Eczema, or atopic dermatitis, is a inflammatory skin condition that affects approximately 16% of the North America population. Characterized by exquisitely itchy, dry, flakey skin, eczema often affects the flexor surface of joints: for example, on elbow creases and behind the knees.
Causes of Eczema
Atopic dermatitis is thought to be caused by a deficiency in a protein at the skin dermis, which the immune cells attack. This triggers an inflammatory reaction that disrupts the integrity of the skin, causing itching, redness and dryness. Allergens in the environment further exacerbate this process. Frequent scratching can also affect the skin integrity, or introduce secondary infections. This is known as the “Scratch-Itch Cycle” and can be a barrier to skin healing and recovery.
Conventional Treatment for Eczema
The conventional treatment for eczema is the use of topical corticosteroid creams, applied once a day to affected areas. These can calm skin inflammation, however side effects include thinning of the skin. I find many patients come into my office reporting that the steroids help calm the chronic inflammation, but don’t eradicate their eczema completely.
It’s also important to use an emollient moisturizer or ointment to protect the skin barrier and lock in moisture. The higher the oil content and lower the water content in emollient creams, the better. Examples of these are Cetaphil, Eucerin, petroleum jelly, and ceramide creams that hydrate while adding lipids to skin, like Cerave or Restoraderm.
While emollients are an important part of managing dryness in atopic dermatitis, they’re not always sufficient for treating the condition on their own.
Natural Topical Remedies for Eczema
In addition to emollients and corticosteroids, patients can opt to try natural topical treatments. Colloidal oatmeal baths and ointments can be a helpful replacement for steroid treatment. Studies show they they can improve skin barrier and function, reducing dryness and itchiness.
Other topical treatments may include a combination of red clover, neem oil, topical B12, chickweed, and borage oil or evening primrose oil. Topicals assist in calming inflammation and healing skin integrity. I often recommend patients pair an herbal remedy with an emollient, like Cerave or petroleum jelly, or even coconut oil.
Natural Remedies for Eczema
1. Fatty Acids
There are mixed results in the research literature on the role of fatty acids, such as omega 3, supplementation in treating atopic dermatitis. A review of two studies showed that fish oil significantly improved the effects on daily living in those suffering from chronic eczema compared with placebo. Supplementation with gamma-linolenic acid, found in black currant seed oil (which also contains omega 3 fatty acids), reduced the severity of atopic dermatitis in one review paper.
Given the benefits of omega 3 fatty acids on reducing inflammation in general, I often recommend my patients suffering from eczema either supplement with a good fish oil containing EPA and DHA, or consume 2-3 servings of fatty fish (like salmon, anchovies and sardines) per week.
In a review paper that examined 21 studies performed on almost 7,000 participants, nutritional supplementation showed promise in preventing atopic dermatitis and decreasing its severity. The study found that probiotic supplementation showed the most promise, particularly the Lactobacillus rhamnosus GG strain.
Consuming fermented foods like sauerkraut and coconut kefir, have a growing number of proven health benefits, and there’s a growing body of research linking the health of the micro biome to skin and immune health. Talking to your naturopathic doctor about probiotic supplementation is a good strategy in managing and preventing eczema.
3. Vitamin D
Evidence for vitamin D supplementation in the treatment of eczema is also mixed. However, a randomized, double-blind, placebo-controlled trial of 60 patients with atopic dermatitis found that 1600 IU of vitamin D a day significantly improved the severity of symptoms compared with placebo. While the science on vitamin D supplementation is not settled, ensuring adequate blood levels may be necessary for preventing eczema in those who are susceptible.
Vitamin D can also be helpful in promoting optimal immune function and preventing cancer; there are many other health benefits to ensuring adequate levels and most North Americans are deficient.
4. Elimination Diets
Given that eczema is an inflammatory disease of the immune system, naturopathic doctors often address gut health in their treatment plans. Hippocrates made the claim that “all disease begins in the gut” and, according to most holistic health practitioners, chronic skin infections often have digestive components. While many cases of eczema are connected to true food allergies that involve the activation of IgE antibodies and the release of histamine (treated by antihistamine medication), many are not.
Many cases of chronic atopic dermatitis may have IgG antibody involvement, causing delayed hypersensitivity reactions. Naturopathic doctors parse out which foods may be causing or aggravating chronic skin inflammation by suggesting patients do an elimination diet.
Elimination diets consist of removing certain foods from the diet for a few weeks to months and then slowly reintroducing them. Common food sensitivities seen clinically in those who suffer from eczema are dairy, eggs, soy, and gluten. More naturopathic doctors are recommending an Autoimmune Paleo diet, which involves eliminating all grains, legumes, processed foods, nuts, dairy, and eggs for a length of time, to quell inflammation and calm the immune system.
There’s a small growing body of evidence that indicates elimination diets may play a role in the treatment of atopic dermatitis and other immune-linked skin conditions.
5. Acupuncture and Chinese Medicine
In 17 out of 24 studies, acupuncture was found to play a role in improving symptoms of eczema. However, researchers call for more, better-quality clinical trials before recommending acupuncture as a reliable treatment. We do know, however, that chronic stress plays a role in inflammation and immune activation. Therefore, addressing mental and emotional causes of stress can be an effective strategy for reducing aggravation and severity of symptoms.
Stress-relieving self-care therapies like acupuncture, yoga, massage, and even psychotherapy may play a role in treating chronic eczema.