Eczema – Dealing with it Naturally ——————————————————————————– Written by Jill Dunn – MHSc Complementary Medicine, Registered Naturopath, Registered Medical Herbalist, Registered Nurse (Non-practising) “Eczema is a common condition in children and affects two to seven percent of the population. Most children with infantile eczema grow out of it by three or four years of age, but in others it can continue into adulthood, and maybe a forerunner of other allergic conditions such as hay fever or asthma. In two-thirds of those with eczema, there is a family history, and most improve with a diet that eliminates common food allergens. How to recognise eczema The terms eczema and dermatitis refer to the same condition and are used interchangeably. Eczema’s appearance is slightly different depending on what stage it is at, whether it is acute, subacute or chronic. In the acute stage little vesicles (fluid-filled bubbles) appear, in the subacute stage the skin is red and scaly, and maybe inflamed and crusted if secondary infection is present. Chronic persistent eczema appears thickened and is the result of constant itching or rubbing. Those who are prone to eczema have altered immune responses, whereby specialised white blood cells called mast cells release higher amounts of histamine and other allergic compounds that trigger inflammation. They are also more susceptible to skin infections, warts and cold sores. Teething, skin or other infections, contact with animal dander, severe anxiety or stress, and exposure to food or environmental allergens (chemicals, wool, and detergents) maybe precipitating factors. Food and environmental allergens Eczema is in part due to food or environmental allergies, and often starts to develop when solid foods are introduced around four to five months of age. Sometimes eczema occurs earlier when a baby is totally breast or bottle-fed. An environmental allergy to wool, washing powder, detergents, clothes-softening products, and perfumes in shampoo, soap or creams or even nappies maybe a factor, and a change to low allergen, perfume free, low-chemical and natural-based products is advisable. In others, food allergy or a combination of food and environmental sensitivities can be responsible. Eczema in a totally bottle-fed baby may indicate an allergy to the milk formula, and in a totally breastfed baby maybe related to something the breastfeeding mother is having in her diet, causing a transfer of allergic antigens into her breast milk. Having said this, breastfeeding during infancy provides significant protection against eczema and allergies in general. Introducing foods to your baby A baby’s digestive system is immature at birth and relies solely on colostrum and breast milk for nutrition. Until the digestive system matures, foreign proteins may be absorbed into the blood stream, and this is why exclusive breastfeeding for the first six months of life can help reduce the likelihood of food allergies. Start introducing foods slowly and if there is a family history of allergy wait until baby is six months old. Breast milk is a food in itself, but if you are concerned about low iron levels, there are infant liquid iron supplements available. To reduce the likelihood of allergies to dairy or soy, breast milk is the best milk for the first twelve months of a baby’s life. Care needs to be taken when introducing new foods to all babies. Only introduce one new food each week and always give the food in a cooked form. This makes it easier to digest and enables the easy identification of any problem food. Keep a diary identifying the food introduced and any reactions that occurred, such as nappy rash or colic. If a reaction occurs, stop the food and reintroduce in several weeks time. Start with foods such as stewed pears, kumera or pumpkin and rice. When baby is about eight or nine months old, finely chopped unprocessed meat and chicken can be introduced together with green leafy vegetables like silverbeet and spinach. Continue the slow introduction of new foods and delay the introduction of the common allergens (wheat, dairy, soy, legumes, tomatoes and citrus) until after the child is one year old. Eggs and berry fruits can be added around eighteen months to two years of age and ground nuts (including peanuts) and fish/shellfish after age three. Organically grown foods that are free of pesticides, herbicides, colours, flavours and preservatives are best. Physical reactions to foods can change, often beginning as colic or eczema, but as the child grows older may result in migraines or bronchial tendencies. This is where your food diary itemising your baby’s reactions to foods, becomes a useful tool for the identification of problem foods later in life. Identifying food allergies Tracking down food allergies can become complex and may require trained naturopathic or nutritional advice to unravel the culprit(s). Food allergens are identified by systematically eliminating a suspect food from the diet for ten days followed by reintroduction of the food. Common allergens include: dairy products, milk, eggs, peanuts, fish, soy, wheat, citrus and chocolate, although virtually any food can be involved. Any removal of foods from the diet should be compensated for, by use of other foods or dietary supplements in order to avoid nutrient deficiency. Eczema and essential fatty acid metabolism Those with eczema appear to have altered essential fatty acid metabolism. Analysis of fatty acids present in blood, and red and white blood cells has indicated that in those with eczema, essential fatty acids are not well converted into their long chain form. The omega-3 essential fatty acid (alpha linolenic acid [ALA] found in flaxseed oil and leafy green vegetables) and omega-6 (linoleic acid found in nuts, seeds and vegetable oils) require conversion into the active long-chain polyunsaturated fatty acids (eicosapentaenoic acid [EPA], docosahexaenoic acid [DHA], gamma linolenic acid [GLA]) which if decreased, leads to a tendency towards allergy and inflammation. The ratio of omega-3 to omega-6 fatty acids has also been found to be lower in those with eczema, this can be improved by eating more fatty fish such as mackerel, herrings, salmon and tuna or supplementing the diet with omega-3 fish oils. Evening primrose oil (EPO) and omega-3 fish oils are both beneficial for those with eczema. Supplementing the diet with these products provides a ready useable source of long chain polyunsaturated fatty acids (LCPUFAs) which reduce the body’s tendency to produce inflammatory prostaglandins. It takes approximately three months to see the full benefits of supplementation, as it requires this time for the LCPUFAs to be taken up into cell membranes. The dose of EPO or fish oils required varies with age. For infantile eczema (when the child is breastfed), the mother’s diet can be supplemented with two Evening Primrose oil 1,000mg capsules and one Omega-3 (1,000mg) fish oil capsule daily with food. Evening Primrose oil can also be applied to the affected areas of skin. For babies who are not breastfed and for children under three years of age Efamol Efanatal can be used as an additional source of essential fatty acids that is suitable for this age. For children aged two to five years use one capsule of Evening Primrose oil 1,000mg daily, and children aged six to twelve years take two capsules daily. For children twelve years and older two to four capsules of Evening Primrose oil 1,000mg maybe required. Also include fresh fish, tuna, salmon, sardines and herrings in the diet at last three times per week. Most eczema responds to dietary changes and supplementation with essential fatty acids. For those with a family history of allergy (eczema, asthma, and hay fever) supplementation with omega-3 and omega-6 essential fatty acids during pregnancy is particularly advisable, and there are specifically formulated products for this time. Eczema and herbal medicine More severe cases of eczema will require herbal medicines to help correct underlying metabolic imbalances. Herbalists use combination formulas that hasten removal of metabolic wastes while supporting proper digestion. Nettle and heartsease are used for their blood cleansing properties, and liver and kidney supporting herbs such as dandelion and St. Mary’s thistle, open up the body’s natural channels of elimination and the removal of metabolic wastes, while strengthening digestive function. Flavonoid-rich herbs like grape seed extract, bilberry, Ginkgo biloba, Albizzia lebbeck and Scutellaria baicalensis have natural anti-allergy properties and form part of the treatment for troublesome chronic allergic conditions. Use of external creams or ointments containing herbs such as Calendula, Nettle and Chickweed are prescribed for itching and inflammation, and possess natural antimicrobial properties. On their own may provide relief from mild eczema, but in chronic cases are used to help reduce hardening of the skin and to heal any cracks that provide an entry point for bacteria. Evening Primrose oil combined with Manuka honey and Tea tree oil can also be useful to help prevent skin infection, although some individuals can be sensitive to Tea tree oil. Before using Manuka or Tea tree oil products, always test them on the inside of the wrist and leave for 24 hours. If skin redness or itching develops, avoid all products containing these ingredients. If there is no reaction, as with any ointment choose a small patch of affected skin to treat initially, until you are sure no aggravation is occurring. Relief is at hand External preparations are useful, but it is the LCPUFAs on the inside that make most difference. Although having said that, adding one tablespoon of almond, jojoba, grapeseed or sunflower seed oil to a nightly bath, soothes and moisturises the skin. The oil will float on the surface of the water and moistens the child’s skin when they get out of the bath. Calendula oil is even better as it has antimicrobial and skin healing properties and replaces soap that should never be used by those with eczema. It can be added to bath water or applied externally following a bath. Also when making dietary changes always supplement with a multivitamin and mineral formula, especially in children and if dairy products are removed ensure your child is receiving adequate calcium from elsewhere (almonds, brazil nuts, sunflower seeds, tofu, miso, dried figs, broccoli, seaweeds, calcium fortified dairy substitute milks). Children aged one to ten years require a total of 800mg of calcium per day and teenagers require 1200mg and to reach this amount you will probably need to use dietary supplements. And finally if your child is troubled by eczema, consider the clothing they are wearing. Avoid skin contact with synthetic fabrics. Wool, untreated cotton or linen fabrics are best and are readily available today.”