Written by Dr Meghan van Drimmelen, ND
Atopic dermatitis or eczema is characterized by dry, irritated, inflamed, itchy skin, usually found behind the knees, in the crease of elbows, wrists and ankles, as well as on the hands, neck and face. In Canada it is estimated that 17% of the population will suffer from eczema at some point in their lives![1] It most commonly starts in infancy or childhood, but can develop at any point in a person’s life. Children who have eczema are more likely to develop asthma and environmental allergies, and often have family members that have these concerns.[2]
Standard medical treatment involves the use of topical steroidal cream. This anti-inflammatory cream will take out the itch and redness but unfortunately doesn’t get to the underlying cause of the skin disorder. So, once you stop using the cream, the itch and redness can come back with a vengeance.
A naturopathic approach to healing eczema targets the root cause of skin inflammation, and is a long term answer to managing skin health. The cause of eczema seems to be the combination of environmental and genetic factors. Specifically, we know that eczema is associated with a malfunction of the immune system. In individuals with eczema the immune system is misguided, and rather then just attacking bacteria and viruses that invade the body, they start to attack the skin cells causing inflammation. When the body attacks our own cells, it is viewed as autoimmunity.[3]
So, to treat eczema, we are actually targeting the immune system. Follow these 3 simple steps with the help of your Naturopathic Doctor to naturally ease your eczema!
Step 1: Identify and remove food sensitivities & allergies
Immune reactions to food can cause inflammation in various parts of the body. In the case of eczema, this immune reaction presents as inflammation on the skin. There are two main types of immune related food reactions – immediate onset allergies (IgE reactions), or delayed onset food sensitivities (IgG reactions).
While food allergies tend to be related to hives, problems breathing, and anaphylaxis, they can also be related to skin disorders like eczema.[4] [5] These reactions are immediate in nature and a skin flare up is typically noted soon after the trigger food is ingested.
Food sensitivities, on the other hand are delayed in nature, and can take up to 72 hours to manifest on the skin after ingesting the food trigger. They tend to be harder to pinpoint, and may be associated with eczema,[6] and other chronic health concerns such as irritable bowel syndrome,[7] and migraine headaches. [8]
There are two main ways to identify food sensitivities and allergies – blood testing, or an elimination and challenge diet. With blood testing we are actually measuring the amount of antibodies (IgE and IgG) you are producing to various types of food. The higher the antibody levels, the more sensitive or allergic you are to the food. The elimination and challenge diet, on the other hand, involves the elimination of the most common food triggers for a period of 4-6 weeks. After the 4-6 weeks we start to slowly introduce each food one by one, looking for skin flare-ups along the way. If adverse effects are noted, we have found the food culprit! The most common food triggers that I see in my practice are dairy, egg, gluten, and soy.
Food sensitivities can be tested in children over the age of 2, while allergies can be tested in infants 6 months and older. In breastfed infants I will often recommend food testing, and change in diet in mom, and have seen good success with this.
Food allergies and sensitivities can change over time, and are largely influenced by the health of our digestive tract. Once food triggers are identified I often recommend a full elimination for 3 months while we work on healing the intestinal lining, and balancing the immune and digestive system. After these 3 months, occasionally these reactive foods can be eaten again in moderation. However, in some individuals long-term elimination is required.
Step 2: Heal the gut
We know that 80% of the immune system surrounds the gut. So it makes sense that any imbalance in our digestive system will lead to immune imbalance and autoimmunity, and contribute to conditions like eczema. A basic protocol for healing the gut involves supplementation with a high dose multi-strain probiotic, omega 3 fish oil, and L-glutamine.
Probiotics are naturally occurring ‘good’ bacteria that line our digestive tract. Supplementing with probiotics helps to re-establish a healthy balance of good to bad bacteria, which helps to modulate the immune system. Because of this, we are now seeing numerous studies showing the clinical benefit of probiotics in the treatment and prevention of eczema.[9][10][11]
Omega 3 fish oil is anti-inflammatory and immunomodulatory in nature.[12] Increasing your fish intake and supplementing with omega 3 fish oil can help to decrease inflammation in gut and the skin, and ameliorate symptoms of atopic dermatitis.[13][14]
Lastly, L-glutamine is an amino acid that acts as fuel to heal damaged intestinal cells.[15] By restoring intestinal health, and decreasing intestinal permeability, there is less immune reactivity and systemic inflammation.[16]
Step 3: Lather your skin with a natural soothing moisturizing cream
While working on healing the skin from the inside out, and addressing the underlying immune imbalance, soothing skin itchiness with a natural moisturizing cream or ointment can be helpful. I often recommend an all-natural coconut oil or manuka honey based cream that is applied to problem areas two times per day.
Article originally published in alive Magazine - link to article here.
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[1] Canadian Dermatology Association. https://dermatology.ca/public-patients/skin/eczema/
[2] Canadian Dermatology Association. https://dermatology.ca/public-patients/skin/eczema/
[3] National Institute of Arthritis and Musculoskeletal and Skin Disorder. http://www.niams.nih.gov/health_Info/atopic_dermatitis/default.asp#d
[4] Evaluation of food allergy in patients with atopic dermatitis. http://www.ncbi.nlm.nih.gov/pubmed/24229818
[5] Serum IgG antibodies to gliadin and other dietary antigens in adults with atopic dermatitis. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2230.1985.tb00561.x/abstract
[6] Total and specific IgG4 antibody levels in atopic eczema. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1535979/
[7] The value of eliminating foods according to food-specific immunoglobulin G antibodies in irritable bowel syndrome with diarrhea. http://www.ncbi.nlm.nih.gov/pubmed/22429360
[8] Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomized, cross-over trial. http://www.ncbi.nlm.nih.gov/pubmed/20647174
[9] Probiotics in the management of Atopic Dermatitis. http://www.ncbi.nlm.nih.gov/pubmed/11069570
[10] Efficacy of probiotics in the treatment of pediatric atopic dermatitis: a meta-analysis of randomized controlled trials. http://www.ncbi.nlm.nih.gov/pubmed/19055205
[11] Prebiotics and synbiotics: two promosing approaches for the treatment of atopic dermatitis in children above 2 years. http://www.ncbi.nlm.nih.gov/pubmed/16512804
[12] Polyunsaturated fatty acids, inflammation, and immunity. http://www.ncbi.nlm.nih.gov/pubmed/11724453
[13] Dietary polyunsaturated fatty acids and non-digestible oligosaccharides reduce dermatitis in mice. http://www.ncbi.nlm.nih.gov/pubmed/23577592
[14]Relationship between dietary fat and fish intake and the prevalence of atopic eczema in pregnant Japanese females: baseline data from the Osaka Maternal and Child Study. http://www.ncbi.nlm.nih.gov/pubmed/19114399
[15] L-Glutamine enhances enterocyte growth via activation of the mTOR signaling pathway. http://www.ncbi.nlm.nih.gov/pubmed/25280462
[16] Possible links between intestinal permeability and food processing: A potential therapeutic niche for glutamine. http://www.ncbi.nlm.nih.gov/pubmed/20613941