Eczema, also called atopic dermatitis, is a chronic, inflammatory skin disorder.
It is mostly characterised by small blisters that dry to become scaly, itchy rashes because too much moisture is lost from the skin’s upper layer. This leaves the skin without protection, making it easy for bacteria and viruses to penetrate. Eczema may occur episodically, in other words, there may be periods when symptoms are severe (flares/breakouts) and times when there are no symptoms at all (remission).
This skin condition can be anything from mildly irritating to almost completely debilitating, depending on its severity. The unpleasant manifestations of dryness and recurring skin rashes are characterised in different individuals as redness, skin oedema, intense itching, crusting, flaking, blistering, cracking, oozing and bleeding, or dry, leathery areas with more or less pigment than their normal skin tone (called lichenification) which make it uncomfortable, embarrassing and sometimes socially awkward.
Although eczema mostly starts in childhood, it can also appear in adulthood, at times seemingly out of the blue. In children it commonly manifests in under-two-year olds and starts to show on the cheeks, elbows, or knees. In adults, it tends to be located on the inside surfaces of the knees and elbows, but can spread to anywhere on the body. Although 65% of cases appear before the age of one year old, up to 90% of cases become evident before the age of five.
CAUSES
The question is often asked: is this an internal problem (i.e. food intolerance, medication) or is it an environmental problem (i.e. allergy to animals, house dust, pollens, etc)? The short answer is that it can be either, or both. Perhaps the best way to approach this is to do all you can to change the things that can be changed, and manage those you can’t. You are able to control everything that goes into your mouth, and up to a point, control certain environmental factors – but for the most part, the environmental factors will be the most difficult to control.
Foods that may noticeably aggravate symptoms include dairy products, gluten-based grains, sugar and fructose. There are other foods as well, but by avoiding these foods which are most commonly associated with eczema for a season, you may notice a swift improvement. Keeping a journal of what you have eaten and noting down your observations and reactions, will give you a fairly good idea after a month or so as to which foods are problematic. Learn to ‘listen’ to your body by journaling what you eat, how you feel, what your skin looks like and whether there is a marked improvement after avoiding the food(s) for a while, and you will frequently be able to identify the food culprit all on your own if food is in fact the problem.
Stress makes everything worse, particularly in the case of eczema. Susceptible individuals will testify that stress can cause severe breakouts. By controlling stressors you may be able to prevent breakouts.
Laundry detergents, especially those with sodium laurel sulphate (SLS or SLES) should be avoided (in fact by everyone). Don’t be misled either by the ‘natural’ washing powders around, as most seem to still have some toxic chemicals present. Soaps, deodorants, detergents, skin creams and cigarette smoke can all contribute to or cause eczema. Choose products wisely, and read labels extensively.
OTHER CONTRIBUTING FACTORS
You might want to consider the presence of parasites in your system, in which case a good herbal parasite cleanse wouldn’t go amiss. A quick way to find out whether you have parasites is to eat a large handful of pumpkin seeds on an empty stomach once or twice a day for about a week. Chew these very well, and have water with them. Often there is evidence of parasites appearing in the loo a few days later! If this is the case, find a health professional who will guide you in a proper parasite elimination strategy.
Bowel flora can be so severely compromised after a course of antibiotics that eczema breaks out; by reintroducing several strains of probiotics there is often a remarkable reversal of this condition. A fungal infection can also be mistaken for eczema if not diagnosed by a professional, in which case using tea tree oil on the affected part while taking probiotics will also improve the condition significantly. One of the manifestations of Candida albicans is extremely itchy skin, so if you suspect you have candida, follow a simple diet to eradicate this condition – it may well be the answer to what you thought was eczema all along. There are many other suspects like house dust, pets, wool, moulds and medications – in fact, just about anything could be the cause.
STRATEGY
It is helpful to avoid junk foods and particularly chocolate, as these interfere with the essential fatty acid status in your body. Increase the intake of healthy food and of essential fatty acids, especially omega-3 found in oily fish. Include meat from organically farmed animals and chicken eggs along with organic vegetables and fruit (not citrus though, as this can be an irritant in some cases), and reduce grains in your diet. Preferably eliminate all grains and sugars from your diet for a while, and totally avoid trans-fatty acids as found in margarine and vegetable oils. This is part of a strategy that should certainly bring significant relief if not complete recovery.
TOPICAL ASSISTANCE
Some skin care products contain a list of chemicals so long you would swear that you were purchasing a weapon of chemical warfare. But wait – this is chemical warfare! These chemicals wage war on our bodies, whether we manifest with eczema or the dangerous effects go on within us, perhaps unnoticed for years. One interesting example is propylene glycol. This and the related chemical ethylene glycol was first used in industry as anti-freeze and hydraulic brake fluid before it found its way into our food supply and personal care products. Although undoubtedly proven ‘safe’ by the limited tests vested interests and industry have carried out on this particular chemical, serious concerns remain about what the long-term effects are on human health. If you suffer from eczema toxic cosmetics need to be avoided. Fortunately there is no excuse in South Africa anymore as we have a number of healthy and organic ranges (some local) which are safe and free from harmful chemicals.
Topical oils that can be used effectively for relief include emu oil, lavender oil, neem oil and oregano oil. Because different things work for different people, it’s worth trying something for a while and if it doesn’t work move onto something else. You will eventually find something that works for you.
Amazingly, applying something as simple as potato or rhubarb juice can ease the itchiness and discomfort for many people. It’s certainly cheaper, readily available and well worth a try. Cut a potato in half (if you don’t have rhubarb juice readily to hand) and rub it onto the affected area.
The crushed leaves of calendula (marigold) applied topically can be quite successful according to some people. Mixing calendula with the oil of chamomile is anecdotally reported to bring great relief, and is something else you can do inexpensively at home.
Find a good natural emollient that is free from all parabens and other chemicals, and use this constantly to keep the affected area moisturised. Putting the cream/gel into the fridge in summer is helpful if the eczema feels hot, as this can offer a temporary cooling sensation to the area while moisturising it.
A really helpful method for many people is to relax in an oatmeal bath. Add one or two cups of porridge oats to lukewarm bathwater, and soak for a while. The itchier you are, the more oats you might want to add. When you get out of the bath, apply a good moisturiser or emollient straight onto damp but dry skin.
NUTRITIONAL AIDS
The most effective treatment for eczema is unquestionably the omega-3 fatty acids EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) from fish oils. They have shown significant inflammation marker reduction, according to the results of a recent study published in the British Journal of Dermatology. In this study1, the researchers reported: ‘With this randomised, double-blind, controlled trial we show that an 8-week supplementation with 5.4 g daily of the n-3 PUFA DHA led to a significant clinical improvement of atopic eczema compared with baseline scores.’
The researchers recruited 53 people with atopic eczema (average age 26) and randomly assigned them to receive either a daily supplement of 5.4 g of DHA or a control of saturated fatty acids with an equivalent caloric value. After 8 weeks, the researchers reported that the severity scoring of atopic dermatitis (SCORAD) reduced from 37 to 28.5 in the DHA group, and by 35.4 to 33.4 in the control group. The researchers concluded: ‘DHA, but not the control treatment, resulted in a significant clinical improvement of atopic eczema in terms of a decreased SCORAD.’
There have been literally thousands of studies on the beneficial effects of omega-3 fatty acids DHA and EPA from fish oils, and at present there is globally a growing body of evidence that this is not only vital for eczema, but for all bodily functions at cellular level. The powerful anti-inflammatory effect of fish oils cannot be ignored, and in the case of eczema, taking the right amount (which may be considerably higher in some people than the recommended dosage) shows near-miraculous results in many subjects. Most natural health professionals agree that fish oil is the first choice in eczema treatment.
Vitamin E is an important part of treatment as well and can be used to good effect both topically and orally. A good vitamin E cream, safe and free from toxic chemicals, moisturises and heals affected areas in some people. Adding vitamin E oil to a cream you already have is an option for topical application as well. An oral dosage of 400 to 800 IU a day of dry vitamin E is usually the most effective dose for noticeable results. When taking any oils it’s always wise anyway to take a vitamin E supplement to prevent oxidation thereof.
The importance of water should not be overlooked. While the condition is primarily that of an essential fatty acid deficiency, dehydration is a serious consideration. Not only should the eczema sufferer be drinking plenty of water, but preferably distilled water in order that no additional toxins are ingested. A good level of hydration is important in relieving this condition, so adequate amounts must be taken during the day. When the body sweats, toxins are released, and these toxins can be extremely irritating if the person is dehydrated, as the toxins are then more concentrated. A healthy person should drink about 30 ml of water a day per kilogram of body weight. As such if you weigh 70 kg, then intake should be 2.1 litres a day (70 kg x 30 ml).
SOME HELPFUL NUTRIENTS
Because most atopic eczema sufferers exhibit a deficiency in the delta-6 desaturase enzyme (which converts linoleic acid to gamma-linolenic acid (GLA), and also converts alpha-linolenic acid to stearidonic acid) it is important to totally avoid anything like flaxseed oil as it cannot be converted in the human body, and may further interfere with essential fatty acid metabolism. Fish oils are beneficial as they do not need this enzyme to be metabolised, and are in the form that the body can immediately use, bringing much-needed relief in almost every case. Avoiding an excess of omega-6 oils in the form of sunflower oil, canola oil and processed foods (usually very high in damaged fats) has also been recognised to be important. This is due to the inflammatory nature of these fats, which then compete for the same receptor sites occupied by omega-3 fats, which are anti-inflammatory.
Zinc deficiency is often observed in eczema cases. Supplementing with about 30 mg a day can make a significant difference in bringing the condition under control.
Biotin may be deficient in some cases of eczema, and supplementing with this vitamin, as well as inositol, and vitamin A (25 000 IU/day) often brings relief. Eczema patients appear to be deficient in many of the B vitamins, particularly B12, B6 and B2, so it would be helpful to take a high-strength B-complex once or twice a day to cover all these B vitamins.
If you are extremely stressed, supplementing with licorice to support adrenal function plus high-dose vitamin C (4 – 8 g daily in divided doses of 2 g at a time) can be hugely beneficial. When adrenal function is adversely affected, there is very often an upsurge in allergies and skin conditions.
While evening primrose oil may be helpful for some people, GLA from borage oil appears to be much more effective, usually at a dose of around 1 000 mg a day. Most effective of all are the fish oils at around 3 000 to 4 000 mg a day – these should be taken by anyone with eczema. The combination of the two oils usually works very well; the fish oil does need to be around 60 to 80% ‘active’ though, not just any fish oil will help, and it should be ultra-refined to avoid mercury contamination.
Finally, insufficient production of hydrochloric acid in the stomach, called hypochlorhydria, is a factor to consider. There are cases of people taking too much calcium or regular indigestion remedies, leading to a form of eczema due to the suppression of acid in the stomach. This then may cause intestinal permeability or leaky gut syndrome (often brought about by antibiotics too), which can either cause or exacerbate an eczema-like condition.
Editors note: Here are two articles we are sure you will find helpful: Stop the Itch – tips for eczema sufferers and Hidden Dangers Lurking in Cosmetics
Reference
1. Koch C, et al. Docosahexaenoic acid (DHA) supplementation in atopic eczema: a randomized, double- blind, controlled trial. British Journal of Dermatology 2008; 158: 786-792.
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