A holistic approach to managing eczema

Eczema is a condition suffered by people of all ages and at different times of life. The dictionary definition tells us that it is “an inflammatory condition of the skin attended with itching and the exudation of serous matter” (where serous means watery, resembling serum). 

It looks as if the condition was first given a name in the middle of the eighteenth century using Latino-Greek foundations of  “ek” meaning out of and “ze” (from “zein”) meaning “to boil or ferment”.

Eczema, no matter its origins, can be a miserable, life-restricting condition, bringing pain and frustration both to sufferers and their families.

A description of the symptoms of the most popular form of eczema can be found in a UK patient leaflet.

• The skin usually feels dry.
• Some areas of the skin become red and inflamed. The most common areas affected are next to skin creases, such as the front of the elbows and wrists, backs of knees, and around the neck. However, any areas of skin may be affected. The face is commonly affected in babies with atopic eczema.
• Inflamed skin is itchy. If you scratch a lot it may cause patches of skin to become thickened.
• Sometimes the inflamed areas of skin become blistered and weepy.
• Sometimes inflamed areas of skin become infected.

Typically, inflamed areas of skin tend to flare up from time to time, and then tend to settle down. The severity and duration of flare-ups varies from person to person, and from time to time in the same person.

• In mild cases, a flare-up may cause just one or two small, mild patches of inflammation. Often these are behind the knees, or in front of elbows or wrists. Flare-ups may occur only now and then.
• In severe cases, the flare-ups can last several weeks or more, and cover many areas of skin. This can cause great distress.
• Many people with atopic eczema are somewhere in between these extremes.

The leaflet also goes on to ask “What causes atopic eczema?” and provides the following response.

“The cause is not known. The lipid (oily) barrier of the skin tends to be reduced in people with atopic eczema. This leads to an increase in water loss and a tendency towards dry skin. Also, some cells of the immune system release chemicals under the skin surface, which can cause some inflammation. But it is not known why these things occurs. Genetic (hereditary) factors play a part. Atopic eczema occurs in about 8 in 10 children where both parents have the condition, and in about 6 in 10 children where one parent has the condition. The precise genetic cause is not clear (which genes are responsible, what effects they have on the skin, etc).

Atopic eczema has become more common in recent years. There are various theories for this. Factors which may play a role include: changes in climate, pollution, allergies to house dust mite or pollens, diet, infections, or other early-life factors. However, there is no proven single cause. There may be a combination of factors in someone who is genetically prone to eczema, which causes the drying effect of the skin and the immune system to react and cause inflammation in the skin.”

Whatever the underlying causes of eczema, it cannot be treated in a simple way if the condition is to be managed effectively. Putting a steroid cream on a patch of skin is only going to appear to help the skin to look normal again and hopefully stop the irritation. In reality it does nothing to affect the source of the outbreak, merely pushing it back inside the body to reappear in another form some time later.

Eczema needs a holistic approach. Hopefully you will have a period of time when the condition is relatively “quiet” to put together your own “plan of campaign” which will include strategies for both prevention and flare-ups, so you have support available when the time comes.

You need to think about eczema from the inside out. The skin is the largest organ in the body, so for someone to be showing signs of eczema there is some imbalance inside the body which is forcing its way out.

I have put together some questions to ask both yourself or anyone you are caring for which may help you to understand what may be happening within the body and some herbal suggestions which may help you to manage the condition.

Everything starts with digestion.

• What are you actually eating (as opposed to what you think you are eating)? Keep an accurate food diary for at least seven days and preferably two weeks. Include all snacks, treats, sweets given by doting grandparents or other carers/colleagues. 
•  Is there any allergic reaction to the three main food groups - wheat, dairy and solinaceas (potatoes, tomatoes and peppers). Do a three week exclusion diet for each group and see what happens when you start re-introducing the food.

Help digestion.

• Take a bitter half an hour before you eat to get your stomach working. Use chamomile as a tea to help you improve your digestive function.
• Help the liver to detoxify whatever is not helping you. Use dandelion and burdock or milk thistle seeds. Eat milk thistle leaves in salads.
• Stop drinking coffee and alcohol and see what improvements are made.
• Stop simple carbohydrates and concentrate on whole foods, lots of vegetables, fruit and pulses. 
• Eat good fats and meat.

Keep hydrated.

• How much water do you drink during the day? 
•  How many good fats do you consume in your diet? If you have been cutting back on fats to lose weight, this may affect your body’s ability to hold moisture. 
• Think about the type of fat you eat and whether you could change this to something healthier. Experiment with using coconut oil or ghee and see if you notice any changes.

Keep moisturised

• Do you need to shower or bathe every day? Would a strip wash do on alternate days? 
• Use a moisturiser either in the bath water or after you shower but before you dry off. Pat yourself dry, don’t rub. 
• Use a calendula/chickweed salve or cream several times during the day to keep your skin well covered. Remember to use a cream every time you wash your hands. If you want to add mucilaginous herbs to your cream try marshmallow, violet or heartsease. 
•  If your scalp is itchy with dry skin/dandruff/dermatitis soak your scalp with an equal combination of double infused rosemary and thyme oil for an hour before washing or showering. Continue to do this once a week for several months and you should notice a real difference.

Identify your current stress factors

• What is causing you stress at the moment? Is this financial? Work-related? Family related? Incident related? Emotional e.g. fear, anger, grief? Exhaustion?
• How much sleep are you getting? Is this because you find it difficult to sleep or because you don’t go to bed early enough?
• How much are you able to relax? Can you designate time to relax? Can you do breathing exercises/meditation/visualisations to aid relaxation? Do you have a favourite activity or hobby which pleases and relaxes you?
• How much exercise do you do?

Identify your triggers

Keep a diary and notice when your eczema becomes more bothersome.

• Where were you?
• What were you doing?
• What did you touch?
•  What did you eat? 
• What cleaners/aerosols/air fresheners/dishwasher cleaners/washing powder/fabric conditioners were you using or exposed to?

Identify all your avenues for support

• Who can help you?
• Do you have enough helpful information? If not, where might it be obtained?
• What physical support do you have available including food, plant and plant based materials/medicines, cleaning items, natural fabrics etc?

Determination/enthusiasm for change

• How much do you want to improve your health? On a scale of 1-10, how much do you want to change? What would have to happen to enable you to move up the scale by 0.5?

Dealing with an eczema outbreak

If you are dealing with an eczema outbreak which is hot and red, don’t use an oil or cream directly on the skin. Use a chamomile or elderflower water to cool the area down and soothe it. Drip it over the area and rub in lightly. Once the area is cooled and no longer inflamed, use a salve made from chamomile, calendula and chickweed to reduce the itching. If there is danger or presence of infection add St John’s wort oil. Use chickweed double infused oil in the bath or after a shower.

You can also use anti-inflammatory herbs internally to reduce the outbreak. Think turmeric, yarrow, plantain, calendula.

Recipes

Here are some links to recipe or articles with herbal products you can easily make yourself to help manage your eczema.

• Bitters
• Double infused oil (chickweed, calendula, St John’s wort, plantain, violet, marshmallow)
• Elderflower or chamomile water

Something to remember

Herbal remedies are rarely instantaneous. You need to allow one month for every year you have been suffering from the condition. This also gives you the time and opportunity to make any lifestyle changes you feel may be helpful. Don’t forget to look back and compare what is happening now with what was happening when you first started to make those changes.

• Have they been helpful?
• Do you feel more able to manage your condition?
• Would you do this again or would you do something different?