1. “How did you not notice this for so long?” - I don’t think it was this bad my entire life, as I’ve said I’ve only seen flakes sometimes. It got like this sometime recently. I don’t particularly make note of checking my scalp on a periodic basis. Also if you haven’t already noticed by my username, I have ADHD. Out of sight out of mind. I don’t even intend to be gross… but like many others with ADHD we can struggle with habit, routines, etc.
2. “Why did you not just go to a doctor?” - I’m in America and healthcare costs are high. I can’t afford to go see one at this time even with insurance.
3. “Where did you put shampoo then?” - I put it on my head (obviously) and throughout all my hair. I think since my hair is so thick that when lathering the shampoo in, I may not have been really getting it onto my scalp enough. I’ve made note of the shampooing twice to help with that though, so thanks to those who said that!
4. “Did your parents not teach you ‘xyz’?” - Apparently not. Not everyone has good parents. I definitely did not. I’ve had to figure out many things throughout life on my own.

ANA tests

Tests used in diagnosing lupus

• anti-dsDNA - anti-Double Strand DNA is sometimes automatically tested for, but may need to be ordered separately. This test, when highly positive (2-3 times max cut off at least) is almost exclusively seen in SLE. However, only about 30% of SLE patients have this antibody. It's great if it's there to confirm diagnosis, it does not rule out diagnosis if it is absent.
• ENA Panel - Extractable Nuclear Antigen panel, usually automatically done if ANA comes back positive
• anti-Sm - Anti-Smith. Typically included in the ENA panel. This is another antibody, that when highly positive, almost always means SLE, but only about 25% of SLE patients have this antibody.
• RNP - Anti-Ribonucleoprotein. Typically included in the ENA panel
• anti-chromatin - Anti-chromatin is a relative newcomer in diagnostic testing for SLE and probably will NOT be ordered automatically. Its exact utility in diagnosis is still being determined.
• Apl panel - Antiphospholipid Antibody Panel, which consists of 3 tests:
  • LA - lupus anticoagulant
  • aCL - anti-cardiolipin antibodies
  • Anti-β2GP - anti-beta 2-glycoprotien antibodies
• CBC - Complete Blood Count, some abnormalities in WBC, RBC and PLT counts can be significant.
• CMP - Comprehensive Metabolic Panel, here the doctors are generally looking for kidney dysfunction (GFR, BUN/CR).
• ESR - Erythrocyte Sedimentation Rate, this is a nonspecific inflammation marker.
• CRP- C-Reactive Protein, another nonspecific inflammation marker.
• C3 - Compliment C3
• C4 - Compliment C4
• CH50 - Compliments, Total, these are part of the compliment system, which is a tertiary part of the immune system.

Diagnostic Process

• Shorter questions get more feedback
• Use ChatGPT to summarize your question if you don't know what to leave out

1. Wash your face with a mild, foamy cleanser.
   
2. Use a cotton pad to apply toner, carefully wiping away dirt and debris.
   
3. Apply a few drops of skin brightening serum to your face and neck, gently rubbing with your fingertips.
   
4. Finally, apply a noncomedogenic moisturiser.
   

1. Disclaimer
2. Introduction
3. Glycerin properites
4. --
5. Research- safety
6. Research- source
7. Research- density and comparison to hyaluronic acid
8. Research- ability to last on applied area
9. Benefits on skin
10. Benefits on hair
11. Use in makeup
12. Use in makeup remover

1. (correction paragraph 18) Starting ratios

1. Please know, I am a regular human, just like you. I am not a specialist, doctor, or a scientist of any kind. I have spent over 2 years in writing this (post has been in my drafts and I worked on it in my free time only.) I have talked about using glycerin and the changes I have seen on my own body many times on here and I always received comments from someone wanting more information on glycerin which is not easily available. (I think it's because of how cheap it is and how its the top ingredient in many products we use, companies don't want us to know lol.) My sources are from medical/universal research libraries that I have access to from my university. Still, research papers are very complicated to understand and takes a long time to get through the whole study so if I made a mistake in comprehending anything, please let me know. Lets begin :)
2. This product/poly compound does have many names/spellings but I'll be sticking to glycerin. Glycerin is used in vast variety of products like medicine/wound care, food industry, hygiene products including soaps, skincare, hair care and more. Glycerin is stable, nontoxic, non irritating and hypoallergenic with mild antibacterial, antiviral, and antimicrobial effects. Because of these properties it is said that about 20% of all glycerin is used in our territory (makeup, skincare, hygiene) which is a very large portion. Glycerin is also fairly cheap so you can see it in the top 10-15% of the ingredient list (especially in products that promote hydration) or towards the bottom 25% in preventative products making it the most underrated, versatile, and affordable product all should have in their cupboards
3. In skin/hair care, glycerin is a humectant (retaining or preserving moisture) an emollient (quality of softening or smoothing of the skin), and a thickener. Meaning a moisturizing agent that draws water to the surface of the dermis from the atmosphere or from layers deep in your skin/hair; brighten and soften the dermis and hair at the same time; thicken any liquid formulas. This said, using glycerin in low humidity or dry, hot air can result in drying out your dermis (skin) or hair shaft because it is pulling moisture deep in your dermis or hair. (Personal note: if you wish to use glycerin in locations or seasons where the air is dry, it is best to keep spritzing the area with a mist of just water, preferably distilled, or other hydration mist to prevent the glycerin pulling any to all moisture from your dermis which could result in flaky, dry skin or brassy, frizzy hair strands. I believe after immense research this is the only downside of glycerin).
4. Glycerin has many benefits. You can look at luxury creams to affordable face wash products and chances are, you will see glycerin in it. Some skincare companies now include a directory on their website to explain what each ingredient does and benefit on the skin but I feel it is very vague and wanted to bring some science to this poly compound. Now the accredited and certified research papers I found available to me are limited on its effect on the skin of humans but are on animals with some following up on humans. I was hoping to include links and incorporate wording however it was too cruel so I will summarize.
5. The vast amount of information available is on, if glycerin is a safe product, its effects to our (human) tissues, and possible illness/diseases scientists believed it can cause or be linked to. Like I said, I'll keep the animal testing gory out but to wrap it all up, glycerin is safe. It did not have any effect on the reproductive system for males or females and is not carcinogenic to humans. In a different study, a group of 25 human volunteers (22 male 3 female) were tested orally which resulted in no change in weight of humans if under 50 with or without diabetes, unless over 50 with diabetes history it caused some jittery behavior in one human (this experiment was conducted orally and used 3x a day.) Researchers checked the sperm of males and saw no abnormalities comparing it to when they first came in. For the females, ultrasound showed no abnormalities on their reproductive health. It should be noted, the researchers did not compare anything regarding glycerin and its effect on the thyroid but the other organs tested no abnormalities were found. I also found several studies on inhalation and applying glycerin on eyes was normal in sense nothing will happen other than some irritation that subsides, on animals. Same study then compared their findings on a group of humans and only a couple of people from the testing group reported it caused mild or moderate irritation that lasted for little while. To conclude, there are no known side effects or illness caused or linked to by usage of glycerin. Still, after immense testing it is recommended to patch test glycerin even if being allergic to glycerin is considered rare according to researchers.
6. Glycerin was originally found from lipids of animals (animal fat) but now can be extracted from plants (vegan) like shea butter, palm oil, coconut oil and more. As of today, glycerin from oil has a high extraction rate from palm. Glycerin can also be formed synthetically through fermentation, bio-diesel or chemically created with its chemical compound ( C3H8O3; Carbon 3 Hydrogen 8 Oxygen 3) (Personal note: I am including this because when purchasing you glycerin, be sure on where and how it was extracted as you will be applying it on your dermis or hair.) Glycerin is non-comedogenic, meaning it will not clog your pores, but reading the different studies I believe there is a difference between lab, plant, and animal lipid created glycerin. Some prefer the animal glycerin as its more suitable to their skin type but majority of the glycerin in our market is from plants or lab. You can tell the difference of glycerin by how tacky it is. Animal glycerin is most tacky (sticky like tree sap) compared to the plant glycerin followed by lab created which only has a slight slip to it.
7. The density of glycerin (1.26g/cm^3) is lower than the density of our skin (1.1g/cm^3) which allows glycerin to penetrate deeper than a lot of other products. Whereas hyaluronic acid (varies but avg. 1.8g/cm^3) may look to be better way to go around but both have their benefits! Glycerin is better suitable when you want your skin or scalp to hold moisture on your skin. HA is suitable if you want to lock in the moisture. But what makes them very different is the molecular level. Glycerin has a smaller molecular level than HA, which in return allows the glycerin to saturate deeper in your dermis or hair strands whereas HA sits on the top 2 layers (about). So using HA on your skin can mean it can take longer to see the visual results on your skin. That said with either or, consistency is important to unlock all the benefits either product can offer.
8. Glycerin will hold onto the water keeping your face soft and smooth (like a newborn babies bum) for long periods of time. (On study showed if glycerin is not washed from the dermis or hair, glycerin can last upto 6 days on the area applied hydrating the top layer of skin. In this study the researchers had 3 groups, 1 controlled, 1 glycerin applied only(group1), 1 glycerin applied with misting water every 6 hours(group2) for 14 days. From control- the group had natural oil build up, group1 had dry almost chapped skin, group2 felt dry to touch, some shine-no oil, bounce on dermis.) It is not recommended to keep glycerin on for this long as glycerin can attract pollutants from settling into pores-it just sits on surface of skin.
9. Glycerin is beneficial to all skin types, most hair types, and help aid in various skin or scalp conditions (if you have a medical condition please consult a doctor or dermatologist.) Applying glycerin consistently, will boost collagen production making brighter, even skin from healing blemishes to hyperpigmentation, aiding in the prevention of acne bacteria spreading on your dermis (help with clearing back acne) aid in healing old acne marks, clearing and hydrating pores for the prevention of black or white heads, smooth skin texture and premature aging lines. Glycerin may act as a mild natural sunscreen by protecting the skin from the sun's rays and environmental pollutants, including smog. On large open pores, because of its density, glycerin can settle into pores reducing the visual size of them and help clear out any dirt or imperfections.
10. Glycerin is more suitable for those with dense or thicker hair and with more texture (curls.) Once again, glycerin pulls moisture from the hair shaft when no moisture is available in the atmosphere. For the scalp, glycerin can be a natural/soft treatment for dandruff or other scalp dryness. For your hair strands, mixing it with our ayurvedic hair masks or hair oil, you can condition any damaged hair strands, preventing further breakage (split ends), and adding strength to protect against harmful rays of the sun and hot tools.
11. Remember we discussed how glycerin is a humectant, emollient, and thickener? Well, this is what many of us expect from a makeup primer. I have used a glycerin primer for when I wanted a quick everyday makeup look or when I misplaced my holy grail benefit POREfessional primer. I used it in 2 ways, One was mixing a drop of glycerin into my moisturizer or my foundation. The other was my standard rose water and glycerin spray bottle. With the rose water I did notice I had to make sure the water and glycerin was well set into my face. I use a damp sponge to press any glycerin sitting on my face deep into my pores before applying foundation to avoid any separation or caking. (If you want an airbrush look; try this method then after dabbing your face with the sponge, apply a thin, even layer of finely milled translucent powder.) Why you may ask do this extra step of dabbing? Well using glycerin in a liquid format like the rose water is also an effective makeup remover! Crazy how it can work both ways.
12. If you pull out any micellar water you may have, the first 2 ingredients are water and glycerin followed by additives to act as mild surfactants and unwanted possible ingredients alcohol, fragrance, preservatives. Surfactant is a substance that will help the water and glycerin chemical properties mix when dissolved together. Sometimes when you let the micellar water sit you see a layer of liquid settle on top of another layer and you have to mix the two, right? The surfactant is the ingredient that leaves that oily feel on the face and I believe blends the glycerin chemical with the surfactant to create a less tacky formula. It will be different brand to brand based on how they source their glycerin and the ratios. That said, after my full beat, spraying a setting spray and all, I experimented to see how the rose wateglycerin will react with my full face of makeup if I just wanted to rehydrate my face with the same mixture. I spray till my face feels nicely hydrated, let that fully dry with help of a fan or my hands, then with a dry sponge, I lightly tap the glycerin back into my dermis and if needed, powder to set any makeup separation or fading.The only time I dealt with makeup reacting with the glycerin was when my makeup began pilling from mixing silicone and water based skincare products with foundation.
13. From my journey: I saw some posts of users using and not having benefactual results so I'd like to inform you how I personally started using glycerin and the changes on my own skin. I remember stumbling on a random Instagram account of Farah Dhukai from Farsali using glycerin back in 2016 and I decided to copy the recipe to lighten dark skin. After following her instructions and started to use her recipes very often, it was not long before I had all family reunions turn into skincare nights. I would make custom masks for my cousins and aunts based on their skin concerns and I would receive endless compliments and discussions on how my skin as a 15 year old teenager looked amazing. It was not long until I connected the dots and started researching extensively into glycerin.
14. At that time, I didn't even have access to these studies and research papers, many were released after 2016! I found another ayurvedic Instagram account (now deactivated) and found my first recipe for rose water and glycerin and we have been going strong ever since. I started off with about 1 cup of fresh/homemade rose water to 1 tablespoon of glycerin. I originally started using this as a toner. I suffer from acanthosis nigricans (thickedry/dark skin on back of neck, elbows, armpits, knees) I would drench a cotton pad and hold the serum onto my skin for 5 seconds before moving it. I would repeat this then go over the same parts on my skin in circular motions. After about 4-6 months I had reduced the appearance on my elbows and knees to about 90% (only small dryness patch was left) my neck still had the thickness of skin but the darkness had reduced significantly and started blending in with my natural skin. Armpits were about 40% lighter but after a year of consistent use I was very happy with my results. Now it is important to mention, skin care can only carry so much; during this time of using the toner I lost about 23 kgs which helped clear the inflammation causing the dark skin in the first place.
15. Along with this toner I only used a light moisturizer and face wash; no SPF, facial scrubs, or actives. My skin was very clear, bright, hyperpigmentation free. Then life hit me with a ton of bricks and depression set in. I gave up skincare and my skin was terrible. Pores, pigmentation, fungal acne and stubborn blackheads on forehead and chin, extremely flaky/irritated cheeks. At this point I had been using glycerin for over 3-4 years so I upped the ratio I mix about 1:4 ratio of glycerin to rosewater now and put it in a spray bottle. I would start by double cleanse my face, use vitamin C serum and drench my face with the glycerin water before bedtime daily (about 1-2 hours before) let it settle then use my fingers to give myself a soft facial massage and help the remaining dripping water settle into my skin or slide it down my neck and chest. Then before bedtime, I splash my face with just cool water and remove the glycerin sitting on top of my skin. Gently dry my face and apply my nightly moisturizer with retinol, let that settle then spray 4x of the glycerin water again, finish with some lip mask and go to sleep.
16. From researching and experimenting, this was best way to clear out my white/black heads. The glycerin made them soft and I did not have to include any active or harsh scrubs or facial tools to pick them out. I found mixing the vitamin C with the glycerin 2 hours before helped tremendously with my hyperpigmentation and left my face glowing and added a beautiful bounce! I now only use a soft facial scrub that was marked to be safe for daily use once a week only. In the mornings, I thoroughly wash your face with some cleanser and apply a light moisturizer and SPF. My skin has gotten significantly brighter and has the glass skin effect without using multiple actives and products. Reason I don't apply it the rosewater glycerin in morning is because we are having dry weather and my schedule is unpredictable to remember to spray a hydrating spray in between wear.
17. For my scalp psoriasis, I used the same toner product just in different ratios and it helped significantly. Only thing about glycerin and your scalp/hair strands is you do not want to dry it out. I only kept it on for about 30 minutes before I shower. I do have thin/pin-straight hair but my ends just felt so much healthier. One research entry mentioned how glycerin was very benefactural to animals with dense fur. So if you have textured(wavy/curly) or coarse(thick) hair definitely try glycerin out on yourself! Im sure it will help your curls be more defined and healthy! Glycerin helps strengthen the hair follicles and strands to prevent breakage, leading to the illusion of faster-longer growing hair. (I have to trim my hair about 3x a year. Each time I trim about 4 inches off. Sometimes I mix the glycerin and rose water in my hair oil concoctions. I feel this allows the oil to penetrate in even deeper. The oil doesn't sit on the stands but absorbs faster which I always struggled with. It leaves my hair so soft/supple, helps my brittle ends when I'm past due for a trim or from heat damage. In the case I add the glycerin into the oil and I wish to keep the oil on longer, I spray my hair with regular distilled water only to keep the moisture constant for the glycerin so it doesn't suck the water out of the strands.
18. Here are a couple ratios you can start to experiment with:

• Hair care: 1/4 cup distilled water, 1/2 cup rose water, and 2 tablespoons glycerin in a spray bottle
• Skin toner: 1:3 glycerin to rosewater in a sterilized bottle of your choice
• Skin mist: 1:6 glycerin to rosewater in a sterilized bottle of your choice

Face

• Skin: Keep it simple, keep it consistent, keep it adapted to your skin needs. Consult with a dermatologist or just do your own research at home (that's what I did!). It took me a while to figure out the products that work for me and the routine. I won't recommend any specific products because each product works very differently. What works for me might not work for you even if we have the same skin type/concerns. My main issues are the occasional spot, big pores and dull skin.
  
  • Night Time: I do a double cleanse at night (oil followed by water cleanser), use retinol, and moisturiser. Vaseline is a game changer if you have any dry or irritations spots on your face. My under eye area is very sensitive and irritates easily with products, and Vaseline is the only thing that works. Also apply Vaseline on your lips before bedtime, you will have the softest lips when you wake up.
  • Morning Time: I don't cleanse my face in the morning because otherwise it would get very dry. I wash with cold water, then Vitamin C serum, moisturizer (I love the Roche Posay Cicaplast Baume), and a generous amount of SPF.
  • One thing I recommend a lot, is that if a product works well on your skin, you should stop using it after a few months to make sure your face doesn't get used to it and decreases its efficiency. I rotate between 2-3 products, and switch them whenever I finish a product.
• Teeth: Brush twice a day and floss daily. Trust me on this. Flossing is a game changer to make your teeth healthier and whiter. I won't recommend any whitening products because I don't use them as my teeth are very sensitive. But if possible try to schedule an appointment with an hygienist once a year to get your teeth cleaned and remove any buildup. This is super important. And remember that healthy teeth >>> white teeth.
  
• Eyes/Eyebrow
  
  • If you want to add an extra step to your routine, I recommend getting a lashlift, it lasts around 8 weeks, looks very natural and elegant, and make your eyes pop. You have smaller eyes (like I do), I really recommend this. You can also ask to do a lash tint so your lashes appear even longer. When you do go to a salon do make sure that it has good reviews (ie hygiene), and also make sure that they test all the products on your hand beforehand, so you don't have an allergic reaction in your eyes.
  • Getting your eyebrows done is definitely a game changer. I don't do any permanent or semi permanent treatments, other than getting my brows professionally plucked.
• Makeup: I like simple makeup (with the main reason being that I don't know how to do more complicated makeup). The good thing about simple makeup is that everyone looks good with it, and really gives you a confidence boost. I use a skin tint (MAC has a nice one, and Maybelline too) that gives the skin a bit of a glow with some concealer under the eyes and to hide spots. I like adding bit of blush (Rare Beauty is quite nice), some mascara, a bit of eyebrow gel (from Benefit Cosmetics), and a clear lip oil (I really like the Clarins one).
  
  • If I am going out, I do the same routine but I make it more intense. For example, I use a darker blush on my cheeks (MAC Swiss Chocolate), a dark brown lip liner as lipstick with the lip oil, and I also use a bit of shimmer on my eyelids to make them pop (I have very dark brown eyes). I will also use a setting spray in between steps along with setting powder to make it last longer.

Body

• Regarding getting fit, there is no easy way out. It will take months of consistently working out and following specific food regimens. If you can, I would advise getting a personal trainenutritionist to at least get you started on a meal and exercise plan. Having a healthy, and strong body will make you feel so confident and good.
• I would recommend getting a blood test to check on your vitals and make sure you don't have any deficiencies (regarding vitamins or hormones). Taking supplements can really boost your energy and improve your health. Magnesium with Vitamin D is great and has a lot of benefits, but please check with a doctor first.
• Some things help a lot with body confidence like getting your nails done (hands and feet!). Trust me. Get a simple semi permanent gel polish in milky white on both your hands and feet, it looks super natural, lasts for weeks, and makes your hands and feet look amazing and fresh.
• Body care: I recommend using a body brush when you shower, it will make your skin feel really smooth, and you suffer from body acne it will help. Tip: don't keep in the shower and clean your brush regularly, so bacteria doesn't accumulate, and cause issues. After the shower, I like using the Ordinary Glycolic Acid toner on my body, followed by a body oil (I recommend Bio Oil). It makes my skin look amazing, soft and minimises stretch marks, scars and hyperpigmentation. When I go out, I like using Nuxe Or to make things a bit more extra. I like being shiny. I also like using a body moisturiser on my elbows, feet, knees where the skin can get a bit more dry.
• For hair removal, I get laser done since it's quite cheap where I'm from. We Southern Europeans are very very very hairy. It honestly has been a game changer. I know it's not available to a lot of people but it's something that does work really well, specially if you have fair skin and dark hair.

Hair

• I have wavy hair, so this advice will not be useful to a lot of people. I thing hair with layers looks great, and I have my hair cut with long bangs and layers since I was 15 years old. I recently got a big chop, right above my shoulders and I am embracing my natural hair colour. I kept the layers and I think it makes easy to style and maintain.
• I recommend getting a haircut every 3 months, just the tips to keep it healthy. I also use Argan oil on my hair tips, and rosemary water on my scalp before I wash it. My washing routine is very standard otherwise with a shampoo that focused on scalp care. I do a hair mask once a week, and don't use any conditioner because it doesn't work for me at all.
• I don't use any heat except hairdryer. If I want to give it a bit of more volume I use a round brush and some curling rolls to style it and make my waves more... wavy I suppose.

Style

• Find clothes that fit you well, and more importantly that you feel confident in. You don't need to wait until you have your 'perfect' body. Get clothes that suit your body type, your complexion. There are some threads on Reddit that I think can help with that.
• I like going on Pinterest and look for outfit inspiration. I also follow a few instagram accounts that focus on creating different outfits, and they even link the items. I use this less to buy new things but more to see if I can use items I already own and style them differently.
• I am very much a basics girl, I think nothing looks better than a well fitting blouse/top with straight jeans and either sneakers/ankle boots. T-shirt/jeans combo is honestly a classic that looks good on everyone as long as the clothes fit well. I don't usually follow a lot of trends because they don't really work for me. I think it's important to keep basics in your closet that will always be in style. Think basic t-shirts, long and short sleeved (in white, black, grey), some form fitting, other loose. Get some straight jeans in different washes. You can create so many different outfits, and it works for both the day and night time. When I go out for drinks, I use a white tight t-shirt and some dark blue jeans with ankle boots. It's simple but it works! Trust me ;)
• Jewellery: I re-use the same jewellery every day. And if you want to start wearing more, try getting some good quality but affordable pieces that always look good and you can use during the day and night. Think some small silver hoops, or gold, maybe a small ear cuff, and a simple necklace. I like using rings on my index fingers, they are quite simple, but look elegant, specially with the milky white nails.

ANA tests

Tests used in diagnosing lupus

• anti-dsDNA - anti-Double Strand DNA is sometimes automatically tested for, but may need to be ordered separately. This test, when highly positive (2-3 times max cut off at least) is almost exclusively seen in SLE. However, only about 30% of SLE patients have this antibody. It's great if it's there to confirm diagnosis, it does not rule out diagnosis if it is absent.
• ENA Panel - Extractable Nuclear Antigen panel, usually automatically done if ANA comes back positive
• anti-Sm - Anti-Smith. Typically included in the ENA panel. This is another antibody, that when highly positive, almost always means SLE, but only about 25% of SLE patients have this antibody.
• RNP - Anti-Ribonucleoprotein. Typically included in the ENA panel
• anti-chromatin - Anti-chromatin is a relative newcomer in diagnostic testing for SLE and probably will NOT be ordered automatically. Its exact utility in diagnosis is still being determined.
• Apl panel - Antiphospholipid Antibody Panel, which consists of 3 tests:
  • LA - lupus anticoagulant
  • aCL - anti-cardiolipin antibodies
  • Anti-β2GP - anti-beta 2-glycoprotien antibodies
• CBC - Complete Blood Count, some abnormalities in WBC, RBC and PLT counts can be significant.
• CMP - Comprehensive Metabolic Panel, here the doctors are generally looking for kidney dysfunction (GFR, BUN/CR).
• ESR - Erythrocyte Sedimentation Rate, this is a nonspecific inflammation marker.
• CRP- C-Reactive Protein, another nonspecific inflammation marker.
• C3 - Compliment C3
• C4 - Compliment C4
• CH50 - Compliments, Total, these are part of the compliment system, which is a tertiary part of the immune system.

Diagnostic Process

• Shorter questions get more feedback
• Use ChatGPT to summarize your question if you don't know what to leave out

ANA tests

Tests used in diagnosing lupus

• anti-dsDNA - anti-Double Strand DNA is sometimes automatically tested for, but may need to be ordered separately. This test, when highly positive (2-3 times max cut off at least) is almost exclusively seen in SLE. However, only about 30% of SLE patients have this antibody. It's great if it's there to confirm diagnosis, it does not rule out diagnosis if it is absent.
• ENA Panel - Extractable Nuclear Antigen panel, usually automatically done if ANA comes back positive
• anti-Sm - Anti-Smith. Typically included in the ENA panel. This is another antibody, that when highly positive, almost always means SLE, but only about 25% of SLE patients have this antibody.
• RNP - Anti-Ribonucleoprotein. Typically included in the ENA panel
• anti-chromatin - Anti-chromatin is a relative newcomer in diagnostic testing for SLE and probably will NOT be ordered automatically. Its exact utility in diagnosis is still being determined.
• Apl panel - Antiphospholipid Antibody Panel, which consists of 3 tests:
  • LA - lupus anticoagulant
  • aCL - anti-cardiolipin antibodies
  • Anti-β2GP - anti-beta 2-glycoprotien antibodies
• CBC - Complete Blood Count, some abnormalities in WBC, RBC and PLT counts can be significant.
• CMP - Comprehensive Metabolic Panel, here the doctors are generally looking for kidney dysfunction (GFR, BUN/CR).
• ESR - Erythrocyte Sedimentation Rate, this is a nonspecific inflammation marker.
• CRP- C-Reactive Protein, another nonspecific inflammation marker.
• C3 - Compliment C3
• C4 - Compliment C4
• CH50 - Compliments, Total, these are part of the compliment system, which is a tertiary part of the immune system.

Diagnostic Process

• Shorter questions get more feedback
• Use ChatGPT to summarize your question if you don't know what to leave out

Unmasking the Culprits: Why Does Moisturizer Burn?

Irritating Ingredients: The Usual Suspects

1. Fragrances: Whether natural or synthetic, fragrances are a leading cause of skin sensitivity and irritation. These complex mixtures of aromatic compounds can cause a stinging or burning sensation upon application, particularly for those with delicate skin.
2. Alcohol: Certain types of alcohol, such as denatured alcohol or alcohol denat, are often used in skincare products as solvents or preservatives. While they can help a lotion feel lightweight and absorb quickly, they can also strip the skin of its natural oils, leading to dryness and irritation.
3. Preservatives: Preservatives are essential for preventing the growth of bacteria and extending the shelf life of skincare products. However, some preservatives, such as parabens and formaldehyde-releasing agents, can cause skin irritation and even allergic reactions in sensitive individuals.

Disrupted Skin Barrier: When Your Skin's Defenses Are Down

1. Dryness: When the skin is excessively dry, it can develop tiny cracks and fissures that allow irritants to penetrate more easily. This can lead to a stinging or burning sensation when applying moisturizer.
2. Over-exfoliation: While gentle exfoliation can be beneficial for removing dead skin cells and promoting cell turnover, overdoing it can strip away the skin's protective barrier, leaving it vulnerable to irritation.
3. Skin conditions: Certain skin conditions, such as eczema, dermatitis, and rosacea, can compromise the skin barrier and increase sensitivity to skincare products.

Skin Allergies: When Your Immune System Overreacts

1. Botanical extracts: While natural ingredients like lavender, tea tree oil, and chamomile are often touted for their soothing properties, they can also be potential allergens for some individuals.
2. Propylene glycol: This ingredient is a common humectant used in skincare products to help attract and retain moisture. However, it can cause allergic contact dermatitis in some people.
3. Lanolin: Derived from sheep's wool, lanolin is often used as an emollient in moisturizers and other skincare products. While it can be highly effective at softening and protecting the skin, it can also trigger allergic reactions in sensitive individuals.

Can Fragrance-Free Lotions Still Cause Burning?

Recognizing the Signs: Symptoms of Lotion Burn

Burning Sensation: The Unmistakable Feeling of Fire

Redness and Inflammation: The Visible Signs of Irritation

Itching: The Urge to Scratch

Rare but Serious: Blistering and Swelling

Soothing the Sting: How to Treat Lotion Burn

Step 1: Discontinue Use of the Offending Product

Step 2: Gently Cleanse the Affected Area

Step 3: Apply a Cool Compress

Step 4: Reach for a Gentle, Fragrance-Free Moisturizer

Step 5: Give Your Skin Time to Heal

Preventing the Burn: Tips for Avoiding Lotion Irritation

Tip 1: Always Perform a Patch Test

Tip 2: Opt for Fragrance-Free and Hypoallergenic Formulas

Tip 3: Look for Soothing, Nourishing Ingredients

1. Aloe vera: Known for its anti-inflammatory and skin-soothing properties, aloe vera can help calm irritated skin and reduce redness and itching.
2. Chamomile: This natural ingredient has been used for centuries to soothe and calm the skin, thanks to its anti-inflammatory and antioxidant properties.
3. Oatmeal: Colloidal oatmeal, a finely ground form of oats, has been shown to help relieve dry, itchy skin and reduce inflammation, making it an excellent choice for sensitive skin.
4. Ceramides: These lipid molecules are naturally found in the skin's natural barrier and help maintain its integrity, preventing moisture loss and protecting against irritants.
5. Niacinamide: Also known as vitamin B3, niacinamide has been shown to improve the skin's barrier function, reduce inflammation, and soothe irritated skin, making it an excellent choice for those prone to lotion burn.

Tip 4: Be Mindful of Your Environment and Lifestyle

1. Hot showers: While a steamy shower may feel relaxing, hot water can strip your skin of its natural oils and disrupt the skin's barrier, making it more susceptible to irritation. Try to keep your showers lukewarm and limit them to 10 minutes or less.
2. Harsh soaps: Like hot water, harsh soaps and detergents can also strip the skin of its natural oils and cause irritation. Opt for gentle, fragrance-free cleansers and avoid using harsh scrubs or exfoliants on sensitive skin.
3. Sun exposure: Excessive sun exposure can damage the skin's barrier and increase sensitivity, making it more prone to lotion burn. Always wear a broad-spectrum sunscreen with an SPF of at least 30, and seek shade during peak sun hours.
4. Stress: Chronic stress can weaken the skin's barrier and increase inflammation, making it more susceptible to irritation. Incorporate stress-reducing practices like meditation, deep breathing, or yoga into your daily routine to help support healthy, resilient skin.

When to See a Doctor: Seeking Professional Guidance

1. Severe or persistent symptoms: If your burning, itching, or redness is severe or persists for more than a few days despite home treatment, it's time to seek professional help. Your doctor can assess the severity of your reaction and recommend appropriate treatment options.
2. Blistering or oozing: If you develop blisters, oozing, or open sores on the affected area, this may be a sign of a more serious allergic reaction or infection. Seek medical attention promptly to prevent complications and ensure proper healing.
3. Spread of symptoms: If your lotion burn symptoms begin to spread beyond the initial area of application or affect other parts of your body, it's important to consult with a doctor. This may indicate a more systemic reaction that requires specialized treatment.
4. Recurrent reactions: If you find yourself experiencing lotion burn frequently, even with gentle, fragrance-free products, it's worth discussing your symptoms with a dermatologist. They can help identify any underlying skin conditions or sensitivities that may be contributing to your reactions and develop a personalized treatment plan.

Beyond Lotion Burn: Understanding Skin Sensitivity

1. Frequent reactions: If you find that your skin often reacts to skincare products, cosmetics, or environmental factors with redness, itching, or burning, this may be a sign of sensitive skin.
2. Dryness and flakiness: Sensitive skin is often prone to dryness and flakiness, as the skin's barrier function may be compromised, leading to increased moisture loss.
3. Visible blood vessels: If you can see small blood vessels under your skin, particularly on your cheeks or nose, this may be a sign of sensitive skin or conditions like rosacea.
4. Prone to eczema or dermatitis: Sensitive skin is often more prone to inflammatory skin conditions like eczema or dermatitis, which can cause redness, itching, and flaking.

1. Using gentle, fragrance-free products: As we've discussed, opting for gentle, fragrance-free skincare products can help minimize the risk of irritation and lotion burn.
2. Avoiding harsh treatments: Harsh treatments like chemical peels, microdermabrasion, or aggressive exfoliation can further sensitize the skin and compromise its barrier function. If you have sensitive skin, it's best to avoid these treatments or consult with a dermatologist before proceeding.
3. Protecting your skin from the elements: Protecting your skin from harsh environmental factors like sun exposure, wind, and extreme temperatures can help reduce sensitivity and prevent irritation. Always wear a broad-spectrum sunscreen and consider using physical barriers like hats or scarves in harsh conditions.
4. Nourishing your skin from the inside out: In addition to topical skincare, nourishing your skin from the inside out can help support its overall health and resilience. This may involve staying hydrated, eating a balanced diet rich in antioxidants and omega-3 fatty acids, and managing stress through practices like meditation or exercise.

FAQs: Frequently Asked Questions About Lotion Burn

What if my skin burns after using a moisturizer I've used before?

Can expired lotion cause burning?

Are there natural remedies for soothing lotion burn?

How long does lotion burn typically last?

What if I have other skin conditions besides sensitive skin?

Conclusion: Finding the Right Fit for Comfortable, Hydrated Skin

Key Takeaways

• Lotion burn can be caused by irritating ingredients, a compromised skin barrier, or individual skin sensitivities.
• Symptoms of lotion burn include a burning or stinging sensation, redness, itching, and in rare cases, blistering.
• To soothe lotion burn, discontinue use of the offending product, gently cleanse the area, apply a cool compress, and switch to a gentle, fragrance-free moisturizer.
• Preventing lotion burn involves patch testing new products, opting for gentle, hypoallergenic formulas, and being mindful of environmental and lifestyle factors that can impact skin sensitivity.
• If you experience severe or persistent lotion burn, or if you have a pre-existing skin condition, consult with a dermatologist for personalized guidance and care.
• Building a skincare routine that supports your skin's unique needs and sensitivities is key to achieving comfortable, hydrated, and healthy-looking skin.

1. Research years can help your application. If you have a borderline application, having a productive research year with quality letters and papers does make you stand out. If you have red flags, a research year will not help (i.e. disciplinary issues, course failures, really low step score).
   
2. If you come from a low-tier med school, you will probably not match at a top-tier program (even if you have an amazing research year). This is a brutal reality, but it is true. When I read comments from med students, there seems to be anger directed at programs that don't match their fellows. The reality is that the top-tier programs get the best candidates. These candidates have impeccable pedigrees, life stories, boards scores, and LORs. Your research year is not going to surpass this. Yes, there are exceptions, but they are uncommon.
   
3. Make sure you get to know all the residents. The biggest cheerleaders for applicants are the residents. If the residents like you, when it comes time to rank candidates, they will let us know.
   
4. You get what you give. Research years can be highly productive or a waste of time. Be prepared to work hard and get projects across the finish line. If you mentor isn't giving you enough work, politely ask them if you can reach out to other faculty to get projects going.
   
5. Be careful about doing a research year with someone who takes more than one fellow. When I read residency applications, if a specific physician writes an LOR for more than one candidate, I can compare them. Invariably, one letter will be stronger than another, and if I must whittle down a stack of applications, the person with the weaker LOR gets the axe.
   
6. Take Step 2 before your research year. With the growing importance of Step 2, please take it after you finish your third year. It is an absolute waste to have an amazing research year and then bomb step 2 because you took it a year later that you should have.
   

1. The best training programs have a university, VA, and county hospital clinic
2. In the real world, where you did your residency matters a lot less than you think
3. Pediatric dermatologists are BRUTAL. If you think you are interested in peds derm, you must be 100% committed on your application and during your interview. If you want to go an extra-mile, apply to peds prelim years, and make sure derm programs know this. Peds derm faculty are often skeptical of applicants who want to go into their field; if you can convince them that you are legit, they will support you. However, if they suspect you are faking an interest in their field to boost your application, they will be the first to shoot you down. The single greatest mistake you can make in your application is faking an interest in peds derm; don't do it!
4. Too many applicants are interested in rheum-derm/CTCL/HS/onco-derm. If you want to standout, emphasize an interest in something different, such as vulvar, acne/rosacea, nails, patch testing, urticaria, psoriasis.

ANA tests

Tests used in diagnosing lupus

• anti-dsDNA - anti-Double Strand DNA is sometimes automatically tested for, but may need to be ordered separately. This test, when highly positive (2-3 times max cut off at least) is almost exclusively seen in SLE. However, only about 30% of SLE patients have this antibody. It's great if it's there to confirm diagnosis, it does not rule out diagnosis if it is absent.
• ENA Panel - Extractable Nuclear Antigen panel, usually automatically done if ANA comes back positive
• anti-Sm - Anti-Smith. Typically included in the ENA panel. This is another antibody, that when highly positive, almost always means SLE, but only about 25% of SLE patients have this antibody.
• RNP - Anti-Ribonucleoprotein. Typically included in the ENA panel
• anti-chromatin - Anti-chromatin is a relative newcomer in diagnostic testing for SLE and probably will NOT be ordered automatically. Its exact utility in diagnosis is still being determined.
• Apl panel - Antiphospholipid Antibody Panel, which consists of 3 tests:
  • LA - lupus anticoagulant
  • aCL - anti-cardiolipin antibodies
  • Anti-β2GP - anti-beta 2-glycoprotien antibodies
• CBC - Complete Blood Count, some abnormalities in WBC, RBC and PLT counts can be significant.
• CMP - Comprehensive Metabolic Panel, here the doctors are generally looking for kidney dysfunction (GFR, BUN/CR).
• ESR - Erythrocyte Sedimentation Rate, this is a nonspecific inflammation marker.
• CRP- C-Reactive Protein, another nonspecific inflammation marker.
• C3 - Compliment C3
• C4 - Compliment C4
• CH50 - Compliments, Total, these are part of the compliment system, which is a tertiary part of the immune system.

Diagnostic Process

• Shorter questions get more feedback
• Use ChatGPT to summarize your question if you don't know what to leave out