Holistic approach douses eczema's fire

Dry, thick, scaly skin—could your customer be turning into a lizard? More likely, these symptoms and others—like crusty red bumps or sores that always seem to itch—signal an all-too-common chronic skin condition: eczema, which affects up to 31 million Americans, according to new research (Dermatitis, 2007).

Also known as atopic dermatitis, eczema can show up anywhere on the body, but usually propagates on cheeks, arms and legs and often behind knees and the crooks of the arms. Eczema shares symptoms with psoriasis—that is, uncomfortable skin inflammation—as well as treatments. The difference? Experts like to say, "You know it when you see it." Psoriasis is usually characterized by silver-scaled red patches of skin that may bleed. Eczema features red to brownish-gray patches that may leak or crust over when scratched.

No one knows exactly what causes eczema, perhaps because it has several triggers. Are food sensitivities the culprits? Stress? Poor digestion? An overstimulated immune system? "Eczema is not well defined," says Dean Neary, N.D., chairman of the physical medicine department at Bastyr University and clinical supervisor at Bastyr Center for Natural Health in Seattle. "It appears to be an inflammatory condition." Doctors often recommend corticosteroids, such as hydrocortisone, to quell the swell and itch, but steroids simply suppress the problem and wreak havoc on the body's natural anti-inflammatory powers (see "Hydrocortisone Hype," below). Instead, Neary asks: "What's causing the inflammation?" To find the answers and address the roots of eczema, he and other natural-lifestyle experts turn to healing foods, herbs and supplements.

Food and lifestyle factors
"The skin is the body's largest organ of elimination," Neary says. "Eczema is something from inside of the body working out." Eczema sufferers often have an overactive immune system, which triggers an allergic response to certain materials, such as soaps, wool or dust, or particular foods, such as dairy, gluten, corn, soy, refined sugar and citrus. To vet out sensitivities, Neary recommends your customers do a food-elimination diet, where they cut out suspect foods for three to four weeks. Then they reintroduce foods, noting which ones bring on eczema.

"Stress is also a huge factor," Neary says. When the emotional pressure is on, it taxes the immune system and can lead to eczema flare-ups. A recent meta-analysis shows that psychological and relaxation interventions like aromatherapy, cognitive-behavior therapy and stress management may supress the itch of ecz?ema (International Archives of Allergy and Immunology, 2007).

Herbal options
Along with food and lifestyle adjustments, laxative and cleansing herbs can also help, according to New York acupuncturist Letha Hadady, author of Healthy Beauty (iUniverse, 2007). "My approach is to help the body eliminate acid [caused by an acid/alkaline imbalance] through proper channels—not the skin, but through the urine and stools," she says. She suggests sipping a tea of liver-cleansing and detoxifying dandelion root (Taraxacum officinale) and antibiotic honeysuckle flower (Lonicera japonica). Simmer a handful of each herb (leaf and flower) for five minutes. Filter, and start with 1 cup with meals for adults and 5 to 10 drops for children. Any more may cause diarrhea. Your customers should see results within three days.

The bitter bark and leaves of the neem tree (Azadirachta indica) purify the body too, according to Hadady. "It takes the inflammation and acid and dumps it through proper channels of elimination," she says. To avoid acrid-tasting tea or powder, Hadady suggests taking neem pills in the dose recommended on the bottle. Or, mix neem oil with nose-pleasing lavender oil and apply the concoction to skin to bring down the puffy redness of eczema outbreaks. (For more skin applications, see "How to make your own," below)

Because eczema often is a visible sign of an internal problem, herbs that kick up adrenal function can address underlying imbalances. Ginseng (Panax ginseng), licorice (Glycyrrhiza glabra) and astragalus (Astragalus membranaceus) all are adaptogens that normalize adrenal function. Although Neary usually recommends taking encapsulated pills standardized to active constituents (at a dose recommended by a health care practitioner), tinctures of whole plant parts also work, as do topical treatments. One study found that licorice gel relieved red, itchy areas (The Journal of Dermatological Treatment, 2003).

Supplement support
Studies show that eczema sufferers sometimes have decreased levels of essential fatty acids in the blood, perhaps because of poor essential fatty acid metabolism (Journal of Clinical Nutrition, 2000). EFA supplements, such as omega-3-rich fish oil, fight inflammation and promote skin lubrication, according to Kristen Burris, founder and director of the American Acupuncture Center in Poway, Calif. Burris recommends taking 800 to 1,200 milligrams a day of good-quality fish oil. Vegetarian options are evening primrose, borage and flaxseed oils, but Burris cautions against taking multiple oils at once to avoid overburdening the gallbladder with too many fats.

Mineral-rich kelp helps heal skin tissues and dries out internal dampness—the accumulation of fluids or mucus in the body—that can lead to external eczema, Burris says. Because most Americans don't eat sea vegetables, try recommending a kelp supplement instead, aiming for 1,000 milligrams a day. But advise your customers to consult with an herbalist or acupuncturist in case of reactions, such as too much iodine interfering with thyroid function.

"If your bowels aren't processing things right, it works its way out and can result in eczema," Neary says. Probiotics introduce "good" bacteria to your gut, which improves overall digestion. Although results aren't consistent, at least one trial shows that a specific probiotic strain—Lactobacillus rhamnosus—may prevent the onset of eczema in susceptible infants (The Journal of Allergy and Clinical Immunology, 2007).

Other important skin nutrients include vitamins B and E, as well as zinc. If stress plays a role in your customer's eczema outbreak, he or she can take 100 milligrams of B-complex vitamins three times a day to temper the pressure, as well as promote circulation for healthy skin. But if your customer's immune system is down, zinc (at 50 milligrams a day) can offer a boost—and also heal skin tissues. Study participants who took 400 IU of natural vitamin E a day for eight months had greater improvement of eczema than those taking a placebo (International Journal of Dermatology, 2002).

Getting to the source of eczema
Because eczema seems to have many causes, treatments vary widely. For some, the solution may mean a dietary overhaul. For others, a simple supplement may do the trick. Before your customers decide, experts recommend that those with eczema first talk to a health care practitioner who can properly diagnose the internal condition that's setting off the external manifestation and recommend therapies for lasting relief. Bottom line: "Eczema is the body telling you that something else is going on," Neary says.

Pamela Bond is a freelance writer in Eldorado Springs, Colo.

Natural Foods Merchandiser volume XXIX/number 1/p. 30,34