Allergy, Eczema, Asthma, Infant and Children, Immune | August 26, 2016 | Author: Naturopath
Eczema (atopic dermatitis) is a chronic inflammation of the upper layers of the skin causing itching and irritation. It is very common for children under the age of 12 months to be diagnosed with eczema and it can also continue through to adulthood.
There is usually a strong connection between eczema and other allergic conditions such as asthma, allergic rhinitis and food allergies. There is also a tendency for people to develop eczema who have family members with these conditions. A large cohort study identified that the prevalence of eczema in children in countries such as Australia and New Zealand is increasing by more than 14% each year. Approximately 10-20% of infants suffer from atopic dermatitis, making it one of the most common skin diseases.
Infantile eczema involves lesions that are red, crusted and oozing that develop on the face, diaper area, face, scalp, hands, arms or legs.
Adults or older children with atopic dermatitis (the most common form of eczema) usually present with dry, red lesions, usually in one or a few spots on the hands, upper arms, behind the knees and near the elbows. Lichenification can occur when there are large areas of scaly skin with scratching.
Other forms of eczema include contact eczema where a localised rash appears after an offending agent has come into contact with the skin and neurodermatitis which has a major stress related component.
Pruritus (itching) is a common symptom of all forms of eczema usually causing further damage to the skin and promoting infection. It is also typical for the severity of the symptoms to fluctuate due to the fact that there are many contributing elements.
Atopic eczema is associated with IgE antibody production as it is a type I allergic reaction. Foods commonly identified as allergens in people with eczema include cow’s milk, egg white, peanut, wheat, nuts and fish.
There may also be allergies to plant pollens, dust mites, animal dander or other chemicals.
Testing can be obtained via a skin prick test, specific IgE test or a patch test to determine delayed hypersensitivity reactions.
Other contact irritants can include strong detergents, soaps, fabrics such as wool and fragrances.
Psychological stress, skin dryness, becoming overheated, viruses and other infections, scratching and changes in the weather (temperature and humidity) can also be ongoing aggravating factors.
It is important to avoid factors that have been identified as main triggers such as food or environmental allergens. An elimination diet might be helpful in pinpointing food allergies or intolerances by eliminating them from the diet and then rechallenging foods to see if there is a reaction. It is also important to reduce external stressors and modify lifestyle risk factors such as smoking and alcohol consumption.
A key component of treatment is to reduce inflammatory foods in the diet such as saturated fats from meats, chicken and dairy, processed foods and sugar.
It is important to avoid the use of soap, detergents and perfumed products on the skin but to then keep the skin well hydrated. Topical anti-inflammatory herbs such as licorice, aloe vera and calendula can be used in a cream base to promote wound healing, while stinging nettle can help with excessive itching. Creams with manuka honey can help act as a natural antibacterial on the skin to reduce infection. Cool compresses can also be helpful to reduce inflammation and itching especially in children. Exposure to skin affected by eczema to sunlight for short periods of time may help to alleviate the area but be careful not to over expose.
The supplement with the most ground-breaking research involves the specific strain of probiotic, lactobacillus rhamnosus GG. Multiple studies have proven that it is effective in reducing the severity of eczema and food allergy by alleviating intestinal inflammation and promoting endogenous barrier mechanisms. A double-blind, randomised placebo-controlled trial showed that if taken in the last trimester of pregnancy it also reduced the child from developing eczema by half.
Eczema has been linked to a essential fatty acid deficiency, specifically a deficiency in delta-6-desaturase (the enzyme that converts linoleic acid to gamma-linolenic acid).
Gamma linolenic acid (GLA) found in evening primrose oil has been found to help ameliorate the symptoms of eczema. Fish oil has also found similar benefits by reducing inflammation and improving epithelial integrity. Cod liver oil may also be helpful as it contains omega 3, vitamin A and D.
Zinc and vitamin C are also important nutrients needed for skin healing and to reduce the allergic response. They also act as antioxidants, reducing oxidative stress on the skin.
Anti-allergy herbs such Albizia and Perilla can be helpful in reducing the release of histamine which contributes to inflammation and pruritus. The gastrointestinal system is considered an important element to treat in the management of skin disorders.
Herbs that can improve digestion and liver function include milk thistle (silybum marianum), dandelion root (taraxicum officinale), globe artichoke (Cynara scolymus) and gentian (Gentiana lutea). Lemon juice or apple cider vinegar in warm water before meals may also ensure adequate digestion of foods.
To conclude, an important primary step in management is to remove, where possible, any allergenic triggers. The treatment protocols above help to improve immune function, dysbiosis (an imbalance in the gastrointestinal bacterial population) and address potential nutritional deficiencies. It is also important to use topical agents to address skin repair, give symptomatic relief and improve skin barrier function.
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