Eczema: 5 Tips for a Natural Solution to a Stubborn Issue
Eczema, or atopic dermatitis, is a common problem that is estimated to affect around 1 in 4 Australian children by the age of 2. This is one of the highest rates in the world! It’s characterised by red, itchy skin and although it is an issue of the skin, it is now widely considered to be a complex systemic issue. There’s an involvement of immune dysfunction (in particular an imbalance of our immune cells Th1 and Th2), a skin barrier issue due to an issue with the filaggrin gene, there’s generally some suboptimal gut function leading to inflammation and an altered gut microbiota, there may be food intolerances and or allergies and even low Vitamin D. Children with a family history of eczema are twice as likely to develop the condition, and risk factors also include c-section birth, and antibiotic exposure in the prenatal or perinatal period.
Although many children simply “grow out” of their eczema, there is a great benefit to addressing the issue at the systemic level, as what we see in some children is what is termed the “atopioc march” - which describes the fact that children who have experienced eczema have a much higher incidence of going on to develop asthma or allergic rhinitis. And whilst for lots of children eczema is simply a bit of an irritating itch, for some it can greatly affect their quality of life, lead to moodiness & behavioural challenges, severe skin infections & even hospitalisation.
#1 The Importance of Gut Health in Eczema
What we do know is that people suffering from eczema usually have altered gut microbiota, so from a Functional Medicine practitioner's point of view, the gut is a fantastic (& effective!) area to target treatment. From my point of view, I focus on getting the right type of probiotics into the gut (strain-specific, and with eczema we are generally talking about Lactobacillus salivarius LS01), as probiotics can support our gut lining, reduce overall inflammation, regulate microbiome dysbiosis & regulate immune cell imbalances. And whilst getting the right type of probiotics in there is important, we also need to feed the microbes for them to flourish, and we do this by eating a wide variety of prebiotic fibre. Particularly good food sources of prebiotic fibre are our allium family (onions, leeks etc), asparagus, garlic, geen banana, oats, flaxseeds, seaweed & apples (basically all our vegetables, fruits, nuts & seeds!) but one that may surprise you is butter - butter is high in butyrate which is a short chian fatty acid that supports our gut lining.
#2 Encourage Anti-Inflammatory Eating
Remember the saying, eat the rainbow? That’s a fantastic goal to have in mind when meal prepping for our kids - include as much colour and variety as you can. When we talk about an anti-inflammatory diet, we’re really talking about including all those fantastic phytonutrients, anti-oxidants, fibre, vitamins, minerals & other beneficial food components that are found in all our colourful plant foods, so look to include as many different types of fruits & vegetables in your child’s diet that you can, along with other anti-inflammatory foods such as beneficial oils like olive oil, avocado & oily fish, legumes and wholegrains. At the same time as increasing all these fantastic foods, we also want to reduce those foods that are going to increase inflammation, namely - sugar & highly refined processed foods. Where you can, replace the highly processed foods with wholefood options, like a home-made granola bar instead of a high-sugar supermarket option. Get into the habit of reading the labels of anything you buy in a packet, and choose the options with the most wholefoods, and the least amount of strange ingredients & numbers.
#3 Include These Skin Supporting Micronutrients
Focus on including nutrients that support our skin health, like zinc, fish oil and Vitamin A. I am seeing more and more children presenting in clinic with low zinc, especially in children who are particularly fussy eaters and those who tend towards a vegetarian diet. To ensure your child is meeting their zinc needs include zinc-rich foods, such as oysters & shellfish, red meat & poultry in your child’s diet. Vitamin A can be another tricky nutrient to get adequate intake of & whilst we can convert the carotenoids or pro-Vitamin A found in our orange & red coloured fruits & vegetables to our usbale form of Vitamin A, it is important to also include Vitamin-A rich foods like egg yolk, beef liver & oily fish into your child’s diet as well.
Checking your child’s Vitamin D levels with your GP can be worthwhile, as observational studies have indicated a link between Vitamin D status & eczema outcomes, including an association between lower levels of Vitamin D & severity of eczema symptoms. Along with regular (& safe) sun exposure, inclduing foods like sun-soaked mushrooms, cod liver oil & grass-fed butter or ghee are a great way to ensure your child is getting food-sources of Vitamin D.
#4 Investigate Food Intolerances or Allergies
It’s estimated that one to two thirds of children with eczema also have a food allergy. Dairy is the most common allergen that I see in children with eczema in clinic, but it’s definitely also worth considering gluten, eggs & nuts. Then there are the tricker ones to identify, which are reactions to food chemicals such as salicylates, amines, glutamates. It can be hard work identifying which ones are the trigger for your child - usually an elimination and re-introduction is the best way to discover if a particular food is the culprit for your child. (And I always recommend doing this under the guide of a Practitioner.) And then, of course, it may not be a food-related intolerance or allergy at all - common environmental triggers for eczema include dust mites, pet hair, soaps & detergents.
#5 Nourishing the Skin from the Outisde
Whilst we’re focusing on addressing your child’s eczema from the inside, we shouldn’t forget about the topical creams that can help at skin level, as well. Your GP will usually prescribe a steroid cream for your child’s eczema, which generally gives pretty good relief, especially to begin with. But steroid creams are typically not designed to be used long-term, and there are plenty of non-steroid based topical natural treatments you can experiment with. Keeping the affected areas moist is important, so applying an anti-inflammatory/anti-itch cream underneath a thick emollient cream can be great. A product I like that I often recommend to clients is the Beetanicals Bee Relief Balm, or the Bioceuticals Eczema Relief Cream which has a mix of probiotics and herbs. Having a luke warm bath with oats can help restore moisture to the skin & reduce the itch - you can blend oats to a powder to make a milky bath, or put a cup or so of rolled oats into a stocking and gently squeeze it over the affected areas . Be careful to avoid hot showers & baths as heat can aggravate the itch even further. For severe eczema, wet wraps at night are often recommended, and bleach baths to reduce skin infections (you need to carefully follow the hospital guideleines for this one!).
References
McLean WH. Filaggrin failure - from ichthyosis vulgaris to atopic eczema and beyond. Br J Dermatol. 2016;175 Suppl 2(Suppl Suppl 2):4-7. doi:10.1111/bjd.14997
Dębińska A, Danielewicz H, Drabik-Chamerska A, Kalita D, Boznański A. Filaggrin loss-of-function mutations as a predictor for atopic eczema, allergic sensitization and eczema-associated asthma in Polish children population. Adv Clin Exp Med. 2017 Sep;26(6):991-998. doi: 10.17219/acem/61430. PMID: 29068602.
Rotaru M, Iancu GM, Matran IM. Importance of food in the control of inflammation in atopic dermatitis. Exp Ther Med. 2020;20(6):206. doi:10.3892/etm.2020.9336
Catherine Mack Correa M, Nebus J. Management of patients with atopic dermatitis: the role of emollient therapy. Dermatol Res Pract. 2012;2012:836931. doi:10.1155/2012/836931
Palmer DJ. Vitamin D and the Development of Atopic Eczema. J Clin Med. 2015;4(5):1036-1050. Published 2015 May 20. doi:10.3390/jcm4051036
