Why dermatologists don’t use loofahs — and you shouldn’t either

Taking a shower rids the body of surface level germs and bacteria. The squeaky-clean feeling, however, isn’t thanks to harsh loofahs. In fact, most dermatologists don’t recommend them—and would definitely not use them on their face.

Loofahs are harsh on your skin

If you’re making the mistake of washing your face in the shower, you might not know that loofahs aren’t the best option for clean skin. “You should avoid rubbing with a loofah or washcloth as these are too irritating and will damage the skin,” says Benjamin Garden, MD, a dermatologist practicing in Chicago. “Gently use your fingers to rub the face wash on and gently wash off.” Over-washing depletes the skin of the natural lipids that are an important part of its protective barrier, which is why Peter O’Neil, MD, the Chief of the Division of Dermatology at NYU Winthrop Hospital on Long Island, also suggests using gentle cleansers and avoiding vigorous scrubbing.

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11 things your itchy skin can reveal about your health
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11 things your itchy skin can reveal about your health

Kidney disease

An intense itch all over the body often occurs in people with late stage kidney disease or who suffer from chronic renal failure. In fact, one study showed that 42 percent of dialysis patients suffered from moderate to extreme renal itch. “Some people describe it as a nuisance,” says Anthony M. Rossi, MD, assistant attending at Memorial Sloan Kettering Cancer Center and New York Presbyterian Hospital.  “[The itch] is so intense that people wake up in the middle of the night scratching.” Science has yet to uncover why kidney disease causes itchiness, but doctors suspect it has to do with the build up of toxins in your body when your kidneys are unable to remove the waste from your bloodstream. Aside from treating the disease, a doctor may prescribe medications like gabapentin, an anti-seizure medicine that’s been FDA-approved for off-label use to quell renal itch. Here are 9 more little body changes that could signal much bigger health problems.

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Liver disease

Itching all over could also be a silent sign of liver disease. Where incessant itchiness shows up late-stage in kidney disease, it can be an early symptom of liver disease. “If your liver is not functioning properly to detoxify the body, byproducts like bile acids back up,” says Dr. Kathleen Cook Suozzi, MD, assistant professor in the Department of Dermatology at Yale School of Medicine. “The primary goal is to treat the underlying liver disease and prescribe medications that can eliminate the bile acids.” Doctors will typically prescribe medications that can inhibit your body’s uptake of bile acids or help reduce the amount of bile acid returning to the liver. Don't miss these  9 signs your liver is in big trouble.

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Spinal disease

A chronically itchy upper middle of the back (without a rash) can be a hallmark of neuropathic itch, a symptom of nerve malfunction. Before providing treatment, doctors will first rule out spinal cord disease as a cause. Research has shown that spinal disease, whether due to age or injury, can apply pressure on the nerve and pinch it, which results in an itchy sensation on the skin. Neuropathic itches can occur on one side of the body or both, but it's a big red flag if scratching brings no relief. “People with eczema get a good sensation from scratching,” says Dr. Rossi. “But [nerve itch] doesn’t improve with scratching. The itch intensifies most of the time.” Some people say it feels like insects are crawling on them. Once spinal cord disease or other health conditions have been ruled out, neuropathic itches can be treated with capsaicin cream, which is derived from hot peppers, to burn out the nerves that are firing irregularly on the skin. Make sure you know what muscle spasms can reveal about your health

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Celiac disease

Extremely itchy bumps or blisters on knees, elbows, buttocks, and/or hairline are signs of dermatitis herpetiformis (DH), a skin manifestation of celiac disease. “When a person with celiac disease consumes gluten, the mucosal immune system in the intestine responds by producing a type of antibody called immunoglobulin A (IgA),” John Zone, MD, Celiac Disease Foundation medical advisory board member told celiac.org. These IgA antibodies travel to and bind with the skin cells to trigger an itchy response. The prescription Dapsone can provide short-term itch relief for the skin, but the intestinal damage is serious and patients have to adopt a strict gluten-free diet for life. If they continue to eat gluten, celiac patients can develop malnutrition, anemia, bone loss, ulcerative colitis, and even cancer. Here are 11 celiac signs you need to pay attention to.

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Lymphoma

“The other thing that you want to rule out are blood disorders,” says Dr. Suozzi. “Anywhere from five to 30 percent of lymphomas such as Hodgkin’s and non-Hodgkin’s can present with itch.” Itchiness with or without a rash can be the first symptom of Hodgkin’s disease—likely caused by cytokines, cell signal molecules that trigger inflammation in response to infection. If your doctor suspects lymphoma, she may order a chest X-ray to eliminate the possibility. If you're diagnosed with the disease, the itching will cease soon after starting chemotherapy or radiation therapy. 

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Thyroid disease

“Thyroid disease, whether it’s overactive or underactive can cause weird sensations in the skin,” says Cameron Rokhsar, MD, associate clinical professor of dermatology at Mount Sinai Hospital and dermatologist and cosmetic surgeon at New York Cosmetic, Skin & Laser Surgery Center. “No one knows the association but it may be that the changes in the sweat glands can cause skin dryness.” Itchy, dry skin is more common in people who have hypothyroid, because skin tissue contains thyroid hormone receptors that are seeing diminished cellular activity in the absence of thyroid hormone.

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Allergies

Allergies are one of the most common chronic health conditions in the world. In fact, many skin allergies are classified under the umbrella term contact dermatitis, the itchy rash on your skin that you get when you come into contact with an allergen. Poison ivy, nickel, or compounds found in personal care items like baby wipes and makeup are just a few of the allergens that can cause contact dermatitis. Your dermatologist may stick patches on your skin with different compounds that are correlated to the most common allergens to pinpoint the root cause of your allergies. “It’s like a treasure hunt when we’re trying to look into all the products that people use,” says Dr. Suozzi. A strong topical steroid is prescribed for relief. Don't miss these 8 signs your skin products are secretly damaging your face.

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Menopause 

If you’ve finally hit menopause, you may have noticed a sudden change in your appearance—including dry skin. The loss of estrogen, an essential building block for collagen production, leads to thinner, itchier skin due to a diminished supply of natural oils that keep your skin’s moisture intact. Maintain your fountain of youth with Aloe Vera gel or calamine lotion, which help hold water in your skin’s outermost layer to alleviate drying and itching.

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Breast cancer

Paget’s disease of the nipple is an incredibly rare form of breast cancer where cancer cells collect in or around the nipple. According to the National Cancer Institute, Paget’s disease of the nipple accounts for less than 5 percent of all breast cancer cases in the United States. The first sign is scaly, red, itchy patches around the nipple and areola. “Sometimes it's misdiagnosed as eczema of the nipple,” says Dr. Suozzi. “But when it's breast cancer-associated it's unilateral.” Itchy skin isn't the only sign of disease; here are the 10 subtle signs of disease that your feet can show

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You're pregnant 

The American Pregnancy Association states that 1 in 150 women will develop pruritic urticarial papules and plaques (PUPP), an outbreak of itchy red rashes commonly seen on the abdomen, though they can also appear on your legs and arms. Most women can’t do much about the itch because the rash typically doesn’t develop until late into the third trimester when most medications are off limits. “It’s not proven but some people say [PUPP] can happen with multiple gestations like twins,” says Dr. Rossi. “And some people think it’s because the skin gets stretched out.” Fortunately, it’s harmless and goes away after pregnancy.

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Dermatographia

If after lightly scratching your skin, your fingernails leave thin, raised red welts on your skin that take 15 to 30 minutes to disappear, you may suspect dermatographia. Although the cause of this condition is unclear, the Mayo Clinic says it could be triggered by stress, infections, allergens, or medications like penicillin. “It’s an extreme skin condition, where your skin is sensitive to touch and releases too much histamine,” says Dr. Rokhsar. Areas of touch and clothing are the most susceptible to dermatographic flare-ups. It’s easy to diagnose but often goes undiagnosed because it’s not severe or bothersome enough for people to make an appointment with their dermatologist. If the itch becomes severe, your doctor can prescribe an antihistamine to relieve the inflammation. If this becomes a regular occurrence, ask your doctor if you might have histamine intolerance or even mast cell activation syndrome—both are conditions where the body fails to process histamine properly.

And should your itch not be due to one of these conditions, check out the 7 bug bites you should never ignore.

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Loofahs and bacteria go hand-in-hand

On a germier note, Joel Schlessinger, MD, a board-certified dermatologist, and RealSelf contributor says it’s one of the things dermatologists never put on their faces because of bacteria. “I wouldn’t recommend using a buff puff or loofah,” Schlessinger says. “Loofah sponges are intimate with many unclean areas of the body and then sit around allowing bacteria to multiply within the nooks and crannies of the sponge.” Organisms colonize in these spaces, particularly in the warm, moist environment of a shower, per Dr. O’Neil. This creates the potential for serious infections, particularly in patients with weak immune systems thanks to disease or medication, he adds. But bacteria on loofahs isn’t a new discovery. Research dating as far back as 1994 shows loofahs can transmit species of bacteria that may cause infection.

Here’s what you should do if you insist on using a loofah

There are some cases where it could make sense to use a loofah on your body. Dr. O’Neil occasionally recommends loofahs to patients with skin conditions that lead to a buildup of cells, such as psoriasis. If you do use one, take some precautions: avoid over-scrubbing; limit use to once or twice a week; and always rise the loofah thoroughly before letting it completely air dry, Dr. O’Neil says. Soaking it in vinegar or diluted bleach minimizes the growth of microorganisms, too, according to Dr. O’Neil. Now that you know better about using loofahs, note these 12 other things you should never do to your skin, according to dermatologists.

The post Why Dermatologists Don’t Use Loofahs—And You Shouldn’t Either appeared first on Reader's Digest.

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