My office is often the last stop on the block for people with chronic skin conditions who’ve been to dermatologists who’ve prescribed regimens of creams and pills that mask the condition temporarily, only to have the problem flare up again with the same, or worse, intensity. One of the most common of these conditions is eczema, or atopic dermatitis. One suffering patient of mine, a woman in her mid-thirties, came in with her fingers completely bandaged and throughout our first meeting, incessantly scratched her arms. Saddled with this disease since she was an infant, Celia was currently on the very strongest steroid available and it was doing nothing; the eczema seemed to be getting worse, in fact.
Eczema is marked by red, bumpy, scaly patches that itch terribly. The exact cause is unknown and likely varies from person to person. The Mayo Clinic describes it as a malfunction of the body’s immune system and, indeed, in many patients certain antibodies are elevated. An emotional component to eczema has been found to exacerbate symptoms but not cause the disorder. Most patients have a family history of eczema or some other atopic condition like asthma or seasonal allergies and, indeed, these patients might concurrently develop these issues, as well. As it turned out, Celia had also severe allergies since childhood.
Conventional treatment for eczema typically consists of topical inflammation-reducing steroids, antibiotics, oral or injected corticosteroids, and immunomodulator medications. The side effects of these drugs deter many people from using them. The problem that I see clinically with these treatments—which are sometimes quite necessary for people to take in order to merely go about their daily lives—is that they don’t get at the cause of why the body is reacting with eczema outbreak to some kind of systemic imbalance.
In naturopathic medicine, we view disease as a manifestation of imbalance in the body. The skin is a common pathway by which the body expresses internal disorder because it is the largest of the body’s five organs of detoxification (the others are the lungs, kidneys, liver and gastrointestinal tract). Eczema, then, can also be understood not only as an immune dysfunction and genetic predisposition but also as an expression of toxicity and deficiency in the body.
The latter is where I often start in my treatment of patients with eczema. The role of food sensitivities in atopic dermatitis has been widely researched. Specific sensitivities to wheat and dairy are common. This has been reinforced time and again in my practice, where I typically run a IgG/IgA food sensitivity panel to determine the foods to which an individual is personally reactive. Another common sensitivity I see is to egg whites. Celia tested off the charts in her reaction to every form of dairy and wheat, as well as egg whites so we took her off those foods for a period of 60 days.
Food sensitivities can unfortunately cause leaky gut in patients, which create micro-perforations in the gut lining that allow large molecules of undigested symptoms to recirculate into the blood stream. The body then mounts an immune attack, causing the immune system to go into overdrive, which is likely how further allergies develop. In Celia’s case, she complained that her stomach hurt frequently after eating and that she was often bloated and gassy. These are clinical signs of leaky gut so I ran a comprehensive digestive stool analysis (CDSA) on her and, indeed, her digestive system was rampant with bad bacteria and yeast. Intestinal flora plays a fairly major role in not only the overall health of the body, as I’ve written about before, but in the manifestation of eczema. I put Celia on a probiotic of 20 billion viable Lactobacillus acidophilus and Bifidobacterium bifidum species per day, while doing a gentle candida cleanse, similar to what I’ve written about before.
Lastly, we think about deficiencies when it comes to eczema, particularly that of essential fatty acids (EFAs) like omega-3 and omega-6. In fact, studies of people with eczema have shown low levels of EFAs so I often run a basic blood panel to determine people’s levels of these. Celia came back deficient in total fatty acids, as well as EPA, DHA and a few others. She immediately started a high quality fish oil. The final deficiency I typically test for is a zinc deficiency. Because of the gut dusfunction of many people with eczema, zinc is improperly digested and absorbed and they often come back low in this mineral, as Celia did. Zinc is essential for EFA metabolism, so it was essential for her to start on zinc supplementation, as well.
About three months after we began treatment, Celia returned to my office with no bandages on her fingers. When I exclaimed at her lesion-free hands and arms, she turned her hands over and looked at them with amazement saying, “It’s gone, I have no more itching and barely and eczema, only when I stray from my diet.” I later saw her 6-year old daughter, Kelsey, who also had a pretty severe case of eczema; it’s often a family affair. After following a similar program, Kelsey is happily no longer “itchy and scratchy” all the time. I hopefully won’t have to see this duo for a long time to come, as they now have the tools to manage the condition on their own.
Schedule an appointment with Dr. Maura to address your own issues with eczema.