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Detergent:
The Hidden Problem
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Patients with atopic
dermatitis often have generalized or localized dry skin. Dry skin seems
to be worse during winter and best during summer months. The mechanism of
this seasonal variation is not well understood. Two likely reasons are that
sebaceous gland secretion decreases in the winter and that indoor humidity
is lower in winter, too. But this does not explain why wintertime problems
are often worse on skin around one's trunk. To determine whether residual
washing detergent in cotton clothes plays a role in wither deterioration
of dry skin, 148 children and adults (ages 6 to 58) with atopic dermatitis
who visited a dermatology clinic were examined for distribution of their
dry skin. These patients were asked to switch for two weeks from a common
laundry detergent (typically anionic; with many additives like whiteners
and proteolytic enzymes) to a nonionic detergent that was additive-reduced.
Photographs were taken before and after switching detergents. An improvement
in dryness occurred in 76% of patients after two-weeks of the new detergent.
No patient showed worsening of dry skin. The authors concluded that residues
of common washing detergents in cotton underclothes play an important role
in winter deterioration of dry skin among patients with atopic dermatitis.
(Kiriyama T et al. J Dermatol 2003; 30:708-712.)
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