6 Main Factors that Cause a TSW Flare
Note: Please read my first article on how topical steroids affect our skin first so that you may understand fully the explanations below.
There are many factors that can cause a flare. So many that it is difficult to figure out the triggers. These 6 categories are just a simple way of grouping them so that you may identify the cause of a flare up more easily.
Allergens and Irritants
The number 1 cause of flares are allergens and irritants, and this is one of the trickiest to solve, as TSW skin is extremely sensitive to everything, even products formulated for sensitive skin and baby skin. This is because our skin is thin and damaged, not just sensitive.
I find that the key to managing allergen and irritant flares is having an open mindset. We are conditioned to use many products in our daily lives that we do not actually need. For example, products like air fresheners, cleaning agents, soaps, detergents. If we do not use them, we feel uncomfortable and strange and worry that we are not clean enough. But many of these products cause irritation to TSW skin and may be prolonging your healing without you knowing.
The best way to figure out if you are experiencing any irritation from an allergen or irritant is to eliminate as many as possible and notice if your skin improves. In my quest to find out my allergen/irritant triggers, I moved to my aunt’s place, I did laundry in just plain water, I did not mop my floor with any detergent, and I did not use any soap for 6 months. I found out that my allergen was my laundry detergent, insecticide spray and air freshener that were used back at my home. I stopped flaring up and my skin cleared up considerably.
It is important to remove any triggers, as I have come across people with TSW whose skin are constantly triggered and not healing because of an unknown allergen, and they are confused why they are not healing! You may find a list of common allergens/irritants in the contents page. I highly encourage you to go through them one by one and start eliminating as many as possible.
Emotional Stress
Stress is a well-known factor for causing flare ups. It also does not just refer to stress like work stress or mental pressure. Stress includes emotional stress such as depression, anxiety, pressure from friends/family/society, sadness etc.
The skin can also produce cortisol of its own. When a person is stressed, the skin produces cortisol, which suppresses the immune response and skin cell proliferation rate. For normal healthy skin cells, this does not affect a person’s skin condition very much, except for a small breakout of acne/pimples from excess sebum production. However, for TSW skin which is thin and which already has a low cell proliferation rate, the skin will appear redder and more flaky/rough - red from the skin being thin, and flaky/rough from the difference in cell proliferation rates of the skin cells.
Falling ill
Falling ill generally lowers your immunity. In addition to repairing your skin, your body has to fight off a virus/bacteria, and this naturally slows down the progress on your skin and can cause a flare up.
Monthly period
Females usually notice a flare up before and/or during their monthly period. The female body prepares for the period every month. The womb lining is considered “skin” to the womb - when the lining is shed, repair cells are on stand by to heal it. Thus resources for repairing TSW skin are temporarily shifted to the repair of the womb, and this can cause a dip in the skin quality. The immune system is also temporarily weakened/suppressed during ovulation and could have an impact on your skin’s healing.
Lack of sleep/rest
Our bodies regenerate and heal when we sleep. It is a period of rest and repair. The optimal time for healing is between 10pm to 2am, so it is best to head to bed early. However most of us are insomniacs! We somehow itch and feel the most uncomfortable during this time frame. My personal belief (not scientific, I will update if I find any scientific backing for this) is that we itch most when the skin is healing the most. When you do not have adequate sleep, the body is unable to heal optimally, hence the skin quality drops. Take naps whenever you can! Over exerting yourself can also cause a flare as the body is depleted of energy to do its healing.Alcohol
Drinking alcohol affects cell signalling, it is as if your skin cells are drunk too, and are unable to perform its functions, causing a flare up.Other environmental factors (heat and high/low humidity)
In addition to allergens and irritants in our environment, heat and too much/too little humidity can also cause flares.
Heat and excessive exposure to UV rays can cause flares. The skin is sensitive to temperature changes, and heat in general causes irritation. TSW skin is very thin, and any sun exposure can also cause a flare. It is highly recommended to protect yourself from UV rays at all times. You may read the article on UV/Sun/Phototherapy and TSW in the contents page.
I’ve also noticed that too much humidity/moisture can cause flares, and dry climate changes (winter) can also cause flares. This usually happens when the change in climate is too sudden or extreme for weakened skin to adapt quickly.
Managing and preventing flare ups
Whenever you experience a flare up, look through these 7 factors and try to determine which of it could be the cause. It may not be obvious right from the start, particularly if there are several factors happening at once, or if you are exposed to an allergen/irritant you are unaware of.
As you keep practicing how to identify your flare triggers, you will get better at avoiding flare ups and eventually heal quicker. Being able to identify your flare triggers will also give you more confidence in your daily life activities and reduce any anxiety you might have about potential flare ups.
Over time, as your skin becomes stronger, your skin will be more tolerant of these triggers and experience less intense and less frequent flare ups.
For a list of allergens/irritants and a guide on identifying allergen/irritant flares, read here.
[The information referred to in this article was sourced from Skin Health Centre. https://www.skinhealthcentre.sg].