November has seen me in Australia for the entire month- something I have enjoyed immensely! Enjoying the beautiful Sydney Springtime weather and enjoying spending time with Freddy- our elderly and affable dog, and Izzy the 1 year old menace. She’s adorable but is instinctively drawn to all the wrong things. I am now having to look at my couches and rugs and just accept that maybe she’s the training manual I need to embrace being a grandparent. No- I have no announcements at this stage on that front. On the ESK front I have been diving more deeply into sensitive skin and on that theme, I have 3 nifty studies for you to geek out on! Enjoy! 

Understanding is Growing about Histamine Intolerance

Histamine intolerance is a bit of a buzz term in 2024. And yes, it’s a real thing! I read with fascination a new study that did a deep dive into the condition. It happens when the body accumulates histamine and then can't break it down fast enough, leading to a buildup that can trigger a variety of symptoms. This condition is often confused with food allergies, but they’re not the same! Histamine intolerance can cause reactions like headaches, skin itches, hives and rashes, as well as digestive issues, and even nasal congestion after eating certain foods.

So, why does this happen? Normally, an enzyme called DAO (diamine oxidase) breaks down histamine in the gut. But things like genes, medications, or even alcohol can reduce DAO activity, causing histamine levels to spike. 

The tricky part is that symptoms vary a lot. Some get bloating or headaches, or rashes or sneezing or all of the above. This makes it hard to diagnose. Current treatments focus on a low-histamine diet (avoiding foods like aged cheese, processed meats, tomatoes, coffee, wine, and fermented products) and sometimes adding DAO supplements to help the body handle histamine better. Antihistamines can also give some relief.

Because of the wide range of symptoms and lack of any diagnostic tests, histamine intolerance is often missed or misdiagnosed. If you think this sounds like you, try a low histamine diet for 2 -4 weeks yourself!

Impact of Menopause on Skin Microbiome

In the journal, Frontiers on Aging, a new study explored how hormone dips that happen in menopause affect the skin microbiome, separate from age-related changes. Researchers compared the facial skin microbiome of pre- and postmenopausal women with a relatively small age gap (average difference of 12.4 years) to eliminate the impact of aging on the skin.

The study found that postmenopausal women had a higher bacterial diversity on their skin compared to premenopausal women. If you think more diversity is a good thing, think again. That’s true for the gut but not the skin! This increase in diversity was not related to age or skin elasticity changes, but rather to menopause itself. Certain bacteria, like Cutibacterium (commonly found in oily skin), were less abundant in postmenopausal women. Conversely, the abundance of other bacteria like Streptococcus (usually found in drier skin) and Corynebacterium (found in aging skin) increased, reflecting the drier skin of postmenopausal women. But also the fact that skin aging relates more to menopause than chronological age. The bottom line is that this study concluded that the changes in the skin microbiome were primarily driven by hormonal changes associated with menopause, rather than chronological aging. These findings suggest that targeting the skin microbiome could be a novel approach for managing menopause-related skin issues, offering an alternative to hormonal replacement therapy (HRT). Everyone is obsessed with the microbiome and this study could help our ability to develop microbiome-based skincare treatments for postmenopausal women, to help with concerns like skin dryness and inflammation that arise from hormonal changes during menopause. One day! We don’t have any evidence yet!

Are you a bit sweaty? Do you have sensitive skin? They’re linked!

I was fascinated by a new study published in the Journal of Drugs in Dermatology. Researchers were curious if there's a connection between people who sweat a lot (have hyperhidrosis) and those who have sensitive skin (the kind that reacts to basically everything). They figured, hey, both conditions might be linked because both involve some funky nerve signalling, especially when sweat, stress, and heat come together.

They surveyed over 600 people with hyperhidrosis to see how many also had sensitive skin, and surprise, surprise! In fact 89% of them did! The sensitive skin showed up not just in sweaty areas like the armpits or hands, but also in places not affected by all that sweating. This made the researchers think there’s more going on than just sweat irritating the skin. It could be that the same nerve signals that make people sweat too much also make their skin overreact to harmless things.

In the end, the study suggested that doctors should probably keep an eye on patients with hyperhidrosis for sensitive skin as well. Plus, there’s a possibility that tweaking how nerve signals are managed (with drugs like anticholinergic treatments) could help both problems. More research to come on that!

See you next month!