Holistic Perspectives on Eczema: Calming the Itch and Addressing the Source by Dr. Susan Bradt
March 25, 2014
I’ve seen many cases of childhood eczema recently so I’m sharing a bit about this irritating and itchy rash including some tips on addressing its underlying causes. Eczema, also known as atopic dermatitis, affects both children and adults and is characterized by an itchy red rash. The rash comes and goes over time and is aggravated by certain triggers.
It is common in childhood, affecting up to 11% of children and often continues, although more mildly, into adulthood. It can also start later in life. It typically presents before 2 yrs of age and is commonly seen with asthma and allergies, being called the “allergic triad”. Thirty percent of children with eczema develop asthma later in life. Since there is a strong genetic component to the condition, there is almost always a family history of eczema or another immune mediated condition like asthma or allergies.
Eczema is not just a rash that comes from a condition of the skin itself. It originates with an immune system that is over-reactive, releasing chemicals under the skin causing inflammation and itch. The rash can be triggered by a number of things including dry skin, frequent hot showers or baths, food sensitivities, chemicals, soaps, fabrics, stress, temperature changes, sweating, etc.
The rash of eczema is often mistaken for other skin problems or thought to be dry skin. It can appear anywhere on the body, although it tends to be on the face, neck and extremities in infants and children. The skin rash may look like red, scaly circular or oval patches (often confused with ringworm), diffuse dry skin with red bumps, fluid filled vesicles that can weep or ooze, or large patches of red irritated or scaly skin.
Coming from my perspective as a physician dedicated to improving health and working toward preventing illness, I take a deeper look into the health of a person’s immune system and to their eczema triggers.
Holistic Treatment of Eczema
Eczema must be approached from 2 angles, internally strengthening the immune system and externally calming and protecting the skin.
Strengthening the immune system involves looking at nutrition and possible food sensitivities as well as adding immune support supplements.
Foods that tend to inflame the immune system (i.e. sugar, dairy, wheat) should be limited in the diet. About 10-20% of people with eczema have a food sensitivity that will trigger their eczema. I often advise my patients or families to try a version of an elimination/challenge diet to investigate whether certain foods may be triggering the eczema. The most common triggers include dairy, wheat, eggs, soy or corn.
The most important supplements to support skin health and healthy immunity for eczema patients include:
- Essential fatty acids (fish oil supplement)
- Borage or Evening Primrose oil (these contain a fatty acid called GLA found to be helpful in eczema)
- Probiotics – beneficial bacteria which help send proper messages to the immune system
- Vitamin D – at least 400IU for children or 2000 IU for adults
- Other vitamins and herbals can be tailored to the individual especially in the setting of other similar illnesses such as asthma or allergies
Using moisturizers regularly is the most crucial ingredient to keeping eczema under control. Even when the eczema is under control or gone, it is important to keep the skin moisturized to prevent flaring. Typical lotions or even natural plain oils such as coconut oil are often not very effective. In order to stay as natural and organic as possible I usually encourage trying natural salves and creams for mild cases of eczema (Calendula creams, etc.) and if not effective, move up to more effective but less natural products. Over the counter emollient creams/moisturizers like Eucerin, Aquaphor, CeraVe, Vanicream are going to be the most effective.
The moisturizer should be applied multiple times a day (2-4 times depending in the dryness of your skin) and right after a bath or shower to lock in moisture.
For children or adults, bathing/showering less frequently will definitely improve eczema. I do not recommend bathing children with eczema more than 2-3 times a week. Just the act of bathing or showering will deplete your skin of its natural oils, which protect from eczema. Use warm, not hot water.
Any soap or wash that foams a lot contains soaps or detergent, which will further dry the skin and worsen eczema. These should be avoided or replaced with a non-soap based alternative. Soap free, or emollient washes can be used for cleansing the skin (examples include: Aquabar, Aveeno bath & shower oil, Cetaphil wash, Cetaphil cleansing bar, Doublebase Wash, E45 wash, Hydromol bath & shower emollient, Oilatum soap bar)
* My favorite natural soap alternative is a pure goat milk bar made only with goat milk and added oils. Additives like oatmeal or honey are fine but any perfumes or essential oils should be avoided. These can be purchased at local health food stores.
An oatmeal bath can be wonderful to calm the rash if the skin is particularly inflamed. Use ½ cup rolled oats tied in a sock and tossed in the bath (Tip: also great for poison ivy or chickenpox).
Avoid Skin Irritants
The skin of a person with eczema has a lower threshold to any potential skin irritant. Some of the most common irritants are heat and perspiration, wool, emotional stress, alcohol, respiratory infections and dust mites. Chemicals should be avoided from contact with the skin. Laundry detergents should be free of perfumes or dyes. Hand soaps should be gentle and free of chemicals (goat milk soap as above).
If you are doing all you can to avoid eczema triggers, strengthen the immune system and care for the skin and the rash is still severe, steroid creams can be used as needed to break the cycle of inflammation in the skin. These can be prescribed by your physician and used once daily as needed for times of flares.