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Eczema

 

Eczema Introduction

:eczema.jpg Eczema, also known as Atopic Dermatitis, is an inflammatory skin disease that is often associated with environmental allergies and sensitivities. Most patients, some two-thirds of all sufferers with Eczema, also have a positive family history of Eczema. Those with this condition are also at an increased risk of developing other conditions, such as hay fever and asthma. [1] There also seem to be abnormalities in the mast cells of persons with atopic dermatitis, which causes specific cells to release high amounts of histamine and other mediators of allergic reaction. [2] Other aggravating factors that can trigger exacerbations of eczema include; changes in humidity, temperature, and varying emotional stress factors.

Eczema Symptoms

Atopic Dermatitis can manifest differently, and is dependant on the age of the patient. In infants; red, weeping, and crusty spots, located on the face, scalp, diaper area, arms and legs, are a common finding. It is common for these rashes to improve by age 3-4, but flare-ups later in life are common.

In older children and adults, the rash tends to be more localized in stereotypical areas, like the crooks of elbows and backs of knees (flexural folds). Rashes may also appear on the eyelids, neck, and wrists and/or hands. These areas appear to be red and scratched. Persons may also have thickened skin, resulting from possible concomitant bacterial infections. [3] It is also possible for atopic dermatitis to become generalized. As mentioned, it is common for those with atopic dermatitis to also exhibit symptoms of hay fever and asthma.

Eczema Treatment

Dietary changes should take place and include the elimination of major reactive foods, such as milk, eggs, and peanuts. These particular foods account for a significant percentage of eczema cases. It may also be worth while to consider undertaking food allergy testing and an elimination diet to determine if there are less obvious food sensitivities that are contributing to the condition. [4, 5]

Similarly, food additives should be eliminated from the diet as much as possible, as some patients have been responsive to elimination of these compounds. [6] Animal products should be limited due to their high content of pro-inflammatory arachadonic acid, and adding fish such as mackerel, salmon (wild caught), and herring is also beneficial. These foods contain higher amounts of omega-3 fatty acids, which can produce anti-inflammatory activity in those suffering from this condition.

It would also be prudent to avoid environmental allergens such as dust, dust mites, fabric softeners, fragrances, and wool garments. Trimming of fingernails can help to discourage too much scratching, or to lessen the damage that is done, when scratching occurs. Scratching greatly increases the chances of developing potentially serious infections, as atopic individuals have a higher incidence of staph infections. [7] The bathing regimen should also be addressed in treatment protocol. Water should be luke warm, because of the likelihood of extreme temperatures leading to the further aggravation. Any soaps used should be both mild and free of fragrances. [8, 9]

Supplements helpful for Eczema

Essential Fatty acids

Essential fatty acids are represented by the omega-3 and 6 Fatty acids. Sources of omega 3 fatty acids include; flax, hemp, canola, fish and walnut oils. Sources of Omega 6 include;: corn, canola, safflower, soy and sunflower oils. In the body, essential fatty acids are incorporated into cell membranes and contribute to the physical characteristics thereof. It is these fatty acids that are liberated from the membrane (via the enzyme Phospholipase) and used to make many compounds, including thromboxanes, leukotrienes, and prostaglandins. These compounds are responsible for beginning and controlling the inflammation response.

The fatty acids that are derived from grain fed animal sources (called Arachadonic acid), as well as those that are damaged by processing such as hydrogenation (ie to make margarine), tend to lead to the formation of more pro-inflammatory series of prostaglandins. When adequate omega-3 fatty acids are available, the compounds that are derived from them are much less inflammatory and will lead to less symptoms of inflammation in disease conditions, such as eczema. [10] Evening primrose oil is a source of essential fatty acids and has also been found to be effective in lessening the symptoms of eczema, including itching. Although this can be an expensive treatment choice and is not always effection in eczema sufferer. [11]

Zinc

Zinc is an important nutrient for skin health and is necessary for the function of enzymes that help to utilize EFAs. Essential fatty acids must undergo numerous biochemical changes before they can be used in the body’s processes, regardless of their availability in the human body. If there is a deficiency with Zinc, Magnesium, or Vitamin B6, the necessary desaturase enzymes may not be able to function properly. [14]

Flavonoids

Flavonoids are compounds that function (among other things) in plants to prevent damage from excessive sun exposure. When ingested, flavonoids compounds act to “quench” reactive oxygen species that have the capacity to damage cellular structures, such as membranes and DNA. Flavonoids have demonstrated a number of effects within the human body including; assisting the reduction of capillary permeability and fragility, and specific anti-viral and anti-inflammatory properties. Flavonoids help to reduce damage that free radicals can cause as well as reducing the intensity of allergic reactions. [15]

Herbal Treatments:

Licorice root (Glycerrhiza glabra)

Licorice root (Glycerrhiza glabra) is a botanical agent that appears to be useful both internally and topically in patients with atopic dermatitis. Patients reported better sleep and less itching in studies using licorice. [16] Licorice exerts cortisol sparing effects by inhibiting the enzymes that are responsible for cortisol metabolism. Cortisol is a natural anti-inflammatory compound within the body. By sparring cortisol, licorice root’s anti inflammatory action can be heightened without having to use synthetic hydrocortisone compounds. [17] Topical applications of Glycyrrhetic acid from licorice have resulted in significant improvements in eczema symptoms. Effects are comparable to that of hydrocortisone cream, but are less likely to have some of the same side effects that can be observed in the use of pharmaceutical hydrocortisone cream.

Chamomile (Matricaria recutita)

Chamomile has shown promise in specific treatments of eczema. Chamomile is known for having anti-inflammatory, wound healing, anxiolytic, anti microbial, and antispasmodic properties. This herb can be used both topically and internally to address some of the possible complications that are inherent in cases of atopic dermatitis. An extract of chamomile has been shown to have benefits superior to that of 0.5% hydrocortisone cream in treating the symptoms of atopic dermatitis. It was also shown to promote the formation of granulation tissue; a tissue vital for proper wound healing. [19]

Another use for chamomile in eczema sufferers may be anxiety-related conditions. Anxiety is a common psychological condition among patients with this skin disease. The anxiolytic and calming effects of chamomile may help to ameliorate feelings of tension and anxiety, which can come from the itching and discomfort of eczema. [20]

References

[1] Beers,Mark H and Berkow,Robert. 1999. The Merck Manual . 17th ed. p788-789, Merck Laboratories Publishing. Whitehouse Station NJ.

[2] N. Soter and H. Baden,Pathophysiology of Dermatologic Disease, New York: McGraw-Hill, 1984.

[3] Fitzpatrick, Thomas B.. 1997. Color atlas and Synopsis of Clinical Dermatology, 3rd ed. p61-63. McGraw-Hill. New York NY.

[4] Broberg A, et al. Elimination diet in young children with atopic dermatitis. Acta Derm Vernereol 1992;72:365-369.

[5] Fiocchi A, Bouygue GR, Martelli A, Terracciano L, Sarratud T. Dietary treatment of childhood atopic eczema/dermatitis syndrome (AEDS). Allergy. 2004 Aug;59 Suppl 78:78-85.

[6] Worm M, et al. Clnical relevance of food additives in adult patients with atopic dermatitis. CLin Exp Allergy 2000;30:407-414.

[7] Dhar S, Kanwar AJ, Kaur S, Sharma P, Ganguly NK. Role of bacterial flora in the pathogenesis & management of atopic dermatitis. Indian J Med Res. 1992 Sep;95:234-8.

[8] Beers,Mark H and Berkow,Robert. 1999. The Merck Manual . 17th ed. p788-789, Merck Laboratories Publishing. Whitehouse Station NJ.

[9] Murray, Michael T and Pizzorno, Joeseph E. 1998. Encyclopedia of Natural Medicine. 2nd ed.p448-454, Prima Health. Rosevillle CA.

[10] Mitchell, William A. Foundations of Natural Therapeutics. Self Published

[11] WrightS, Burton JL. Orla Evening Primrose seed oil improves atopic eczema.Lancet 1982;2:1120.

[12] Soyland, E Dietary supplementation with very long-chain n-3 fatty acids in patients with atopic dermatitis. A double-blind, multicentre study.Br J Dermatol. 1994 Jun;130(6):757-64.

[13] Gaby, Alan R. 2001 Nutritional Therapy in Medical Practice. p85. Nutrition Seminars. Seattle WA.

[14] el-Kholy MS, Gas Allah MA, el-Shimi S, el-Baz F, el-Tayeb H, Abdel-Hamid MS. Zinc and copper status in children with bronchial asthma and atopic dermatitis.J Egypt Public Health Assoc. 1990;65(5-6):657-68.

[15] Amella M, Bronner C, Briancon F, Haag M, Anton R, Landry Y. Inhibition of mast cell histamine release by flavonoids and biflavonoids. Planta Med. 1985 Feb;(1):16-20.

[16] Sheehan MP, Rustin MH, Atherton DJ, Buckley C, Harris DW, Brostoff J, Ostlere L, Dawson A, Harris DJ. Efficacy of traditional Chinese herbal therapy in adult atopic dermatitis. Lancet. 1992 Jul 4;340(8810):13-7.

[17] Robbers, James E Speedie,Marilyn K Varro, Typer E. 1996.Pharmacognosy and Pharmacobiotechnology. WIlliams &Wilkins. Baltimore

[18] Murray, Michael T and Pizzorno, Joeseph E. 1998. Encyclopedia of Natural Medicine. 2nd ed.p448-454, Prima Health. Rosevillle CA

[19] Patzelt-Wenczler R, Ponce-Poschl E.Proof of efficacy of Kamillosan(R) cream in atopic eczema. Eur J Med Res. 2000 Apr 19;5(4):171-5.

[20] Mills and Bone. 2000 Principles and Practices of Phytotherapy, Churchhill Livingston.p319-327 Edinburgh London New York Philadelphia St Louis Sydney Toronto.

[21] Mills and Bone. 2000 Principles and Practices of Phytotherapy, Churchhill Livingston.p319-327 Edinburgh London New York Philadelphia St Louis Sydney Toronto.

[22] Jordan JM, Whitlock FA. Emotions and the skin: the conditioning of scratch responses in cases of atopic dermatitis. Br J Dermatol. 1972 Jun;86(6):574-85.