Skin Series 3: Eczema
Treatment today is majorly lacking for eczema. So many parents are struggling with treating their child’s chronic eczema, often with topical steroid applications which are basically bandaid solutions to a never-ending problem. Eczema, also called atopic dermatitis, is a systemic issue, and working with a healthcare provider is essential to combatting eczema.
The following are general recommendations for adults with eczema. Consult the Nutrition Dispensary for guidance on this chronic skin condition including diet, supplementation, and lifestyle changes. Most of the supplementation recommendations also apply to children, but the specific products are meant for adults.
What Causes Eczema?
There are a few theories on what causes eczema. The generally accepted theory is that it’s a combination of genetics, poor skin barrier function, an immune response where IgE antibodies attack the skin (these antibodies cause allergic reactions), and environmental factors that aggravate the condition (1). A newer, possible theory is that eczema is actually an autoimmune condition, where the immune system IgE antibodies mount an immune response and attack the skin cells, causing widespread inflammation and damage (2).
Either way, we know that eczema is a chronic inflammatory skin condition, and that lowering inflammation, improving and regulating the immune response, while reducing known triggers (food, environmental etc.) can be very helpful for managing this condition. In holistic nutrition, our perspective is that many chronic diseases stem from gut health. So, we can target the gut in a holistic approach to managing eczema, with reducing inflammation being a main strategy.
General Lifestyle Recommendations
In terms of diet, there are certain foods known to be triggering for eczema, including dairy, eggs, wheat, soy, and more (3). Doing a short-term elimination diet (30 days) would be helpful in learning your or your child’s eczema triggers, which would usually appear in a matter of hours or days. It is helpful to work with a nutritionist when doing an elimination diet. Overall, an anti-inflammatory diet which removes the foods that you are personally sensitive to, is beneficial.
In addition, a few specific foods would be helpful in reducing inflammation and promoting gut health including:
- Bone broth, which helps in gut healing
- Fermented foods, like sauerkraut, which contains probiotics
- Anti-inflammatory spices (turmeric and ginger are very effective)
- A fibre-rich diet with lots of vegetables, fruit, and whole foods in general (organic grains, grass-fed meats, nuts, seeds, etc)
Make sure to also use gentle, natural products when choosing laundry detergent, personal care products, and anything else that touches your skin. For dry eczema, make sure to moisturize the skin well, especially when damp, to lock in moisture. Weeping eczema needs to be treated with a gentle antibacterial. Homemade salves (or those prepared by a herbalist) made with antibacterial herbs can be helpful for infections caused by scratching. Calendula cream can be very soothing on the skin.
Which Nutrients Can Help to Manage Eczema?
Eczema shows up as a result of an immune response. To modulate the immune system, probiotics can be extremely helpful. A good quality probiotic is becoming more common practice as more and more studies are coming out about its effectiveness in improving eczema. Multiple studies have shown effectiveness in improving atopic dermatitis with lactobacillus rhamnosus (4), a specific intestinal bacteria, especially allergy-related eczema (which is determined by a skin prick test measuring elevated IgE levels) (5).
Interestingly, one study gave this probiotic strain to pregnant mothers with eczema in their genetics (a one-degree relative, or their partner), as well as their infants for 6 months after birth. At age 2, the children in the probiotic group had half as much documented eczema as the placebo group (6). This suggests that prenatal and postnatal probiotics could be effective for preventing eczema outcomes in children. Another study had children from ages 1-13 on lactobacillus rhamnosus and lactobacillus reuteri for 6 weeks. The probiotic group experienced 56% improvement based on their own experience, versus 15% of the placebo group (7).
Genestra HMF Multi-Strain includes 16 different probiotic strains, including lactobacillus rhamnosus. For children, NFH Children Probio SAP contains a variety of probiotic strains including lactobacillus rhamnosus and child-specific probiotics.
From a holistic nutrition perspective, eczema is very much an inflammatory condition triggered by poor gut health. With impaired gut function, digestion and absorption is not optimal. The gut struggles to absorb proper nutrients from food and break it down properly during digestion, further exacerbating the problem. Digestive enzymes can be extremely effective in helping relieve some of the stress to the GI system, and pancreatic enzymes have also been studied for their effectiveness in improving eczema. One small study noted significant improvement in 9 of 11 participants with pancreatic enzymes, though this is considered a very small study (8).
Douglas Laboratories’ GI Digest is a mixture of pancreatic enzymes, plus lactase to help with dairy digestion if keeping this in the diet (a common trigger for eczema).
This is a great thing to add to promote gut healing. L-glutamine is an amino acid that works to heal the loose junctions in the cells of the digestive system, as well as promote cell regeneration in the intestines. Bonus: it will, over time and in combination with diet, help with other gut-related issues, like allergies, poor digestion, and more. Adults can take Designs for Health’s L-Glutamine Powder at the recommended dose.
Stronger skin is more resilient skin. In order to have strong skin, we must have adequate fat to provide the support that the top layers of skin require. Essential fatty acids are showing great promise in many skin conditions, including eczema, psoriasis, and more (9). Both omega 3s and 6s have important roles for the skin including immune system regulation, lowering inflammation, and creating homeostasis in the skin barrier (9). For more information about how fat plays a role in skin health, refer to our other Skin Series Articles on Aging and Acne .
Essential fatty acids can come from the diet in:
- Wild-caught fish and shellfish, as well as fish oils
- Oils: flaxseed, evening primrose oils, borage oil
- Raw, unseasoned nuts and seeds: walnuts, hemp seeds, chia seeds, etc.
Consuming a lot of fish may not be enough, taking an EFA supplement can augment your diet and be beneficial to your overall health. Consider either Pure Encapsulations EPA/DHA Essentials or Genestra’s Omega EFA Liquid. Also of importance to note is that fish oil in liquid form doesn’t taste like fish (at all!) due to enhanced molecular distillation.
This vitamin is often recommended for eczema sufferers, as it has so many roles in the immune system, skin health, and helping with autoimmunity. In North America, we simply do not get enough vitamin D in the winter months. Getting vitamin D levels tested is a good start to ensure you are getting enough. If supplementation is needed, 1000IU or more is a good starting dosage from October to May, but working with a practitioner and testing levels often is wise to ensure your levels are optimal.
Specific to eczema, vitamin D helps to strengthen the skin barrier, lower overall inflammation, help to modulate the immune response, and lessen the severity of symptoms (10). A small study of 11 children showed significant improvement in participants’ symptoms after only one month of supplementation with 1000IU. A larger study of 30 participants showed positive results as well (10).
There are many options for supplementation, including tablets or liquids (ideal for children). There are numerous choices; NFH Vitamin D3 capsules for adults or Genestra D-Mulsion 400 for children are two of them. Many fish oils supplements will also contain Vitamin D effectively combining two products into one.
Red Light Therapy
Red light therapy is a machine that emits low wavelengths of two types of light: red light, which mimics the light from sunrise and sunset; and near-infrared light, which is responsible for charging the cells with energy, promoting healing and lowering inflammation. Note that this is different from UV light, which allows for vitamin D production – red light does not burn your skin. Red light is calming, and near-infrared light promotes improved energy for the cells. They must be used in combination for their healing benefits. While there is no substitute for real sunlight, these machines are helpful biohacks, especially for those of us in the Northern Hemisphere with long, dark winters.
Currently, there is little research proving the effectiveness of red light therapy with eczema in humans, but there are many, many anecdotal reports of people claiming it virtually cleared their eczema. One very small study of 9 participants with psoriasis showed success and demonstrated the anti-inflammatory effectiveness of red light therapy (11), and another larger study of 136 participants showed that both red and near-infrared light improved skin density, collagen density, and overall skin “feeling” (12). There have been a few studies that demonstrate effectiveness of red light therapy treating atopic dermatitis in mice (13, 14) in combination with either immunosuppressant medication or water bath.
We will have to wait for the human studies to show red light therapy’s effect on eczema specifically, but we know that this type of light is beneficial for wound healing and inflammation in the skin (15). Since red light therapy promotes wound healing and lowers inflammation, it could be useful for healing eczema and psoriasis rashes and scars, providing itch relief, as well as lowering inflammation in the skin overall (16). Since it helps with collagen density, this provides structure to the skin and makes it stronger and more resilient.
Note that red light therapy machines are quite costly, so if this interests you, it would be an investment. If you find a machine that seems too good to be true in terms of cost, it is likely just that. Do your research before making this purchase.
Eczema is a complicated systemic issue, and your best success with combatting this issue will be through working with a natural healthcare ally such as a nutrition coach. This person can help you make the necessary changes to your diet, supplements and lifestyle needed to manage eczema. It is possible: contact us today.
Blog Written by: Jennifer Costello
Nov 2022 Nutrition Dispensary Inc.
Advice and/or information provided is not intended to diagnose, cure, treat or prevent disease.
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