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Eczema

MagazineMarch 2010 (Vol. 20 Issue 12)Eczema

My seven-year-old daughter has recentlydeveloped atopic eczema

Q. My seven-year-old daughter has recently developed atopic eczema. I've gone through the kitchen and bathroom cupboards, and got rid of any potential triggers, but I'm struggling to find a safe and effective treatment for her. Are there any natural remedies that have been proven to work?-F.F., London

A. Atopic eczema, also called 'atopic dermatitis' or just simply 'eczema', is an inflammatory skin disorder commonly seen in children. It's itchy, unsightly, painful and has no cure, so it's no surprise that the condition can profoundly affect the quality of life for both the sufferers and their families (Health Technol Assess, 2000; 4: 1-191).

The treatment of eczema usually involves medicated creams or oint-ments that aim to control inflamma-tion, decrease itching and manage infections that may occur as a result of repeated skin irritation. However, as with many drug solutions, these agents often come with a rash of side-effects. Topical corticosteroids, for instance, can cause thinning of the skin (BMJ, 2003; 327: 942-3), while the immunomodulators Protopic (tacroli-mus) and Elidel (pimecrolimus)-two leading brands of eczema creams-have both been linked to skin cancer (Drug Saf, 2008; 31: 185-98).

Fortunately, there are a number of drug-free ways to keep eczema under control. You've made a good start by looking for potential triggers in your home. A vast array of chemical irritants and allergens may be lurking in your house, and could be making your daughter's eczema worse. Our special report in WDDTY vol 16 no 5 can tell you what to look out for.

You should also check for food allergies. Compelling studies suggest that identifying and eliminating specific allergy-causing foods can significantly improve symptoms of eczema and reduce the need for medication (Medicina [Kaunas], 2009; 45: 95-103).

Besides these lifestyle changes, a variety of natural remedies can help.

- Essential fatty acids (EFAs). Both omega-3 and -6 fatty acids may

be useful for controlling eczema. Adults who were taking 5.4 g/day of docosahexaenoic acid (DHA; an omega-3 fatty acid) saw significant improvement in their eczema compared with a control group (Br J Dermatol, 2008; 158: 786-92).

In another trial, children were given 3 g/day of gamma-linolenic acid (GLA)-an omega-6 fatty acid occurring naturally in borage (starflower), evening primrose and blackcurrant oils-for 28 days. Although no complete cures were seen, all saw improvement in their symptoms and reduced their need for medication-with no side-effects (J Int Med Res, 1994; 22: 24-32).

- Vitamin B12. Topical application of this vitamin proved to be significantly better than a placebo in reducing the extent and severity of eczema in adults (Br J Dermatol, 2004; 150: 977-83). It was also found to be a successful treatment for children, too (J Altern Complement Med, 2009; 15: 387-9).

- Probiotics, especially Lactobaci-llus rhamnosus GG, have achieved some success in treating childhood eczema. In one review of the literature, probiotics reduced the severity of symptoms in roughly half of the 13 randomized con-trolled trials evaluated. There is even evidence to suggest that taking probiotics can prevent the eczema from developing in the first place (Am J Clin Dermatol, 2008; 9: 93-103).

- Hypnosis. Several reports suggest that hypnosis may be an effective treatment for eczema-particularly where conventional therapies have failed. In one trial, 19 out of

20 children saw an immediate improvement, while more than half reported less itching and scratch-ing after 18 months. Hypnosis also appears to work in adults, with benefits lasting for up to two years in one trial (Br J Dermatol, 1995; 132: 778-83).

- Biofeedback. This method of feeding back information to the patient on how the body is responding was combined with relaxation training to treat five adults with eczema. Two months later, all of them showed clinical improvement and, two years later, three of them were completely cured (J Behav Ther Exp Psychiatry, 1988; 19: 221-7).

- Massage. Childhood eczema appears to respond well to parental massage. Regular massage with and without essential oils led to significant improvement. However, a deeper investigation into the essential-oil group revealed further deterioration of the children's eczematous condition, possibly due to an allergic reaction to plant oils. Tactile contact between parent and child, and not the oils, appeared to be the key to healing (Phytother Res, 2000; 14: 452-6).

- Herbs. A number of herbal creams have been successfully used to treat eczema. A 10-per-cent ointment made from a 95-per-cent ethanol extract of Lupinus termis (lupine seed extract) produced results comparable to those of topical steroids (J Nat Prod, 1981; 44: 179-83).

Liquorice (Glycyrrhiza glabra) and St John's wort may also work when used topically (J Dermatol Treat, 2003; 14: 153-7; Phytomedicine, 2003; 10 Suppl 4: 31-7).

In Indian Ayurvedic medicine, the root of Euphorbia acaulis is used orally to treat eczema. In a double-blind study, of the 23 patients given 50 mg of powdered E. acaulis root three times daily

for two to six weeks, 18 achieved complete relief and three enjoyed 75-per-cent relief (Indian J Dermatol, 1971; 16: 57-9).

As herbs can have powerful effects, make sure you consult an experienced herbal practitioner who can offer guidance on dosage and duration of treatment.

Vol. 20 05 August 2009

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