Adventures in Patch Testing: India's Eczema Story
I’ve been a rashy person all my life. When I was a child, I used to get eczema in the crooks of my elbows and behind my knees. When I was in university, I started relying on cortisone cream to heal the cracks at the sides of my mouth that I got from the cold, dry weather. The consistent use of cortisone on my face led to a condition called perioral dermatitis, which is basically a lovely collection of bumpy sores all around your mouth and nose. A few years later, when I was opening the store, I was so stressed out that I broke out in a rash that covered half my face. Today, whenever I’m under stress, I often get a rash around my eyes, on my eyelids, or around my mouth. It’s a super good time! Along the way, I’ve been prescribed long courses of antibiotics, as well as medicated creams and ointments to help quell my chronic eczema. These solutions were all well and good, but I hated not being able to identify the root cause of my issues.
Enter Dr. Gillian de Gannes, a Vancouver-based dermatologist who runs the only patch testing clinic in British Columbia. My family doctor referred me to a dermatologist, who referred me to Dr. de Gannes. When I went for my initial consult, she explained to me that some eczema is merely hereditary. My dad’s stress manifests itself in a similarly rashy way, so this makes sense. The overuse of irritants can also trigger eczema. Considering that I live and die by liquid exfoliants, compound irritation could also be a potentially disappointing cause of my eczema. Finally, eczema can also be triggered by allergies, which is where patch testing comes in. Since I work in the beauty industry, where I am always surrounded by lovely smelling things, I was still considered to be a candidate for patch testing.
I’ll link Dr. de Gannes’ clinic’s information here but here’s a quick summary. They put 80 common allergens on little patches of paper, which they then tape to your back and leave on for 48 hours. These allergens are things like synthetic fragrance, preservatives, metals, and humectants that are often used in personal care products. You also have the opportunity to have the products you own tested on patches on your arm. I brought in 15 of my favourite skincare products, and I said a little prayer before handing them over, in hopes that none of them would be sources of irritation. The products you are allowed to test can only be things that you do not have to wash off. You cannot test something like your laundry detergent, because leaving it taped to your body for a week will result in a burn. I tested favourites like Vintner’s Daughter, Biologique Recherche p50 lotion, Dr. Barbara Sturm Hyaluronic Serum. All skincare products that you can pry from my cold, dead hands. And then I waited.
After my third and final appointment, Dr. de Gannes and her team of dermatology residents determined that I am allergic to two things: Fragrance Mix 1 and cobalt. Fragrance Mix 1 is a collection of different ~smells~ that -- are typically used in things like liquid hand soap, dish detergent and inexpensive body washes. Cobalt is a metal that you can find in costume jewelry, industrial/construction tools (something I may very well never encounter), and blue-dyed things. That means no blue eyeshadow for me. What a shame.
I was so thrilled to be able to do patch testing because I would never have otherwise known that I was allergic to these ingredients. A fragrance is somewhat unsurprising because it can be irritating to many people, but cobalt! Who knew? Certainly not me.
Luckily enough, I wasn’t allergic to any of the products I use on a regular basis. At IRC, we are incredibly conscious of the ingredients that go into the products that we carry, so many common irritants aren’t included in their formulations. That said, some people can find certain "natural" ingredients like essential oils irritating.
If you suffer from chronic skin irritation, I highly recommend you ask your family doctor about a possible referral to the Contact Dermatitis Clinic. The whole referral and waitlist process took about a year, but it was worth it.
The one major take away I had from this experience, however, is that you can test yourself to see if a product causes you irritation or not. When companies recommend you do a patch test before using one of their products, I always assumed this means you are supposed to rub some of it on your body and then wait a few minutes to see if you go into anaphylactic shock or break out in a full-body rash. Surprisingly enough, this is not how you do it. If you are hesitant about using a new skincare product, or if you suspect you are allergic to one you are already using, you can do a patch test at home as long as the product you are testing is made to be left on your skin (ex. No face cleansers or face masks). Cut up a small piece of paper or cloth and saturate it with the product you want to test. Then, adhere it tightly to your arm or back with some kind of medical tape. Leave it on for a few days and then see what the affected area looks like when you remove the tape. If your skin is bumpy, red, and inflamed, you probably should not use the product. Wait a few more days to see how quickly the rash disappears or if it continues to develop. If you react to the product, you should consult a professional before using it regularly, or you should avoid using it entirely.
I’ll probably always suffer from some mild eczema since the condition can be triggered by many things other than just personal care products. If you suffer from chronic skin irritation, I highly recommend you take inventory of all of the potential causes in your life. These may be the products you use, the environment in which you live, or the stress you feel. Remember that our skin acts as a mirror of what is going on inside of us. Wanting to live a rash-free life is so much more than just a cosmetic concern—it’s about your overall health and wellbeing.