Dermatology in Focus: My Journey with Sulfites
Victoria Asuquo
My journey into medicine was reaffirmed from a deeply personal moment—the night my father had his first stroke. I remember the fear that hung in the air and how powerless I felt watching someone I loved suffer. Amongst the things that left the biggest impact on me, however, wasn’t just the medical care he received— it was the way his doctor took time to understand our culture, our language, and our fears. That moment planted a seed. It showed me how healing is not just about diagnoses and procedures—it’s about connection, empathy, and advocacy.
As I moved through my academic journey, I held onto that lesson when I faced a struggle of my own. I developed a persistent and painful skin condition that left me feeling reclusive and insecure. It was a challenging time, both physically, emotionally, and socially. But what changed everything was the care I received from my dermatologist. She saw me not just as a patient, but as a person. She treated me with compassion, listened to my concerns, and helped me feel confident in my skin again. That experience didn’t just heal my skin—it reignited my sense of self.
Dermatology quickly became the bridge between two of my deepest passions: the science of the human body and the power of restoring self-worth. I realized that the skin is so much more than just a physical barrier—it’s where we show up in the world. And when someone is battling a visible skin condition, it can affect every part of their identity. I want to be the kind of physician who sees that, who understands that, and who helps people reclaim their confidence.
That desire took root early. While in college, I volunteered with the Look Good Feel Better program, working with patients undergoing chemotherapy and radiation. I helped teach skincare techniques, but more importantly, I witnessed the strength it took to battle terminal illnesses while holding onto self-esteem. Helping patients feel empowered, comfortable, beautiful, and seen—despite the toll of treatment—was a profound reminder of how powerful dermatologic care can be.
As a medical student at Morehouse School of Medicine, I’ve had the opportunity to build on that foundation. I've worked with underserved communities and mentored other students navigating through the field of medicine. My experiences at Morehouse have reinforced what I believe to be true: medicine is about service, and dermatology is a unique space where science meets self-empowerment.
Now, as I prepare for residency, I carry all of those experiences with me—the fear and hope I felt beside my father, the vulnerability of being a patient myself, and the privilege of standing alongside others in their own health journeys. These moments have shaped who I am and the kind of dermatologist I hope to become. Every person deserves to feel seen, valued, and confident—and I’m committed to being a physician who helps make that possible.
Sulfite Allergens and Contact Dermatitis: What You Need to Know
In recent years, concerns about food allergens have gained widespread attention, but one group of compounds often flies under the radar: sulfites. These inorganic preservatives are commonly found in everyday foods and beverages—from wine and dried fruit to sodas and medications. While useful for extending shelf life and preventing discoloration, sulfites can trigger serious allergic reactions and may play a hidden role in contact dermatitis.
What Are Sulfites?
Sulfites are chemical compounds that release sulfur dioxide, a gas that acts as a powerful antioxidant and antimicrobial. They're used to preserve the color, flavor, and freshness of foods such as fruit juices, seafood, baked goods, and alcoholic beverages. Sulfites also occur naturally through the fermentation process, especially in wine and beer.
Though sulfites have been approved for use by the FDA, any food or drink that contains 10 parts per million (ppm) or more must be labeled accordingly. However, labeling doesn't always guarantee safety—particularly for individuals with sulfite sensitivity.
Sulfite Sensitivity: More Than a Food Allergy
For some individuals, exposure to sulfites can lead to a range of adverse reactions including wheezing, chest tightness, coughing, and even life-threatening bronchospasms, especially in people with asthma. Others may experience skin-related symptoms such as urticaria (hives) or angioedema (swelling).
Sulfite sensitivity can develop at any point in a person's life and is not routinely included in standard allergen testing in the United States. In contrast, screening panels in Europe and by the North American Contact Dermatitis Group (NACDG) include sulfites, specifically metabisulfite, in their patch test series. This omission in U.S. testing protocols raises concern—especially given the rising rates of contact dermatitis in the general population.
In fact, the American Contact Dermatitis Society (ACDS) named sulfites the "Allergen of the Year" for 2024 to highlight this exact gap in dermatologic care and encourage more comprehensive screening.
Testing Sulfites in Everyday Beverages
To better understand sulfite exposure in common consumer products, researchers are using practical tools such as sulfite test strips to analyze beverage samples. These strips react with sulfites in a drink, changing color to indicate concentration levels—usually ranging from 10 mg/L to 500 mg/L.
For example:
- Wine can contain up to 350 mg/L of sulfites.
- Beer generally falls in the 10–50 mg/L range.
- Fruit juices and sodas may also contain sulfites, depending on the brand and preservatives used.
While not as precise as laboratory methods like the Monier-Williams distillation-titration, test strips offer an accessible and cost-effective way to estimate sulfite levels—especially for research, public health studies, and consumer awareness.
Why This Matters for Dermatology
The growing use of sulfites across industries, combined with their omission from common allergen tests, presents a challenge for dermatologists trying to diagnose unexplained cases of contact dermatitis. Patients may react to products they consume or touch regularly—yet without sulfites on the patch test panel, the true allergen may go unnoticed.
Adding sulfites to standard testing panels could improve diagnosis and treatment for many patients. Until then, healthcare professionals and consumers alike need to remain vigilant.
Moving Forward
Sulfites are everywhere—from our grocery store shelves to our medicine cabinets. For individuals with sensitivities, exposure can lead to more than just mild discomfort. It can result in serious dermatologic and respiratory reactions that affect quality of life.
Raising awareness, improving testing standards, and conducting continued research into everyday exposure will be key steps in ensuring better care, especially as we strive to provide more personalized and inclusive dermatologic treatment.
