Eczema

Eczema, also called atopic dermatitis, is a chronic, inflammatory skin disorder. Its main features are blisters that dry to become scaly, itchy rashes. The skin becomes dry and itchy because too much moisture is lost from its upper layer. This leaves the skin without protection, making it easy for bacteria and viruses to penetrate. The disease occurs episodically; in other words, there may be periods when symptoms are severe (flares) and times when there are no symptoms at all (remission). Eczema is not contagious, but nevertheless it is very common- estimates are that more than 15 million people in the United States have eczema. People with eczema often have a personal or family history of allergic conditions like asthma or hay fever. There is no cure, but treatments can reduce symptoms and help prevent outbreaks.

Signs and Symptoms

Symptoms of eczema occur repeatedly. The most common signs of eczema are:

• Dry, extremely itchy skin
• Blisters with oozing and crusting
• Redness of the skin around the blisters
• Raw areas of the skin from scratching which may even lead to bleeding
• Dry, leathery areas with more or less pigment than their normal skin tone (called lichenification)

Eczema in children under 2 years old generally begins on the cheeks, elbows, or knees. In adults, it tends to be located on the inside surfaces of the knees and elbows.

Causes

The cause of eczema is thought to be a combination of hereditary (genetic) and environmental factors. This means that factors such as allergies can cause eczema in susceptible people. Exposure to certain irritants and allergens (see Lifestyle section for further definition of these substances) in the environment can worsen symptoms as can dryness of the skin, exposure to water, temperature changes, and stress.

Risk Factors

• Young age-infants and young children are most affected by eczema (about 65% of cases occur before age one, and approximately 90% occur before age 5)
• Skin exposure to harsh conditions
• Living in a climate with low humidity
• Personal and/or family history of allergies to plants, chemicals, or food
• Deficiencies of certain vitamins and minerals (for example, zinc)
• Stress can make eczema worse
• Irritants that may worsen eczema include:
• Wool or synthetic fibers
• Certain soaps and detergents as well as perfumes and some cosmetics
• Dust or sand
• Cigarette smoke

Preventive Care

Control of stress, nervousness, anxiety, and depression may help prevent flares of eczema. Mind/body techniques that have shown some success include cognitive-behavioral therapy, autogenic training, and these two techniques combined with learning about eczema.

Dietary restrictions that may help avoid flare ups include eggs, fish, peanuts, and soy. This is very individual and should be discussed with your health care provider. A doctor, dietitian, or naturopath, for example, can help you make these dietary changes and determine if the lack of these foods in your diet is reducing the incidence and severity of your eczema.

Although somewhat controversial, some studies have shown that children who are exclusively breast-fed for at least 4 months are less likely to get eczema. This is particularly true when the nursing mother has avoided cow's milk in her own diet.

Similarly,  recent  studies  suggest that babies whose mothers used probiotics during pregnancy and while breastfeeding were less likely to have eczema up to 2 years of age. (See Nutrition and Dietary Supplements section for definition and more information on probiotics.) Preliminary studies suggest that pretreatment of skin with creams containing omega fatty acids can reduce the severity of eczema or prevent eczema entirely.

Treatment Approach

The goals when treating eczema are to heal the skin, reduce symptoms, prevent skin damage, and prevent flares. Treatment may vary depending on age, symptoms, and general health. Developing skin care routines, identifying factors that trigger flares, and avoiding these triggers is a large part of any treatment plan.

Lifestyle

• Avoid anything that aggravates the symptoms, such as allergens (substances to which the immune system overreacts) and irritants to the skin. Common allergens include pollen, dust mites, and animal dander. Common skin irritants include wool, synthetic fibers, soaps and detergents, perfumes, cosmetics, lanolin, certain chemicals such as chlorine and solvents (including mineral oil), cigarette smoke, dust, and sand.
• Avoid scratching or rubbing affected areas
• Protect skin from rough clothing and irritants
• Be aware of emotional stress and try stress-reducing techniques
• Keep your environment cool, with stable temperature and humidity

Dry skin often makes the condition worse. Remember to:

• Avoid hot baths or showers; lukewarm water is best
• Wash or bathe as quickly as possible to lessen water contact.
• Use a mild soap or a non-soap cleanser, or less soap than usual.
• Moisturize. After bathing, it is important to trap the moisture in the skin by applying lubricating cream on the skin while it is damp (within 3 minutes of bathing).

Parents can help their children by:

• Providing distractions to prevent them from scratching
• Keeping fingernails short to reduce chances of infection from scratching
• Being aware that there may well be social and emotional stress associated with visible skin lesions;

additional support and encouragement may be needed

Nutrition and Dietary Supplements

Paying attention (even keeping a diary) to what you (or your child) eat and the effect it has on your skin (or your child's) may help you (or your child) avoid foods that provoke flares of eczema. Potentially provoking foods include peanuts, milk, soy, fish, and eggs. Foods high in saturated fats (like meat and full fat dairy) and trans-fatty acids (such as fried foods and hydrogenated oils) may stimulate inflammation as might sugar and highly processed foods. On the other hand, fresh fruits (particularly dark berries) and vegetables, whole grains, and foods rich in omega-3 fatty acids (such as nuts, flax, seeds, and cold-water fish) may reduce inflammation in those without sensitivities to these foods.

Supplements to consider and discuss with your healthcare provider include:

Gamma-linolenic acid (GLA)

GLA is an omega-6 essential fatty acid. Studies are mixed, but there is some evidence that the metabolism of essential fatty acids is abnormal in people with eczema, resulting in low levels of GLA. Several early studies suggested that GLA derived from evening primrose oil (EPO) is beneficial for relieving symptoms associated with this skin condition such as itching, redness, and scaling. However, more recent studies have not had the same positive results. Whether or not GLA or EPO supplements work for eczema may be very individual. Interestingly, preliminary studies show that pretreatment of skin with fatty acid-rich creams can reduce the severity of eczema

or prevent eczema entirely.

Probiotics

Probiotics, or "good" bacteria, inhabit the intestines and protect against the proliferation of "bad" organisms that can cause disease. Studies suggest that gut bacteria in babies at high risk for allergic disorders may be different from that of other babies. Two well-designed studies of mother-infant pairs showed that babies of mothers who took probiotics while pregnant and breastfeeding were less likely to have eczema in the first two years of life. The most commonly used probiotics are Lactobacillus species.

Sulfur

Sulfur is found abundantly in keratin, a protein that strengthens hair, nails, and skin. Sulfur baths, and other forms

of sulfur applied directly to the skin, seem to benefit eczema.

Suggested Nutritional Supplementation

Acute Stage -    -    Weeks

• DNA Homeopathic #D-23 (Eczema) - 2/3 dropperful under tongue 3 times daily.
• Omega-EFATM - 2-4 softgels twice daily

Omega 3 & 6 fatty acids essential to human health

• Ultra Flora Plus® DF Capsules - 2 capsules twice daily. (2 bottles)

Ultra Flora Plus DF Capsules is a non-dairy probiotic supplement that provides highly viable, pure strains

of Lactobacillus acidophilus (NCFM® strain) and Bifidobacterium lactis.

Recovery/maintenance

• Perimine - One tablet twice daily with food

Patented, Flavonoid-Rich Perilla Seed Extract.

• EndefenTM - Mix two level tbls. in 2 to 4 oz. of juice or water 1 to 2 times daily. Multi-dimensional support for GI health
• Appropriate Wellness EssentialsTM formula - 1-2 packets daily

Key Vitamins & Minerals, Essential Fatty Acids, PLUS Patient Specific Nutrition.

Child Eczema

• Ultracare for Kids® - Mix 1 level scoop in 8-10 oz. of pure, distilled, or filtered water.

Ultracare for Kids is a specialty medical food drink mix designed for children with food allergy-related

conditions

• D-23 (Eczema) - 1 dropper full under tongue 2 times daily

Indications: Acute and chronic eczema, pimples, herpes, rashes and eschar

• EPA-DHA Balanced LiquidTM - 1 teaspoon 1 to 3 times daily with food

EPA-DHA Liquid is an ideal source of health-promoting, antioxidant-stabilized, omega-3 essential fatty acids from purity-tested fish oil.

• BifoViden IDTM - One capsule one to two times daily (capsule can be opened up)

BifoViden ID is a non-dairy probiotic supplement featuring 15 billion live organisms of a symbiotic, strain- identified blend of Bifidobacterium lactis and Streptococcus thermophilus.

Dietary Suggestions

• Modified Elimination Diet