Wellness Wednesday: Eczema

Understanding Eczema

The terms eczema and dermatitis are synonymous with these types of skin reactions. Eczema can either be acute in nature (sudden onset), or chronic (long-term). The term eczema refers to a grouping of disorders that share similar clinical features but may have different causes.
 
In either case, an eczematic flair may have several factors involved, these can be environmental, systemic, or potentially food sensitivity based. In addition to these reactionary standards, there are different types of eczema, the most common being Atopic, Seborrheic, Discoid, and Irritant/Allergic contact eczema (Contact Dermatitis). A short description of the types will be discussed below.

Atopic Eczema
Atopic eczema is one of the most common types. It is categorized by prolonged hypersensitivity to environmental factors. This can include things such as pollen, dust, foods, chemicals, or pets. There is often a strong genetic predisposition in this type of eczema and may include other factors such as asthma, hay fever, and food allergies/sensitivities. This type of eczema has increased 2 to 5-fold since the early 1980s, and now potentially affects up to 1 in 10 individuals during their lifespan.
 
The reasoning behind this is not clear in standard Western medical practice. However, in natural medicine circles, it is thought to be caused by the increase of chemical usage in foods, care products, household cleaners, and so forth, all contributing to something called "Toxic Load Reaction."
 
Most commonly, this type of eczema is seen in children and young adults. Although onset may happen after the age of 30, it is not common unless it takes place in a pregnant individual.
 
Atopic eczema looks different at different ages and in individuals of different skin colors, some of the features and symptoms may include:

• Elevated IgE levels in blood tests (found in 80 to 90% of individuals)
• Personal or family history of eczema, asthma, hay fever, or general environmental and food allergies
• Food allergies/sensitivities
• Itching (mild to severe)
• Skin inflammation (mild to severe)
• Rash on the face (common in children and infants)
• Thick and leathery buildup on the skin (common in adults)
• Recurrent Conjunctivitis (An itchy infection of the eyes – Pink Eye)
• Facial swelling or pale complexion
• Wool intolerance
• Intolerance to hot water or hot weather
• Increased itching and redness when sweating
• Dry and inflamed splitting of the skin
• Weeping sores
• Blister like sores
• Plaque and scaling on the skin
• A red and itchy rash without defined edges
• Involvement of the hands, wrists, elbows, trunk, back, legs, buttocks
• Secondary infection by Staphylococcus aureus – may contribute to the progression of this skin disorder

In addition to these classic signs, there are exacerbating factors that can also impact Atopic eczema. They are commonly:

• Heat
• Sweating
• Anxiety
• Stress
• Frustration
• Infections
• Sudden temperature changes
• Contact with irritant or change in personal care products
• Excessive hand washing
• Continued use of allergen inducing foods or substances (these may be unknown to the individual)
• Secondary microbial infection

Seborrheic Eczema
Another common form of eczema, Seborrheic eczema, is thought to affect up to 2% of the population. This type of skin reaction is most seen in areas of the skin where sebaceous glands are most numerous, such as on the scalp, forehead, eyebrows, eyelids, ears, cheeks, and on the chest or between the shoulder blades, and can include dandruff or a cradle cap type infection. Oftentimes, this type of reaction is marked by a red or pink rash with non-regular edges and can include a yellowish, greasy looking scale. Because of this, it can be easy to mistake this type of eczema with psoriasis.

This type of eczema is one of the most common types seen in infants, usually during their first three months of life, and seen in adults between the ages of 30 and 70. The disorder is more common in men, often runs in families, and can be made worse in cold weather.

This type of eczema is also commonly found in individuals with HIV and AIDS, but is also commonly seen in individuals under large amounts of stress, and those with neurological disorders such as Parkinson’s disease.

Some of the symptoms associated are as follows:

• A slow, gradual onset that causes greasy scaling of the scalp that can include itching and sometimes hair loss.
• Yellowish or reddish scaly pimples may appear along the hairline, behind the ears, in the ear canal, on the eyebrows, on the bridge of the nose, around the nose, on the chest, or the upper back may occur.
• In infants, frequently a stubborn diaper rash accompanies the scalp rash.
• Older children and adults may develop a thick, tenacious, scaly rash with large flakes of skin.

Discoid/Nummular Eczema
Discoid, or nummular eczema, is a persistent, usually itchy rash with inflammation that is characterized by circular-shaped spots with tiny blisters, scabs, and scales. Most commonly, this type of eczema presents itself on the lower legs, forearms, and backs of the hands. It can be mistaken for ringworm, but unlike ringworm, it does not have a red border around the outside edge. Like most types of eczema, the cause is unknown. There are two common peaks of onset for this type of eczema: young women aged 15 to 30 and middle-aged adults of both sexes.

Some of the symptoms associated are as follows:

• Circular rash without a red edge.
• Itchy patches of pimples and blisters that later ooze and form a crust.
• Rash may be local or widespread.
• Often spots are more obvious on the backs of the arms or legs, on the buttocks, and may also appear on the torso.

Contact Eczema/Dermatitis
Contact dermatitis is an acute or chronic condition with itching and inflammation. It mostly results from exposure to substances in the environment caused by allergens, soaps, detergents, organic solvents, or other substance of food-based environmental triggers. It can also be caused by such familiar things as allergies to dogs and cats or contact with some plants such as poison ivy or poison oak.

Some of the most common symptoms and causes are as follows:

• Skin dryness
• Skin cracking
• Fissures
• Inflammation
• Pattern of the rash is often asymmetrical and comes with itching and burning, and sometimes stinging and blisters may be present.
• Commonly caused by poison ivy or poison oak
• Commonly seen from household chemicals and cleaners
• Commonly seen in those who work daily with chemicals such as individuals in the beauty, automatic, or construction industry
• Patch testing can often be done to find the reactionary culprit.

When one approaches eczema from a holistic standpoint, it is important to remember that all parts of the body and individual are related. In saying this, a practitioner who is trained in holistic applications will look at the individual’s current emotional health, stress levels, nutritional habits, environmental exposure, medications, and all body systems to gain a full picture of the potential issue.

Traditionally Used Herbs

• Pau d’arco (Tabebuia impetiginosa) – Pau d’arco is a powerful herbal ally. Since oftentimes issues with candida and staph (clinical or pre-clinical) can be a secondary issue with eczema, Pau d’arco is an appropriate specific which can be used internally or topically. Traditionally used as an immune stimulant, anti-microbial, anti-bacterial, anti-viral, and anti-fungal it is specific for eczema. Additionally, it is considered to be highly anti-inflammatory, detoxifying, and a helpful bitter used to support the liver and its various metabolic functions.
• Licorice (Glycyrrhiza glabra) – Glycerrhetinic acid from licorice root has shown advantages over corticosteroid creams with applied topically and taken internally. Licorice is considered a general tonic, anti-inflammatory, detoxifying, demulcent, and protective to liver function. It is specific for eczema and is indicated in most flares. It is not appropriate for individuals with high blood pressure.
• Calendula (Calendula officinalis) – The bright orange flower of calendula is a specific in cases of eczema. Used internally or externally, it is traditionally used for its ability to be anti-inflammatory, gently astringent, anti-candida, and restorative to soft tissue. Specifically in conditions of the skin, calendula is considered specific for its actions in increased cellular granulation, or rather, its ability to help the skin heal and restore and a more active pace.
• Cat’s Claw (Uncaria tomentosa) - Much like pau d’arco, cat’s claw vine is an important and active antimicrobial. It is traditionally used in situations where systemic restoration is needed. It is also used traditionally for its properties as an immune stimulant, tonic, antioxidant, anti-inflammatory, anti-bacterial, anti-viral, and alterative. It is excellent in the use of weakened immunity, degenerative, and inflammatory conditions. It is also supportive of the GIT as a whole which may be needed in eczema if there is an allergic/inflammatory reaction taking place in the mucosal lining of the GIT.
• Dandelion Root (Taraxacum officinalis radix) – Dandelion is often considered a triad herb, meaning its various parts can be used for different things. In the case of dandelion, those parts are the flower, leaf, and root. The dandelion’s root is a specific to eczema due to its hepatoprotective qualities (protects the liver), and its ability to aid in liver detoxification and proper function. The importance of this is due to the many metabolic functions and detoxification methods of our liver. It is our main detoxifying organ and can often be weighed down by excess toxic load from environmental exposure, chronic allergen exposure, or endocrine-disrupting chemicals.
• Stinging Nettle (Urtica dioica) – Like dandelion, nettle has multiple uses for its various plant parts. In herbal medicine, the seed, roots, and aerial plant body are used. In regard to eczema, it is the leaf that is most commonly utilized. Nettle is specific for its histaminic actions and allergy calming benefits. Since the majority of individuals with eczema have raised IgE levels, the use of nettle is considered specific. Traditionally, it is used in cases of acute or chronic allergic reaction and is considered to be tonic, antiseptic, splenic, astringent, anti-allergic, blood tonic, detoxifier, and nutritive. It is a specific in all cases of eczema and is said to be excellent in cases where stress and chronic environmental exposure may play a role.
• Oats/Milky Oat Seed (Avena sativa) – This herb is considered a general tonic plus nervous system tonic, a demulcent, and nutritive. In regard to eczema, it is traditionally used for skin irritations and inflammation, itchiness, and is a specific to eczema and can be used both topically and internally.
• St. John’s Wort (Hypericum perforatum) – Before its modern uses in depression and anxiety, St. John’s Wort was often used topically for skin and soft tissue injuries. It is considered to be effective topically against pain and is antiseptic, antimicrobial, and anti-inflammatory.
• Blue Chamomile Essential Oil (Matricaria chamomilla) – Blue Chamomile, also known as German Chamomile is exceedingly rich in a constituent known as azulene. Azulene is deadly against staph and candida, both of which are common secondary infections present in eczema outbreaks. The essential oil is applied topically in a carrier cream and often in combination with other herbs.

Commonly Used Supplements

• Liquid Multi-Vita Min – A high potency multivitamin with additional minerals is key to overall health in body functions. A liquid multivitamin is often more bioavailable than a capsule or tablet because the body does not have to work harder to break down constituents or digest. Instead, the liquid can go directly to the gut where it is absorbed within the walls of the small and large intestine. In many individuals with eczema, nutritional deficiencies are quite common.
• Probiotic – Because the intestinal flora plays a major role in personal health and immunity, especially regarding eczema, probiotic therapy is particularly indicated. Studies show that the administration of probiotics in individuals with allergens demonstrates a significant reduction of eczema severity.
• Omega – Therapeutic results from omega-3 fatty acids in multiple double-blind studies have shown that fish oils supplementing EPA and DHA fatty acids show significant protective effects against allergy development as seen in eczematous outbreaks. Fish oils contain primarily long-chain omega-3 fatty acids, which are further down the anti-inflammatory pathway reaction in the body.
• Vitamin E with Mixed Tocopherols – Vitamin E is critical in the healing of soft tissue and oxidative damage. Vitamin E is a fat-soluble vitamin that contains a family of compounds called tocopherols, including d-alpha, beta, delta, and gamma. Naturally occurring tocopherols (d-alpha, beta, and gamma) are the most biologically active forms of vitamin E. Vitamin E is crucial to proper cellular function; it protects and supports a wide range of physiological functions through its free radical scavenging activity. An effective chain-breaking antioxidant and free radical scavenger, vitamin E is considered the first line of defense against lipid peroxidation. It protects the integrity of the body’s cellular membranes and has the ability to unite with oxygen and prevent it from being converted into toxic peroxides.

Dietary and Lifestyle Modifications

• The removal of gluten, dairy, eggs, citrus, and tomatoes – these are common triggers for eczema.
• A full elimination diet may be warranted to find a potential trigger. Food allergies in susceptible individuals are the major cause of eczema.
• Allergy testing – this may be done with your MD or with a private lab. If you are interested in a private lab panel, please feel free to reach out to us.
• Use colloidal oatmeal in a gently warmed bath. Colloidal oatmeal products contain starches and beta-glucans that have protective and water-holding effects, and their polyphenols (avenanthramides) are antioxidant and anti-inflammatory.
• Wash clothing with mild soaps only and rinse thoroughly – Unscented Dr. Bronner's castile soap is most recommended.
• Avoid exposure to chemical irritants and any other agent that might cause skin irritation. Pay special attention to the presence of perfumes (this can hide up to 10,000 unspecified ingredients).
• Be mindful of personal care products, switch to unscented and natural varieties – ingredients on the label should be simple and easy to understand.
• Regular exercise – walking/stretching/yoga. The goal of exercising is to keep your lymphatic system in motion as it is a major part of the body’s detoxification system.

As you can see, eczema is a multi-faceted condition with various types and possible triggers. If you would like to reach out to ask any questions or have a no-cost initial meet and greet to discuss your current wellness issues, please feel free to contact the office directly.

I hope you enjoyed this article and found its content useful.

In health and wellness,
Petra - CHT, Herbal Medicine

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References:

• Davidson’s Principles & Practice of Medicine 22nd Edition by Brian Walkter, Nicki College, Stuart Ralston, Ian Penman – Churchill Livingstone Elsevier 2014 Toronto
• Current Medical Diagnosis and Treatment 4th Edition by Mazine A. Papadakis and Stephen J, McPhee – McGraw Hill Education 2015 Toronto
• Ferri’s Color Atlas and Text of Clinical Medicine by Fred F. Ferri MD – Saunders Elsevier Philadelphia 2009
• The Merck Manual of Medical Information Second Edition – Merck Research Laboratories, Whitehouse Station NJ – 2003
• Staying Healthy with Nutrition – By Elson M. Haas MD – Celestial Arts Press, Berkeley and Toronto 2006
• The Encyclopedia of Natural Medicine Third Edition – By Michael T. Murray ND & Joseph Pizzorno, ND – Atria Publishing 2012
• Atopic Dermatitis in Children: Clinical Features, Pathophysiology and Treatment by Dr. Jonathan J. Lyons MD, Joshua D. Milner, MD, and Kelly D. Stone, MD, Ph.D. – Published by the Immunology and Allergy Clinical Findings of North America, Feb 2015 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4254569/
• Medicinal Herbs Quick Reference Guide Revision 7 – By Julieta Criollo DNM, CHT – Self Published 2017

 The information supplied is not to be considered as a replacement for advice or prescription drugs from your medical doctor. If you have a health issue, please see your primary care physician first and foremost. 

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Petra Sovcov holds a Doctorate of Natural Medicine (DNM) with a focus on Herbal Medicine (CHT) and is a current faculty member at the Institute of Holistic Nutrition Nutrition. She is a new member on the HWB Board of Directors,  and has been a member of HWB since 2014. She currently runs the HWB Mahonia Chapter for the greater Vancouver BC area and coordinates the community free clinic. She is also the owner of Healing House Natural Wellness Centre, a multi-modality center located in BC Canada. For more info please visit the site, or follow her on Instagram @healinghouseherbal ​