Functional Approach to Eczema
What is eczema
Eczema is the name for a group of conditions that cause the skin to become red, itchy and inflamed. Different types of eczema include atopic dermatitis, contact dermatitis, dyshidrotic eczema, and seborrheic dermatitis for example.
Eczema is common, and it can be manageable! Over 30 million Americans have some form of eczema, and the condition is not contagious. Symptoms can be mild, moderate or severe, and can fluctuate in intensity. These symptoms may include:
- Dry, sensitive skin
- Red, inflamed skin
- Very bad itching
- Dark colored patches of skin
- Rough, leathery, scaly patches of skin
- Oozing or crusting
- Areas of swelling
Who gets eczema
Most kids tend to outgrow eczema, but it does continue in some into adulthood. Adults can develop it, even if they never had it as a child. Eczema can occur anywhere on the body.
What causes eczema
The exact cause of eczema is not known, but in those that do develop it, there is a combination of genetics and environmental triggers involved. When a trigger (which could be environmental, or food related for example) switches on the immune system, and especially when that trigger is chronic or ongoing although it doesn’t have to be, the body reacts adversely and in some people the reaction effects the skin and causes the symptoms of eczema.
From a functional and clinical nutrition perspective, we can look for the root causes of conditions and address them naturally with diet, supplements and lifestyle interventions. Addressing the root cause of the problem rather than covering it up with medications that mask symptoms is important. Root causes left to persist can result in other problems down the line.
Common treatments include over the counter remedies and prescription topical medications. Topical steroid medications can cause what’s called red skin syndrome, topical steroid addiction, or topical steroid withdrawal. This can be debilitating, even worse than the eczema itself, and is due to the use of topical steroids. Sometimes it’s even mistaken for worsening of eczema. The longer you use steroid creams the worse the problem can become. Your skin can literally become addicted to the steroid creams, which also are endocrine disruptors (meaning they can cause imbalances in your hormones, including your adrenals and this can be even worse in kids because their systems are still developing).
Whatever you put on your skin, ask yourself, would you eat it? Things you put on your skin get absorbed into you bloodstream, just as if you had eaten whatever it is.
After use of topical steroid creams, especially long term, there can be a rebound effect when stopping them, where symptoms flare (this is topical steroid withdrawal syndrome). While some folks stop cold turkey and suffer through the symptoms, others wean from use of these medications, and it can take months or longer for the issue to resolve, everyone is different. Interventions to help are limited but involve strategies to improve sleep and reduce anxiety for example.
Because of the problems associated with conventional treatments, preferred ways to address eczema are natural.
For many people, food allergies/food sensitivities and eczema go hand in hand. Therefore from a nutritional standpoint, we can remove common eczema trigger foods from the diet. These include:
- Cow’s milk (goat’s milk is better tolerated in many people that can’t do cow’s milk), and dairy products
- Gluten and wheat
- Processed foods (additives, preservatives, artificial ingredients)
Start small, with one or two eliminations. The most common are gluten and dairy. Eggs can be a common eczema trigger as well. If removing common trigger foods doesn’t help with symptoms, undertaking a more formal elimination diet with the guidance of a professional can help because we need to be strategic since eliminating too much can lead to nutrient deficiency.
There is a wide range of eczema trigger foods out there and everyone may be affected differently. To learn more about food triggers for eczema, download my free Skin Rash Food Triggers Cheat Sheet, and for a more comprehensive listing of these triggers, you can purchase my eBook, Skin Rash Food Triggers.
Consuming foods containing quercetin, which is a natural antihistamine and powerful antioxidant found in plant foods may be helpful. Foods rich in quercetin include:
There are also quercetin supplements that can be helpful in place of medications like Claritin and Zyrtec. These medications block histamine, and the problem with this long term is histamine is needed for stomach acid production. Without enough stomach acid we can develop problems digesting and absorbing foods and nutrients, leading to nutrient deficiency. There are a variety of nutrients important for skin health and deficiency of them can lead to skin conditions.
Without enough stomach acid we can also end up with impaired gut health, which can actually lead to food sensitivities and food allergies. What happens is that undigested food particles serve as food for gut bacteria rather than us, and this can cause dysbiosis (infections in the gut or gut bacterial imbalances), which leads to inflammation, and can cause leaky gut.
The intestinal lining is one cell layer thick. These cells are held together by tight junctions. Inflammation causes the tight junctions to loosen and food particles that are too large escape into the bloodstream. Because the food particles aren’t supposed to be there, the body mounts an immune response. This is how food sensitivities and allergies can develop, and this over time can lead to autoimmune disease. In fact eczema is considered an autoimmune disease, so exploring what’s happening with gut health can be an important piece of the puzzle.
There is functional testing and there are interventions to address these types of issues from a root cause perspective, because as you can see, taking medication to relieve symptoms can end up causing the very problem you may be taking them to resolve!
Food allergy (IgE) and food sensitivity (IgG) testing can be helpful (eliminations diets can work for this too however) for identifying foods that trigger symptoms. These tests may involve blood testing or skin prick testing.
Taking probiotics to support the gut microbiome (the bacteria in our gut that lives symbiotically with us and keeps us healthy when it’s balanced) can be helpful, and research shows not only can this help with eczema, but it also may help with food allergies and asthma.
Fermented foods are natural probiotic sources, and examples include:
- Yogurt (if avoiding dairy can use coconut yogurt)
Digestive enzymes can help break down foods to improve digestion and absorption, however it is best to work with a professional here to help determine a need for this intervention.
Omega 3 fish oil supplements can reduce inflammation.
Regarding diet and eczema, eating a whole, real foods diet, that is anti-inflammatory and rich in antioxidants, like a Mediterranean style diet is recommended. This diet style includes:
- Vegetables and fruits
- Healthy fats omega 3 from fish, and olive oil for example, avocados and avocado oil, coconut oil
- Grass fed, pastured, free range, organic animal products
- No/low sugar
Of course if we're talking about kids, toddlers are often picky eaters! There are some strategies that may help. Keep in mind that it can take anywhere from 10-20+ tries of a food before a toddler takes to it, so be patient. Modeling the behavior can help, so make sure you’re eating what you’d like your toddler to develop a taste for. This is a tricky age, toddlers are beginning to express their own free will so “no” becomes a favorite word. A way for them to express this is with refusing foods.
If you keep healthy snacks in the house instead of processed treats, they will be more likely to eat what is available, and learn to develop a taste for it.
We also want to address the skin barrier. Petroleum jellies are not helpful! The skin is a living, breathing organ, and petroleum jelly clogs the system essentially. Alternative, natural ways to address the skin barrier include:
- Sunflower seed oil can improve the barrier function of the skin
- Adding colloidal oats to bathwater (finely ground oats boiled to extract the colloidal material) may help because oats have cleansing, moisturizing, soothing and anti-inflammatory properties
- Adding rice starch to bathwater can be helpful for repairing a damaged skin barrier
- Adding a few drops of chamomile oil to bathwater can be soothing and anti-inflammatory, however patch test with the diluted oil first to check for allergies
- Heat and sweat can make eczema worse
- Probiotics for the skin can be helpful, because we have a skin microbiome just like we have a gut microbiome
- Mother Dirt products are fantastic for topical use.
- MegaSporeBiotic probiotics, not only taken orally, but also applied topically to the skin (mixed in moisturizing creams like shea butter), can be soothing for skin conditions like eczema. Again, to access MegaSporeBiotic probiotic, you will need to register as a patient and then use my personal access code because it is only available through a qualified practitioner. Follow this link to register, https://microbiomelabs.com/register/, and use the patient direct code JCBN to get your MegaSporeBiotic probiotics.
- For products/supplements that are not child specific, use 1/4 the adult dose (this is a general recommendation, however please consult a health care professional regarding dosing for your child).
- Let kids get dirty! This is how they develop their microbiome (gut and skin)
- Steer clear of dyes, fragrances and chemicals like those found in:
- Commercial skin care products/cosmetics
- Laundry detergent and fabric softeners
- There are some other skin hacks in my toolbox, and some come from my kitchen!
- All over body moisturizer, face included (avoid the eyes)
- Coconut oil (look for organic virgin), it could cause allergies in some people, so patch test before using it extensively
- Remedy for super dry skin, including the dryness that comes along with eczema
- Facial skin toner
- Apple cider vinegar diluted with filtered or distilled water (in a jar/container mix 1 part apple cider vinegar with 2 parts water, you may need to adjust the quantities, everyone is different)
- All over body moisturizer, face included (avoid the eyes)
Wrapping it up
Keep in mind that everyone is different. There is no one size fits all approach, and if you’ve tried all of these things and still have problems, working with a professional that can help guide you through these various interventions, and making sure they are customized for your (and your baby's) nunique biochemistry is important.
There are non-invasive diet, lifestyle and supplement recommendations that are more effective than many conventional treatments because they address root causes of the problem rather than masking symptoms with medications that will only make the problem worse long-term.
As you can see, eczema is way more than skin deep!
For assistance with identifying root causes and developing a customized protocol for your and your toddler's unique biochemistry, contact me today!