Functional Approach to Infant 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
Babies and children tend to develop eczema on their face (cheeks and chin especially), and in their elbow and knee creases, but it can occur anywhere on the body. 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.
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.
From a nutritional standpoint, if baby is bottle fed, you may have tried broken down hydrolyzed cow's milk protein formulas, however know that some studies show that using this type of formula is NOT better for preventing eczema and allergic conditions. If your infant already has a cow’s milk allergy that you know about, extensively hydrolyzed formula might be helpful, but using this type of formula isn’t going to help prevent eczema and allergy symptoms from happening in the first place. Soy is an alternative, but soy can also trigger eczema and allergy symptoms. Alternative options are protein hydrolysate formulas, which are made for babies that can’t tolerate soy or milk. These formulas are hypoallergenic, and contain all the essential nutrients baby needs, and they are easy to digest.
For infants that are breastfed, step one is for mom to remove common trigger foods from her diet. These trigger foods 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:
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 a probiotic during the last month of pregnancy and while nursing could reduce your baby’s risk of eczema. Probiotics support the gut microbiome (the bacteria in our guts that lives symbiotically with us and keeps us healthy when it’s balanced). Not only can this be helpful for eczema, it also can help with food allergies (lessen the risk for their development as the infant grows into childhood), and asthma. Infants and children can benefit from taking probiotics too. Fermented foods are natural probiotic sources, and examples include:
- Yogurt (if avoiding dairy can use coconut yogurt)
Regarding diet and eczema, eating a whole, real foods diet, that is anti-inflammatory, 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
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:
- Coconut oil is moisturizing, but it could cause allergies, so patch test before using it extensively
- 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
- 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
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 baby's unique biochemistry, contact me today!