Taking Control Part 6 - Dr Raed Alhusayen: The Skin

Next at the Sjogren's Conference we heard about another problem area - this one where people seldom take our complaints seriously. After all, they say, "Doesn't everyone have dry skin?"

Dr Raed Alhusayen is a dermatologist at Sunnybrook Health Sciences Center. His areas of interest include autoimmune skin disease and skin lymphoma. His talk was titled "Sjogren's Syndrome and the Skin" so we were on the road to finding out more.

Dr Raed Alhusayen at the round table discussion  (Photo Dona Lankin)

He said "Moisture is the key" and reviewed the main skin manifestations in Sjogren's. They are vasculitis, dry skin and Raynauds. For Raynauds he emphasized the importance of keeping your fingers and toes warm. Two layers is better than one. He also mentioned warm oil massage as being helpful because the oil holds the heat longer. (see ending for details)

Dry skin affects 50% of Sjogren's patients. Here are his tips:

A bath is better than a shower
Lukewarm water
*Non-soap hydrating cleansers (eg. unscented Dove, Cetaphil, Cliniderm, Cera Ve)
Pat gently, don't rub
Apply moisturizing cream immediately after to trap the moisture
Apply moisturizing cream 2 to 3 times per day
Wear cotton clothing

There are 3 types of moisturizer 

1. Oil based which includes ointments. They are water insoluable and more effective
2. Water based products like gels, lotions and creams. They are water soluable and less effective
3. Emulsions which are a mixture. Oil in water or water in oil.

Moisture loss is a real hazard  (Photo Annette McKinnon)

To reduce moisture loss from the skin you can use barrier creams that trap water. They are very effective on dampened skin. This category includes lanolin, mineral oil, lecithin, beeswax and two others new to me called squaline and dimethicone. Barrier creams are the best and petroleum jelly is one that is effective but thick and greasy. You may at some times need medicated cream for better control.

Other ways to preserve moisture are humectants like glycerin, urea, honey, hyaluronic acid and sorbitol that attract water from the dermis or emolliants that repair the skin barrier and replace your natural lipids. Emolliants include ceramide (a natural lipid in the skin), cyclomethicone, jojoba oil, decyl oleate, dimethicone, propylene glycol, shea butter and coconut oil. Now you know what to look for in the ingredient lists. 

Dr. Alhusayen recommended some moisturizerrs: Aveeno, Cetaphil, Dove, Eucerin, Lipicort, Lubriderm, Olay and Epicream. (the last one may be covered by insurance). 
Some of those mentioned are humectants, some are barrier creams and some have the features of both.

In conclusion he emphasized that supportive skin care is simple and yet essential to improving the quality of life in Sjogren's patients

A few more tips 

Warm Oil Massage for Raynauds

Use a natural oil e.g. olive oil. Make sure the heat is low and then rub it on both hands and feet including between the fingers and toes. Put socks and gloves on after this to preserve the warmth.

For skin fissures you can use Crazy Glue.

Facial moisturizers should have an SPF of 30.

 

Sjogren's Syndrome and the National Conference 2014 (Taking Control)

It's spring almost everywhere and time for the National Conference held by the Sjogren's Society of Canada.  "Taking Control" is the name of this year's event.

Spring Crocuses

There is a great deal of evidence that suggests that patient knowledge, skill and confidence with managing chronic disease is a good indicator of better outcomes.

This weekend I saw Sjogren's Syndrome spelled like this: Sourjons, Soujgrens,Sjorgen's and Sojourns, all by different people who suspected this was a diagnosis that they would be adding to their other autoimmune disease(s). You can only imagine how difficult their searches for accurate information are going to be.

The upcoming National Sjogren's Conference should be a great way for both patients and health care professionals to learn more reliable facts. All you need to do is register and come to the Delta Chelsea in Mississauga on May 3. Health care professionals who attend are eligible for continuing education credits.



I am planning to take notes and post what I learn as I have in the past. This conference has a distinctive special feature. For one hour the speakers and other volunteer heath care professionals from Sjogren's related fields will host round table talks where attendees have a chance to ask personally relevant questions.  It's great to have that opportunity and also interesting to hear about the problems others face.

Here's a quick overview of the speakers and their topics.

Dr Arthur Bookman, the co-ordinator of the Multidisciplinary Sjogren's Clinic at Toronto Western Hospital and co-chair of the Sjogren's Canada Medical Advisory Board will start the program with "An Overview of Sjogren's Syndrome."

The talk on "Brain Fog in Sjogren's" by Dr. Sherise Ali, Neuropsychiatrst, is sure to get a good reception. This is a subtle complication that some doctors don't really believe in. The role of medical treatment is limited so for patients any ideas for taking control will be welcome. 

Dr. Cindy Marek's presentation is titled "Strategies For Oral Health and Comfort in Sjogren's Syndrome." For those of us struggling with this symptom new strategies and an understanding of  the causes will be welcome. Her field is dental pharmacotherapy. 

Dr. Rookaya Mather will discuss "Tear Film Dysfunction in Sjogren's Syndrome." She manages patients with complex ocular surface problems.

Dr. Ann Parke is a rheumatologist who studied in the UK and Canada before she settled in the US at the University of Connecticut. She is speaking about "Current Treatment Options and New Therapies On The Horizon." As an active researcher her opinions are always informed and welcome. She is the co-chair of the Sjogren's Canada Medical Advisory Board, as well as serving on the International Sjogren's Syndrome Advisory Committee. 

"Oral Manifestations of Sjogren’s Syndrome". Dr. Mahvash Navazesh, DMD, Dentist will raise awareness about the role of saliva in health and disease and will focus on the common oral complications associated with salivary gland hypo-function in patients with Sjogrens

Dr Raed Alhusayen "Sjogren's Syndrome and the Skin." His areas of interest are autoimmune skin diseases and skin lymphoma.

Dryness of the mucous membranes is a hallmark of Sjogren's Syndrome

This is the 8th Annual Conference.  You can register at the Sjogren's Society of Canada website


Notes for Health Care Professionals:
Physicians will earn 7.25 Continuing Medical Education Credits approved by the Canadian Rheumatology Association (CRA) and the Royal College of Physicians and Surgeons.

The Sjӧgren's conference this year will allow your healthcare professionals to receive accreditation if they attend. Optometrist, Dentist, Hygienist, and health care professionals can receive CE credits for attending the Saturday Conference.