ECZEMA

THEY'RE RED, ITCHY, SOMETIMES weepy patches of skin, and they are as distressing to adults as they are to children. Scratching worsens them; the patches become scaly, thickened and infected. They're the calling card of eczema.

Although the medical name for eczema, atopic dermatitis, means allergic skin inflammation, researchers have not yet nailed down the precise role that allergies play in this condition. They do know that eczema seems to occur along with other allergic conditions, such as asthma and hay fever.

DRUG TREATMENT

Topical Corticosteroids

Many types and many brands. Function: suppress skin inflammation; usually used topically, but in rare, severe cases, used internally. Side effects of topical drugs: thinning skin, linear streaks on the skin, suppression of body production of steroids. Side effects of oral drugs: acne, nausea, vomiting, indigestion, headache, insomnia, dizziness, increased appetite, weight gain, poor wound healing, immune system suppression; with long-term use, muscle loss, cataracts and osteoporosis.

Sedating Antihistamines

Diphenhydramine (Benylin and others), clemastine (Tavegil), hydroxyzine hydrochloride (Atarax, Ucerax). Function: decrease itching by blocking body chemicals called histamines. Side effects: drowsiness; dizziness; dry mouth, nose and throat.

Non-sedating Antihistamines

Acrivastine (Semprex), loratadine (Clarityn), cetirizine hydrochloride (Zirtek). Function: decrease itching by blocking histamines. Side effects: dry mouth, nose and throat.

Other Drugs

Topical creams containing coal tar (Alphosyl, Clinitar, Exorex, others). Function: decrease itching and inflammation when corticosteroid creams fail, or when the potency of topical corticosteroids needs to be reduced. Side effects: inflammation of hair follicles, increased skin reactions to sun exposure.

Aluminium acetate solution. Function: helps relieve skin irritation.

Side effects: usually none.

HOW TO KEEP THE MOISTURE IN

Because eczema is generally a dry skin condition, you want to keep your skin moist. Although baths hydrate the skin, turn down the hot water, which often aggravates itching. And don't soak too long or bathe too frequently; you're depleting your skin's natural oils. On the few parts of your body that need soap (most do not), use a mild variety. Finally, when you're done bathing, pat excess water rather than rub dry. Immediately apply plenty of body lotion or cream to hold the moisture. Avoid products with alcohol, synthetic fragrances or lanolin; use products that incorporate skin-soothing herbs.

THE FATTY-ACID CONNECTION

Some people with eczema have fatty-acid imbalances. Basically, they need more of the omega-3 fatty acids (the kind found in cold-water fish and flaxseeds) and more of an omega-6 fatty acid called gamma-linolenic acid (found in borage, blackcurrant and evening primrose seeds).

Some studies have found that medicinal oils rich in gamma-linolenic acid, such as evening primrose oil, improve the condition. One suggested dose for evening primrose oil is 3,000 milligrams in capsules per day.

Other studies show benefits from fish oil, a rich source of omega-3 fatty acids. Flaxseed oil contains alpha-linolenic acid, which the body can convert to the omega-3 fatty acids that occur in fish oil. If you really want to boost your overall health along with your skin's health, incorporate into your diet foods rich in omega-3s: cold-water fish (mackerel, salmon, herring, sardines, anchovies), ground flaxseeds, pumpkin seeds, walnuts and dark-green leafy vegetables.

ALLERGIES AND ECZEMA

Research indicates that three types of allergens mad contribute to eczema.

1. Food allergens. Although food allergies can be a factor for some people with eczema, so far no simple, bulletproof tests accurately diagnose all food allergies. Many experts think the best test is removing the common culprits - especially milk, eggs and peanuts - from the diet for at least four days and watching for changes in your skin and overall health. Then reintroduce the suspect foods one at a time, no sooner than every three days. If a food recreates or worsens your symptoms, you've solved at least part of your itchy mystery.

2. Airborne allergens. Whether they're inhaled or they come in contact with your skin, these fly-abouts may be part of an eczema problem. The most common culprit is the very common house-dust mite. Others are plant pollens, animal danders and moulds.

3. Microbes. Bacteria and yeast can aggravate skin allergies. Many people with eczema also have more bacteria, such as Staphylococcus aureus, on their skin than people without the condition. People with eczema are also more likely to develop fungal skin infections and allergic reactions to these fungi. Cleaning with antibiotic or antifungal products can help.

A HERBAL REMEDIES

Liquorice (Glycyrrhiza glabra)

This herb has potent anti-inflammatory properties, just what you want in a herbal remedy for eczema. It seems to act similarly to corticosteroids, but without the negative side effects of such drugs. Liquorice also inhibits the breakdown of cortisol, the body's own corticosteroid.

In a study children with eczema who drank a tea made from 10 Chinese herbs - one of which was liquorice - showed marked improvement over those who received a placebo tea that didn't contain the herbs. Typical dosage: up to two 400- to 500-milligram capsules three times per day; or 20 to 30 drops of tincture three times per day; or up to 3 cups of tea per day (simmer 2 teaspoons of dried root in 680 millilitres of hot water for 10 to 15 minutes). Liquorice is intensely sweet, so you might want to add other herbs to your tea.

To use liquorice externally, simmer 2 tablespoons of ground dried root in 450 millilitres of water for 15 minutes. Strain, cool, and apply to eczema patches with a clean flannel. Or you can look for natural skin products that contain liquorice or glycyrrhetic acid, one of liquorice's active ingredients. Caution: do not take internally for more than six weeks. Do not use if you're pregnant or have high blood pressure, heart or liver disease, diabetes or severe kidney disease.

Burdock (Arctium lappa)

Taken internally, this root decreases inflammation. Herbalists consider it a traditional remedy for many kinds of skin disorders, including eczema. Rich in minerals, burdock also contains inulin, which stimulates an immune pathway to destroy the skin bacteria that can worsen eczema. Typical dosage: 1 to 4 cups of tea per day (simmer 2 teaspoons of dried root in 680 millilitres of hot water for 10 to 15 minutes); or two 400- to 500-milligram capsules three times per day; or 10 to 25 drops of tincture three times per day. To use externally, simmer 1 tablespoon of dried root in 450 millilitres of water for 10 to 15 minutes. Strain, cool and apply with a clean cloth.

Dandelion (Taraxacum officinale)

Like burdock, this common plant contains inulin, which improves the body's ability to dispose of unwanted bacteria. Dandelion also stimulates digestion and liver function. And it's full of vitamins and minerals, many of which help maintain healthy skin. You can eat the young, fresh leaves raw in salads or steamed as a vegetable. Typical dosage: 1 to 4 cups of tea per day (simmer 2 to 3 teaspoons of dried root in 450 millilitres of hot water for 15 minutes); or two 400- or 500-milligram capsules three times per day.

Gotu Kola (Centella asiatica)

This versatile herb can be used externally and internally to help heal wounds and reduce skin inflammation. Typical dosage: 1 cup of tea per day (steep 1 teaspoon of dried herb in % litre of hot water for

10 minutes); or up to eight 400- to 500-milligram capsules per day; or 20 to 40 drops of tincture twice per day. For external use, cool the tea above and apply it to eczema patches using a clean cloth. You can also find gotu kola as an ingredient in herbal creams.

Echinacea (Echinacea purpurea, E. angustifolia, E. pallida)

This American wildflower contains substances that fight infection, decrease inflammation, and stimulate the formation and repair of connective tissue. A German study found that a salve made from the juice of the above-ground parts of E. purpurea was effective in treating several types of inflammatory skin conditions, including eczema. In addition to using echinacea salves, you can apply an echinacea tea as a cool compress. Simmer 1 tablespoon of dried, minced root in 450 millilitres of water for 15 minutes. Strain, cool and apply to inflamed skin with a clean cloth.

 

 

Comfrey (Symphytum officinale)

This traditionally revered herb contains allantoin, an ingredient in many skin lotions. Allantoin soothes the skin and speeds healing by promoting the growth of skin cells. To use, apply comfrey as either a salve or a compress. Simmer 2 teaspoons of dried root in 450 millilitres of water for 10 minutes, strain and cool; use a clean cloth to sponge on the solution. Caution: do not apply to broken or scraped skin. If you're pregnant or breastfeeding, avoid applying comfrey or comfrey products to large areas of skin.

Coleus (Coleus forskohlii)

This Indian variety of coleus should not be confused with the common houseplant. The medicinal coleus can reduce the release of histamine and other inflammatory chemicals by increasing levels of a substance called cyclic adenosine monophosphate (cAMP) within cells. So far, studies have focused on its use for asthma, but researchers are currently looking at new eczema drugs that also work to prevent the breakdown of cAMP. If drug companies are willing to invest research funds on cAMP's role in eczema, then herbs that affect cAMP may be worth a try for your eczema. Michael T. Murray, N.D., author of The Healing Power of Herbs, recommends that people with eczema take 50 milligrams of an extract standardised to contain 18 per cent of the active ingredient forskolin two or three times per day.

Oregon Graperoot (Berheris aquifolium) and Goldenseal

(Hydrastis canadensis)

These herbs have a place in the treatment of eczema for two reasons. First, they promote good digestion and liver function, thereby helping the body get rid of minor toxins that may promote inflammation. Second, the berberine that both herbs contain is a potent antimicrobial substance. It fights bad bacteria such as streptococci and staphylococci that can complicate eczema. Typical dosage: up to six 500- or 600-milligram capsules per day in divided doses; or 10 to 20 drops of tincture three times per day. To use externally, simmer 2 teaspoons of dried root of either herb in 450 millilitres of water for 10 to 15 minutes, strain, cool and use as a wash. Caution: do not take either herb internally if you are pregnant.

Oats (Avena saliva)

This familiar breakfast grain soothes and moistens skin. There are three great ways to use oats for eczema. Method 1: boil 2 to 2% litres of water, toss in 2 handfuls of oatmeal, and simmer for 10 to 15 minutes. Strain into a bathtub of water, or cool the solution and apply to your skin with a clean cloth. Method 2: put 1 to 2 handfuls of oatmeal in a sock or tie into a piece of muslin. Drop the oat sock in the bath as the hot water is running. You can then use the oat bundle as a sponge on itchy areas. Method 3: buy a commercial colloidal oatmeal mix. These products are designed to be poured directly into the bathtub. The one method to avoid is pouring whole oats directly into the bath. This creates a giant cleaning project and isn't good for your plumbing.

Avocado (Persea americana)

Avocado is good to eat because it contains vitamins A, D and E. The same vitamins make avocado good for the skin. To help reduce the itching, dryness and inflammation, apply the mashed fruit directly to patches of eczema, or (if green's not your colour) apply the oil.

ONE GOOD EXCUSE TO SUNBATHE

Sunlight often helps clear up eczema. To reduce the risk of sunburn, either keep sun exposure short or wear a hypoallergenic sunblock. Go indoors if you start to feel hot and sweaty, which can aggravate itching.