The Laundry Conundrum

I’ve decided to write a separate commentary on the subject of laundry because I have come to feel that this issue is often overlooked and misunderstood in the treatment of eczema–especially, when those who are frequently found doing the laundry are not the ones who suffer from eczema.

Over the years, I have found that the laundry process required for successful treatment/maintenance of eczema is a meticulous and time consuming business for those with eczema, and a source of confusion and frustration for those without it. Even my wife–who has done everything in her power to help and support me in my struggles with eczema–has difficulty fully wrapping her head around the need for an extremely meticulous laundering process.

I believe that part of this frustration and lack of understanding stems from the average individual’s lack of sensory sensitivity to detergent additives and the residues they leave behind in the fabrics they are intended to wash. As well as a lack of sensitivity to fragrances in products like shampoos, soaps, lotions, etc., in general.

Laundry detergents are rather caustic solutions. They are intended to break down dirt and grease, remove tough stains and accumulated dyes that do not belong in the fabric as it was manufactured. This requires some harsh chemicals that the human body is not always readily able to cope with in healthy individuals, let alone overly sensitive eczema sufferers.

A few laundry detergent companies have released “hypo-allergenic”, dye and fragrance-fee detergents for sensitive skin. Sun Products Corporation have been producing “All Free Clear” laundry detergent for at least two decades, now. This has been the only detergent I have been able to use with any success. Tide, Cheer, Dove, Arm & Hammer, and several others have products aimed toward people with sensitive skin, and Dreft has been recommended for babies for as long as I can remember. But, not all “hypo-allergenic” detergents are created equal, nor are they all suitable for every individual with eczema. I have tried all of these other products, and I have found that the “All Free Clear” detergent is the most suitable for me.

But, is using a laundry detergent labelled “hypo-allergenic”, “fragrance-free”, or “for sensitive skin”, enough?

No, it isn’t.

All laundry detergents leave residues behind in the fabric, and a single cycle in the washing machine is often far too little to ensure everything is gone–especially if if the detergent has a fragrance and/or a fabric softener (which are both extremely bad things for eczema sufferers).

My recommendation–I believe I was told something similar by a dermatologist, about thirty years ago–is the following:

  1. Use ONLY fragrance-free, dye-free, hypo-allergenic detergent
  2. Wash smaller loads of laundry
  3. Use more than adequate water levels
  4. Use the warmest possible water for the fabric being washed
  5. Use slightly less detergent than stated on the label
  6. After each spin cycle, remove, fluff, and return the “expanded” clothing to the washer
  7. Run a full cycle with no detergent *after* washing to fully rinse; 1 cup of white vinegar may be added to this rinse cycle to help release detergent residue.
  8. Regularly scrub the washing machine to clean out dirt and grime build-up on the inner tub, agitator, and under the tub collar.

I also recommend that an entire family follow these same steps while an eczema sufferer is in the house, as simply doing separate laundry loads–i.e., using “regular” detergent for the rest of the family–can be a hidden source of triggers for the eczema sufferer.

Sometimes, it may be impossible to find appropriate laundry detergents. Travelling, especially, is one these times. While staying with family in the Philippines, I have an extreme amount of difficulty with detergents, and the “All Free Clear” bottle that I send ahead usually doesn’t seem to last long enough for the trip (Murphy’s Law?). For times like this, I have found that locating the least fragrant, white (dye-free), detergent that can be found is the best option, along with running several more rinses to ensure that as much of the detergent as possible has been removed from the clothing. Air drying outdoors in the sun, with a breeze, can also help a bit, but don’t rely on it. It’s not a perfect solution, but it can be better than nothing.

Even the smallest amount of residue–especially, fragrances and fabric softeners–can cause eczema to flare.

Simply touching someone’s clothing that has been washed in a “fragrant rich” detergent can be enough for my own eczema to flare.

Sleeping on bed sheets that have any fragrance or fabric softener left in them will worsen my eczema.

Even being in the same room with the fragrance of strongly-perfumed laundry detergent in the air is enough to trigger my eczema (and my allergy-induced asthma).

What might seem a bit obsessive–or, even, completely “over-the-top”–to the average individual, can be a potential life saver to an eczema patient. And, just because the average person “doesn’t notice” the presence of a fragrance in the air, doesn’t mean it isn’t sufficient to cause harm to a sensitive individual.

For families with an eczema sufferer, it is often best for the entire family to follow daily procedures that prevent the exacerbation of eczema. Anyone using harsh and fragrant products in the house–detergents, shampoos, soaps, colognes, body sprays, lotions, household cleansers, etc.–may be contributing to the flare-ups. While it may be inconvenient, frustrating, and even the source of some resentment for a family, it could mean the difference between an existence of complete misery or one of reasonable comfort to an eczema sufferer.

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6 Responses to The Laundry Conundrum

  1. Desiree says:

    Thank you for your insight on eczema. I’m hoping my daughter grows out of this terrible skin condition. I always try to remind her that this is better than having something seriously wrong internally or anything serious. My daughter is only 5, but has had her condition for right at 4 years now. I have done tons of research to help my daughter. We have switched to fragrence free everything in the home…including shampoos. We actually was her hair in the kitchen sink, hoping it will help with no products getting in her skin. I have done this just within the past year, along with keeping her hair very short off of her neck. I have done this for a few years. Her skin stays inflamed from her neck and all the way down to her ankles. At times hers may not be inflamed quite as bad as other times, but I can’t stop her scratching and she has scratch marks constantly over her body. I will add her steroid cream over her body as needed, I hate this stuff…body it does improve things, then I do organic coconut oil, her thick Eucerin cream, followed by Vaseline. We do this 3-4 times a day. It’s all very time consuming and she hates it. If I miss a session her skin gets so incredibly dry that it starts to actually flake away. It breaks my heart. Even her little eye lids get inflamed and incredibly dry at times. I’m not complaining about these steps but I just wish there’s was some way to understand what is causing her flare ups so often. It gets so overwhelming for me, just as a parent, I couldn’t ever imagine being the victim if this skin condition. We have tried gluten free diet. I feel at a loss. Please continue with your writings your insight will encourage others, as it has helped me. At least you can understand where your flat ups are linking from. In time as she gets older she will recognize more so. I stumbled across your helpful advice about how you do your laundry, from googling a question about eczema, lol! Thank you and have a beautiful day!!

    • Greg Stewart says:

      Desiree,

      My sympathies to you and to your daughter. I have a few friends with young children that suffer from eczema in varying degrees, and I can understand how difficult it is as a parent to cope with it, and the treatment process. And, keeping track of what your child is exposed to can be a nightmare, in itself.

      Have you tried a more inclusive elimination diet? I am considering going full-on elimination with only rice for a couple of weeks; after which I’ll start re-introducing things. But, it’s a difficult process. I suspect there are still foods that my body’s recent developments can’t handle, but it’s been difficult to isolate them. Wheat/gluten does not seem to be an issue for me. But, tomatoes may be another food I have to add to my list.

      I have noticed that with the onset of my food sensitivity to coconut and soy, I can no longer use them topically–some moisturisers have one or both in them; read the labels. You might try going without the coconut oil for a bit, to see if that could be part of the problem.

      I too hate the topical steroids, and I do my best to keep their use to an absolute minimum.

      Also, Eucerin Original and Aquaphor ointments contain lanolin, which could be counter-productive. Many individuals with eczema are sensitive to lanolin (the waxy sebum produced by wool-bearing animals). I am so sensitive to it that I cannot wear wool at all, or use the Eucerin products.

      For my eyelids, I apply the petroleum jelly as needed during a day. Sometime I will use a prescription moisturiser called EpiCeram, followed by the petroleum jelly to seal it in.

      Have you tried to get your daughter to use ice/cold-packs on the itch, instead of scratching? I know it’s not always practical, but it could help.

      And, one friend whose daughter suffers with eczema has sugar as one of her triggers, and it usually gets her scratching quite soon after eating something sweet. It’s just another thing to look at.

      Good luck to you and your daughter. You are not alone in the struggle.

  2. Matt says:

    I was under the impression that diet does not affect eczema …. think that was from webMD

    • Greg Stewart says:

      Eczema is a tricky disease, and it affects each individual slightly differently. Everyone seems to have different triggers, but diet can most certainly be one of them. Eczema is closely tied to IgE and histamine levels, so any substance that cause an allergic reaction can cause eczema flares. As well, anyone with other allergies can potentially develop eczema at any time.

      WebMD appears to focus on the viewpoint that “no studies have been able to establish a link” between diet and eczema. Unfortunately, a lack of studies is not evidence against. The National Institute of Health database has publications that describe viewpoints equally for and against dietary connections with eczema. And, I can say with absolute certainty that, since 2011, certain dietary elements have absolutely been triggers of mine. I don’t need studies to support the testing I’ve done on myself.

      While I haven’t had full specific IgE labs done (it gets costly, and my new insurance has a cap on allergy testing), the labs I did request to verify my observations on diet have definitely confirmed my experience with diet and eczema flares.

      This may not be the case for you, but if you have exhausted all other suspect triggers with no relief, it cannot hurt to explore possible triggers in your diet.

      Now, there have also been claims on the internet about “eczema cure diets”, which I do not believe in. There is no diet that can “cure” eczema. In fact, there is currently no “cure”, at all. But, there are diet guidelines that can help maintain an eczema free lifestyle by eliminating dietary triggers, such as the one my friend Harrison Li has written about on his website, Cure Eczema Slowly. In Harrison’s case, diet was the source of his eczema. Again, all the specifics of his experience may not work for you, but his information is a good general guideline.

      For some, it may be necessary to try a full elimination diet, eating only rice for a few weeks, and extremely slowly adding foods back into the diet to test for specific food triggers. When eczema flares after reintroducing a food (it can take up to 36 or even 48 hours), that particular food should then be avoided. It’s a typical allergy elimination diet.

      Also, keep in mind that for many individuals, dietary triggers are not the only triggers causing the eczema. So, focusing on diet alone may not be the answer for everyone.

  3. Steve says:

    Hi,
    I represent one of Europes largest retailers of White Goods and there is talk of us releasing our own branded washing machine cleaner/de-scaler. As a father of 2, I have watched my 4 year old son grow up with moderate to severe eczema and therefore I know first hand of the difficulties and pain that our children have to go through with this terrible and underestimated disease.
    I have been very thorough in how I keep my own washing machine insides clean but feel there is not enough education on the need to do so.
    I am in a position to try to influence the product and marketing which I see as an amazing opportunity to increase awareness of how washing machine neglect and incorrect washing has an impact on our childrens skin and (in my opinion) an increase in general skin complaints.
    I’d like to know more about your opinion on this and if you think a product available when we buy our washing machine along with educational information would be a good idea?
    Kind regards.

    • Greg Stewart says:

      Steve,

      I actually think that would be an excellent idea. I spend a fair bit of time between clothes washes just de-greasing the basin of all the petroleum jelly that has melted out of my clothing, towels, and bed sheets. And, I am certain that there is still a ton of muck still in the machine that I cannot get to with an alcohol saturated scrubbing sponge.

      I have often thought of doing periodic wash-throughs with a half dozen or so bottles of 90% isopropyl to try to dislodge anything I haven’t been able to reach. I do have the suspicion that some of the grease that accumulates on the outside walls of the inner tub does find its way back into the clothing, eventually.

      The only other way I can think of would be to periodically replace the washing machine, and I really don’t have that sort of cash on hand.

      If there were a product that could to added to the washing machine for a clean-through run or three, that would remove all the grime from the insides of the washer, that would be an excellent thing to have available.

      Of course, any product of this sort would also have to be safe enough that it doesn’t exacerbate eczematous inflammation on its own–not an easy thing to formulate, I would expect.

      Another option would be to have a washing machine design that can be easily broken down for thorough cleaning, throughout; then easily re-assembled without risk of leakage (or, personal injury, and “extra screws”).

      I don’t know that educational material about cleaning routines to be sold with washing machines would reach as many people as should really know about it. It would be good to have available; but, seriously, if it’s packaged with the owners manual, not many people would notice it.

      Educational material for eczema sufferers and their families, more specifically, is certainly a very good tool to have available. I admit I really didn’t treat the need for cleaning the machine with too much urgency in my post, above, but I have actually been considering doing a video to show how I get the job done as best as I am able. The problem with that, though, would be that everyone would see just what gets stuck in my clothing, and MAN! is it disgusting when it comes out of the washer.

      Anyway, if you really have the ability to influence washing machine cleaning products and care materials, this is certainly a great idea.

      –Greg

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