What is eczema?
Eczema is an inflammation of the skin occurring in infants, children, adolescents and adults, characterized by redness, swelling and tiny fluid filled blisters when acute. The blisters may be oozing, scaly, crusting and can sometimes harden into very thickened skin. The chronic phase is characterized by crusting, scaling, continued redness and thickening of the skin.
The patients and their relatives have above average incidences of asthma and hay fever. Studies have indicated that the immune factors of expectant mothers are passed on to infants, with baby having twice the risk of developing eczema if their mothers had asthma or eczema during pregnancy.
Factors that may trigger the itch include extremes of heat or cold, rapid changes of temperatures, sweating, woolen prickly clothing, irritants such as soaps, detergents, hydrocarbon solvents (eg petrol or kerosene) cutting oils and greases.
How is the immune system involved?
The immune system is balanced with T1 and T2 cells. These are called T helper cells, and have separate effects to provide immune defense, while limiting the over expression of each other. T1 cells are in charge of killing potential bacteria, viruses, fungi and tumours, whereas T2 cells protect the body from allergens, chemicals and parasites.
The proposed reason why children show higher frequency of allergy is because we are all born in a T2 dominant state, which prevents the foetus from being attacked in utero as a potential invader by the T1 cells. Th2 dominance continues into childhood and then adolescence if insufficient Th1 stimulus has not been provided. This could be due to an overly sanitary lifestyle (known as they hygiene hypothesis), where the T1 defense system does not get enough practice in fighting bacteria and viruses, and the T2 system may over react as an allergic reaction to harmless substances like pollen or food antigens.
The other proposed hypothesis for increased prevalence of familial allergic diseases is that nutritional patterns have changed or we are exposed to environmental toxins that were not previously present.
There are several modifiable factors that play a role in polarizing the immune system to an allergic state such as:
· Psychological stress
· Dietary elements
· Dysbioisis (imbalance of good and bad bacteria in the gut) Antibiotics kill good bacteria.
· Environmental pollutants/ chemicals
· Long term pharmaceutical drug use eg antibiotics.
· Vaccinations promote allergies by stimulating TH2 immune response and inhibit TH1(1)
The most important of all is the link between digestive disorders and allergy.
T1 and T2 cells are a part of the immune system.
Eczema is a classical T2 condition, and patients often suffer with related T2 excess conditions such as asthma, hay fever, food allergies, and allergic rhinitis. The excessive T2 response results in greater B cell activation which in turn secrete high levels of IgE antibody. IgE antibodies bind to mast cells and release histamine. Histamine is responsible for redness, itching, vasodilatation and mucus production.
The Atopic March
How symptoms in childhood may develop over time.
Atopic eczema and food allergy commonly occurs in infancy and early childhood
Asthma and perennial rhinitis commonly occurs in school years
Seasonal rhinitis and conjunctivitis commonly occurs in the teenage years.
Douglas JA, O’Hehir RE. Diagnosis, treatment and prevention of allergic disease: the basics
MJA 2006; 185:228-233
Causes and Naturopathic treatment of eczema
According to the 10th edition of Harrison’s Principles of Internal Medicine, over 30per cent of eczema patients develop respiratory allergic manifestations. Environmental factors such as pollution, foods, chemicals, detergents and stress, can act as triggers. Other problems are poor elimination through weakness of the liver and/or kidneys and sluggishness of the bowel and skin. These latter problems may be inherited and often accompany a particular constitution which predisposes towards chronic skin ailments. As part of this inherited tendency in cases of childhood eczema, we often find a lack of assimilation of calcium. Any form of treatment which is suppressive such as cortisone, tar ointments or even mild anti inflammatory agents such as calamine lotion, is strictly avoided. Eczema is treated as a toxic condition which involves an inherited factor. Treatment is directed to improving elimination through bowel, kidney and skin and to improving detoxification by toning the liver. (2)
Recommendations for Eczema
· ABO Blood type diet
· Avoid soaps and detergents
· Lubrication such as Essential fatty acids, olive oil, or vitamin E
· Remove wheat, milk, eggs, peanuts
· Remove tomatoes and night shade foods
· Remove additives and preservatives
Many atopic Eczema patients show a deficiency in Delta-6 Desaturase. (the enzyme that converts dietary fats down a pathway to proper assimilation in the body) Delta-6 Desaturase deficiency may be a principal underlying cause of atopic eczema. Most (usually children) atopic Eczema patients show Glutathione Peroxidase deficiency. Fish oil and evening primrose oil do not require this enzyme reaction to be utilized, and are excellent treatment options.
Most (usually children) atopic eczema patients show glutathione peroxidase deficiency. Nutrients which increase glutathione include selenium, B2, cysteine, glutathione glycine and glutamine. Selenium (Brazil nuts, garlic) helps restore these levels.
B6 is essential for activation of delta 6 desaturase enzyme and increases T1 cells.
Lactobacillus acidophilus may alleviate Eczema by enhancing T1 immunity and balancing T2 immunity.
Lactobacillus rhamnosus may alleviate (atopic) Eczema by enhancing natural immunity.
Eczema may sometimes occur as a symptom of Calcium deficiency. According to Dr Morris Blackmore, suppression of eczema with creams etc can drive wastes deeper and can manifest in the future as asthma. Eczema is an attempt to eliminate pathogenic wastes through the skin. In babies with colic regularly upon feeding, and children who vomit easily this remedy is indicated. It is also indicated in itchy, eczema and chafed skin. Calcium is not normally considered in dermatological conditions, yet in mineral therapy calcium phosphate is regularly utilized. Calcium phosphate is highly indicated in times of growth in children.
Other minerals may be indicated to enhance digestive function.
In chronic eczema the severity of the condition seems to correlate with the extent of stomach hydrochloric acid deficiency. This decrease in HCL is associated with B vitamin group deficiency and genetics.
Emu Oil (applied topically or capsules consumed orally) may reduce the inflammation of the skin associated with Eczema.
Lavender (oil added to bath water) may alleviate Eczema. Eczema is claimed to respond well to Neem Oil (applied topically).
Oregano Oil (applied topically) may alleviate Eczema.
Tea Tree Oil (applied topically to the site of the Eczema) may alleviate the itching associated with Eczema.
Garlic oil mixed with lanolin or liquid chlorophyll mixed with lanolin. Garlic contains selenium and glutathione which act as antioxidants and is anti inflammatory
Essential oils of Geranium, Chamomile, and Lavender for dry eczema, and
Bergamot and Juniper for wet eczema can be used in a base of jojoba oil or dropped into the bath. It’s always a good idea to patch test essential oil blend to make sure they are not going to irritate your skin condition first.
Attending to the underlying cause of eczema is important in successful treatment and prevention of ongoing atopic allergic reactions. The total mucosal surface of the adult human gastrointestinal tract is up to 300m2, making it the largest body area interacting with the environment. The intestinal mucosa represents a large proportion of the human immune system. (6, 7)
Inflammation of the mucosa of the digestive tract can cause intestinal permeability and increases the amount of allergens able to pass across the intestinal mucosa. Inflammation can also result in immune disturbances, directing the immune response towards allergy in susceptible individuals and be an under lying cause of the majority of gastrointestinal disorders which may further perpetuate allergy. (5)
Amongst many important gastrointestinal changes, the microflora of the digestive tract in allergic individuals has been shown to be altered with decreased bifidobacteria and increased numbers of pathogenic organisms. This is important because the gut bacteria influence systemic immune function and may predispose to or prevent allergies. (3, 4)
Testing of gut bacteria can be achieved with a simple urine analysis in clinic.
Comprehensive resolution of allergy requires the correction main causative factors mentioned whilst simultaneously restoring good digestion and correcting any inflammatory and permeable gut issues.
1: Ward BJ, Griffin DE. Changes in cytokine production after measles virus vaccination: predominant production of IL 4 suggest induction of a Th2 response. Clin Immunol Immunopathol 1993 May; 67(2); 171-7
2: Judy Jacka ND A-Z of Natural Therapies Third Edition 2005 Griffin Press
3: Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol.2003 Dec; 112(6 Suppl): S118-27.
4: Yale S, LaValle JB. Food Allergies and atopic dermatitis. Alternative and complementary therapies 2002:76-80.
5: Heyman M. Gut barrier dysfunction in food allergy Eur j Gastroenterol Hepatol 2005; 17: 1279-1285.
6: Bjorksten B. Effects of intestinal microflora and the environment on the development of asthma and allergy. Springer Semin Immunopathol. 2004 Feb; 25(3-4):257-70
7: Biancone L 3et al. Resident bacterial flora and immune system. Dig Liver Dis. 2002 Sep; 34 Suppl 2:S37-43.
Websites of interest
http://www.dadamo.com/ Blood type diet
http://www.novamagazine.com.au/article_archive/2009/2009-04-costofclean.htm Dr Dingle
http://drdingle.com/info_sheets.html Dr Dingle
www.possibility.com.au (The chemical maze)
My dog eats better than your kids. Dr Peter Dingle
Is your home making you sick? Dr Peter Dingle
Breaking the vicious cycle by Elaine Getshall
Grainfree gourmet by Jodi Bolger and Jenny Lass