Life can be a misery if you have eczema. The characteristic symptoms of red, dry, scaly skin and intense itching can make daily life difficult and sleep almost impossible.
And the treatments are often worse than the condition itself. The usual medicated creams and ointments (steroids) can cause skin irritation, skin discoloration, thinning of the skin, infections and stretch marks when used for a long time. More worrying, the immunomodulators Protopic (tacrolimus) and Elidel (pimecrolimus)-two leading brands of eczema creams-have both been linked to skin cancer (Drug Saf, 2008; 31: 185-98).
The good news is that there's an abundance of drug-free ways to tackle eczema, ranging from changing your diet to trying herbs and hypnosis.
Treating eczema naturally
The best way to treat eczema is to find out what's causing it or what things in your life are making it worse. However, there are so many possible eczema triggers that this may not be as simple as it sounds (see boxes, pages 26 and 28).
Whatever the triggers, the following are good treatment options that most people may find helpful.
Get enough good fats.
Both omega-3 and omega-6 essential fatty acids (EFAs) may be useful for controlling eczema. Adults who were taking 5.4 g/day of docosahexaenoic acid (DHA, a type of 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, young children (mean age 11.4 months) were given 3 g/day of gamma-linolenic acid (GLA)-an omega-6 fatty acid found in borage (star-flower), evening primrose and blackcurrant oils-for 28 days. Although no complete cures were seen, all saw improvement in their symptoms-with no side-effects-and all had a reduced need for medication (J Int Med Res, 1994; 22: 24-32).
Try topical vitamin B12.
Application of this vitamin directly to the skin in a cream 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).
Up your zinc.
A lack of this essential mineral is common among allergy sufferers, and may play a role in the development of recurrent and chronic eczema (Br J Dermatol, 1984; 111: 597-601).
In one study conducted by Hungarian researchers, zinc supplementation reduced the severity of eczema symptoms in children (Orv Hetil, 1989; 130: 2465-9). The suggested dosage is 15 mg/ day of zinc with 2 mg of copper (as zinc is known to deplete the body's copper reserves).
Go for probiotics.
These popular good bacteria may be helpful for eczema, according to some studies. Lactobacillus rhamnosus GG in particular has achieved success in treating childhood eczema.
In one review of the relevant medical literature, probiotics reduced the severity of symptoms by roughly half in the 13 high-quality trials evaluated. There is even evidence to suggest that taking probiotics can prevent eczema from developing in the first place (Am J Clin Dermatol, 2008; 9: 93-103).
Several reports suggest that hypnosis may be an effective treatment for eczema-especially 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 scratching 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).
This method of feeding back objective physiological information to the patient on how the body is responding was combined with progressive 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).
Childhood eczema appears to respond well to parental massage. Regular massage with and without essential oils led to significant improvements in symptoms.
However, deeper investigation into the group using essential oils revealed further worsening of the children's condition, possibly due to an allergic reaction to plant oils. This suggests that tactile contact between parent and child, and not the oils, may be the key to healing (Phytother Res, 2000; 14: 452-6).
Drink oolong tea.
Japanese researchers found that oolong tea-a partially fermented tea with a milder flavour than the black variety-can help to relieve eczema symptoms. Around 120 patients with atopic dermatitis drank three cups of oolong tea every day after meals. After just one month, two-thirds showed an improvement in symptoms and some noted improve-ments as early as one week in. At six months, more than half the patients were still showing a good response to the tea 'treatment' (Arch Dermatol, 2001; 137: 42-3).
This ancient traditional Chinese tech-nique may be beneficial for eczema. In a study carried out in Germany, acupunc-ture helped to prevent and relieve itching when eczema sufferers were exposed to an allergen stimulus (house-dust-mite or grass-pollen skin pricks) (Allergy, 2010; 65: 903-10).
A number of herbal creams and gels have been successfully used to treat eczema. A 10-per-cent ointment made from a 95-per-cent ethanol extract of Lupinus termis (a type of lupin) seeds produced results comparable to those of topical steroids (J Nat Prod, 1981; 44: 179-83). Liquorice (Glycyrrhiza glabra), chamomile, witch hazel and St John's wort (Hypericum perforatum) are other herbs that may be helpful for eczema symptoms when used topically (J Dermatol Treat, 2003; 14: 153-7; Phytomedicine, 2003; 10 Suppl 4: 31-7).
In traditional Indian Ayurvedic medicine, the root of Euphorbia acaulis made up into a paste is used to treat eczema topically.
In one controlled study, of the 23 patients using 50 mg of powdered E. acaulis root three times a day for two to six weeks, 18 achieved complete relief and three enjoyed 75-per-cent relief (Indian J Dermatol, 1971; 16: 57-9).
However, as herbs can have powerful effects, make sure you consult an experienced herbal practitioner, who can offer guidance on dosages and duration of treatment.
What causes eczema?
A multitude of things can cause eczema or make it worse, and they vary from person to person. The following are among the most common factors known to be related to the condition.
Psychological factors,such as stress and anxiety. A Swedish study found that hand eczema was much more common in people reporting high stress levels (Br J Dermatol, 2011; 165: 568-75). Also, a recent survey of dermatologists by British researchers reported a surge in eczema and other skin conditions since the start of the economic recession.
Irritants in the home or at work,such as dust mites, animal dander and certain plants. It's estimated that some
5 per cent of the human population, for example, is sensitive to dust-mite allergens (Ann Acad Med Stetin, 2006; 52: 123-7).
Foods. Common allergens include eggs, peanuts, milk, fish, soy and wheat. In
one landmark study, 63 per cent of children with eczema showed food hypersensitivity when challenged (double-blind, placebo-controlled) by these six foods (Acta Derm Venereol Suppl [Stockh], 1992; 176: 34-7).
Food additives, including preservatives such as parabens E214-218, sodium benzoate E211 and sorbic acid E200, antioxidants like butylated hydroxyanisole (BHA) E320 and butylated hydroxy-toluene (BHT) E321, and colourings such as tartrazine E102, erythrosine E123 and amaranth E127.
Drugs. A vast array of agents has been linked to eczema, including antivirals, antihistamines, steroids, anaesthetics and anticancer drugs (see box, page 28).
Industrial and chemical irritants,such as detergents (including shampoos, body washes and bubble baths containing sodium lauryl sulphate, or SLS), biological washing powders and chlorine in swimming pools.
Climate.Low altitudes and low humidity can worsen symptoms, while central heating and wearing woollen or synthetic clothes can cause overheating and make itching worse.
Hard waterin the domestic water supply can make eczema worse, according to some evidence (Environ Res, 2012; 116: 52-7). If your water is particularly full of chemicals, consider installing a water filter in your home.
Drugs that can cause eczema
.Antibacterial drugs (aminoglycosides and antibiotics such as amoxycillin, ampicillin, erythromycin, gentamicin, lincomycin, rifampin and cephalosporins)
.Antimycotics or antifungals
.Antivirals, such as tromantadine hydrochloride and idoxuridine (for treating herpesvirus infections) and acyclovir (for treating chickenpox and shingles, as well as herpesvirus)
.Phenothiazines (an antipsychotic agent)
.Non-steroidal anti-inflammatory drugs (NSAIDs)
October 2012 vol. 23.7