Richard Whelan ~ Medical Herbalist

I have treated hundreds of people with eczema since I began full time practice as a Medical Herbalist in 1989. I've had many successes along the way but it has rarely been easy!

The biggest immediate challenge in treating eczema is the rebound that kids and adults get when they stop or even just slow down on their steroids.

Steroids work, no doubt, steroidal creams (and internal steroid drugs if things are bad enough) are by far the main treatment that conventional medicine brings to eczema. Unfortunately after the effects wear off the problem rebounds back again.

Rebound is not a chance event that only happens to the unlucky; it is a phenomenon that occurs again and again and many people with eczema get caught in this cycle. It is a hard place to get out of, courage and patience are needed along with the maturity to know when things have become too inflamed to not resort to using a steroidal treatment again. The less you use steroids the better, obviously, but an all of nothing approach to this will not work for severe cases.

I hope that some of the ideas I discuss here will help you in your journey with getting well and free from eczema. I do not promise quick fixes or easy answers but eczema is a condition that I know well and can say ‘here are some things that reliably seem to work’.

You may have already realized that I am not selling or promoting any products on my website, also unless you are able to see me in person I cannot treat you from afar so if you or someone you love has bad eczema then I urge you to consider finding a good herbalist to help you along your way.

Serum IgE (an allergic antibody) levels are elevated in eighty percent of eczema patients
Many eczema patients eventually develop other allergies, e.g hay fever and/or asthma
There is a family history of allergy in two-thirds of eczema patients
Most people with eczema improve with a diet that eliminates common food allergens

These statistics are well supported by research, up to seven percent of the population suffers from eczema so there have been good quality studies shedding light on who gets it and what kinds of things cause it.

For example, studies support the position that breast-feeding offers significant protection against eczema and allergies in generally. If infants who are breast-fed develop eczema it is usually the result of the transfer of allergic antigens in the breast milk. If this occurs, a mother should try to avoid the most common food allergens; milk, eggs, and peanuts, and to a lesser extent, fish, soy, wheat, citrus, and chocolate. Having the mother avoid these common allergens is associated with a complete cure in the majority of cases! In older, or formula fed infants, milk, eggs, and peanuts appear to be the most common food allergens that induce eczema. In one study, these three foods accounted for roughly eighty-one percent of all cases of childhood eczema.

Finding a pattern of a family history can be an important factor in determining the likelihood of allergy, as the tendency to be reactive to certain foods or substances can be inherited. A pattern of physical signs such as cracks in the corners of the mouth, dark rings under the eyes and a horizontal crease on the eyelids can also point to a greater likelihood of allergies.

I have written an article here on Allergy and Intolerance that goes into more depth on this subject.

A big problem with eczema, especially when it has become advanced, is secondary infection of the skin. The skin has been damaged by inflammation and scratching and so becomes vulnerable to the bugs that are always around us.

As you can easily spread this infection around your own body by scratching one of the most practical and important things you can do to prevent this is to keep your child’s or your own fingernails very clean and very short!

I recommend my patients to use some kind of antiseptic treatment as part of their eczema program. It is hard to make a general recommendation about what might be best to use here because eczema is so variable but these are some common considerations

If the skin is dry then a cream that contains antimicrobial substances will generally be very beneficial. However if the skin and eczema is damp or wet then substances in the cream can just end up feeding the bacteria. In those cases a straight wash of tea-tree or lavender oil essential well diluted in water may be much more helpful.

For the science-minded of you reading this, an alteration in the immune systems of eczema sufferers has been noted. It involves a defect in the alternate complement pathway, which is an immune mechanism that is important in destroying bacteria and foreign particles. Interestingly, the historic use of eczema ‘cleansing’ herbs such as Burdock root and Dandelion root has been shown to potently activate this alternate-complement pathway (thought to be because of a substance called ‘inulin’ in both Burdock and Dandelion roots).

As an eliminative organ itself, the skin is especially vulnerable to showing problems when the liver, bowel or kidneys are struggling to cope with the load of cleansing that they are required to keep up with on a daily basis. The use of diet and medicines to promote cleansing and detoxification has been the main traditional approach of herbal medicine for thousands of years for chronic skin problems. Herbs such as Burdock, Dandelion, Red Clover and Cleavers have been seen to make a lasting difference if used over a sustained time frame. You can read more about this area in these articles on‘What is detoxification’ the ‘Cleansing diet program’ and the ‘Juniper and Celandine cleanse’

In the early 1990’s several European studies demonstrated some very positive effects from using Evening primrose oil for chronic eczema patients. There were good reasons for this as summarised in the technical explanation below. Subsequent studies have shown that omega-3 is equally effective as Evening Primrose oil.

Patients with eczema appear to have an altered essential fatty acid and prostaglandin metabolism (prostaglandins are hormone-like compounds made from fats). Analysis of fatty acids in blood cells of patients with eczema demonstrates a tendency for linolenic acid levels to be increased while levels of longer-chain polyunsaturated fatty acids tend to be relatively low. These changes lead to a greater tendency to allergies and inflammation. Initially it was thought that patients with eczema might have a decreased activity of delta-6-desaturase, the zinc dependent enzyme that converts linolenic acid to gamma-linolenic acid. If such a defect exists, supplementing the diet with evening primrose oil, borage, or blackcurrant oil should prove helpful. Ths had been seen to be true; several double-blind studies using high doses of evening primrose oil have shown benefit in improving the symptoms of eczema. Further studies have shown that treatment with omega-3 oils also appears to deal effectively with these prostaglandin abnormalities.

I often get my adult patients to take from 6 to 8 capsules of either Omega-3 fish oil, Evening primrose oil or a combination of both. When they are getting much better we can drop the dose. I recommend they take 3 capsules a day long term even when they are well. I have special omega-3 sachets for children that are similarly high dose. You will be easily able to find such products too.

Does stress cause eczema?
I don’t know. Many of my patients have said they think so, perhaps they are right.
Does stress make eczema worse?
To that I think I can say yes, definitely.

Eczema causes plenty of its own stress too. I have seen that visible eczema, when it is noticeable on the face and/or hands, is one of the most stressful things a person can have to deal with, such problems can be profoundly demoralizing.

Stress is a huge subject in itself, I talk about it a lot in different parts of this site but the main point I want ot make is that eczema itself is stressful and for that reason alone anything that you can do to reduce stress and increase relaxation can only help in its successful resolution.

I said at the beginning that I have treated hundreds of people with eczema and have had a great many successes and challenges along the way. This is true but I didn’t say spell out what I thought was the difference between success and failure. Steroidal rebound is certainly the biggest immediate challenge but by far the hardest overall challenge in getting well from eczema is that it takes time. You have to be thinking in terms of months and for many people that is, understandably, not an easy prospect to face.

Of course you expect to see signs of progress along the way to know you are on the right track but it also often happens that there are temporary set-backs when things get worse again too, that's hard. Herbal, natural treatment of eczema truly can work wonders but it may need much patience and perseverance.