For the past month, I have been struggling with eczema. What started as a small patch on my right ankle climbed to my hip and then spread to my left leg too. Patches of red, inflamed skin that were extremely itchy stole sleep from my night. I felt tired and irritable all day. I couldn’t stay still or focus because the itch was so distracting. I felt everything that came in contact with my skin, be it the cloth of my pants or the moving air, so intensely that my nerves were on high alert constantly.
Eczema, I learned from this experience, is a condition that combines:
- The barrier – the skin
- The immune system – inflammation
- Gut health – balanced gut microbiome & food irritants
- The nervous system – is exposed and triggered.
Therefore a care plan for eczema needs to address all these components.
Eczema begins with small red dots that are red, hot, and extremely itchy. The skin gets dry, cracked, and leathery, which makes it more preamble to pathogens.
Healthy skin produces lipids and sebum that keep elasticity and protect it from pathogens.
The sebum produces antioxidants, antibacterial and anti-inflammatory substances that act as protective barriers. Other lipids create a welcoming environment to a diverse colony of bacteria that inform and recruit the immune system in the presence of pathogens.
Research showed that when the integrity of the skin is altered, there is also a change in the composition and diversity of skin bacteria.
Care Plan for the Skin
- Use topical anti-inflammatory herbs such as chamomile and calendula in ointment.
- Burdock has an affinity to the skin, drink a decoction of burdock root a couple of times a day or add burdock to your bone broth.
- Zinc is a mineral that is very important for skin health. You can find ointments that contain zinc and spread them topically. I used a formula that blended anti-inflammatory herbs with zinc, and it dramatically reduced the itchiness. Taking zinc supplements can be helpful too.
- Probiotics, both internally and topically, can help restore balance to your skin’s bacterial ecology. Simple organic yogurt can do the job too.
The immune system:
Eczema is a symptom of a dysregulated immune system; that is also associated with asthma and allergies. The immune system reacts to irritants and allergens via the innate and adaptive immune response.
The innate immune response is the part of the immune system we are born with. In eczema, part of the immune system launches an inflammatory response.
The adaptive immune response develops throughout your life and is constantly learning, remembering, and… well adapting to your environment.
These systems are constantly communicating between them but also with… guess who? The bacteria. Research shows that genetic and overactive immune systems can trigger the innate and adaptive immune response, shift the skin’s ecology and create eczema.
Care plan for the immune system:
- Vitamin D supplementation. Research found an association between low serum vitamin D and the severity of eczema. Supplementing with vitamin D is found to support the barrier in the body and balance immune response. I supplement with vitamin D internally and drop a couple of vitamin D drops into the ointment before I spread it over my eczema.
- Exposing your eczema to the sun or ultraviolet light might be helpful too.
- Remove toxins and irritants from your environment. Consider the products you use for self-care and to clean your house. Read labels.
- Vitamin E is an antioxidant that may help reduce inflammation.
- Omega 3 fatty acids are essential anti-inflammatories. I like to use them as Cod Liver oil, so I get the A vitamin too. It is important because research found that vitamin A deficiency exacerbates eczema.
80% of the immune system is found in the gut. Many conditions that develop in other parts of the body begin with an immune reaction to substances such as food or medicine in the gut. In my case, for example, eczema developed as a response to an antibiotic medicine that I consumed following an oral procedure.
The gut’s ecology of bacteria modulates the balance between adaptive immune cells that stimulate immune response and adaptive immune cells that inhibit immune response. A healthy immune system is in constant goldilocks status alert but not too responsive.
Some of the things that can throw the immune system in the gut out of whack:
- Unbalanced gut bacteria or reduced diversity of the gut bacteria.
- Food irritants. The first that come to mind are gluten and dairy.
- Medicines, specifically PPI, NSAIDs, birth control, and SSRIs. (please don’t see that as a recommendation to stop using these that your PCP prescribed. Instead, always check with your caregiver before stopping the use of meds prescribed by them.)
Care plan for the gut:
- Avoid food irritants. The top 5 food irritants are gluten, dairy, soy, corn, and eggs. An elimination diet for six weeks to three months is the golden standard to determine if a particular food irritates your gut and immune state. Eliminating and reintroducing food should be done with the support of a caregiver who was trained to support these conditions.
- Eat veggies – About 75% of your plate should be veggies. More color means more nutrients and diverse antioxidant content.
- Feed your gut bacteria: Eat food rich in inulin and resistant starch. Fibers and resistant starch such as root veggies, whole grains, and legumes can not be fully broken down by you, but your gut bacteria thrive on them.
The nervous system:
Stress can become a vicious cycle when it comes to eczema. Stress triggers the immune response and causes inflammation. Research found that people prone to eczema tend to have an increased number of mast cells and increased mast cell-nerve fiber contacts, types of cells that regulate the nerve immune response in the cells. The more activated mast cells nerve fibers, the higher your chances of developing an immune response.
On the other hand, as I can now attest from my personal experience, eczema is a very stressful condition. The constant itch is distracting, your entire nervous system feels exposed, and you don’t get a good night’s sleep.
Can you sense how this cycle is unfolding?
Stress may trigger eczema but eczema also cause stress and on and on.
Care plan for the nervous system:
- Sleep. it is vital that you make enough time for rest and sleep, not just at night.
- Herbal Tonics are herbs that reduce your body’s resilience to stressors. Three such herbs are milky oats, Tulsi and Ashwagandha.
- Herbal sedatives are herbs that support and relax the nervous system when stressed, two such herbs are Lemon Balm and Motherwort.
Eczema has a genetic component to it. Specific genetic skin makeout and genetic immune tendencies combined with environmental exposure to allergens, irritants, and nutritional status create a strong inflammatory response that dramatically impacts your life quality.
A care plan for eczema should go far beyond the symptomatic care that most dermatologists offer. Steroids, topically or internally, can help reduce symptoms in the short term, but they don’t offer the body relief from the root cause of this condition.