The Dermatologist Says…
For people who suffer from eczema, cold, dry winter air and irritating products can wreak havoc, causing flare-ups of dry, red, itchy and inflamed skin. These symptoms are typically found in the folds in the arms, behind the knees, on the back of the legs and on the face. Most instances of eczema can be categorized as atopic dermatitis, which means that the individual has genes that make her likely to suffer from eczema, asthma and seasonal allergies – known as the “atopic triad.” If you don’t have asthma or allergies, you might notice that others in your family do. Atopic dermatitis tends to begin in childhood, but it’s possible to notice the onset of eczema at any stage of life. Even if you’ve used the same creams or cleansers for a long time without an issue, you can develop sensitivities to certain irritants and allergens in those products that can trigger flare-ups at any time.
One of the most important things that eczema sufferers can do is purify their skin care regimen by eliminating fragrances and other harsh ingredients and seeking out gentle cleansers and moisturizers. Though some people think “gentle” means products with “natural” ingredients, this is generally not true. I recommend moisturizers that contain ceramides, which help skin retain moisture, and ingredients like oatmeal, which produce ceramides. Keep your showers short and moisturize within three minutes of getting out. Hard water and chlorine can be problematic for eczema sufferers, so rinse off immediately after swimming and, of course, moisturize again. In some severe cases, people may experience eczema around their mouths from eating acidic foods, which can irritate the skin directly, but otherwise diet doesn’t seem to play a significant role.
Getting Rid of Your Eczema, ASAP
To treat an excezma flare-up in the short term, I might prescribe a corticosteroid at a strength and formulation that’s tailored to you, based on your age and the severity and location of your eczema. It’s important that steroids are used appropriately, so avoid using a more potent steroid intended for hands or feet on your face or genital area and refrain from using the steroid in the same place for weeks or months at a time because the skin can begin to thin. I may also recommend topical immune modulators, which limit inflammation locally when the skin is healed or only slightly irritated. In rare cases where topical treatments don’t seem to be working, I may prescribe oral anti-inflammatories or immunosuppressants, which quiet the immune system and reduce its overreaction, which is causing the inflammation.
Dr. Sam Hanna is a dermatologist in Toronto and president of the Toronto Dermatological Society
The Naturopath Says…
Eczema is caused by an imbalance in the immune system, so when I’m treating a patient with eczema, I establish a thorough health history to see what factors might have caused her immune system to go awry. It’s true that eczema often has a genetic link, but since eczema sufferers experience good periods, during which their skin is unaffected, it’s important to figure out what’s going wrong when the flare-ups occur. Each person is different, but many of my patients that mention that feeling stressed, sleeping less and eating more sugar are triggers for them.
Eczema and Food Sensitivity
There are a few key things that may cause an immune imbalance. The first is food sensitivity. Most of the medical community thinks food isn’t related to eczema, but I find that’s not true clinically. About 30 percent of eczema cases are connected to diet in some way. Wheat and dairy are the most common culprits, but nuts, soy, dairy and eggs are also common food sensitivities. To find out if food might be a trigger for you, I would suggest an elimination diet, where you cut out foods that are commonly associated with sensitivies for three weeks and then reintroduce them one by one, leaving at least 72 hours between each one to watch out for signs of a reaction.
Next, since the microflora in the gut is intricately tied to the immune system, I would recommend supplementing with probiotics and taking certain herbal medicines, which have antifungal or antibacterial properties to help balance the organisms in the digestive tract. You can also support your body’s natural elimination process with natural remedies, such as herbs for the liver, cranberries for the kidneys and fibre-filled chia or flaxseed for regular bowel movements. We would also talk about your sugar intake because sugar feeds immune-disrupting organisms in the gut.
Finally, we would discuss stress, which impacts the immune system, and I would work with you to develop a stress-management plan. For some people, exercise works best; for others, it might be counselling, prayer or practicing yoga.
To treat your topical symptoms, I might recommend a multi-mineral and an anti-inflammatory fish-oil supplement to help reduce flare-ups, as well as a moisturizer with ceramides to help improve the skin barrier. Once in a while, I prescribe topical steroids – I’m not opposed to pharmaceuticals, but it’s not my first choice of therapy.
Dr. Nari Pidutti is a naturopathic doctor at Springs Eternal Natural Health Clinic in Vancouver