Can vaccination trigger Sweet’s syndrome?

Updated 4/09/17.

Sweet’s syndrome triggered by vaccination.

There is some medical evidence to show that certain vaccinations can potentially trigger Sweet’s syndrome, but this is very rare, and it is important to take the following information into consideration:

  • Sweet’s syndrome is rare, probably affecting no more than 3 people per 10,000 (Zamanian and Ameri, 2007).
  • It mainly affects adults not children, and only 5% to 8% of cases have been in children (Sharma et al, 2015).
  • In some people, something is needed to trigger the onset of Sweet’s syndrome, but in up to 71% of people with Sweet’s syndrome there is no known trigger (Tam and Ingraffea, 2015).
  • Infection is a more common trigger for Sweet’s syndrome than vaccination, and as a result, Sweet’s syndrome tends to be more common in countries where people are more likely to develop infections (Ginarte and Toribio, 2011: 120). It is most commonly triggered by upper respiratory tract infection, but can be triggered by other infections too.
  • There have only been 11 cases of Sweet’s syndrome triggered by vaccination reported in medical literature in the past 42 years, globally. In some of these cases, a definite connection between the vaccination and Sweet’s syndrome was not established.
  • Sweet’s syndrome has only been associated with certain vaccinations and not others (see below).

Which vaccinations have been associated with Sweet’s syndrome?

Sweet’s syndrome has been associated with the following vaccinations:

  • Bacillus Calmette-Guerin (BCG or tuberculosis) (Carpentier et al, 2002: 82; Cruz-Velasquez et al, 2016). Two cases. One in 1986, occurring 15 days after vaccination, but the authors of the medical article that reported this did not control the tuberculin (Mantoux) test. One reported in 2002, occurring 10 days after vaccination.
  • Hepatitis B (Enokawa et al, 2017). One case in a 69-year-old man with the autoimmune condition, systemic lupus erythematosus. Symptoms of Sweet’s syndrome started to develop 48 hours after vaccination, and there were no lesions at the vaccination site.
  • Influenza (Cruz-Velasquez et al, 2016; Hali et al, 2010, Jovanovic et al, 2005; Tan el al. 2006; Wolf et al. 2009). Four cases. One reported in 2005; in 2006, one case of bullous Sweet’s syndrome following vaccination in a HIV-infected patient; in 2009, neutrophilic dermatosis of the hands occurring 12 hours after vaccination; in 2010, one case of Sweet’s syndrome after H1N1 influenza (swine flu) vaccination.
  • Smallpox (Carpentier et al, 2002: 82; Cruz-Velasquez et al, 2016). Two cases reported in 1975, occurring 3 days after vaccination.
  • Streptococcus pneumonia (Carpentier et al, 2002: 82; Cruz-Velasquez et al, 2016; Pedrosa et al, 2013). Two cases. One reported in 1990, occurring 4 days after vaccination following a splenectomy. One reported in 2013, and the first with the 13-valent conjugate vaccine.

Do vaccinations trigger Sweet’s syndrome because they are toxic or contain dangerous chemicals?

No. Vaccinations do not trigger Sweet’s syndrome because they are toxic or contain dangerous chemicals, and anyone who tells you this may be doing so for one of the following reasons: they have no real understanding of vaccination or Sweet’s syndrome; they are trying to scare you; they are trying to promote their own agenda, e.g. anti-vax or financial; they are trying to sell you something, e.g. ‘detox’ products that will supposedly cleanse your body of vaccine ‘toxins’, and thereby, cure your Sweet’s syndrome.

Why do vaccinations trigger Sweet’s syndrome?

Vaccination can trigger Sweet’s syndrome because of hypersensitivity reaction.

What is hypersensitivity reaction in Sweet’s syndrome?

Sweet’s syndrome is caused by errors in the innate immune system, the body’s most primitive, ‘hard-wired’ immune system, and a part of the immune system that doesn’t produce antibodies. Because of these errors, in some people with Sweet’s syndrome, their innate immune system responds to antigens in a way that it shouldn’t, i.e. is hypersensitive and goes into overdrive, overreacting to the presence of infectious, inflammatory, drug, or tumour cell antigens (Bhat et al, 2015: 257; Kasirye et al, 2011: 135).

Antigens are mainly proteins or sugars on the surface of a cell or a non-living substance, that a part of your immune system called the adaptive immune system sees as a foreign invader and produces antibodies in response to. The presence of antigens associated with certain health conditions, medications and vaccinations can potentially trigger Sweet’s syndrome by stimulating the innate immune system to produce chemical messengers called cytokines, which eventually leads to the activation of white blood cells called neutrophils (Gosheger et al, 2002: 70). The neutrophils migrate to skin tissues and sometimes other tissues, causing skin lesions or other symptoms of Sweet’s syndrome.

If I have Sweet’s syndrome should I avoid having vaccinations?

No. Most people with Sweet’s syndrome don’t need to avoid having their vaccinations unless they can’t be vaccinated for other medical reasons, e.g. they are taking certain types of medication or have other health conditions. However, if the Sweet’s syndrome was initially triggered by a particular vaccination, e.g. influenza, then it would not be advisable to have the same kind of vaccination again.

How do I know if vaccination has triggered my Sweet’s syndrome?

Remember, Sweet’s syndrome triggered by vaccination is very rare, but if it does happen then symptoms usually develop within hours or days, less commonly, a few weeks after vaccination. Skin lesions sometimes appear at the vaccination site, but this can also happen because of the skin damage caused by having the vaccination (puncture wound from the needle) rather than the vaccine itself. This response is known as pathergy.

Are there other triggers for Sweet’s syndrome?

Yes, and aside from the triggers that have already been mentioned (infection, skin damage, and vaccination), other triggers for Sweet’s syndrome include:

  • Cancer and blood disorders in 15-20% of cases, most commonly, myelodysplastic syndrome which may progress to acute myeloid leukaemia (Chen et al, 2016).
  • Inflammatory bowel disease, e.g. Crohn’s disease and ulcerative colitis (Cohen, 2007).
  • Autoimmune conditions, e.g. rheumatoid arthritis and systemic lupus erythematosus.
  • Medications in up to 5% of cases.
  • Pregnancy in up to 2% of cases. This is probably associated with hormonal changes, but further research is required.
  • Immunodeficiency.
  • Overexposure to sunlight or ultraviolet (UV) light. This can sometimes trigger Sweet’s syndrome, but we are not entirely sure why this happens.

References.

Bhat, Y., Hassan, I., Sajad, P., Akhtar, S. and Sheikh, S. (2015) Sweet’s Syndrome: An Evidence-Based Report. Journal of the College of Physicians and Surgeons – Pakistan, Jul;25(7):525-7 (PubMed).

Carpentier, O., Piette, F. and Delaporte, E. (2002) Sweet’s syndrome after BCG vaccination. Acta Dermato-Venereologica;82(3):221 (PubMed).

Chen, S., Kuo, Y., Liu, Y., Chen, B., Lu, Y. and Miser, J. (2016) Acute Myeloid Leukemia Presenting with Sweet Syndrome: A Case Report and Review of the Literature. Pediatrics and Neonatology (online).

Cohen, P. (2007) Sweet’s syndrome – a comprehensive review of an acute febrile neutrophilic dermatosis (online).

Cruz-Velásquez, G., Pac Sha, J., Simal Gil, E. and Gazulla, J. (2016). Aseptic meningitis and anti-β2-glycoprotein 1 antibodies in Sweet syndrome. Neurologia (Barcelona, Spain), Jul 21 (online). Article in Spanish, use translate.

Enokawa, M., Giovanella, L., Zardo, B., Cunha, J., Rachid Filho, A., Zeni, L., Bisognin, M., Rosseto, C. and Guimaraes, A. (2017) Sweet’s Syndrome Discharged (Caused) by Hepatitis B Vaccine. Brazilian Journal of Rheumatology, 57(suppl 1):S197 (Science Direct). Article in Portuguese, use translate.

Ginarte, M. and Toribio, J. (2011) Sweet Syndrome. In Dr. Fang-Ping (Ed.) Autoimmune Disorders – Current Concepts and Advances from Bedside to Mechanistic Insights. Croatia or China: Intech, pp. 119-132 (PDF). 

Gosheger, G., Hillman, A., Ozaki, T., Buerger, H. and Winklemann, W. (2002) Sweet’s Syndrome Associated With Pigmented Villonodular Synovitis. Acta Orthopædica Belgica, Feb;68(1):68-71 (PubMed).

Hali, F., Sbai, M., Benchikhi, H., Ouakadi, A. and Zamiati, S. (2010) [Sweet’s syndrome after H1N1 influenza vaccination]. Annales de Dermatologie et de Venereologie,  Nov;137(11):740-1 (PubMed).

Jovanovic, M., Poljacki, M., Vujanovic, L. and Duran, V. (2005) Acute febrile neutrophilic dermatosis (Sweet’s syndrome) after influenza vaccination. Journal of the American Academy of Dermatology, Feb;52(2):367-9 (PubMed).

Kasirye, Y., Danhof, R., Epperla, N. and Garcia-Montilla, R. (2011) Sweet’s Syndrome: One Disease, Multiple Faces. Clinical Medicine & Research, Nov;9(3-4):134-136 (online).

Pedrosa, A., Morais, P., Nogueira, A., Pardal, J. and Azevedo, F. (2013) Sweet’s syndrome triggered by pneumococcal vaccination. Cutaneous and Ocular Toxicology, Sep;32(3):260-1 (PubMed).

Sharma, A., Rattan, R., Shankar, V., Tegta, G. and Verma, G. (2015) Sweet’s syndrome in a 1-year-old child. Indian Journal of  Paediatric Dermatology;16:29-31 (online).

Tam, C. and Ingraffea, A. (2015) Case Letter: Sweet Syndrome Presenting With an Unusual Morphology. Cutis, Aug;96(2):E9-E10 (online).

Tan, A., Tan. H., and Lim, P. (2006) Bullous Sweet’s syndrome following influenza vaccination in a HIV-infected patient. International Journal of Dermatology, Oct;45(10):1254-5 (PubMed). 

Zamanian, A. and Ameri, A. (2007) Acute febrile neutrophilic dermatosis (Sweet’s syndrome): a study of 15 cases in Iran. International Journal of Dermatology, Jun;46(6):571-4 (PubMed).

Wolf, R., Barzilai, A. and Davidovici, B. (2009) Neutrophilic dermatosis of the hands after influenza vaccination. International Journal of Dermatology, Jan;48(1):66-8 (PubMed).

© 2012-2017 Sweet’s Syndrome UK

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Mindfulness can reduce psychosocial distress in patients with conditions affecting the skin

What is mindfulness?

Taken from the UK mental health charity, MIND (MIND, 2016).

MIND describes mindfulness as:

‘A technique which can help people manage their mental health or simply gain more enjoyment from life. It involves making a special effort to give your full attention to what is happening in the present moment – to what’s happening in your body, your mind or your surroundings, for example – in a non-judgemental way. Mindfulness describes a way of approaching our thoughts and feelings so that we become more aware of them and react differently to them.’

Can mindfulness help those with conditions affecting the skin to cope better?

Yes. A study by Montgomery et al has shown that mindfulness can help people ‘to reduce the distress associated with social anxiety and avoidance found in many skin conditions’ (Montgomery et al, 2016). This is very important, as those with conditions affecting the skin are at increased risk of developing anxiety and depression, often avoid social situations as a result of the distress that they cause, and can experience disability levels that are the same as those with other long term diseases.

Can anyone be mindful, and are there different ways to be mindful or practice mindfulness?

Yes. Anyone can be mindful, and there are many different ways in which you can practice mindfulness, e.g. by stopping to notice the small everyday things, by practising meditation or yoga, and by watching your thoughts or learning to view them in a different way (NHS Choices, 2016). For more information on how to be mindful, see ‘References’ below and click on the links.

References.

MIND (2016) Mindfulness (online).

Montgomery, K., Norman, P., Messenger, A. and Thompson, A. (2016) The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. British Journal of Dermatology, Nov;175(5):930-936 (online).

NHS Choices (2016) Stress, Anxiety and Depression: Mindfulness (online). Includes information on the different ways in which you can be mindful.

Skin Support (2017) Support Materials. British Association Dermatologists (online). Includes ‘Meditations and Mindfulness’.

© 2012-2017 Sweet’s Syndrome UK

Baking soda is not a treatment for Sweet’s syndrome or myelodysplastic syndromes

Updated and links added 26/01/17.

In 15-20% of patients with Sweet’s syndrome (SS), their condition develops secondary to some form of blood disorder or cancer, particularly a group of blood disorders called myelodysplastic syndromes (MDS). Depending on what type of MDS you have, MDS may cause problems such as anaemia (a low number of red blood cells) or more serious problems such as the blood cancer, acute myeloid leukaemia.

Is baking soda a treatment for Sweet’s syndrome or myelodysplastic syndromes?

No. Baking soda, otherwise known as sodium bicarbonate, is not a treatment for SS or MDS.

Fairly recently, sodium bicarbonate has been advocated as a treatment for SS and/or MDS by Melissa Mendez who is a transformational nutrition coach with a website called ‘The Pure Appeal’ in the United States. She has also publicly stated that she was diagnosed with SS and MDS in Oct. 2015.

This idea that sodium bicarbonate is an effective treatment for SS and/or MDS is a potentially dangerous claim that is not supported by medical research, and if you have SS or/and MDS, you will need proper medical treatment. In some cases, if you do not receive proper medical treatment, this could result in you becoming seriously ill or even losing your life.

Melissa Mendez supports the work of a doctor called Tullio Simoncini. He was treating patients who have cancer with sodium bicarbonate. If he’s a doctor, doesn’t that mean it works?

No. Dr. Simoncini is a former Italian doctor and known fraudster, and his practice is very dangerous. In 2003, he was struck off the medical register for treating cancer patients with sodium bicarbonate instead of chemotherapy. In 2006, he was found guilty of fraud and manslaughter after a patient died as a result of using his treatments.

Unfortunately, the myth that MDS or other forms of cancer can be cured with sodium bicarbonate is still being spread, despite the fact that there has never been any medical evidence to support this claim. This pseudoscientific claim (false or made-up claim that appears to be scientifically based, but is not) is based on the idea that cancer is caused by Candida (fungus) or Candida albicans which causes the common fungal infection ‘thrush’, and that the body develops cancer in an attempt to protect itself from fungal infection. Sodium bicarbonate supposedly gets rid of the Candida and therefore cures the cancer. This is completely untrue. Cancer is not caused by Candida, and sodium bicarbonate isn’t even a treatment for fungal infections, let alone cancer.


Is it true that an acidic diet can cause MDS or other forms of cancer, or that an alkaline diet can cure cancer or Sweet’s syndrome? Do I need to take baking soda to make my diet or body more alkaline?

On The Pure Appeal website (22/03/16), Melissa Mendez states that:

‘If baking soda can alter the ph of the body (MM means make it more alkaline) to encourage healing, and it was clearly helping one of the rarest skin disorders (MM is implying that it helped to heal her SS), what does this mean for MDS?

Baking soda is almost like the magic bullet to jumpstart your body into full on healing mode. Cancers can not grow in an alkaline state. Even malignant tumors are incredibly acidic, so it only makes sense to go to the opposite end of the spectrum, if you want your body to heal.’

The information that Melissa Mendez has posted is inaccurate and makes no biological sense. There is no evidence that an acidic diet can cause cancer or SS, or that an alkaline diet can cure cancer or SS, or promote healing. The overall pH or potential hydrogen (pH tells us how acidic or alkaline a liquid is) of the body cannot be altered simply by changing your diet or adding things to it, i.e. make it more or less alkaline or acidic by consuming certain foods, substances or drinks. To begin with, your blood is slightly alkaline anyway, and the pH of the body is tightly regulated by the kidneys which keep the pH within a normal and narrow range. The pH can’t be changed for any significant amount of time by what you consume, and any extra acid or alkali is simply peed out in urine. It is true that cancer cells are unable to live in a very alkaline environment, but neither can any other cells in the body. Therefore, if an alkaline diet did really have the ability to change the pH of your body, then it would probably kill you.


Even though you say that sodium bicarbonate isn’t a treatment for Sweet’s syndrome or/and cancer, if I want to try it, is it safe to use?

Sodium bicarbonate can be safe to use, and is commonly given as an antacid, i.e. to reduce stomach acid, but is sometimes used to treat other health conditions too. However, it is not always safe to use, particularly when taken in larger doses. This may be because of side-effects, certain health conditions or medications, pregnancy or breastfeeding. If given in high doses, the consequences may be serious or even fatal.

How is sodium bicarbonate given?

Sodium bicarbonate can be given orally (via the mouth), as an intravenous injection (injection into a vein), or as an intravenous infusion (into a vein via a drip). The way in which it is given depends on what kind of condition the sodium bicarbonate is being used to treat.

What are the side-effects of sodium bicarbonate?

Side-effects can depend upon how the sodium bicarbonate is given but may include:

  • Nausea.
  • Bloating.
  • Flatulence.

Less commonly:

  • Swelling of the hands, ankles and feet.
  • Sudden weight gain.

Rarely:

  • Dizziness.
  • Muscle aches and spasms.
  • Mental or mood changes, e.g. confusion, irritability or memory problems.
  • Vomiting.
  • General weakness.
  • Passing significantly more or less urine.
  • Chest pain.
  • Seizures.
  • When taken with lots of calcium (in the diet, medications or supplements), may cause milk-alkali syndrome.

In which health conditions should sodium bicarbonate be avoided or used with caution?

Not to be used in those with the following health conditions:

  • Certain breathing problems, e.g. pulmonary oedema.
  • Congestive heart failure.
  • Severe kidney disease.
  • Severe liver disease.
  • High sodium levels.
  • Swollen ankles, legs or feet due to retaining water (peripheral oedema).

To be used with caution in those with:

  • Low calcium levels.
  • High blood pressure.
  • Heart problems.
  • Kidney disease.

Also, to be used with caution or avoided in those who are on a low-salt diet, pregnant or breastfeeding.

Which medications can be affected by sodium bicarbonate?

When taken orally, sodium bicarbonate can interact with some medications, and should not be used if you are taking the following medications:

  • Aspirin and other salicylates, e.g. salsalate.
  • Barbiturates, e.g. phenobarbital.
  • Calcium supplements.
  • Corticosteroids (steroids), e.g prednisone.
  • Memantine.
  • Medications with a special coating to protect the stomach (enteric coating).
  • Lithium.
  • Quinidine.
  • Water pills (thiazide diuretics such as hydrochlorothiazide).

Reduces the effectiveness of some medications, and to be used with caution when taking the following medications:

  • Certain drugs that require stomach acid to work, including ampicillin.
  • Atazanavir.
  • Certain azole antifungals (such as ketoconazole, itraconazole).
  • Iron supplements.
  • Pazopanib.
  • Sucralfate.

Sodium bicarbonate may also interact or reduce the effectiveness of some other medications, or should not be used in patients with health conditions that have not been listed above. Please speak to your doctor before use.


Further information.

Alternative and nutritional therapies that don’t work, should be used with caution, or completely avoided in patients with Sweet’s syndrome.

American Cancer Society (2017) Myelodysplastic Syndromes (online).

Childs, O. (2014) Don’t Believe the Hype – 10 Persistent Cancer Myths Debunked. Cancer Research UK (online).

MDS UK Patient Support Group.

Smith, E. (2015) Alternative therapies: what’s the harm? Cancer Research UK (online).

The British Bone Marrow Registry (2017) How can I help? (online). This is a UK organization that manages the donation, storage and transplantation of blood, organs, tissues, bone marrow and stems cells, and researches new treatments and processes.

The National Marrow Donor Program (2017) Be the Match (online). This is a US organization that for the past 25 years has managed the largest and most diverse marrow registry in the world.


Additional note.

Sweet’s Syndrome UK does not promote the use of alternative or nutritional therapies. This is because there is no evidence to show that these therapies are effective, or sometimes even safe to use in those with Sweet’s syndrome. If anyone does have information that proves that alternative or nutritional therapies can be used to treat Sweet’s syndrome, I will be more than happy to read it. However, only peer-reviewed medical articles and case-studies will be accepted as evidence. The following will not be accepted as evidence: anecdotal evidence or personal stories; testimonials; YouTube videos; information on blogs or websites where there are no references or links to peer-reviewed medical articles or case-studies, or where the author is not willing to provide this information; blogs or websites where someone tries to pass off their feelings or instincts, beliefs or opinions as facts or evidence – Michelle Holder, Sweet’s Syndrome UK.

Keep safe!

© 2012-2017 Sweet’s Syndrome UK

A warning about Polly Heil-Mealey! Sweet’s syndrome cannot be cured with herbs or homeopathic remedies

Update 3/08/15.

P. Heil-Mealey’s response to this post:

‘This is an interesting comment. I feel sorry for you, that you are in the medical profession (you say you are a nurse) and have suffered SS for many years. If you read my blog correctly, I did not say that I cured Mr. P. I reported what I saw, and his own testimony as to how the herbs and homeopathy helped him. His doctor said that his was idiopathic, but I do agree with you, that many cases are an auto-immune disease.

The medical profession will tell you that there is no cure for this syndrome. Why not look elsewhere and see if other modalities will give hope? I certainly do agree that not all health modalities are appropriate for every person, but if you have tried allopathic treatments, and they have not worked for you, you have nothing to lose in trying homeopathy or herbal remedies. Always go to a trusted professional, as these types of illnesses are very complex and you will need professional help.

And to my nurse friend, you have a very poor understanding of homeopathy and herbal remedies. It is very mean-spirited to strike out against me and the good results that we had dealing with this syndrome. I wish you well, and hope you find help for your issues.’

A few comments taken from this response that are cause for concern:

  • Refers to ‘allopathic treatments’. This is a term that is sometimes used by alternative therapists to refer to evidence-based medicine, and distinguish it from alternative therapies. By using this term, P. Heil-Mealey is essentially admitting to the fact that her herbal and homeopathic treatments don’t work as there is no evidence to prove that they work. If they did work and were evidence-based then they would become allopathic.
  • Mentions Mr. P’s testimony, but has absolutely no evidence to back up her claims.
  • P. Heil-Mealey is of the opinion that people have nothing to lose from trying these remedies. Unfortunately, this isn’t true. These remedies or alternative therapies can be costly, often don’t help, and can sometimes make Sweet’s syndrome or an underlying condition worse.
  • P. Heil-Mealey doesn’t want to take any responsibility for her actions, and despite the fact that she is the one giving Sweet’s syndrome patients potentially harmful advice, she seems to be insisting that I am the problem. For example, I am the problem because I have misread her blog, I have a very poor understanding of homeopathy and herbal remedies, and I need help with my issues (I clearly stated on this blog that my own Sweet’s syndrome is now far less problematic than it once was, so I’m not entirely sure which issues she’s referring to – Michelle Holder, Sweet’s Syndrome UK).
  • P. Heil-Mealey resorts to insults in order to justify her practice. For example, because I disagree with her unsafe practice that is not supported by research, then I am ‘mean-spirited’ and striking out. This reaction is incredibly telling. Alternative therapy practitioners sometimes become insulting and abusive when questioned about the legitimacy of their treatments. This is to cover-up the fact that the treatment doesn’t work and that there is no evidence to back-up their claims. Genuine and effective health care practice is backed-up by research, and practitioners do not need to resort to name-calling to support it.

Posted 1/08/15.

A Texas-based naturopath, Biblical nutritional counsellor, and iridologist called Dr. Polly Heil-Mealey has been treating Sweet’s syndrome (SS) patients and offering advice, despite having a very poor understanding of this condition. Her information and advice is inaccurate and potentially harmful (posts date from Dec 2011 – Jan 2015). Also, in her disclaimer (under ‘About’ on her website), she states that she is not a ‘Medical Doctor’ and that her ‘site does not provide medical or health care advice’, despite the fact that she is clearly providing health care advice. N.B. The State of Texas does not license naturopathic doctors.

The main Sweet’s syndrome post from her blog-site.

December 2nd 2011.

‘Nothing is sweeter than seeing a client respond well to holistic treatment. The client I am referring to came to my clinic about three weeks ago. He had been diagnosed by his medical doctor with an illness known as Sweet Syndrome (a link to the Mayo Clinic was added here).

If you check out this link, you will see that this has nothing to do with sweetness. This disease turns its sufferers into modern-day Jobs. You remember Job in the Bible? He was covered head to foot with boils and skin abrasions. Such was the case of my client.

He had been suffering with these skin lesions for two and a half years. He had been seeking traditional medical treatment, with no progress, no healing. The Mayo Clinic states that this disease is idiopathic which means that no one knows what causes it. If there is no determined cause, then it is very hard to treat with pharmaceuticals.

Such was the state of affairs when Mr. P came to see me. After taking a case history, we embarked upon a treatment with homeopathic remedies and herbs. After one week, Mr. P called me, stating that the lesions on his skin were more numerous and it appeared that he was getting worse. What he did not know, (and maybe you need to know too) is that when the body starts to heal, the natural healing process is to push out the offending germ/bacteria/virus/microbe/parasite through the natural elimination pathways of the body. Because we don’t know what the cause of Sweet Syndrome is, one of the best ways to bring him to healing was to encourage the body to eliminate whatever was the origin. The skin is the body’s largest eliminative organ, so seeing the lesions become worse in a very short time gave hope that the body was clearing itself.

Mr. P came back into the clinic, and we made up a topical preparation with almond oil and about four different herbal extracts to put on the lesions. After about two weeks had passed, we called him this week to check on his progress. He said that he had been to his medical doctor, and his doctor was amazed at his recovery. In fact, his doctor wants to know what we did to effect this improvement.

Yesterday, Mr. P came into the clinic. He rolled up his pants leg, and I was amazed at the transformation. Three weeks ago, his body was covered with very sore, painful running tiny blisters.  Today, the sores are all scabbed over, and are fifty percent smaller. There is no blistering, very little pain, and no inflammation. Mr. P’s testimony is that he is very much better than he has been in the previous two plus years, and he wants to continue working with other health issues in a holistic manner.

As a Naturopath, I see stories like this all the time. People come into the clinic regularly, very frustrated and disappointed with their medical outcomes. Often, like Mr. P, they have been under allopathic medical treatment for many years, and are not getting any better. They have been told that nothing can be done, and that they will have their conditions the rest of their lives. This is just not true.

Life should be sweet. If you are not enjoying health and a sweet life, I encourage you to research holistic therapies. There is a path to healing as long as there is breath in the body.

Until next time,

Dr. Polly.’


Inaccuracies in Polly Heil-Mealey’s blog post and the problems with her advice.

The inaccuracies in the blog post and problems with her advice include:

1. The suggestion that Sweet’s syndrome is always idiopathic.

P. Heil-Mealey says, ‘The Mayo Clinic states that this disease is idiopathic’.

She does not make it clear that not all cases are idiopathic, i.e. that there can be a trigger for SS. Read more here.

2. Sweet’s syndrome patients are like modern day Jobs.

SS patients are not modern day Jobs, a character from the Old Testament of the Bible who Satan covered from head-to-toe in boils. God allowed Satan to do this in order to prove that Job was a faithful and true believer, and not just worshipping God because of the earlier blessings that God had bestowed upon him. This was part of a trial or test of faith.

Unlike Job, SS patients are not covered in boils from head-to-toe, and it’s highly inappropriate to imply that someone has SS because God wants them to be ill and suffer. The skin lesions caused by SS are not the same as boils, can range in severity, sometimes only appear in one area, and on occasion, patients can develop SS without skin lesions.

3. Nobody knows what causes Sweet’s syndrome.

SS may be a poorly understood condition, but we do have some idea as to what causes it. SS is an autoinflammatory condition, and these are rare disorders that are caused by errors in the innate immune system.

Specific causes for SS include hypersensitivity reaction, cytokine dysregulation and genetic susceptibility.

4. Patients are being told by doctors that nothing can be done or that they will have Sweet’s syndrome for the rest of their lives.

This is not true! The majority of patients are not being told by their doctors that nothing can be done or that they will have SS for the rest of their lives. In fact, most patients only have one episode of SS and it never comes back. For further information see no.5 – ‘Pharmaceuticals are not an effective form of treatment for Sweet’s syndrome’.

5. Pharmaceuticals are not an effective form of treatment for Sweet’s syndrome.

This is not true! The steroid medication, prednisone, is the main form of treatment for SS, and is a very effective form of treatment. At least 33% of SS patients experience repeat flare-ups after initial treatment, but this means that the majority (up to 66%) do not. If steroid medication is not effective by itself, then other medications are available.

6. Homeopathic remedies and herbs can treat or cure Sweet’s syndrome.

This is not true! There is no evidence to show that SS can be treated or cured with homeopathic remedies, herbs, essential oils or any other kind of alternative treatment. Some of these may even be harmful. ⚠️

7. When a herbal treatment, cream, lotion or oils make skin lesions worse, it is a sign that the treatment is working. ⚠️ ⚠️

This is not true! If symptoms are getting worse it means that the treatment isn’t working, and if something applied to the skin makes the skin lesions worse then the treatment needs to stop!! Continuing the treatment could potentially lead to the development of new lesions (pathergy), permanent skin colour changes or scarring, infection (sometimes causes pain so severe that the patient needs to be hospitalized), and ulceration of existing lesions. On rare occasions, if the lesions are on the digits, i.e. fingers or toes, it could lead to amputation of a digit.

8. Skin lesions are caused by ‘toxins’ or something in the body that needs to be eliminated.

This is not true! Skin lesions in SS patients are not caused by ‘toxins’ or something that needs to be eliminated from the body. They are caused by the activation of cytokines and white blood cells called neutrophils. See no.3 – ‘Nobody knows what causes Sweet’s syndrome’ and click on ’causes’.


Other concerns (taken from Polly Heil-Mealey’s comments section).

1. P. Heil-Mealey states that red root (blood root) is a key treatment in Sweet’s syndrome. ⚠️ ⚠️

This is not true! Red root is not a treatment for SS, and there is absolutely no evidence to support this claim. It may not even be safe to use, and should never be applied to skin lesions. Read more here.

2. P. Heil-Mealey does not understand Sweet’s syndrome-related medical terminology.

P. Heil-Mealey does not understand the term ‘histiocytoid Sweet’s syndrome’ (the person leaving the comment refers to it as ‘histoicitic’), yet in the main blog post implies that she can cure SS. She states that ‘They have been told (by doctors) that nothing can be done, and that they will have their conditions the rest of their lives. This is just not true.’

As someone who is ‘curing’ SS, it would be acceptable to expect P. Heil-Mealey to have a much better understanding of SS.

3. P. Heil-Mealey has no basic understanding of how Sweet’s syndrome should be treated.

A woman states that her mother’s treatment for SS is not working. This is because her mother has been given different antibiotic therapies which is the wrong treatment for SS, and when this happens, it’s often because the SS looks like an infection. P. Heil-Mealey fails to tell the woman that her mother has been receiving the wrong treatment which would have been the responsible thing to do, but also suggests that P. Heil-Mealey has no understanding of SS. Instead, she agrees to provide a referral to a naturopath.

4. P. Heil-Mealey refers someone for EAV and bioenergetic testing. ⚠️

EAV and bioenergetic testing are pseudoscientific forms of testing that involve using electrodiagnostic devices that can supposedly determine the cause of a disease by detecting the ‘energy imbalance’ causing the problem, or even cure a condition by correcting this imbalance. Please treat anyone who offers or refers you for such testing with extreme caution, and if they are in the United States (US), report them to the relevant authorities. These tests are a scam, and the importation of EAV devices into the US has been banned.


If you wish to try an alternative method of treatment then that is your right, but treatments and practices that are not supported by medical research may be unsafe. If you are considering using alternative therapies, it is advisable to check that it is a safe form of treatment at the very least.

Do not automatically believe what you are told or what is written on alternative therapy websites, and be particularly wary of anecdotal evidence and testimonials. Anecdotal evidence is a personal account of something that has happened. Testimonials are statements testifying that a treatment has worked, even when it may not have worked. Sometimes, people are even paid or offered something in return to give false testimonials, and neither anecdotal evidence nor testimonials are a replacement for proper medical evidence. Genuine health professionals do not rely upon anectodal evidence, and rarely use testimonials. In fact, regular use of anecdotal evidence or testimonials is often a warning that something isn’t quite right.

Finally, just because something is ‘natural’ doesn’t mean that it’s safe or doesn’t have side-effects. There are plenty of herbs, plants and extracts that have side-effects, can cause allergic reaction, be poisonous, or even prove fatal.

Keep safe! ❤️ ❤️


Further information.

Action Fraud (2010) Health Scams. National Fraud & Cyber Crime Reporting Centre (online).

Baking soda is not a treatment for Sweet’s syndrome or myelodysplastic syndromes.

Herbs and supplements that should be avoided or used with caution in Sweet’s syndrome.

Sense About Science (2008) I’ve got nothing to lose by trying it (PDF). This is a free guide to weighing up claims about cures and treatments.

© 2012-2017 Sweet’s Syndrome UK

A wheat or gluten-free diet is not a treatment for Sweet’s syndrome

Updated on 8/09/17.

Is a wheat or gluten-free diet a treatment for Sweet’s syndrome?

No. A wheat or gluten-free diet is not a treatment for the autoinflammatory condition, Sweet’s syndrome (SS), and there is no evidence to show that these diets can help. However, people with SS can find that they are pressurized by others into following a wheat or gluten-free diet, or some other kind of special diet as a treatment or cure for their SS. This is often well-meant, but sometimes, someone is just trying to promote their own agenda, or sell a particular product or service.

Do some people with Sweet’s syndrome need to follow a wheat or gluten-free diet?

Yes. You will have to follow a 100% gluten-free diet if you have developed your SS secondary to the autoimmune condition, coeliac disease (CD). A gluten-free diet is needed to manage CD, and in people who develop their SS secondary to another condition, if the underlying condition isn’t brought under control then the SS often won’t settle down. However, SS developing secondary to CD is very rare, and only one case has been reported in medical literature (Eubank et al, 2009).

What is gluten?

Gluten is sometimes incorrectly referred to as a toxin. It is in fact a family of proteins found in grains like wheat, rye, spelt and barley. The two main proteins in gluten are gliadin and glutenin.

What is coeliac disease?

In people with CD, when they eat gluten the surface of the small intestine (part of the gut) becomes inflamed, and this affects the body’s ability to digest food. Management or treatment of CD includes a gluten-free diet, sometimes extra vaccinations and/or supplements, and less commonly, medication.

Do people with Sweet’s syndrome sometimes need to follow a wheat or gluten-free diet for reasons other than coeliac disease?

Yes. Occasionally, someone with SS may need to follow a wheat or gluten-free diet for other types of condition that affect the gut, but this condition may or may not be associated with SS. Some people may also benefit from a low FODMAP diet. Wheat, as well as some other plant foods, contain small fermentable carbohydrates (sugars), termed FODMAPs (Shrewy and Hey, 2016). A low FODMAP diet may improve the management of certain conditions affecting the gut by reducing fermentation in the large intestine.

When is a wheat or gluten-free, or low FODMAP diet necessary or potentially beneficial?

A wheat or gluten-free, or low FODMAP diet may be necessary or potentially beneficial in the following conditions:

  • Wheat allergy. No reported connection between wheat allergy and SS. In wheat allergy, a wheat or gluten-free diet is necessary. To learn more about wheat allergy, see ‘Question 3’.
  • Irritable bowel syndrome (IBS). No reported connection between IBS and SS. People with IBS often benefit from a low FODMAP diet (about 70% effective), but it should only be followed under the guidance of a registered dietitian (KCL, 2017).
  • Inflammatory bowel disease (IBD), e.g. Crohn’s disease or ulcerative colitis. SS can develop secondary to IBD, and a low FODMAP diet may be useful in managing IBD, but further research is required.

To learn more about IBS and IBD, see ‘Further information’.

If I want to follow a wheat or gluten-free diet is it harmful?

Eliminating wheat or gluten from your diet shouldn’t be harmful as long as you make sure that you are meeting all of your nutritional requirements (Biesiekierski and Iven, 2015). However, it’s also important to acknowledge that foods containing wheat and gluten can be of nutritional benefit, and wheat or gluten-free diets aren’t suitable for everyone, with the potential to increase the risk of nutritional deficiency in some people, e.g. calcium, iron, or B vitamin deficiency (Biesiekierski and Iven, 2015; Shrewy and Hey, 2016). For example, someone may have a health condition that increases their risk of nutritional deficiency, or not have that much money to spend on food, and gluten-free products can be more expensive then their gluten-containing counterparts.


Frequently asked questions.

Question 1: Can a wheat or gluten-free diet be used to directly treat or cure Sweet’s syndrome and other autoinflammatory conditions?

No. Autoinflammatory conditions such as SS are not caused by diet, but errors in the innate immune system – the body’s most primitive, ‘hard-wired’ immune system, and a part of the immune system that doesn’t produce antibodies. These errors mean that the innate immune system activates inflammatory cells, often for unknown reasons, which leads to inflammation.

The majority of autoinflammatory conditions are genetic, which means that they occur as a result of gene mutation that affects how the innate immune system works. However, there are some, including SS, that are not usually genetic. In such cases, people are more likely to have certain genes that increase their risk of developing a particular autoinflammatory condition, i.e. they are genetically susceptible, but something may be needed to trigger it. Diet is not one of these triggers. Read about triggers for SS here.

Alongside genetic susceptibility, other causes for SS include hypersensitivity reaction and cytokine dysregulation.

Question 2: People with the autoimmune condition, coeliac disease, have to follow a gluten-free diet. Does this mean that people with the autoinflammatory condition, Sweet’s syndrome, should be on a gluten-free diet too, even if they don’t have coeliac disease?

No. Most of of time, if someone with SS doesn’t have CD, then they won’t need to be on a gluten-free diet. This is because even though SS can develop secondary to a number of different autoimmune conditions, autoinflammatory and autoimmune conditions are not the same thing. As a result, gluten cannot play the same kind of role in autoinflammatory conditions as it does in CD, as there is no antibody production in response to gliadins, or naturally occurring proteins in the body. Read the following points for further explanation:

Point 1.

Point 2.

  • In people with CD, the adaptive immune system mistakes gliadins in gluten, and tissue transglutaminase or tTG (a multifunctional enzyme and protein that modifies gliadins so you can digest them), for foreign invaders such as a bacteria or virus. White blood cells called B-lymphocytes then make antibodies in response to the gliadins and tTG, the antibody production in response to tTG causing significant inflammation and damage to the lining of the gut. Antibodies are also produced in response to endomysium (EMA) which is the protective covering of connective tissue that surrounds each individual muscle fibre. However, this does not cause direct symptoms to intestinal muscle.

Point 3.

  • As already mentioned, SS can develop secondary to a number of different autoimmune conditions. However, just because people with CD have to follow a gluten-free diet, doesn’t mean that people with other autoimmune conditions will benefit from this kind of dietary change. This is because which proteins in the body are targeted by antibodies will depend on what kind of autoimmune condition you have, i.e. antibodies will not be produced in response to gliadins, tTG and EMA, but other proteins.

Question 3: Is Sweet’s syndrome an allergic reaction to wheat?

No. SS is not an allergic reaction to wheat.

What is wheat allergy?

Genuine wheat allergy is rare, and is an IgE-mediated reaction to proteins in gluten and sometimes other proteins found in wheat. The symptoms of wheat allergy can develop within minutes to hours after the wheat has been eaten, and can include itching and swelling in the mouth, nose, eyes and throat, skin rash, wheezing, and the life-threatening reaction, anaphylaxis (Biesiekierski and Iven, 2015).

What is an IgE-mediated allergic reaction?

An IgE-mediated allergy is the most common type of allergy. It is an adverse reaction that the body has to a particular substance that is foreign to the body, e.g. a food or pollen, that does not normally cause harm. This substance is known as an allergen. Allergic reaction occurs when the immune system mistakes an allergen for a foreign invader such as a bacteria or virus. The adaptive immune system then quickly produces allergen-specific immunoglobulin E (IgE) antibodies in response to this, in order to fight and kill the allergen. Chemicals such as histamine are also released, and the more histamine in your body, then the worse the allergic reaction will be.

Question 4: Is my Sweet’s syndrome being caused by an intolerance to gluten?

No. SS is not caused by an intolerance to gluten.

What is gluten intolerance?

Gluten intolerance or non-coeliac gluten sensitivity (NCGS) is a sensitivity to gluten in people who don’t have CD or wheat allergy (Shrewy and Hey, 2016). In those who have NCGS, it causes intestinal and other symptoms as a result of eating foods containing gluten.

Does NCGS really exist or is it a fake condition?

There is ongoing debate over whether or not NCGS exists, and the general medical consensus is that if it does exist, only a very small percentage of people are genuinely affected by it (Biesiekierski and Iven, 2015; Shrewy and Hey, 2016).

Why is there debate over whether or not NCGS exists?

There is debate over whether or not NCGS exists because its exact nature is not fully understood, it may be confused with other conditions, and gluten may not be the problem. Here are a few of the difficulties associated with diagnosing NCGS:

  • There is currently no test to diagnose NCGS. Certain doctors (non-NHS), alternative therapists and businesses offer tests, but there is no evidence to prove that these tests work, and may be a scam.
  • The role of the immune system still remains unclear in NCGS (Catassi et al, 2013: 3849). The intestinal innate immune system seems to play an important role, but the research is ongoing (Catassi et al, 2013: 3849; Shrewy and Hey, 2016).
  • It has not been determined whether or not symptoms of NCGS relate specifically to gluten or other components in grain (Biesiekierski and Iven, 2015; Shrewy and Hey, 2016). As a result, the term ‘non‐coeliac wheat sensitivity’ (NCWS) is now sometimes used instead of NCGS (Shrewy and Hey, 2016).
  • A person may have IBS and not NCGS, an overlap in symptoms between the two conditions making diagnosis difficult (Biesiekierski and Iven, 2015; Catassi et al, 2013: 3841).
  • Someone on a gluten-free diet may start to feel better and assume that it’s the removal of gluten that’s improving their condition, when in fact, it’s the reduction in FODMAPs (Biesiekierski and Iven, 2015; Shrewy and Hey, 2016).
  • The placebo effect (Catassi et al, 2013: 3849). This means that when someone strongly believes that they have NCGS even when they don’t, when they start a gluten-free diet they feel better.
  • We do not know whether or not NCGS is always a long-term condition. In some people it may be short-term, transient or passing.

What are the symptoms of NCGS?

NCGS can cause a number of different symptoms. Gastrointestinal symptoms include bloating, abdominal pain, diarrhoea or constipation (Catassi et al, 2013: 3843). Extra-intestinal symptoms, i.e. symptoms that are not gastrointestinal, include headaches, dermatitis, skin rashes, joint pain, ‘brain-fog’, tiredness and fatigue. NCGS in children is less likely to cause extra-intestinal symptoms than in adults. Overall, the most common extra-intestinal symptom is tiredness, and there are no known major complications of untreated NCGS.

Please note that the symptoms of NCGS are also common symptoms of many other health conditions, and as a result, people sometimes think that they have NCGS when in fact they have another condition.


I (Michelle Holder) am not a registered dietitian. This information has simply been provided to help you make an informed decision about your dietary choices. Please seek further advice about the suitability of a wheat or gluten-free, or low FODMAP diet from a registered dietitian.


Further information.

NHS Choices (2016) Coeliac Disease (online). Last reviewed 4/12/16. Accessed 8/09/17.

NHS Choices (2017) Inflammatory Bowel disease (online). Last reviewed 25/04/17. Accessed 8/09/17.

NHS Choices (2014) Irritable Bowel Syndrome (online). Last reviewed 25/09/14. Accessed 8/09/17.

NHS Choices (2015) ‘Leaky Gut Syndrome’ (online). Last reviewed 26/02/15. Accessed 8/09/17. This is a condition that can supposedly be caused by gluten and other things, and lead to the development of certain health problems. It is a condition that is not recognised by the medical community, and there is absolutely no evidence to prove that it exists. Please do not believe anyone that tells you that SS is caused by leaky gut syndrome.

NHS Choices (2015) Should you cut out bread to stop bloating? (online). Last reviewed 18/05/16. Accessed 8/09/17. Includes information on bread-related gut symptoms, health problems caused by wheat, and the low FODMAP diet which originally designed for people with IBS.

Tousseau, J. and Durrant, K. (2014) Myth 6: It must be an allergy. Stop eating diary, wheat, gluten, MSG, etc and you will be fine in “It’s Just a Fever,” and Other Myths & Misconceptions About Periodic Fever Syndromes. SAID Support, May 22nd (online). Accessed 8/09/17.

References.

Biesiekierski, J. and Iven, J. (2015) Non-coeliac gluten sensitivity: piecing the puzzle together. United European Gastroenterology Journal, Apr; 3(2): 160–165 (PMC).

Catassi, C., Bai, J., Bonaz, B., Bouma, G., Calabrò, A., Carroccio, A., Castillejo, G., Ciacci, C., Cristofori, F., Dolinsek, J., Francavilla, R., Elli, L., Green, P., Holtmeier, W., Koehler, P., Koletzko, S., Meinhold, C., Sanders, D., Schumann, M., Schuppan, D., Ullrich, R., Vécsei, A., Volta, U., Zevallos, V., Sapone, A. and Fasano, A. (2013) Non-Celiac Gluten Sensitivity: The New Frontier of Gluten Related Disorders. Nutrients, Sept; 5(10):3839-3853 (MDPI).

Eubank, K. , Nash, J. and Duvic, M. (2009) Sweet syndrome associated with celiac disease. American Journal of Clinical Dermatology (PubMed).

King’s College London/KCL (2017) Information on the low FODMAP diet (online). Accessed 8/09/17.

Shrewy, P. and Hey, S. (2016) Do we need to worry about eating wheat? Nutrition Bulletin/BNF, Mar; 41(1): 6–13 (Wiley-Blackwell).

© 2012-2017 Sweet’s Syndrome UK

Sweet’s syndrome and an increased risk of developing thrush

Links checked 3/04/17.

What is thrush?

Thrush is a very common fungal (yeast) infection that is caused by Candida albicans.

How is it caused?

Candida organisms live harmlessly in your gut, and in one in five women reside in the vagina. They usually coexist with other normal organisms in the body, and are kept in check by the immune system and good bacteria. However, if the immune system becomes weakened, the natural balance of the body is upset, or good bacteria are destroyed, Candida infection can develop. This can affect both the mucosa, e.g. the lining of the mouth, anus and genitals, and the skin. Less commonly, it can cause a deep-seated or persistent infection.

Are people with Sweet’s syndrome at increased risk of developing thrush?

Possibly.

A 1992 case-study showed that Sweet’s syndrome can affect the immune system’s ability to deal with fungal infection (Driesch et al, 1992). The study involved 7 patients with active Sweet’s syndrome, and in 5 out of 7 of these patients the white blood cells (immune cells that help the body fight infection) had a diminished ability to kill C. albicans fungal spores.

References.

Driesch, P., Simon, M., Gomez, R. and Hornstein, O. (1992) Impairment of some granulocyte functions in Sweet’s syndrome. Acta Dermato- Venereologica;72(2):109-11 (PubMed).

Further information.

Oakley, A. (2003) Candida. DermNet NZ (online). Accessed 3/04/17.

© 2012-2017 Sweet’s Syndrome UK

Smoking and Sweet’s Syndrome

Updated 3/04/17.

Should you stop smoking if you have Sweet’s syndrome?

Ideally, yes.

If you are diagnosed with Sweet’s syndrome, it is very important to try to stop smoking for the following reasons:

  • Smoking is bad for overall health.
  • Smoking is bad for the skin.
  • Some people with Sweet’s syndrome are taking medication or develop their Sweet’s syndrome secondary to a condition that weakens or severely weakens their immune system. This means that they are more likely to develop infections, and infection can sometimes trigger Sweet’s syndrome. This is because some people with Sweet’s syndrome experience hypersensitivity reaction. Read more here.
  • Smoking increases your risk of developing a respiratory infection, and upper respiratory tract infection is the commonest infectious trigger for Sweet’s syndrome.

What are upper respiratory tract infections?

Upper respiratory tract infections are illnesses caused by an acute infection which involves the upper respiratory tract: nose, sinuses, pharynx, larynx, and bronchi (airways going into the lungs). They commonly include tonsillitis, pharyngitis, laryngitis, sinusitis, bronchitis, otitis media (middle-ear infection), flu, and the common cold.

What are the symptoms of an upper respiratory tract infection?

A cough is the most common symptom of an upper respiratory tract infection. Other symptoms include:

  • Fever.
  • Headaches.
  • Stuffed or runny nose.
  • Sneezing.
  • Sore throat.
  • Muscle aches and pain

The symptoms of an upper respiratory tract infection usually pass within one to two weeks.

Smoking is bad for the skin. Why is this?

Smoking is bad for the skin because it can (Simpkin and Oakley, 2016):

  • Speed-up the skin ageing process. Ageing of the skin means that it can sag; develop wrinkles and lines; becomes dry and coarse; have uneven skin colouring; blood vessels can be more prominent.
  • Slow-down wound healing which means that skin injuries and surgical wounds will take longer to heal.
  • Increase your risk of skin or wound infection.
  • Double your risk of skin cancer (squamous cell carcinoma), and increase your risk of developing other cancers. 75% of cases of oral cancer and lip cancer occur in smokers.
  • Increase your risk of developing the disabling skin condition palmoplantar pustulosis which mainly affects middle-aged women, particularly those who smoke (more than 90% of cases).
  • Increase your risk of developing other skin conditions, e.g. psoriasis, hidradenitis suppurativa and cutaneous lupus erythematosus.
  • Make skin conditions worse and more difficult to treat.
  • Make certain medications less effective, e.g. insulin, analgesics, antipsychotics, and anticoagulants.

References.

Simpkin, S. and Oakley, A. (2016) Smoking and its effects on the skin. DermNet NZ (online). Originally published in 2010, and updated by Professor A. Oakley in Nov 2016. Accessed on 3/04/17.

Further information.

NHS Choices (2016) Live Well – Stop Smoking (online). Accessed 3/04/17.

© 2012-2017 Sweet’s Syndrome UK