Six diagnoses, same pattern

Illustration af huddiagnoser — eksem, rosacea, acne, KP, skæl og psoriasis
Seks diagnoser. Seks industrier. Samme mønster.

Six diagnoses. Six industries. Same pattern.

Before you read on… I’m not a doctor. I’m a soapmaker. This isn’t medical advice. It’s a summary of what the research says — with sources, so you can check for yourself.

And an honest disclaimer… I have keratosis pilaris. It’s the only skin trouble I’ve ever had. And dry skin, which is nearly gone since I changed my routine.

No acne. No eczema. No rosacea. Not as a teenager, not during pregnancy, not on medication, not under stress. Never.

I’m not arguing my own case here. I’m arguing yours.

First, acne. A market worth 7.2 billion dollars in 2024. Acne isn’t a dirt problem. It’s hormone-driven, microbiome-driven, and inflammatory. Clogged pores, overproduction of sebum, Cutibacterium acnes thriving in a low-oxygen environment.

There are three big treatments. Benzoyl peroxide kills bacteria with free radicals. Effective short-term. Long-term it breaks down the lipid barrier, depletes vitamin E and C, and makes the skin dependent. Stop, and the acne comes back — often worse. Salicylic acid exfoliates from within. Up to 30 percent of users experience barrier damage. The skin gets stripped, sebum rebound sets in, and that gives more acne. Same paradox. And retinol accelerates cell turnover. The early improvement rarely lasts. After about 12 months the skin adapts, and the epidermis can become thinner than where it started.

The acne market grows from 7.2 billion to 12.4 billion dollars by 2034. The prevalence isn’t dropping. “Purging” — where the skin gets worse before it gets better — has been normalized. Your skin is screaming, and they call it progress.

Then eczema — the leaky barrier. Chronic inflammatory. The skin barrier is defective — it doesn’t hold moisture in and irritants out.

A mutation in the filaggrin gene raises the risk three to five times. Without enough filaggrin you get a defective stratum corneum, increased water loss, dry and irritable skin.

SLS strips ceramides — the mortar that holds the skin cells together. SLS reduces profilaggrin expression after six hours. For eczema skin, which already has a weak barrier, SLS is gasoline on the fire.

Tallow soap contains oleic acid — around 47 percent — palmitic acid, around 24 to 28 percent, and stearic acid, around 18 to 25 percent. These are the same fatty acids that dominate in human sebum. That’s not a buzzword. It’s biochemical compatibility. The fatty-acid profile matches.

An honest note… direct clinical trials of tallow as a topical product are missing. Thousands of personal accounts. No randomized trials. The honest answer is… it matches biochemically, but we can’t say “proven.”

Then rosacea — the triggers are in the products. Chronic inflammatory. Redness, visible blood vessels, bumps that look like acne but aren’t.

66 percent of rosacea patients report worsening from alcohol in products. 30 percent from witch hazel. 29.5 percent from fragrance. 21 percent from menthol. SLS is advised against.

The three most common ingredients in mainstream skincare — alcohol, fragrance, and SLS — are all on the list of triggers. The products sold as the solution contain the ingredients that worsen the problem.

Then keratosis pilaris — KP. 30 to 50 percent of adults. 50 to 80 percent of teenagers. Keratin plugs in the hair follicles. Rough skin like sandpaper, typically on the upper arms and thighs.

It’s genetic — the filaggrin gene again. Sibling to eczema.

Scrub is the intuitive answer. And the wrong one. Physical exfoliation irritates the follicles, it causes inflammation, and the skin produces more keratin as repair. Same paradox as over-washing.

Urea works. Urea is a natural part of the skin’s Natural Moisturizing Factor. 7 percent of it is urea. At 10 to 30 percent it dissolves keratin plugs chemically without physical irritation. Eucerin has built an empire on it — but in a base of mineral oils, silicones, and PEG emulsifiers.

I have KP myself. My approach… wash less often, drop the scrub, use urea. It’s not a cure. It’s the honest version.

Then dandruff — the Head and Shoulders irony. Dandruff is the fungus Malassezia, which lives off sebum. It splits the sebum into free fatty acids that irritate the scalp.

Head and Shoulders’ active ingredient was zinc pyrithione — fungistatic, not fungicidal. It puts the fungus on pause. Doesn’t kill it. Stop the shampoo, and the fungus wakes up.

At the same time, Head and Shoulders contains SLS. SLS strips sebum, the scalp overproduces, and that gives more food to the fungus. One hand fights the fungus, the other feeds it.

And zinc pyrithione? Banned in the EU since March 2022. Reproductive toxicant — it can harm unborn children. The replacement, piroctone olamine, works at least as well. So what was the point of zinc pyrithione for 40 years?

Head and Shoulders’ own website says… “Dandruff can’t be cured, only controlled.” That’s not a warning. It’s a business model.

And finally psoriasis — above soap’s pay grade. Autoimmune. The immune system attacks healthy skin cells. Accelerated cell division. Thick, scaling patches.

No soap cures psoriasis. Anyone who says so is lying.

But SLS, fragrance, and harsh surfactants can trigger flare-ups by disrupting the skin barrier. Mild, fragrance-free soap at least doesn’t make it worse. That’s the honest answer.

All six have one thing in common… the industry sells the solution to the problem it helps create. And calls it care.

Sources:

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