Eczema
Atopic eczema is a very common inflammatory skin condition. Symptoms include itchy, dry, red skin that may be broken or cracked. Scratching can lead to more severe symptoms in which the skin is constantly itching, swollen and oozing fluid and may become scaly, thickened and infected with bacteria, usually Staphylococcus aureus. White blood cells from people with eczema tend to have decreased prostaglandin levels, increased histamine release and decreased ability to kill bacteria.
Atopy is a genetic predisposition to form excessive IgE antibody. This results in hypersensitivity to environmental antigens which can manifest as asthma, hay fever, food and other allergies or atopic eczema. There is a large genetic component to atopic eczema with 70 % of suffers having a family history of atopy. The incidence of atopy has risen in the past twenty years, perhaps due to the increasing load of sensitizing agents in the environment. Recently, as many as one-third of British children were reported to have some form of atopy, and 20 % of all British children were found to have atopic eczema.
Atopic eczema in infants is most common on the face, scalp, arms and legs whereas in children it occurs on the hands or around joints on the arms and legs, such as the inside of the elbows or the backs of the knees. The adult form of atopic eczema often extends to the upper chest, the hands and feet, and the skin overlying joints. It is also associated with marked dryness of the skin, and there may be scarring if the itching and scratching has been long-standing.
In addition to environmental factors (allergens, irritants and infectious agents) stress is a major factor in eczema both as a cause and as a result of the condition. Other factors that can trigger flare-ups include cold weather, humid conditions, sudden temperature changes and anger.
Treatment, whether conventional or alternative, is aimed at preventing and controlling flare-ups. Conventional treatment consists of the use of emollients to reduce drying of the skin, topical and oral corticosteroids which are anti-inflammatory, antihistamines to reduce itching, antibiotics for infected eczema and topical calcineurin inhibitors which are immunosuppressants. These treatments appear to alleviate the condition but only intermittently and may be associated with unwanted side effects.
Herbal medicine can be used either as an alternative or to augment conventional treatments. Herbs can be taken internally as a tincture or tea or used for topical application. It is important that if you follow an integrative approach, to make sure that each type of health-care provider knows of the other treatments being used, so that you can get optimal care without experiencing unwanted side effects or decreasing the effectiveness of individual treatments.
The approaches taken by a medical herbalist depend on the particular presentation of each individual patient and aim to support the natural functioning of the skin and other organs. Traditionally, skin conditions were considered to signal inner toxicities and were treated with ‘blood cleansers and purifiers’. Today emphasis is given to eliminatory functions by the liver, bowels and kidney, function of the immune system and consideration of diet and lifestyle.
Some of the following herbs might be selected:
Burdock (Arctium lappa) aids in cleansing the system by promoting the excretion of toxins through the urine and bowel.
Marigold (Calendula officinalis) cream is useful where there is risk of infection or to help heal broken skin.
Chamomile (Matricaria recutita) tea is soothing and calming and is good before bed to promote rest from the irritation and stress of eczema. Chamomile cream applied topically is very soothing and has an anti-inflammatory effect which is comparable in efficacy with hydrocortisone cream (1, 2).
Chickweed (Stellaria media) cream can be used to help soothe the itching of eczema.
Cleavers (Galium aperine) is a cleanser specifically for the lymphatic system
Dandelion root (Taraxacum officinale) contains sesquiterpene lactones which give the herb its bitterness and stimulates digestive and liver function. People with eczema can have lower than normal acid in the stomach.
Echinacea (Echinacea sp) has immunomodulatory, antimicrobial and wound healing actions.
Gotu Kola (Centella asiatica) can be used externally and internally to help heal wounds and reduce skin inflammation and scaring.
Lavender (Lavendula angustifolia) essential oil included in a cream has anti-inflammatory and antiseptic action and improves well being
Licorice (Glycyrrhiza glabra) is an excellent natural anti-inflammatory. It has a similar action to corticosteroids and inhibits the breakdown of cortical, the body’s own corticosteroid
Oats (Avena sativa) an oat bath can be used to sooth and moisturise the skin.
Oregon graperoot (Berberis aquifolium) both promotes good digestion and liver function, and contains berberine which is a potent antimicrobial.
Skullcap (Scutellaria lateriflora) is a mildly sedating nervine which has a calming effect to reduce the effects of stress.
St. John's wort (Hypericum perforatum) oil relieves inflammation and blistering when rubbed into affected skin.
Stinging nettle (Urtica dioica) has an anti-allergic, anti-inflammatory, cleansing action.
Valerian (Valeriana officinalis) acts as a mild sedative to reduce tension and anxiety and improves sleep quality.
1. Patzelt-Wenczler R, Ponce-Pöschl E. (2000) Proof of efficacy of Kamillosan(R) cream in atopic eczema. European Journal of Medical Research. 5:171–175.
2. Srivastava,J.K., Sharkar, E., Gupta, S. (2010) Chamomile: A herbal medicine of the past with a bright future. Molecular Medical Report. 3 (6):895-901.
Diet and Lifestyle
The use of harsh soaps and anything with artificial scents should be avoided and detergents should be pure and liquid.
Food allergies should be identified using a simple food exclusion test. The commonest allergens for eczema are cow’s milk products, wheat and sugar so these should be considered.
People with eczema may be deficient in essential fatty acids. Several small human studies of atopic eczema suggest benefits of taking evening primrose oil.
Foods rich in the following vitamins and minerals should be increased or taken as a supplement to reduce inflammation and promote wound healing and tissue repair: Bioflavanoids, Vitamin A, Zinc and Vitamin E
Atopic eczema is a very common inflammatory skin condition. Symptoms include itchy, dry, red skin that may be broken or cracked. Scratching can lead to more severe symptoms in which the skin is constantly itching, swollen and oozing fluid and may become scaly, thickened and infected with bacteria, usually Staphylococcus aureus. White blood cells from people with eczema tend to have decreased prostaglandin levels, increased histamine release and decreased ability to kill bacteria.
Atopy is a genetic predisposition to form excessive IgE antibody. This results in hypersensitivity to environmental antigens which can manifest as asthma, hay fever, food and other allergies or atopic eczema. There is a large genetic component to atopic eczema with 70 % of suffers having a family history of atopy. The incidence of atopy has risen in the past twenty years, perhaps due to the increasing load of sensitizing agents in the environment. Recently, as many as one-third of British children were reported to have some form of atopy, and 20 % of all British children were found to have atopic eczema.
Atopic eczema in infants is most common on the face, scalp, arms and legs whereas in children it occurs on the hands or around joints on the arms and legs, such as the inside of the elbows or the backs of the knees. The adult form of atopic eczema often extends to the upper chest, the hands and feet, and the skin overlying joints. It is also associated with marked dryness of the skin, and there may be scarring if the itching and scratching has been long-standing.
In addition to environmental factors (allergens, irritants and infectious agents) stress is a major factor in eczema both as a cause and as a result of the condition. Other factors that can trigger flare-ups include cold weather, humid conditions, sudden temperature changes and anger.
Treatment, whether conventional or alternative, is aimed at preventing and controlling flare-ups. Conventional treatment consists of the use of emollients to reduce drying of the skin, topical and oral corticosteroids which are anti-inflammatory, antihistamines to reduce itching, antibiotics for infected eczema and topical calcineurin inhibitors which are immunosuppressants. These treatments appear to alleviate the condition but only intermittently and may be associated with unwanted side effects.
Herbal medicine can be used either as an alternative or to augment conventional treatments. Herbs can be taken internally as a tincture or tea or used for topical application. It is important that if you follow an integrative approach, to make sure that each type of health-care provider knows of the other treatments being used, so that you can get optimal care without experiencing unwanted side effects or decreasing the effectiveness of individual treatments.
The approaches taken by a medical herbalist depend on the particular presentation of each individual patient and aim to support the natural functioning of the skin and other organs. Traditionally, skin conditions were considered to signal inner toxicities and were treated with ‘blood cleansers and purifiers’. Today emphasis is given to eliminatory functions by the liver, bowels and kidney, function of the immune system and consideration of diet and lifestyle.
Some of the following herbs might be selected:
Burdock (Arctium lappa) aids in cleansing the system by promoting the excretion of toxins through the urine and bowel.
Marigold (Calendula officinalis) cream is useful where there is risk of infection or to help heal broken skin.
Chamomile (Matricaria recutita) tea is soothing and calming and is good before bed to promote rest from the irritation and stress of eczema. Chamomile cream applied topically is very soothing and has an anti-inflammatory effect which is comparable in efficacy with hydrocortisone cream (1, 2).
Chickweed (Stellaria media) cream can be used to help soothe the itching of eczema.
Cleavers (Galium aperine) is a cleanser specifically for the lymphatic system
Dandelion root (Taraxacum officinale) contains sesquiterpene lactones which give the herb its bitterness and stimulates digestive and liver function. People with eczema can have lower than normal acid in the stomach.
Echinacea (Echinacea sp) has immunomodulatory, antimicrobial and wound healing actions.
Gotu Kola (Centella asiatica) can be used externally and internally to help heal wounds and reduce skin inflammation and scaring.
Lavender (Lavendula angustifolia) essential oil included in a cream has anti-inflammatory and antiseptic action and improves well being
Licorice (Glycyrrhiza glabra) is an excellent natural anti-inflammatory. It has a similar action to corticosteroids and inhibits the breakdown of cortical, the body’s own corticosteroid
Oats (Avena sativa) an oat bath can be used to sooth and moisturise the skin.
Oregon graperoot (Berberis aquifolium) both promotes good digestion and liver function, and contains berberine which is a potent antimicrobial.
Skullcap (Scutellaria lateriflora) is a mildly sedating nervine which has a calming effect to reduce the effects of stress.
St. John's wort (Hypericum perforatum) oil relieves inflammation and blistering when rubbed into affected skin.
Stinging nettle (Urtica dioica) has an anti-allergic, anti-inflammatory, cleansing action.
Valerian (Valeriana officinalis) acts as a mild sedative to reduce tension and anxiety and improves sleep quality.
1. Patzelt-Wenczler R, Ponce-Pöschl E. (2000) Proof of efficacy of Kamillosan(R) cream in atopic eczema. European Journal of Medical Research. 5:171–175.
2. Srivastava,J.K., Sharkar, E., Gupta, S. (2010) Chamomile: A herbal medicine of the past with a bright future. Molecular Medical Report. 3 (6):895-901.
Diet and Lifestyle
The use of harsh soaps and anything with artificial scents should be avoided and detergents should be pure and liquid.
Food allergies should be identified using a simple food exclusion test. The commonest allergens for eczema are cow’s milk products, wheat and sugar so these should be considered.
People with eczema may be deficient in essential fatty acids. Several small human studies of atopic eczema suggest benefits of taking evening primrose oil.
Foods rich in the following vitamins and minerals should be increased or taken as a supplement to reduce inflammation and promote wound healing and tissue repair: Bioflavanoids, Vitamin A, Zinc and Vitamin E
