Eczema is a skin inflammation that has symptoms of itching, scaling, and even the formation of blisters. Some forms of eczema are better known as dermatitis, such as contact dermatitis or seborrheic dermatitis. Eczema is easy to diagnose and not at all dangerous. But it’s a real challenge to treat effectively and permanently. While many cases of eczema clear up by themselves when whatever irritating substance that started the whole thing is avoided, some cases can be incredibly stubborn. They disappear only temporarily when cortisone creams are applied, then return like an unwelcome relative on your doorstep.
Incorporating some of the alternative measures we’ve used successfully with our patients, our WholeHealth Chicago recommendations just might help you clear up your eczema once and for all.
What is Eczema?
Also called dermatitis, eczema is a noncontagious skin inflammation that produces itchy, red, rashlike areas. These occur on the face, scalp, wrists, and hands, as well as at the crease of the elbows, in back of the knees and sometimes elsewhere on the body. The word eczema means “boiled” in Greek, because in its early stages, the skin does indeed have a bubbly appearance. Eczema can spread or worsen if you scratch the affected areas. And persistent scratching or rubbing can bring on chronic eczema, with its distinctive dark, thickened, scaly red patches. There are different types of eczema, some classified by causes, others by specific symptoms. Atopic dermatitis is marked by a hypersensitivity, or allergy, to a food, inhalant, or other common substance that doesn’t bother most people. It tends to be genetically linked, affecting individuals with a family history of hay fever, asthma, or eczema. Flaking and scaling on the face and scalp are typical of seborrheic dermatitis, while contact dermatitis produces an acute local rash after someone sensitive to it comes in contact with an irritant (say, the nickel in jewelry or the oil on a poison ivy leaf).
Many cases of eczema respond to soothing creams and various nutrients, but sometimes secondary bacterial infections can invade the irritated skin, and these may have to be treated with prescription antibiotics. A separate type of eczema, stasis dermatitis, affects the lower legs and ankles and is associated with insufficient circulation of blood in those areas.
Key Symptoms
- Itchy, red rashlike patches of skin that are dry, rough, scaly or cracked
- Small red pimplelike blisters
- Leaking (“weeping”) of fluid, crusting and flaking in affected areas
- Chafing and peeling
- Thickened, dry patches of skin in persistent cases
- Itching, swelling and inflammation in lower legs and around ankles (stasis dermatitis)
What Causes Eczema?
Allergies are a common cause of eczema. People who are susceptible tend to have a personal or family history of allergic reactions to foods, pollen, animal fur or other substances. Many people with eczema also have (or eventually develop) hay fever or asthma, and their bodies often contain above-normal amounts of histamine, a chemical that triggers an allergic defense reaction in the skin when it’s released.
Eczema symptoms can be triggered by such foods as milk, eggs, shellfish, nuts, wheat, strawberries, and chocolate. They can also be aggravated by contact with various substances, including animal fur, plant allergens, such as poison ivy and poison sumac, jewelry containing chrome and especially nickel (watchbands, rings, earrings), cosmetics (including nail polish), fragrances, deodorants and antiperspirants, shaving lotions and skin creams, different types of fabrics (particularly wool and silk), dyes, latex and rubber, leathers, and household cleaning agents (including dishwashing and laundry detergents).
Other factors associated with outbreaks of eczema are dry air; too much sun; stress; topical medications and certain drugs, such as penicillin; hot baths; and exposure to dust, pollen, and animal dander.
Treatment and Prevention
Soothing creams and ointments can help to lessen the excruciating itchiness of eczema–and it’s important not to scratch, as this can worsen the condition. The mainstays of conventional treatment for eczema are corticosteroids, usually in the forms of ointments, creams, gels or lotions. Severe cases, however, may require a short course of oral prescription steroids.
In addition, extreme itching often responds well to over-the-counter or prescription antihistamines; secondary bacterial infections of eczema require topically applied or oral antibiotics. Rarely, a case of eczema can be so severe and so unresponsive that it requires potent medicines to suppress the immune system. This course of treatment, however, should be undertaken only under the supervision of a physician familiar with it.
A variety of nutritional supplements can also provide relief. These can be used alone, taken with other supplements, or combined with prescription or over-the-counter drugs (such as corticosteroids taken orally or applied topically). Immediate therapeutic benefits usually appear within three or four days.
The recommended supplements can be continued over the long term to help prevent recurrences. Of course, avoidance of the eczema-causing substance or factor (if known) is the most effective preventive measure.
Just a reminder: If you have a serious medical condition or are taking medication, it’s always a wise idea to talk with your doctor before beginning a supplement program.
How Supplements Can Help
Because people respond differently to supplements, many eczema sufferers have to try several before they find one (or a good combination) that works well for them.
Evening primrose oil (in capsules, soft gels, or liquid) contains essential fatty acids that can help revitalize the skin and relieve itching and inflammation. Studies have shown that recommended daily doses of evening primrose oil can reduce the need for steroid drugs and creams. Alternatives to evening primrose oil are the less expensive black currant and borage seed oils.
Flaxseed oil contains equal amounts of both omega-3 and omega-6 essential fatty acids, which can be helpful in the treatment of any chronic allergic condition, including eczema.
Fish oils were found to relieve chronic eczema in a double-blind study. They appear to work by reducing levels of leukotriene B-4, a substance in the body involved with the inflammation of eczema. Eating cold-water fish regularly is the best source for fish oils, but if you’re not a fish fan, you can always take fish oil capsules.
Vitamin A has been used by dermatologists for a variety of skin conditions since the 1930s and can be helpful for relieving skin dryness and itchiness. (Pregnant women or women considering pregnancy, however, shouldn’t exceed 5,000 IU of vitamin A per day).
Sometimes allergies may trigger the intensely itchy rashes associated with eczema. Vitamin C, a natural antihistamine, helps block this inflammatory response to allergens such as pollen and pet dander.
Vitamin E is a potent antioxidant considered by many nutritionally oriented physicians to be helpful in the treatment of eczema, possibly by enhancing the effect of vitamin A.
The mineral zinc promotes healing and heightens the functioning of the immune system; it’s also necessary for the body’s utilization of essential fatty acids. If used for longer than a month, zinc should be taken with copper, because zinc supplements can deplete the body’s copper stores.
Grape seed extract is rich in flavonoids (antioxidant substances that inhibit the body’s allergic responses). Grape seed extract can help relieve and prevent the itchy flare-ups of eczema.
Get supplement dosages and tips in our WholeHealth Chicago Supplement Recommendations for Eczema
Self-Care Remedies
Try to identify and avoid foods that may cause an allergic reaction. Common culprits for eczema-prone people include milk, eggs, shellfish, wheat, chocolate, nuts, and strawberries. A food elimination diet may be very helpful in determining what’s bothering you.
Control your itching. Eczema is often referred to as “an itch that rashes” by dermatologists. Use soothing lubricating creams or even over-the-counter antihistamines like Benadryl to help control itching.
Reduce your stress. If your eczema is worsened by stress, consider learning relaxation techniques, such as meditation or yoga. Try the herb kava, a nonsedating mild natural tranquilizer.
In treating eczema with topical applications, a good rule of thumb is to use herbal liquids or lotions on oozing spots, and creams and ointments on dry patches.
Topical creams containing chamomile or licorice reduce skin inflammation and can be wonderfully soothing when applied directly to sores and cracked skin. (People with hay fever may be allergic to chamomile, however.)
Licorice cream (also called glycyrrhetinic acid cream) works especially well in combination with prescription or over-the-counter cortisone creams. Glycyrrhetinic acid both enhances the effectiveness of cortisone and also reduces cortisone’s possible side effects, such as itching and burning.
Witch hazel cream can relieve itching, making it beneficial for the treatment of eczema. Another itch-reliever, calamine lotion, can be applied with a cold compress for relief. Some people have even found relief from cold milk compresses. Just pour cold milk onto a washcloth and place it on an affected area for several minutes. (A small number of people have allergic reactions to topical applications of milk and so should avoid this paricular remedy.)
Loose-fitting cotton clothing is less likely than wool, silk, or synthetic fabrics to irritate the skin.
Less frequent bathing and showering reduce the risk of the skin drying out (dry skin is more prone to eczema). Lukewarm water is best. Be wary of deodorant soaps, bubble baths, and perfumed products, all of which can worsen eczema. After bathing, the skin should be patted dry, not rubbed. Apply unscented moisturizer on damp skin after bathing to seal in moisture.
A patch test is a very good way to head off trouble from cosmetics. Some brands come with patch-test instructions, but if they don’t, a do-it-yourself patch test is fairly simple: Put a drop or two of the product on the inner forearm and cover it with a small bandage. Repeat once a day for three or four days. Then wait a day or two. If no redness or other inflammation has occurred, that product is probably safe for you to use.
When to Call a Doctor
- If an eczema-like rash or other skin irritation doesn’t respond to self-care measures within three or four days
- If eczema is especially widespread, painful or recurrent
- If oozing or crusting sores appear. These may indicate a bacterial infection–and should be treated with a prescription antibiotic.
Supplement Recommendations
From David Edelberg, M.D. at WholeHealth Chicago: To begin, you need to accept the fact that eczema is a chronic condition, which reflects a mild but quite fixable internal imbalance. This means that you can’t expect everything to clear up permanently after just a few days of diligence on your part. Using these supplements, coupled with dietary and other lifestyle changes, may hasten your healing, but you’ll need to be patient.
How to Take the Supplements
For an acute condition Start with vitamins A, C and E, as well as the quercetin/bromelain combination, evening primrose or borage oil, grape seed extract and zinc/copper. (Add the copper only when you are taking zinc for more than one month; the two minerals are often sold in a single supplement.)
Try to include a tablespoon of flaxseed oil every day. You can mix it with juice or pour it on a salad or over some rice. For even more omega-3 fatty acids, eat plenty of cold-water oily fish (salmon, tuna, mackerel), so that you don’t have to bother with the fish oil capsules.
For maintenance All the supplements on the chart can be taken long term. When the eczema shows signs of improving, however, start tapering off on the amounts.
A good maintenance program should start with a high-potency multivitamin plus a daily antioxidant complex. Then you’ll need to keep taking the evening primrose or borage oil (supplying 240 GLA), and the grape seed extract. You can get your zinc from food (seafood, poultry, and nuts), and will have to include the quercetin only if you know your eczema is allergy-based.
Rather than resorting to supplements, your omega-3s can come from eating fish and adding flaxseed oil to your salad. You’ll probably have enough vitamin A in your multivitamin formula. And if you feel you need a maintenance dose of vitamin A, limit yourself to 10,000 IU a day (5,000 IU if you’re pregnant or thinking of becoming pregnant).
For special consideration
If you note a worsening of your eczema during the days prior to your menstrual period, consider using a PMS herbal combination containing chasteberry (2 capsules twice day when not menstruating or follow label directions). This will help to balance your two sex hormones, estrogen and progesterone, and may be useful for other PMS symptoms as well.
Stress can play a major part in eczema flare-ups. If you are aware of a relationship between your emotions and the worsening of your eczema, consider taking kava (250 mg 2 or 3 times a day for stress). This nonsedating mild herbal tranquilizer is capable of reducing anxiety symptoms in about an hour. Kava is very safe and not habit forming.
Food allergies are a common trigger in chronic eczema, so as you begin taking supplements, it’s also important to try to identify any foods that cause an allergic reaction. These often include milk, eggs, shellfish, wheat, chocolate, and nuts. You can use our to discover foods that trigger an outbreak of eczema. Important:
We at WholeHealth Chicago strongly recommend that everyone take a high-potency multivitamin/mineral and well-balanced antioxidant complex every day. It may be necessary to adjust the dosages outlined below to account for your own daily vitamin regimen. All of our supplement recommendations also assume you are eating a healthful diet.
Be aware that certain cautions are associated with taking individual supplements, especially if you have other medical conditions and/or you’re taking medications. Key cautions are given in the listing below, but you need to see the WholeHealth Chicago Reference Library for a comprehensive discussion of each supplement’s cautions and drug/nutrient interactions.
For product recommendations and orders click here for the Natural Apothecary or call 773-296-6700 ext. 2001.
Be well,
David Edelberg, MD