What is eczema?
Eczema (often misspelled exzema) is a form of dermatitis, also known as atopic dermatitis. It is one of the three atopic conditions; asthma and hay fever are the other two and there is a large hereditary component. If one or more of your primary relatives has an atopic condition you are more likely to have eczema. It is more common in children but can persist into adulthood.
Eczema is an inflamed, itchy rash that usually occurs on the inside of elbows and knees but can also appear on the face, neck, or any part of the body really. It is not a contagious rash. If the skin is broken secondary infections can be a real concern, so proper care of eczema flare ups is very important and can be lifesaving for small children.
Most rashes are caused by an overreaction of the immune system that causes inflammation in the skin. Eczema is no different, so looking after the health of your immune system is an important part of dealing with eczema. In fact eczema is assumed by some to be an auto-immune disorder where the bodies immune system erroneously attacks it’s own tissue, however there is still disagreement about this. There is no doubt that caring for you immune system through lifestyle factors is a good idea.
If you suspect you have eczema it is important to get a diagnosis from your doctor to rule out other skin conditions. Unfortunately eczema doesn’t have a medical cure, modern medicine only provides relief of symptoms. The good news is however that there are a number of things that you can do to prevent eczema and to reduce the severity of flare-ups.
What makes eczema worse?
Alcohol is one of the leading triggers of eczema flare-ups. Most people with eczema report that alcohol worsens or precedes eczema. If you suffer eczema keep an eye on your alcohol intake and carefully monitor any relationship between your alcohol intake and your eczema symptoms. Try preservative-free alcohol too, you may be more sensitive to certain ingredients in alcohol such as preservatives like sulfur. Personally I cannot drink red wine for this reason. I tolerate preservative free beer (such as Belgian beer) better than any other type however you may find that any alcohol worsens your symptoms. If you are unsure don’t drink anything for a while to see how your eczema responds.
Stress is another big factor in eczema. Because eczema is an immune system disorder stress can make it worse. That is because stress puts a strain on the immune system. Try to minimize stress in your life and include stress-reducing activities such as meditation and exercise into your routine.
Diet is another important factor. Too much sugar in your diet can encourage the inflammatory response. Sugar is a big no no when it comes to maintaining healthy skin. Other things like caffeine and food preservatives can also worsen eczema, but every one is different. Cutting out suspect food and drink for a while to see the effect it has on your eczema can help you to identify your eczema triggers.
A lack of essential fatty acids in your diet could also be a problem. Ezcema sufferes need to make sure that they get enough of the ‘good’ fats in their diet from natural sources such as olive oil, nuts and seeds and things like avocados. Saturated fats found in coconut oil might also be beneficial. If you are concerned that your diet could be a factor in your eczema make an appointment with a dietitian.
Irritants from the things in your home should also be considered. Use fragrance free laundry powder designed for sensitive skin. Don’t use soaps or any harsh chemicals on your skin and be careful with things like deodorants and hair dyes. The biggie for me is laundry powder; i need a hypoallergenic one and I avoid fabric softeners with scents.
Sweat from excessive exercise or heat can worsen eczema symptoms. During flare-ups do gentle exercises that don’t make you sweat too much. Caffeine and chili can also make you sweaty so watch your intake if this is the case. In hot weather a water spray can help keep the skin cool, hence reduce the amount of sweat you produce. Avene sells a thermal springs water spray that is very comforting in hot weather but any water spray will do. I buy a small spray bottle and fill it up with spring water with a few drops of aloe vera juice in it. this works just as well and is easier on the hip pocket.
What makes eczema better?
Avoid the things listed above, but there are also specific things that you can do to improve your eczema.
Borage Seed Oil (Borago Officinalis) : The blue, star-shaped flowers of the borage plant have been used in because of its healing properties. This natural oil is a rich source of gamma linolenic acid and has been known to be used in the treatment of eczema and rheumatoid arthritis and in herbal medicine. Borage oil, or “starflower”, as the botanical is known, contains up to 24% Gamma Linolenic Acid (GLA). GLA is an Essential Fatty Acid which the body converts into prostaglandin, a hormone-like substance. Prostaglandin is reported to offer anti-inflammatory properties. In many studies it has been found that a deficiency in GLA attributes to poor skin condition, especially psoriasis and eczema.
Emu Oil: has been shown to help eczema and all kinds of skin conditions. Emu oil contains Super omega 3 and 6. It is hypo-allergenic, giving it a low potential for irritating the skin. Emu oil doesn’t clog pores. Scent free and dye free, safe for all skin types.
Evening primrose oil has been shown to help eczema sufferers in clinical trials. Take one or two capsules a day. If you’re female it can also help with PMS symptoms.
Flaxseed oil is another good supplement to take especially if you are not getting enough good fats in your diet.
Aloe vera juice soothes the digestive system when drunk but can also be used topically added to a home made water spray to sooth skin and reduce inflammation.
Emollients (AKA moisturizers) are essential during an eczema flare up to protect the skin and help it retain moisture. Without them the skin is more susceptible to dangerous secondary skin infections. These should be applied liberally and often (every few hours or so) during an eczema flare-up because the skin has a compromised lipid barrier and cannot retain moisture itself during flare-ups.
Evening Primrose Oil (Oenothera Biennis) : Evening Primrose Oil is good as a natural source of the Essential Fatty Acid, Gamma Linolenic Acid, which is needed by the body. Essential Fatty Acids are critical in the production of prostaglandins. In the body prostaglandins help regulate fat metabolism, inflammatory response, hormones, as well as the cardiovascular, immune and central nervous systems. Modern diets and lifestyles may block the conversion of the Essential Fatty Acid LA into GLA. Evening Primrose Oil is especially helpful in treating premenstrual syndrome (PMS), menstrual cycle irregularities, menopause, and endometriosis. It is used to promote Smooth Skin and to treat Eczema.
Prescription creams containing hydrocortisone can be helpful during eczema flare ups that are not responding to other measures. These are very effective at reducing inflammation but caution should be taken when using these as they can thin the skin and can have other side effects with long term use. Never use steroid creams near your eyes as this can enhance your risk of developing glaucoma. Never use a steroid cream for more than two weeks straight. Use sparingly and as directed. A fingertip length of cream (about 1-2 cm) is sufficient to cover a patch of skin the size of the palm of your hand. If your eczema persists after two weeks of using a steroid cream you should really see your doctor.
Elidel and other immunomodulating creams are alternatives to steroid creams for use on the face. They are preferred because the thin skin on the face is more likely to be damaged by steroid creams. These creams work by suppressing the immune response responsible for eczema. Great care should be taken when using these creams however as there is the possibility that they can cause immune system suppression or other problems. Never, ever expose your skin to the sun with these creams on, or even for two weeks after stopping them. If you must be in the sun wear a good sunscreen and hat. Like steroid creams, never use for more than two weeks straight and see your doctor if your eczema doesn’t improve after two weeks of use.
Salt baths are good for both eczema and other types of dermatitis. The salt naturally acts as an anti-microbial agent causing the bacteria and other cells on your skin to implode (look up osmosis for more info). Try a dead sea salt bath, clinical trials have shown that they improve psoriasis. The salt not only works as mentioned but it also contains plenty of minerals which help condition the skin. If you can’t get your hands on dead sea salt any salt will do just make sure that is is pure salt (preferably natural sea salt) and doesn’t have anything else added to it. Don’t use this when you have broken skin though – obviously it will sting! Swimming in the sea is another good option, in fact this may be preferable. Just be sure to swim in pollution free beaches (not an easy ask for a city dweller). I’ve heard many tales (including my own experience) of people going on beach holidays and having their eczema clear up from swimming in clean ocean water, it really works.
Skin care routines for eczema
There are a number of products out there designed for eczema sufferers and I review a lot of them here. The key with skin care is to keep the skin clean and hydrated without stripping the skin of it’s natural oils. This is best achieved by using a water-free cleansing product and a good moisturizer. A wipe off cleanser is ideal for this. Never wash your face more than twice a day, and only once if possible. I usually use a water-wash-off cleanser in the morning and a wipe-off water-free one at night. Using heavy duty moisturizers (emollient creams) is also essential. During an eczema flare-up you may need to carry a cream around with you and reapply to affected areas every few hours during the day.
Avoid scrubbing the skin. Don’t use exfoliants during an eczema flare-up but be sure to use a very gentle one when your skin is normal to keep it healthy and prevent future eczema. Sloughing away dead skin cells helps to prevent itchiness too.
Lush’s ‘Angles on Bare Skin’ is the best exfoliant I’ve ever tried and is ideal for eczema prone skin as it contains ground up almonds which condition the skin and provide a hit of the ‘good’ oils leaving your skin feeling soft and nourished. For more information on specific products search ‘eczema’ in the search bar at the top of this page to read reviews of the eczema products I’ve tried over the years.