Eczema

Eczema also called dermatitis is a patch of itchy skin where blisters form then dry and become crusty. There is no cure but treatments can make you comfortable and help prevent outbreaks.

Signs and Symptoms

• Itching
• Red bumps
• Blisters
• Crusts
• Swelling
• Oozing
• Scaliness

What Causes It?

• Allergies to plants chemicals foods
• Certain drugs
• Vitamin or mineral deficiencies
• Certain physical or psychological disorders

What to Expect at Your Provider's Office

Your health care provider will look at your skin rash. He or she may ask about stress in your life your diet drugs you are taking and chemicals or materials you may be exposed to at work to find the cause of your rash.

Treatment Options

Treatment Plan

Your health care provider may prescribe a cream to relieve itching and dryness. He or she also may suggest that you do the following.

• Stay away from the things that irritate your skin
• Avoid alcohol and tobacco
• Limit the time you spend in the sun

Drug Therapies

Prescription

• Corticosteroids—oral or topical (meaning that you put it right on your skin); topical creams may stop the attack if applied early relieve itching; topical creams have few side effects but there are various possible side effects if taken orally
• Disulfiram—for eczema caused by sweating or nickel
• Zinc oxide—apply cream for severe itching

Over the Counter

• Corticosteroids—one percent hydrocortisone cream is often used for children

Complementary and Alternative Therapies

Discovering which foods you are allergic to and avoiding them is important. Following nutritional guidelines and using herbs as needed may help reduce swelling and allergic reactions. Eczema may be associated with stress and anxiety so mind-body techniques such as meditation tai chi yoga and stress management may help prevent it. Starch oatmeal and other baths may temporarily relieve the symptoms.

Nutrition

Note: Lower doses are for children.

• Avoid foods you are allergic to. Common allergenic foods are dairy products soy citrus peanuts wheat fish eggs corn and tomatoes.
• A rotation diet in which the same food is not eaten more than once every four days may be helpful in treating chronic eczema.
• Eat fewer foods that cause inflammation such as saturated fats (meats especially poultry and dairy) refined foods and sugar.
• Increase intake of fresh vegetables whole grains and essential fatty acids (cold-water fish nuts and seeds).
• Flaxseed (3 000 mg twice a day) borage (1 500 mg twice a day) or evening primrose oil (1 500 mg twice a day) to reduce swelling. Children can be supplemented with cod liver oil ( 1/2 to 1 tsp. per day) or any of the above oils 500 mg twice a day.
• Beta carotene (25 000 to 100 000 IU/day) zinc (10 to 30 mg per day) and vitamin E (100 to 400 IU per day) to strengthen your immune system and help your skin heal.
• Zinc spray can heal the affected tissue in some patients.
• Vitamin C (250 to 1 000 mg two to four times per day) reduces your body's reponse to substances that cause allergies. Vitamin C from rose hips or palmitate is citrus-free and hypoallergenic.
• Selenium (50 to 200 mcg per day) helps regulate fatty acid metabolism and keeps your liver healthy.
• Bromelain (250 mg two to four times per day taken between meals) reduces swelling.

Bioflavonoids found in dark berries and some plants help reduce swelling strengthen connective tissue and help reduce allergic reactions. The following are bioflavonoids that may be taken in dried extract form.

• Catechin (25 to 150 mg two to three times per day) quercetin (100 to 250 mg two to three times per day) hesperidin (100 to 250 mg two to three times per day) and rutin (100 to 250 mg two to three times per day).
• Rose hips (Rosa canina) are also high in bioflavonoids and may be used as a tea. Drink 3 to 4 cups per day.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts).

• Herbs that help your skin heal and increase lymphatic drainage are useful for relieving eczema. Use the following herbs in combination as a tincture (15 to 30 drops three times per day) or tea (2 to 4 cups per day): burdock root (Arctium lappa) yellow dock (Rumex crispus) red clover (Trifolium pratense) cleavers (Gallium aparine) yarrow (Achillea millefolium) peppermint (Mentha piperita) and nettles (Urtica dioica). To prepare a tea steep the root elements for 10 minutes then add the rest of the herbs and steep an additional 5 to 10 minutes.
• Skin creams and salves containing one or more of the following herbs may help relieve itching and burning and promote healing: chickweed (Stellaria media) marigold (Calendula officinalis) comfrey (Symphytum officinalis) and chamomile (Matricaria recutita).
• Marshmallow root tea (Althea officinalis) may soothe and promote healing of gastrointestinal inflammation that is often found with eczema. Soak 1 heaping tbsp. of marshmallow root in 1 quart of cold water overnight. Strain and drink throughout the day.

Homeopathy

The use of homeopathic remedies may make eczema worse.

Acupuncture

Acupuncture may help your immune system function better and reduce the allergic reactions that cause your eczema.

Following Up

Eczema is usually just an annoyance but it does recur and can become severe. Call your provider if it comes back frequently or grows worse.

Special Considerations

Starting an infant on solid foods conservatively and gradually may help prevent the food sensitivities that can cause eczema.

Supporting Research

The Burton Goldberg Group. Alternative Medicine: The Definitive Guide. Tiburon Calif: Future Medicine Publishing Inc; 1997.

Morse PF et al. Meta-analysis of placebo-controlled studies of the efficacy of Epogam in the treatment of atopic eczema: Relationship between plasma essential fatty acid changes and clinical response. Br J Dermatol. 1989;121:75–90.

Murray MT Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin Calif: Prima Publishing; 1998:296–300.

Noble J ed. Textbook of Primary Care Medicine. 2nd ed. St Louis Mo: Mosby-Year Book; 1996:345–365 368–375 1064–1084.

Tierney LM Jr McPhee SJ Papadakis MA eds. Current Medical Diagnosis and Treatment. Norwalk Conn: Appleton & Lange; 1994.

Werbach M. Nutritional Influences on Illness. New Canaan Conn: Keats Publishing; 1988:186–188.

Copyright © 2000 Integrative Medicine Communications

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