler. I announced that to my pharmacist friend, who was also surprised.
After this discovery, everyone on the trip was tired, but I had loads of energy. I wanted to try to “incite” the asthma by pushing myself to the limits of physical exertion. I didn’t think I would have many other chances to “test” the condition of my asthma. I nearly ran up a 90 foot incline to the top of a dam, so fast that it was a few minutes before anyone else in our party caught up to me after I stopped. I experienced no wheezing! I could not remember the last time I exercised hard, started breathing hard, and did not feel the familiar tightening of my chest and wheezing coming on. I was elated!
Less than a month later, I went on a true cross-country skiing trip in the mountains. This was significant because the level of activity was similar to what I’d done as a younger, more physically-fit person. 4 hours of constant movement through the mountain landscape in cold weather (an aggravator of my asthma) yielded no wheezing whatsoever. Again, I was floored.
Within a month of that last trip, my maternity leave was ending and I was scheduled to return to work. As the solveeczema theory goes, my work environment would contain detergents from many sources: detergent-laden dust from shed skin cells and fabric lint from all my coworkers who have not made the switch the soap, detergent dusts emanating from detergent-washed office carpets, detergent residues on my desk and other office surfaces. For the previous 9 months, I had primarily stayed at home with my daughter and had only been out of the house and into detergent-y environments for short trips (for example to the grocery store, or doctor’s office for check-ups, a few hours each at maximum). For 9 months I had spent my time primarily in a house mostly free of detergent dusts, and I had seen my asthma clear up without drugs in a way that was nothing short of miraculous. I resigned to the expectation my asthma would probably eventually return once I returned to “the world” which is inundated with synthetic detergents. After all, I would be entering detergent-y environments day after day, for at least 10 hours each day, even if I got a break every evening when I returned home.
My Asthma Returns
I was dismayed to discover that my asthma returned with a vengeance in less than a week of being back to work. On day 4 after returning to work, I ran hard for about 15 seconds to catch a bus. It was chilly weather but not as cold as during my recent mountain trips. As I sat down on the bus, I felt the familiar sharp, stabbing pain in my chest that signalled an asthma attack, felt wheezing and compressed lung capacity, and had the taste of blood in my lungs. These are classic symptoms of my asthma attacks.
To say the least, I was shocked by the significant difference in my physical symptoms between what I was experiencing at this moment vs. the 2 trips into the mountains just a few months prior to returning to a detergent-y environment. In the mountains, 3-4 hours of constant and sometimes very hard physical activity in weather cold enough to support snow elicited no wheezing, whereas 15 seconds of running on a day that was chilly but without snow caused burning in my lungs and the taste of blood.
For the next few weeks, I resisted starting my steroid inhaler again. I wanted to see how my symptoms would progress, or if they would subside by themselves. In those weeks, I felt a constant tightness in my chest and wheezy at times, and sadly, not even due to any particularly challenging physical activity. This was just from walking around the office and going back and forth from work to home.
I finally started using my steroid inhaler daily again, but I only took about 1/4 of the dose I used prior to detergent removal. This seemed to get my asthma under control. What was interesting to note was that I didn’t need as much steroid to keep my asthma under control now, as I needed prior to removing detergents from my home. Perhaps not being inundated with detergents 24/7, but only during the hours I’m not at home, has given my lungs enough of a break to keep my asthma under control using a much lower dose of steroid than previously needed. I suspect that some of the the most important changes are that I no longer breathe in detergent-laden dusts from my own person constantly (skin, hair, clothes), and that ultimately the dust I breathe in from my home is no longer laden with detergents.
Over the next year and a half after returning to work, I once again began to eventually ramp down both the frequency and dosage of my steroid inhaler like I had done for a decade before (old habits die hard!). I eventually got to the point where I wasn’t taking the steroid inhaler for long enough (i.e. at least 2 weeks continuously) to consider my asthma “under control from drugs”. I wasn’t terribly physically active and so didn’t have many asthma attacks or wheezing. I did sometimes feel chest tightness, and would periodically take a puff or two of my short-acting inhaler to get some relief. Overall, being back in a detergent-y environment, my asthma settled to a place where it was definitely worse than while I was on maternity leave, but better than the symptoms I’d had my entire life, prior to detergent removal. Overall, compared to prior to detergent exposure, it took more or longer physical exertion or exposure to allergens for my asthma to show up, the symptoms were not as severe when it did show up, and it required less drug to control.
Spirometry Test Results
About 1.5 years after I returned back to work, I went for spirometry testing. I wanted to get a quantitative and objective description of the condition of my asthma. The idea was to make a comparison between my symptoms when regularly exposed to detergents by going to work every day vs. when I was primarily only spending time in my relatively detergent-free home. I was about to embark on a leave of absence from work similar to my maternity leave with my daughter, so I wanted to get spirometry testing done before I started the leave, then re-tested part-way into my leave. I knew that I had to wait at least 2 months to get re-tested, because A.J. Lumsdaine had previously shared with me that, in her observation and feedback from others who have implemented the solveezcema site, it takes about 2 months for detergent residues to make it out of one’s lungs once the detergents have been removed.
At the time I was tested, I hadn’t had any steroid inhaler for about a month and hadn’t been on my steroid inhaler continuously, for 2 weeks or more, for probably 9 months. My chest was feeling tight all the time and I would sometimes take my short-acting inhaler for relief. I was exhibiting markedly more asthma symptoms now than in those few months before I returned to work. I fully expected that my results would indicate my asthma was not under control. To my surprise, the respiratory therapist indicated that the numbers from all tests were very good and said that if she saw the numbers alone, without knowledge of my clinical history, she would say, “This patient does not have asthma”. I was shocked.
One interesting finding from my spirometry was that I blew an FVC of 123% of expected, when compared to a caucasian female of my age and weight. Theoretically, as an Asian, I should have a smaller lung capacity than a caucasian female, so to blow 123% of expected is, to me, significant. The respirologist who reviewed my spirometry numbers noted the unexpected result and proposed that my unexpectedly high lung capacity was likely a “normal physiologic variant”. That’s interesting, since I also clearly have a genetic profile with a predilection for asthma. The respirologist indicated that clinical confirmation of my asthma diagnosis is required presumably since the spirometry results alone do not indicate such. The doctor has a point — I don’t have baseline spirometry results from when I was first diagnosed with asthma to definitively “prove” that I had asthma then and (by numbers alone) “don’t have it” now. But I do have a strong clinical history of asthma and empirical evidence of asthma given that my wheezing has shown positive response to short-acting and steroid inhalers.
Potential Explanations for My Asthma
The respiratory therapist did not seem terribly surprised about my report that my asthma had retreated while at home during maternity leave and returned upon return to work. I told her about the detergent connection, but she seemed rather to believe that my asthma returning was due to re-encountering within the work environment the allergens that cause my asthma (e.g. cat dander on people’s clothes, etc.). I wasn’t as convinced because my asthma had never before retreated completely even when engaged in taxing physical activity without use of inhalers. With my firstborn — my son — I was home on maternity leave in our present house for 6 months, and this was a few years before we did detergent removal, and I still had episodes of wheezing then.
I feel now that perhaps we’re both correct. Detergents would cause increased membrane permeability in my lungs (and according to solveeczema, their impact would increase exponentially compared with on body skin because the lungs are moist). This increase in membrane permeability could allow more of the allergens in the air to cross into my lungs, and result in greater allergic reaction and inflammation, hence an asthmatic reaction. Remove the detergents from my house and dust, and combine with the fact that I don’t have animals (something that can really incite my asthma) in my house, and that would go a long way to potentially explaining my asthma retreat. Re-expose me to detergents for 10-12 hours a day x 5 days a week in the work environment, and combine with exposure to allergens that normally trigger me, and that could go a long way to potentially explaining my asthma re-emergence upon return to work.
If the solveeczema theory is correct, though, then in the absence of detergents but presence of aeroallergens that usually incite my asthma, I should be able to withstand greater amounts of my allergen before hitting the threshold to reacting. That is what appears to have happened with me because I feel since detergent removal that I can tolerate my allergens for longer periods of time before having allergy or asthma symptoms, and even then the allergy or asthma symptoms are not as severe as they were before. As an example, during the time I was on maternity leave with my daughter, there were still aeroallergens in my home such as dog dander, tree pollens and mold spores, that came into my house from outside through open windows and doors, that could have continued to irritate my lungs and potentially incite asthma. Yet my asthma had retreated. (Allergy testing has revealed that I’m allergic to the allergens I listed, though I don’t know definitively if they incite my asthma.)
Based on my complete experience with having twice been on leaves from work where I had reduced daily detergent exposure over several months, I feel that detergents are a significant part of the equation of what incites my asthma. I believe they modulate immune system reactions to allergens through their impact to membrane permeability.
A Lasting Solution for Dry Sky
The final change I experienced, and this is not insignificant, is that my skin improved to the point where I don’t have moisturize daily. Though I don’t suffer from eczema, there was a period of time when my hand and foot skin was so dry, despite frequently moisturizing (with a cream that contains detergents that probably made things worse overall), that I would be jolted awake in the middle of the night by the burning and discomfort. I even tried sleeping with my hands coated in Vaseline and protected with nitrile gloves. For awhile, I put a cold gel pack under the blankets in my bed, to relieve the burning feeling on the soles of my feet. That was how dry my skin was.
Now, my skin is naturally soft without constant use of moisturizers. When the temperature plummets in the winter and it’s less humid, my skin starts to feel tight and dry even though it doesn’t ever look red or dry, so I will use a thin coat of Aquaphor after washing with soap and soft water. I have had incredulous reactions from friends, both eczema sufferers and not, when they feel my skin after finding out I don’t have a daily cream regimen in this dry climate. I’ve always responded that the cause of my dry skin appeared to be detergents and finally resolved without need for continued intervention and products by simply removing the detergents. I’ve found this quote from solveeczema to hold true for me: “I would note, too, that detergents are very often the underlying reason for dry skin in people who don’t get eczema, especially adults. I have heard from many people over the years who have resolved lifelong dry skin problems with these strategies.”
Impacts to “Eczema of the Tongue” a.k.a. Geographic Tongue
Since I was a child, I’ve gotten these periodic irritated patches on the surface of my tongue. When things were really bad, I would develop fissures on the sides of my tongue. My mother used to comment on these lesions, calling them “broken tongue” in Chinese and insisting that I must have picked up some “germs” from biting my nails. As a child, I felt ashamed that I may have been “dirty” in eating germs (but what child doesn’t eat germs!) I’ve adapted to this condition for most of my life to the point where the stinging on my tongue from eating acidic foods (like tomato sauce) when I had a flare nearly goes unnoticed. Since I never knew what the flares were due to and I didn’t appear to be negatively impacted health-wise from this issue, I just “lived with it”.
When I was in 20’s, I happened to be having a tongue flare when at the dentist. He remarked, “You have something we call geographic tongue.” He told me it was benign but they don’t know what causes it. I remember reading about it online, and read entries like this one from the American Osteopathic College of Dentistry, which states that geographic tongue is correlated to eczema. I read, in fact, that some consider it to be “eczema of the tongue”.
During my maternity leave with my daughter, there were 9 months where we had completed the majority of our detergent removal and I was only eating home-cooked food. We had stopped using dish and dishwasher detergents, instead using soap and soap-based products. There would have been no detergent residues on our plates or utensils. During this time, we were becoming increasingly choosey about the foods we ate and served to our children, to try to avoid food containing detergents. Due to our children’s food allergies, we had already significantly reduced our use of mass-produced or processed foods in which we couldn’t control raw ingredients. We cooked a lot of foods from scratch, from fresh ingredients and those sourced directly from farm, and I’d hazard that doing so also significantly reduced the amount of detergents that touched my tongue through food.
One day during that 9 months, I realized that I hadn’t had any tongue flares for months. If indeed geographic tongue is correlated to eczema, and if it might be a type of “eczema of the tongue”, it is possible that its cause is, also, detergents. In the past few years when I’ve returned to eating some mass-produced, packaged/processed foods and eating out (particularly when I was back at work and eating out at lunch), I’ve noticed my geographic tongue flares return. But similar to my asthma, on the whole, the flares seem to be milder and less frequent than they used to be.
Last year, I was away from home for about a week to attend a conference related to work. During that time, all my meals were provided by the conference or were taken at restaurants. Undoubtedly there would have been detergent residues on the plates and flatware as well as detergents in the raw ingredients introduced during processing. When I returned home, I noticed that I had the largest and most severe tongue flare since going detergent-free in our home, larger than I’d had when I ate out only periodically. It is possible that the constant inundation with detergent residues through my food even for one week was the cause of such a flare. I haven’t tracked my geographic tongue flares as diligently as my dry skin or my asthma, since these flares have simply been an annoyance that I’ve learned to live with and ignore throughout my life. However, I would be interested to see if detergent removal reduces flare frequency or severity, or gets rid of flares altogether, for other sufferers of geographic tongue.
My Husband’s Results
My husband’s story is the shortest, possibly because he might be considered as the least atopic out of all of us, if you can reasonably measure that. Consistent with the results for the rest of us, after using the solveeczema problem-solving heuristic and making environmental changes to our home, his environmental allergies seemed to have been reduced in severity and he seems to be able to tolerate more of his allergens before he has a reaction.
My husband is allergic to aeroallergens, seemingly to some pollens that are abundant in the first few weeks of July and to grass cuttings. When he was younger, he used to have such severe reactions to being outside that he, for awhile, thought he might be allergic to the sun (!) and would avoid being outside as much as possible. This is a sad side effect that comes from not knowing how to problem-solve allergy and, more importantly, from believing yourself to be sickly or genetically doomed.
Today, after detergent removal from our home, my husband’s hay fever symptoms that come without fail every year in July are not as severe and do not last as long. When he mows the lawn, his reactions, which used to be sneezing, itchy and red eyes, and runny nose prior to detergent removal, are not as severe, sometimes not showing up at all. When he does have reactions, they do not last as long. For his general hay fever symptoms that peak around early July, likely due to release of a specific pollen, he sometimes still needs to take an anti-histamine for comfort, but one 24hr tablet seems to last for 24hrs whereas before he would feel ill again within 6-12hrs.
It is possible that the increase in tolerance to the allergens and reduction in severity of reactions is due to removal of detergents from his nose, throat and lungs and therefore the removal of an agent which would have increased membrane permeability and allowed the allergens to pass the skin and membranes and cause an allergic reaction in the body. If this is the explanation, the mechanism would be the same as how detergent removal improved my asthma.
It’s also possible detergent removal helped reduce the “level” of my husband’s “allergy bucket”. We saw more clear examples of the bucket analogy of allergy in action in our daughter, our son, and myself and that helped us postulate that a similar mechanism might be at play with my husband.
With my husband’s results, it’s hard to pinpoint if detergent removal itself was solely responsible for the improvement of his allergies or if some of the other environmental changes and his own behavioural changes, both associated with the problem-solving heuristic discussed on solveeczema, had a greater impact. Several changes we made may have had positive impacts.
The carpet removal may have had a significant impact, as it is well known that allergens like pollen are often trapped deep in the carpet. Get rid of the carpet, and get rid of a source of pollen that is constantly kicked up by walking on the carpet.
7 months after the carpet was removed, we installed a new furnace with a MERV-13 filter (this would be sufficient to remove pollen and mold, which are relatively very large as far as particles go). The filter would have taken pollens out of circulation of our indoor air. We also installed an air conditioner so that we could keep windows closed for the majority of the summer. It would be helpful with reducing the “level” in the “allergy bucket” which is part of the solveeczema heuristic. These two indoor air improvements at the HVAC system may have had a significant affect.
Finally, my husband, reaching a similar unwillingness to just tolerate allergy symptoms as I did when I was younger, changed his behaviour to help with his allergies. When he mows the lawn, he wears an N-95 mask in order to reduce the amount of grass entering his nose and mouth. This behavioural change may also have reduced the severity of his allergic reactions. It’s likely, based on what I’ve observed with our children and myself, that all of these factors — detergent removal and reduction and avoidance of allergens — all interplay to reduce severity and duration of his allergies, and raise thresholds to reacting to his allergens.
Why I Now Believe There’s Nothing “Wrong” with People with Allergies
Embedded in my husband’s story was the seemingly insignificant fact that he spent many years during adolescence and early adulthood believing he was sickly, weaker than his siblings. I didn’t hold this exact belief about myself, but once I graduated with biology degree and had an understanding of concepts like natural selection and fitness, I did sometimes feel something akin to it. As I took stock of my genetic profile, that which gave rise to my allergies and asthma, and other traits like my myopia, I often thought that my genes should have been a disadvantage in any setting other than the modern world where advancements in science and medicine mitigate the unforgiving conditions of less modern environment.
I thought that potentially struggling to breathe and not being able to see properly certainly would have stacked the cards against me in the historical world of my ancestors. In short, that I should have been “taken out”. I wondered how those seemingly maladaptive genes then perpetuated at all through so many generations, and finally had to consider that some other trait with compensatory benefits might somehow have been intertwined in that genetic profile. The intertwining would have provided the necessary selective pressure for perpetuation of the whole profile, “defective” genes and all, into the next generation.
Both my husband and I have suffered from a perception through adolescence and young adulthood that we’re genetically sub-optimal or disadvantaged. Such beliefs demonstrate the incredibly negative effects of common messaging that atopy is a genetic defect that is maladaptive and useless. By a short leap in logic that most of us mistakenly make when inundated with such constant messaging from the society, we come to subconsciously (or perhaps consciously for some) believe that the atopic person is therefore defective and maladapted.
Today I reject those perspectives. It bears stating explicitly here, now that I’ve finished presenting our family’s entire story, that through a combination of our experience, my observations, and my formal education in biology, I’ve come to believe that there is nothing “wrong” with me, my husband, or my children — that there is nothing suboptimal or defective about our genetic profile as relates to atopy. It’s simply the fact that we are inundated with synthetic chemicals in our modern world which has unnaturally amplified what would normally have been an advantageous signal, that causes us to suffer in today’s modern environment. Why I’ve come to believe that, insofar as allergy is concerned, we are healthy and there is nothing “wrong” with us, is partially and simply because our experiences have indicated that even 100 years ago, we would not have had such extreme (or any!) allergic manifestations. I have seen enough to believe that 100 years ago — a relatively short time in our human history — I would not have had asthma. I have seen enough to believe that 100 years ago, my daughter would not have had eczema — and then, because of the absence of synthetic detergents that broke open her skin and likely increased permeability in the gut, perhaps no food allergy, either.
I’ve also come to believe the solveeczema author’s suggestion that the larger mechanism of allergy evolved in the human species because it conferred a significant selective advantage. She states the basis of her theory more succinctly and eloquently than I could in Part 2 of “Letter to a Medical Student”:
This is worth restating: I see allergy, “normal” allergy — I consider anaphylactic allergy as different — as an adaptation, not disease pathology. Given the historic prevalence of allergy even before allergy rates saw such precipitous rise after WWII, this makes sense. As with pain, virtually anyone can develop an individual allergic response at some point in life under the right circumstances. For any inherited condition to maintain such significant prevalence in the population, there must be some compensating benefit. Given the rapid rise in eczema and atopy since WWII, the cause of this “abnormal” allergy must be primarily environmental. Per Klueken et al (review, from Schultz-Larsen et al), “This continuously increasing frequency of [atopic dermatitis] during the past 30 to 40 years suggests that widespread environmental factors in the industrialized world are operating in genetically susceptible persons.”
Let me also be very clear by restating once again that I am differentiating historically “normal” allergy from the modern manifestation of eczema and allergy, which are not normal. If eczema is a signal, most eczema today is almost certainly the result of unnatural environmental conditions inappropriately triggering that signal — or, modulating down thresholds to reacting — with a genetic component to the susceptibility. I believe based on my present understanding that the people with naturally lower thresholds to reacting in normal environments would otherwise have a genetic advantage.
Allergens are similar to pathogens to the immune system. To the extent that harmless allergens take more energy to differentiate from pathogens, there is probably a survival advantage to people (or — speaking to possibly evolutionary roots — to migratory groups that have such people among them) whose immune systems can tell them to reduce exposure to certain benign substances that make the immune system’s job more difficult. An interesting aspect of allergy is that “normal” allergy makes sufferers miserable in a way that often points to the source of the misery — aeroallergens relate to breathing symptoms, contact allergens to skin, etc. — but without incapacitating. Allergy concurrently increases adrenaline, giving sufferers the ability to move away from what is making them miserable.
I believe there is probably a survival advantage in the more ready expression of this signal under normal environmental conditions, and that there is likely a way to support my overall perspective on allergy using genetic archeology.
What has been so helpful from the solveeczema approach, heuristic and theory for our family’s journey is coming to a place where, instead of just assuming that we are “doomed to suffer” due to our “faulty genetics”, we have experienced and now know, that our reactions are due to unnatural forces that did not exist for our ancestors, and therefore that this is not “our lot”. To a great degree, we can effectively control and shape our experience in today’s environment. Our experience has also changed the messaging I then allow to get to my children. Early on in our journey, I would repeat this concept to my son in terms to which he could relate: “There’s nothing wrong with you. There are things wrong with the way the world is now. There are too many chemicals in the world.” It was an affirmation to him that his suffering was not his fault, and a poignant way to protect him.
I hope our story provides hope, and provides the fledgling tendrils of faith to all who are atopic (allergies) or have children who are, to believe that there is nothing defective about you or your children and that there is much in your power to do to make your experience better.