Eczema can be a painful and frustrating situation, in both children and adults. Although more common in kids, we do see it affecting some adults and the distribution of areas on the skin can be quite different between these age groups.
In children, we commonly see eczema on the inner elbows, back of the knees, neck, face, ankles and diaper area. Whereas in adults, we tend to see it more on the face and hands. Why this difference exists, we are not sure. One common finding is that the rash in adults may actually be mis-diagnosed seborrheic dermatitis, which is treated a bit differently but can look a lot like eczema.
60% of those affected develop eczema within the first 2 months of life. 30% develop eczema by age 5 and only 10% between 6-10 years old. It's more rare after 20 years old - but we've seen it. It's slightly more common in males than females.
The topical treatments that are generally prescribed are unfortunately not a solution to the problem. Lotions, ointments, steroid creams, etc. The problem with eczema is not an external problem, but actually and internal problem, which if not addressed properly, may cause additional problems down the road.
The problem with eczema is not an external problem, but actually and internal problem, which if not addressed properly, may cause additional problems down the road.
Eczema, allergies and asthma often affect the same person and when seen together are called "atopy"(1). In Naturopathic understanding and experience, the eczema is usually the first problem to be seen which when treated only topically, doesn't resolve the underlying hyperreactive immune system which worsens over time into the development of severe allergies and even asthma. Our goal is to correct the over-reacting immune system earlier in hopes of preventing the later development of allergies and asthma.
So what causes eczema? There are a few common reasons...
Food intolerances or sensitivities (children and adults) - even in completely breastfed babies! (learn more below)...
Zinc or stomach acid deficiency (more common in adults)
Reduced liver and kidney detoxification.
Identifying and removing the foods that are irritating the system are the #1 thing we've seen improve skin conditions, especially eczema. There are a number of ways to find out which foods are a problem, including an elimination/challenge diet, food sensitivity testing or a food intolerance evaluation - learn more here.
Remember that 70-80% of your immune system is located in the digestive tract. If you're eating something that is irritating the system, the immune system is affected and quickly becomes hyperreactive to other foods as well as the offending foods (which creates food sensitivities and allergies). We often recommend identifying and removing food intolerances to help reduce the irritation to the digestive system and immune system which often helps reduce the severity of sensitivities and allergies.
We've had children come into the office for their first appointment with completely tomato red, irritated and itchy, miserable skin. Within a few weeks of removing the food intolerances, the skin was starting to heal and steroid creams were able to be weaned from use. These are some of the most satisfying cases to treat! When the skin isn't so itchy and irritated, those kiddos usually have a completely different demeanor and are so much happier, as are mom and dad! Normal skin is often the end result within a few weeks to months of initiating treatment.
In infants who are solely breastfed and experiencing eczema, we've seen relief when the mother identifies and removes her own food intolerance or sensitivities from her diet. Remember that breast milk contains immunoglobulins and white blood cells from the mother. If her immune system is hyperreactive and creating inflammation, that seems to pass through the breast milk and into baby's delicate digestive system (2-3)
Remember that breast milk contains immunoglobulins and white blood cells from the mother. If her immune system is hyperreactive and creating inflammation, that seems to pass through the breast milk and into baby's delicate digestive system.
Zinc or stomach acid deficiency:
More often seen in adults, zinc deficiency can create many skin problems, and we've seen both seborrheic dermatitis and eczema develop as a result of this mineral deficiency. Zinc is essential for skin health and deficiency often first shows as dermatitis (skin inflammation) (4-6).
Sometimes supplementing a little zinc picolinate with meals can be enough, but it's important to assess stomach function and acid pH as well because zinc absorption relies on healthy stomach acid pH levels. We've seen acne rosacea, eczema and seborrheic dermatitis be the result of incorrect stomach acid pH, which may be leading to or compounding the zinc deficiency.
A nice way to assess zinc levels is through a hair analysis, which can help us see if zinc deficiency is present.
Reduced liver and kidney detoxification:
The liver, kidneys and the digestive system are our main organs of detoxification. If they become burdened (i.e. from what we're eating and/or what we're exposed to), we then rely more heavily on our secondary organs of detoxification - which are the skin/lymphatics and the lungs (7), (perhaps this is why asthma commonly coincides with eczema? Food for thought...)
Herbal, homeopathic and nutrient support of the normal detoxification organs can be helpful - but only if we remove as much of the toxic burden from the diet and the environment as possible. This means, eating clean, healthy and ideally organic food as much as possible, getting fresh air or using air purifiers in the home, bathing and swimming in clean water - which might mean getting a chlorine filter for the shower or tub, and avoiding harsh soaps, topical lotions, creams and make ups with added chemicals and irritating compounds to the skin.
Some of our favorite liver and kidney support includes eating lots of cruciferous veggies, a good quality cod liver or fish oil supplement and herbs such as milk thistle/silybum, fringe tree/chionanthus and celandine/chelidonium as well as dandelion root and leaf/taraxicum. Please consult your naturopathic doctor prior to taking any of these herbs to help avoid any possible drug-herbal interactions and for proper dosing.
Other Effective and Natural Treatment:
Some of the best relief of symptoms while we work on the cause can be from the use of gentle homeopathic medicines:
Apis for skin rashes which are bright red, shiny and itchy.
Graphites for rashes which are scaley and have a yellow discharge to them which crusts.
Sulphur for rashes which intensely itchy, red and warm, better with cold applications.
Rhus Tox for itchy red rashes which looks like poison ivy rashes with tiny hives or wheals.
Start with a low potency like 6C in children, and a little higher, like 30C in adults.
Helpful Topicals for Relief:
One topical that we recommend the most is Wild Carrot Herbals Borage Butter Eczema Cream. While treating the internal environment, this can be incredibly helpful for the skin, especially since borage oil is high in omega-6 fats to help nourish the skin.
Aveno, or oatmeal baths can also be very helpful at soothing that itchy skin. Oatmeal contains proteins and nutrients which help soothe the skin. Read how to do an oatmeal bath here.
Hydrotherapy treatment can help support circulation to the skin which moves healing and repairing nutrients, oxygen and cells to the damaged skin. This often helps speed the healing process, especially when used with high frequency treatment. This is a buzzing wand (we call it a "magic wand" for the kiddos) which produces ozone and can stimulate blood supply to the area for 24-48 hrs after use.
These simple measures usually help clear up about 95% of eczema cases we've seen. In those tougher cases, we may need to look deeper at things such as stress and emotional impacts or adrenal health, stool testing, probiotics and even histamine metabolism.
Resources:
Justiz Vaillant AA, Jan A. Atopy. [Updated 2020 Apr 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK542187/
Neerven RJJV, Savelkoul H. Nutrition and Allergic Diseases. Nutrients. 2017;9(7):762. Published 2017 Jul 17. doi:10.3390/nu9070762 https://pubmed.ncbi.nlm.nih.gov/28714911/
Arshad SH, Matthews S, Gant C, Hide DW. Effect of allergen avoidance on development of allergic disorders in infancy. Lancet. 1992;339(8808):1493-1497. doi:10.1016/0140-6736(92)91260-f https://pubmed.ncbi.nlm.nih.gov/1351183/
Bin, B.-H.; Hojyo, S.; Seo, J.; Hara, T.; Takagishi, T.; Mishima, K.; Fukada, T. The Role of the Slc39a Family of Zinc Transporters in Zinc Homeostasis in Skin. Nutrients 2018,10, 219. https://pubmed.ncbi.nlm.nih.gov/24473704/
Kim JE, Yoo SR, Jeong MG, Ko JY, Ro YS. Hair zinc levels and the efficacy of oral zinc supplementation in patients with atopic dermatitis.Acta Derm Venereol. 2014;94(5):558-562. doi:10.2340/00015555-1772 https://pubmed.ncbi.nlm.nih.gov/24473704/
Kannan K, Mason WA, Cuttance EL. Variability in concentrations of zinc in serum and feed when using zinc oxide as a supplement for the prevention of facial eczema. N Z Vet J. 2016;64(6):356-359. doi:10.1080/00480169.2016.1220337 https://pubmed.ncbi.nlm.nih.gov/27488514/
https://www.fmtown.com/members/pdf/handout_functional_physiology_liver.pdf
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