Eczema Treatments

Eczema affects an estimated 4 percent of the U.S. population—some 10 million people. It can erupt almost anywhere, but occurs most frequently on your neck, hands, elbows, knees, abdomen, shins, and feet. It looks different from person to person, often a source of confusion for untrained eyes. When in doubt about any persistent skin condition, consult your physician.

Fortunately, there are a lot of home remedies and complementary or alternative therapies you can try for treating eczema. And if complementary treatments don’t work, your doctor may prescribe a prescription medication for treatment.

Home Remedies for Eczema

• Lotions for Eczema. Charles Camisa, M.D., head of clinical dermatology at the Cleveland Clinic Foundation, recommends applying moisturizing creams, oils, or gels immediately after showering and throughout the day when you feel itchy. Moisturizers may not cure you, but they help break the itch-scratch cycle.

• Watch out for irritants. These include soaps, detergents, solvents, fragrances, fumes, paints, wool, perspiration, and tobacco smoke. Steer clear of anything you suspect of causing problems. Wear plastic gloves (or better yet, cotton gloves covered with plastic gloves) when handling soaps, detergents, or chemicals, says family practitioner Anne Simons, M.D., an assistant clinical professor of family and community medicine at the University of California’s San Francisco Medical Center.

• Be alert for allergens. If you suspect that allergies play a role in your eczema, follow the avoidance recommendations in the HAYFEVER Chapter.

• Build a better bath. Soap and water dry your skin. Dr. Camisa suggest taking quick showers—no longer than five minutes—instead of extended baths. Shower in warm water, not hot. Experiement with different soaps. Always shower after swimming in salt water or chlorinated pools. Salt and chlorine are drying.

• Change your clothes. If certain fabrics make you itch, for example, wool or polyester, switch to cotton or cotton-blend clothing.

• Avoid alcohol. Toiletries and personal care products may contain alcohol, which dries you skin, Dr. Camisa notes. Read labels, and steer clear of products with alcohol.

• Tinker with your temperature and humidity. If you seem to be sensitive to a dry climate, Dr. Simons suggests installing a humidifier. If perspiration appears to trigger your itching, your home might be too humid. Consider a dehumidifier.

Eczema and Your Diet

• Salmon salvation. Biochemically, the inflammation of eczema is caused by an excess of inflammatory prostaglandins in your body. Essential fatty acids, notably the omega-3s found in fish oil (eicosapentaenoic acid) decrease the synthesis of these prostaglandins, says naturopath Joseph Pizzorno, N.D., president of Bastyr University, the naturopathic medical school near Seattle. Fish rich in omega-3 fatty acids, include salmon, mackerel, and herring. Dr. Pizzorno says that eating more of them can help relieve eczema.

Elimination Diet

• Clean out your cupboard. “Many studies show that eczema, especially in children, is often linked to food sensitivities,” says Alan Brauer, M.D., founder of TotalCare Medical Center in Palo Alto, California, one of the nation’s first clinics to combine mainstream and complementary therapies. Here’s a sampling:

• In a study of 165 eczema sufferers, age four months to 22 years, researchers at the University of Arkansas for Medical Sciences in Little Rock used pin-prick tests to identify food intolerances. Sixty percent of the study participants had at least one food sensitivity. Eight foods accounted for 89 percent of their reactions: milk, eggs, peanuts, soy, wheat, cashews, cod, and catfish.

• At the University of Antwerp, Belgian researchers came up with similar findings in a study of 25 children with severe eczema. Twenty-four (96 percent) showed at least one food sensitivity. The foods most likely to cause skin reactions were: eggs, wheat, milk, and soy. Reactions were also common to chemical food additives (tartrazine, sodium benzoate, sodium glutamate, and sodium metabisulfite).

• Studies by Dutch researchers affiliated with the University Hospital in Utrecht, confirm that people, particularly children, with food-intolerance eczema are most likely to most likely to be sensitive to: eggs, milk, peanuts, fish, wheat, and soybeans.

• Finally, at the University of Capetown in South Africa, researchers tested food sensitivities 112 children with eczema. Foods most likely to provoke reactions included: eggs, milk, fish, peanuts, oranges, pineapple, chocolate, and soft drinks preserved with sulfur dioxide.

If you suspect a food sensitivity, you might consult an allergist/immunologist for skin testing, or try an elimination diet (see Chapter XX), or simply try eliminating the foods most likely to provoke reactions: eggs, wheat, milk, soy, peanuts, cashews, fish, oranges, pineapple, chocolate, and soft drinks.

Supplements to Treat Eczema

• Omega-3 for Eczema. If you’d rather not get your omega-3s by eating more cold-water fish, family practitioner Alan Gaby, M.D., a professor of nutrition at Bastyr University, the naturopathic medical school near Seattle, suggests taking fish oil capsules—3 to 4 g a day for one month, then 1 g a day.

• Plant oils to the rescue. Close chemical relatives of the omega-3 fatty acids are the omega-6s, notably gamma-linolenic acid (GLA), found in evening primrose oil, borage oil, and black currant oil. Many studies have shown that evening primrose oil (EPO) helps treat eczema, notably a British meta-analysis that combined the result of nine trials, and showed that compared with the placebos, EPO produced highly significant improvement. New York City clinical nutritionist Shari Lieberman, Ph.D., recommends 70 to 240 mg of GLA a day. That’s two to six standard EPO capsules, or one capsule of borage or black currant oil. Don’t take more, she warns, or you risk upseting your body’s fatty acid balance.

• Think zinc. Dr. Pizzorno and other nutritionally oriented clinicians, among them Robert Atkins, M.D., of New York City, have found that zinc supplementation also helps relieve eczema. Dr. Pizzorno recommends zinc picolinate (50 mg/day). Be patient. It may take a few months to notice improvement. As your eczema clears, take less zinc.

Relaxation Therapies May Help Treat Eczema

• Visualize beautiful skin. New York City dermatologist Iona Ginsburg, M.D., gave standard psychological tests to 34 adults with eczema, and to 32 controls who did not have skin problems. Those with eczema were significantly more anxious. Visualization can help calm anxiety and treat eczema. At Mt. Sinai Medical Center in New York, Gerald Epstein, M.D., an assistant clinical professor of psychiatry and author of Healing Visualizations, prescribes an exercise he calls Palm Fingers: Close your eyes and take three deep breaths. Imagine your fingers becoming palm leaves. Place your palm-leaves gently on the areas with eczema. Imagine that your palm leaves are filled with honey that flows over your itchy skin, healing it. Visualize your skin clear and healthy. Then open your eyes. Practice this exercise whenever you feel itchy.

Herbal Treatments for Eczema

• Try a chamomile compress. Chamomile is more than a beverage herb. For centuries, Europeans have added chamomile flowers to baths to treat skin problems, and extracts of the herb to cosmetics and hair-care products. No wonder, explains Seattle naturopath Michael Murray, N.D. Chamomile oil has signifcant anti-inflammatory activity. Commission E, the German expert panel that judges the safety and effectiveness of medicinal herbs for German’s counterpart of the Food and Drug Administration, endorses chamomile compresses for eczema and other inflammatory skin conditions. Use 1 or 2 heaping teaspoons of dried chamomile flowers per cup of boiling water. Steep until cool. Dip a clean cloth into the tea and apply it. Or place a handful of chamomile in a strainer and run warm bath water through it.

• Witch hazel: It’s not witch-craft. Witch hazel has nothing to do with sorcery. In medieval Middle English, this herb was called “wych” hazel, meaning pliant or flexible. Witch hazel’s branches are, indeed, flexible—so springy, in fact, that they were used to make bows. The clear liquid extract sold in pharmacies as witch hazel water is a potent astringent that helps treat skin problems. German researchers gave either witch hazel or a placebo to 36 people with allergic eczema. The herb provided significant relief.

Over the Counter Eczema Treatments

• Ditch your itch, plan A. Over-the-counter antihistamines can relieve itching, Dr. Camisa explains. These products often cause drowsiness, but this side effect tends to wear off after a few days of regular use.

• Ditch your itch, plan B. Another approach, Dr. Simons says, is to apply one of the over-the-counter hydrocortisone creams (0.5 percent). Follow package directions.

Hydrotherapy

• Bathe your itch away. In Japan, many people treat eczema by bathing in hot springs. A hot bath might help. In addition, Dr. Simons suggests adding Aveeno powder to your bath. Aveeno is available at pharmacies. Use one or two cups per bath). Or try baking soda, (one-half to one cup per bath), or finely ground oatmeal (one or two cups per bath). Either buy pre-ground “colloidal oatmeal” at a pharmacy or grind your own in a coffee grinder.

Other Good Choices

Chinese Medicine

• During the mid-1980’s Mary Sheehan, M.D., now chief of pediatric dermatology at Mercy Hospital in Pittsburgh, was working at a hospital in London, England, caring for a five-year-old boy with severe eczema that resisted every treatment she tried. The boy’s mother took him to a Chinese physician who treated him with an herb formula containing licorice root, peony root, rehmania, clamatis, and several other herbs. The herb formula provided such dramatic relief that at first, Dr. Sheehan did not recognize her patient. Subsequently, she conducted two rigorous studies of the formula:

• She gave 47 children a placebo for four weeks and the formula for four weeks, with a month-long wash-out period between treatments. While taking the herbal formula, they experienced significant relief from their eczema. The herb formula caused no discernible side effects (except that it tasted bad).

• Then she repeated the study using 40 adults. While taking the herb formula, they experienced significantly less redness and itching, and improved sleep (because they did not feel itchy). Of the 31 who finished the study, 20 preferred the herbal formula, while only four preferred the placebo. The herbal medicine caused no side effects beyond its bad taste.

• Recently, British researchers at the Royal Free Hospital in London analyzed the skin lesions of 10 eczema sufferers and then gave them a Chinese herbal formula. Two months later, their symptom scores were cut in half.

Acupuncture for Eczema

• Needle know-how. The United Nations World Health Organization endorses acupuncture for eczema. San Francisco Chinese physician Efrem Korngold, L.Ac., O.M.D., co-author (with Harriet Beinfield, L.Ac.) of Between Heaven and Earth: A Guide to Chinese Medicine, recommends these points:

• Large Intestine 11. On your outer arm, in the hollow formed between the end of your elbow crease and your elbow when your arm is bent at a right angle.

• Spleen 10. With your leg slightly bent, in the hollow of the muscle on your inner thigh three four finger-widths above the upper edge of your kneecap and just under your thigh bone (femur).

Homeopathic Eczema Treatments

• Make the most of a microdose. Homeopaths prescribe several different medicines for eczema depending on your own individual symptoms, among them: Kali sulphuricum (potassium sulfate), Pusatilla (windflower), and Sulfur (sulfur). But Berkeley, California, homeopath Dana Ullman, M.P.H., author of The Consumer’s Guide to Homeopathy, says many people also respond to a homeopathic ointment made withCalendula (marigold).

Ayurvedic Medicine

• Sesame oil to the rescue. Ayurvedic physicians consider most inflammatory skin conditions a result of excess Pitta (fire) that overheats your blood that turns your skin red and itchy, according to David Frawley, O.M.D., director of the American Institute of Vedic Studies in Santa Fe, and author of Ayurvedic Healing: A Comprehensive Guide.. But the dryness of skin with eczema also means that Vata (air) is involved. Treatment depends on your specific constitutional type, but general remedies that Ayurvedic physicians recommend include: applications of sesame oil, aloe vera gel, and compresses using licorice and marshmallow teas.

Prescription Eczema Treatments

If home remedies and complementary approaches don’t relieve your itching after about two weeks, call your doctor. You might have a fungal infection.

If your doctor decides that what you have is eczema, you’ll probably be offered prescription-strength antihistamines or hydrocortisone creams (1 or 2.5 percent). Prescription antihistamines also cause less initial drowsiness than the OTCs.