Eczema
The Itch that could drive you mad is the best description for eczema. Atopic dermatitis (AD), often known as eczema, is a chronic inflammatory skin disorder with a complex pathogenesis involving a genetic component, immune dysfunction, environmental component and epidermal barrier dysfunction. This debilitating skin condition is described as patches of redness (erythema), and dry scales (lichenification). Secondary bacterial or fungal infections can occur when the skin is broken causing weeping sores, bleeding and crusting.
Symptoms of eczema
The primary symptom is the uncontrollable itch.
Acute eczema. lesions are red, scaly patches. Fluid filled vesicles may be present and the skin may weep and be puffy (oedemic).
Chronic eczema. the skin appears dry and lichenified from scratching and rubbing.
Barrier Function. the wounded skin becomes thinner, reducing its ability to prevent microbial attacks, allowing for transdermal water loss and slowing down its ability to repair. This then allows for environmental allergens to more easily penetrate the skin and causes inflammation and sensitization.
What causes of eczema?
Environment triggers could be anything and can be very hard to establish. It could be from your home or work environment, common cleaning agents used extensively in society – public transport, public toilets, food outlets etc. It can include airborne allergens, certain foods, personal skin products, clothing and even the weather. Your fingertips can transfer to other parts of the body.
For some sufferers, when the weather turns cold, the blood vessels close to the surface of the skin can constict, reducing blood flow and the skin become dry – leading to irritation and scratching.
When the environment is warm and humid, the body becomes sweaty increasing the desire to scratch and also becoming a breeding ground for fungus and bacteria.
If you know what causes your eczema avoidance is essential
Genetics. Eczema can have a genetic component and it has been noted there is a connection to personal or family history of allergic rhinitis, asthma, or allergies.
Immune system. Interleukins, immune proteins that give your body the ability to fight off viruses and bacteria, can mistakenly target the body's own tissues, resulting in an autoimmune reaction.
What can help eczema?
Resolving eczema is not easy. Your skin specialist, your GP and your naturopath aim to prevent the rash occurring by:
- Addressing the causes of the itch - allergy, neurological (nerve endings) and dryness.
- Treating and preventing secondary infections – immune, bacterial and/or fungal.
- Supporting skin barrier function.
The itch
Itch is defined as an unpleasant sensation that makes people want to scratch. It can be acute or chronic and its mechanism is very complex.
Pruritis (itching) can be caused by a substance called histamine that is released by mast cells in the skin, when the skin is damaged, inflamed or under attack. Once histamine has been released it can excite the sensory nerve endings which terminate in the skin epidermis or dermis. Unfortunately, in many cases of chronic atopic dermatitis, antihistamines don’t work.
The scratch can become an unconscious act which can lead to open wounds where bacteria from finger tips can migrate, grow and turn into an uncontrolled infection.
Addressing the itch is probably considered the best mode of action in bringing skin back to normal. Besides using a strait jacket, options include wearing gloves and trying to be conscious of not scratching.
Conventional treatment usually involves trying to identify the allergen/s and aggravating factors, and pharmaceuticals to control the inflammation and pruritis.
Natural Therapies
Natural therapies aim to reduce inflammation, improve digestion, immunity, stress, and skin dryness.
Reduce inflammation using curcuma longa (turmeric) and essential fatty acids such fish oil, evening primrose and flaxseed oils.
Improve digestion. The gastrointestinal function is considered upmost important to the treatment of any skin conditions. Treating any digestion imbalance (dysbiosis) with probiotics and fibre is the best start and will help with a optimally functioning bowel system.
Herbs such as Allium sativum (garlic) and Hydrastis canadensis (Goldenseal) can help reduce heavy pathogenic load. Probiotics taken internally, can not only help digestive balance, but they also help repopulate the surface of the skin with beneficial bacteria, reducing allergic sensitivities and skin infection.
Support immunity. Reducing the histamine release can be helped with the use of the herb Albizia lebbeck, vitamin C, quercetin, magnesium, b6 and zinc. Modulate the immune system with Echinacea and Eleutherococcus senticosus (Siberian ginseng), vitamin D and vitamin A.
Stress reduction. This often means addressing lifestyle factors that may be causing stress and anxiety. Are you getting enough relaxation time, enough sleep. Are you over- committed? To help get you on the right path – magnesium, vitamin B’s, the herbs Rhodiola rosea and Eleutherococcus senticosus can help. Take time out to re-balance your life.
Prevent Dry Skin. Keeping the skin hydrated is an important component to help stop the itch. The skin is a barrier that keeps our internal components separated from the external environment, this includes microbes, water, heat and cold. It is composed of connective tissue, fat, sweat glands, hair follicles and nerve endings.
Support the Skin
Moisturise. Keeping the skin hydrated means protecting from the loss of fluid. This can be done by regularly applying moisturiser. The best ones to choose are those that contain oil or use the oils on their own.
Try olive, sunflower, sesame, jojoba, argon or safflower seed oils - these are suggested for their ability to promote skin barrier homeostasis.
Coconut oil has also been found to inhibit microbial growth. Grapeseed oil may help with skin repair and inhibit microbial growth.
Jojoba oil is high in its content of wax esters which makes it a good repair option for conditions of altered skin barriers, as in eczema. Jojoba oil also has a proven anti-inflammatory effect.
Add some drops of German chamomile oil (Matricaria recutita). In a study IgG1 and IgE levels were significantly decreased in those treated with German chamomile oil application resulting in lower histamine level and decreased frequency of scratching among subjects.
Oils can be taken internally to help with skin dryness and inflammation. They take a while, 2-4 months often, before real results can be felt, but as eczema can be a chronic condition, it is worth persisting. Try fish, evening primrose and flaxseed oils. Flaxseed can be incorporated into the diet by using a liquid on salads or a dollop in you breakfast.
Don’t forget to drink plenty of water
Cleanse. Avoid ‘hot’ showers and use a pH cleanser close to our own pH such as those derived from goat’s milk. Oatmeal soaps have been found to help stop the itch and can be used in the bath or shower. Coconut soap can help improve barrier function. Other suggestions include olive oil, rosehip and shea butter.
Prevent Infection
To prevent secondary bacterial or fungal infections that may occur – keep hands clean by regular hand washing and help reduce load on the skin by using a gentle wash that contains coconut or tea tree oil, and don’t scratch.
Points to remember
- Remove allergens or triggers where possible
- Aim for optimal digestion and bowel function
- Reduce stress
- Keep the skin well moisturized
- Be aware bacteria and fungal pathogens will reduce repair and resolution of eczema
- Don’t scratch
References
Itch-specific nerve cells: an interview with Associate Professor Xinzhong Dong https://www.news-medical.net/news/20130121/Itch-specific-nerve-cells-an-interview-with-Associate-Professor-Xinzhong-Dong.aspx
The effect of topical virgin coconut oil on SCORAD index, transepidermal water loss, and skin capacitance in mild to moderate pediatric atopic dermatitis: a randomized, double-blind, clinical trial. https://www.ncbi.nlm.nih.gov/pubmed/24320105
Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils http://www.mdpi.com/1422-0067/19/1/70/htm
The dynamics and mechanism of the antimicrobial activity of tea tree oil against bacteria and fungi. https://www.ncbi.nlm.nih.gov/pubmed/27388769
Sarris, Jerome and Wardle, Jon; 2014 Clinical Naturopathy2e An evidence-based guide to practice, Elsevier Australia
This article is for informational purposes only and does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a substitute for medical advice. If you have any concerns or questions about your health you should consult with a health professional.