ECZEMA
Eczema, also called atopic dermatitis in medical parlance, is a common skin disorder that affects many children and adults. The cause is often obscure and standard medical therapy is to suppress the lesions on the affected skin with potent corticosteroid creams and lotions. Areas of affected skin are most common on the extensor surfaces of the arms and legs (elbows and knees). The skin is usually dry, somewhat reddened, scaly and may become weepy and ooze fluid in severe cases. The area is usually itchy and may be quite sensitive as well. Episodes tend to come and go and often disappear as the person gets older. Allergic rhinitis (hayfever) and allergic asthma are often associated with eczema, giving a clue to one of its causes. An alternative view of eczema is that it signifies an internal derangement of body function and not a primary skin problem. One of the most common causes of eczematous skin eruptions is food allergy. The most common offenders are milk, eggs, wheat, soy, peanuts and fish. The elimination of offending foods for 3-4 weeks is usually sufficient to resolve the symptoms. Although IgE food allergy testing can be done on blood, results do not always correlate with clinical signs.
Allergens such as dust mites, pollen, and animal dander can also trigger outbreaks. Stringent environmental control can help reduce symptoms.
Malfunction of the skin as a barrier has been theorized to contribute to eczema. Excessive levels of the adrenal hormone, cortisone, may cause a breakdown in the ability of the skin to resist penetration by water, chemicals and allergens.
The immune system is also known to play a role. Infants who are breastfed are less likely to develop eczema. However, if the mother has allergies to certain foods and eats them while breastfeeding the baby, the allergens may be transmitted in the breast milk and cause eczema and asthma.
The first area to consider when eczema develops is the lining of the intestines. There may be bacterial imbalances, overgrowth of yeast from antibiotics, damage to the lining with “leaky gut”, inflammation and an overly active immune system. If these are not corrected, the problem will likely persist.
Alternative therapies have shown promising results in clinical studies. Supplying omega-6 fatty acids as evening primrose oil was more helpful than placebo. A study of using 1.8 grams of EPA (an omega-3 oil) daily reduced scaling and itching. People who test low for zinc improved when given high dose zinc supplementation. The zinc was ineffective when given to people with normal zinc levels. Another study showed than people with low selenium levels improved with a selenium supplement.
Research clearly shows that stress is a major cause of eczema outbreaks. Studies have shown that relaxation exercises, hypnotherapy and cognitive-behavioral therapies can markedly reduce severe cases of eczema.
Daniel Blodgett MD