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Got Problem Skin? Stop Hiding It and Start Fixing It…

I’ve been a practicing Dermatologist for just over 20 years and in that time, I’ve noticed a sharp increase in cases of Contact Dermatitis — a skin condition brought on by adverse reactions to irritants found in skincare or the environment.

In addition to my own observations, the medical community is also reporting a steep incline in this type of inflammation. In fact, an article published in the American peer-reviewed medical journal, JAMA Internal Medicine, said reactions to skincare products reported by the U.S. Food and Drug Administration (FDA) rose 125% from 2013 to 2016 — and that is just people who took time to call in and report!

I see so many of these cases walk through my office that I’ve found myself getting overwhelmed with referrals.  Patients would even drive in from out of town to get answers for their irritated skin.

This deluge of patients, often from places hours outside Toronto, is what prompted me to create the Product Elimination Diet (PED).

Normally, to determine if a patient was allergic to a product or environmental substance, I’d apply anywhere from 25 to 100+ chemicals on their skin and leave them in place for 48-hours (see: Patch Testing 101 blog). The problem is, out of town patients couldn’t just hang around for days at a time. So rather than start with a patch test, I created a list of skincare products for them to avoid and had patients try those first before coming to see me. 

The original idea for PED came from a meeting I attended in New Orleans many years ago. A contemporary put forward a LO-CAL list of products for patients to use while waiting to be patch tested. LO-CAL is a play on an actual food diet, but this diet was for your skin and LO-CAL = “low contact allergen list.” I took this idea back to Toronto with me and tweaked it to make it more about skincare and branded it: The Product Elimination Diet.

The reader might be thinking: isn’t that what labels like sensitive skin and hypoallergenic are for?  Yes, but these terms are not regulated and as a result, shouldn’t be trusted.  

What I have found since putting the PED into practice was most patients with unidentified chronic itchy rashes or exacerbations of chronic conditions like rosacea, acne and psoriasis fare much better when they follow the products on the list (which, BTW, are mainly drug store brands and a few natural oils.) In a lot of cases, I have been able to put patients on a path to re-introducing some of the skincare products they might have missed.  

In some cases, the PED does not work and these patients are the ones who really need to see a Dermatologist for allergy patch testing. 

 

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