Help and support for eczema with Functional Medicine

Eczema is a chronic inflammatory condition of the skin. It can affect both adults and children and symptoms can vary a lot between individuals. In mild cases, the skin is dry, scaly, red and itchy. In more severe cases eczema will be more widespread. There may also be weeping, crusting and bleeding.

Constant scratching of the affected skin can lead to bleeding and skin infections. With time the skin can also change in appearance becoming leathery in the areas where scratching has been persistent.

In healthy skin, the skin cells are tightly knitted together and fats and oils help to keep the skin cells hydrated and keep harmful substances from entering through the skin. In eczema, the protective barrier is not as good as it should be. The skin does not produce as many protective fats and oils and the skin cells don’t fit together as tightly. This causes moisture to be lost from the skin and the skin cells to be less plump. Tiny gaps develop between the cells allowing bacteria or irritants to gain entry. The causes the skin to become dry, inflamed and itchy.

There are lots of different types of eczema. They have similar symptoms but different underlying causes.

Atopic eczema is the most common form of eczema. Symptoms typically occur on the flexor surfaces of the body such as the backs of the knees and inside of the elbows but may be spread all over the body. It is caused by a combination of genetic factors that make the skin barrier leaky, and environmental triggers. It is common for the eczema sufferer or their family members to also have other atopic conditions such as asthma and hayfever. In atopic conditions, the immune system overreacts to things that would not normally do any harm. These can be allergens such as pet dander, dust mites, pollen or foods or household products such as detergents and washing powders. For each person the triggers are unique. When their compromised skin comes into contact with one of their triggers the skin becomes inflamed and itchy as the immune system overreacts. Management of atopic eczema usually involves using emollient (soothing) creams and hydrocortisone (steroid) preparations. These manage the symptoms but don’t treat the underlying cause and long-term use of steroid creams can thin the skin. There are also stronger medications available for very severe eczema that work by suppressing the immune system. These are always a last resort and there are many side effects.

Contact dermatitis is a type of eczema that only occurs when the skin comes into direct contact with an irritant substance. This can be a soap product, a household chemical, a cosmetic product, a perfume, certain raw foods or a metal such as nickel. Common sites for irritant contact dermatitis are the hands and face, but the condition can affect other parts of the body. Symptoms are always limited to the part of the skin exposed to the irritant. In mild cases, the skin will become dry or red. In severe cases, the area will appear burnt and may become ulcerated. A person who had atopic eczema as a child is at an increased risk of developing irritant contact dermatitis. Chefs, hairdressers, cleaners, nurses and construction workers are also at increased risk due to their more frequent contact with potential irritants. Prevention is better than cure so treatment for contact dermatitis involves limiting exposure to the irritant. Emollients and hydrocortisone creams are usually prescribed to manage a flare-up.

Seborrhoeic dermatitis occurs as a flaky skin condition in areas of the body where there are a lot of oil glands. It usually starts on the scalp as dandruff, then progresses to redness, irritation and increased scaling. I can also spread to other areas of the body such as the face, behind the ears, neck, armpits and groin. The affected skin looks red and greasy and sheds white flakes of skin. On the scalp scales stick to the skin and surrounding hair, making the area look thickly crusted. The cause of seborrheic dermatitis isn’t fully understood. It is thought to be the result of an imbalance in the microbes living on the skin, in particular, an overgrowth of yeast species. It is usually treated with medicated shampoos or mild anti-fungal or steroid creams.

The functional medicine approach to eczema involves identifying and managing the underlying causes rather than just the symptoms:

• The first step is to identify trigger factors. This involves getting a thorough understanding of your case history and then where necessary doing additional allergy and sensitivity testing. Your practitioner can also advise on bathing practices and natural skin products which will help. ¹,²,³
• If food is a potential trigger this can be detected using an elimination diet. Your functional medicine practitioner can then give you advice on how to avoid the problem food and what to eat instead.
• There is a lot of research linking imbalances in the digestive system with eczema. Symptoms such as bloating, gas, abdominal discomfort and reactions to foods can indicate an underlying problem. Functional testing can help to pinpoint the cause so the problem can be addressed. ⁴
• Eczema can also be related to disparities in the way the body metabolises certain fats. This can lead to a tendency towards inflammation. Supporting fatty acid metabolism and redressing the balance of these fats with diet and supplements can calm eczema. ⁵
• Functional medicine can also work directly on the inflammation in the body using food and supplements. In eczema, there’s a tendency for the immune system to behave in a more inflammatory way than normal. Specific foods, herbs and supplements can help to temper this. ⁶