Do you experience dry, itchy, cracked, red and flaky skin? You could be living with eczema.
Eczema or atopic dermatitis, is a chronic inflammatory skin condition that affects an estimated 5-20% of children and 10% of adults worldwide. (1) Eczema is often triggered by an immune response to environmental irritants. While conventional treatments focus on symptom management, a naturopathic approach seeks to identify and address underlying causes to provide long-term relief.
Common Symptoms of Eczema
Dry, scaly, and itchy skin
Red or inflamed patches, often on the face, hands, elbows, and knees
Cracked or oozing skin in severe cases
Increased susceptibility to skin infections due to compromised barrier function
Flare-ups triggered by allergens, stress, climate changes, or diet
What Causes Eczema?
Eczema is driven by a combination of genetic, immune, and environmental factors that ultimately lead to skin barrier dysfunction.
Skin Barrier Dysfunction
Our skin consists of a series of layers that protect us from our environment. The three main layers are the epidermis (ie. Outer layer), dermis (ie. Middle layer), and subcutaneous or hypodermis (ie. Deepest layer).
The epidermis in particular plays a key role in the onset of eczema. As this layer is home to cells, fats, enzymes, filaments, and microbes, a disruption in any one of these can lead to eczema.
When exposed to an irritant, the immune system becomes alerted. In an attempt to clear the irritant, our mast cells release histamine to stimulate a more profound response. But as you may know first hand if you live with allergies, histamine is a key player in our body’s “itch” sensation. (1)
What Can Trigger Eczema?
Based on my experience, I’ve seen the following exacerbate eczema for people I work with:
Nutrient Deficiencies
Environmental Irritants
Stress and Emotional Factors
Climate and Seasonal Changes
Gut Dysbiosis
Conventional Approaches to Eczema
Often the first line of treatment is ensuring adequate hydration, experimenting with moisturizing serums or lotions, and minimizing exposure to harsh chemicals. If additional support is needed, a course of either topical or oral anti-histamines may be considered or corticosteroids to calm the immune response and resulting inflammation. (2)
Many people find relief with this approach to start. But if the eczema persists, then it's time to search for a different root cause.
Naturopathic Approaches to Eczema
Naturopathic doctors take a holistic approach when it comes to assessing skin barrier dysfunction.
Addressing Food Sensitivities or Allergies
Although it has yet to be widely accepted, food sensitivities can contribute to persistent immune activation and GI irritation that an affect the Gut-Skin access in those with eczema prone skin. The leading culprits that I have seen clinically include dairy, gluten, eggs, and nuts.
Screening for Enteric Dysbiosis
The community of bacteria and yeasts that comprise our gut microbiome not only help us digest foods and absorb nutrients, they also fortify the gut related immune system and combat systemic inflammation. While research on this topic is still in its infancy, there is evidence that probiotics and imbalances in gut flora can weaken the skin barrier which has potential applications for many skin concerns, including eczema. (3,4,5)
Screening for Nutrient Deficiencies Associated with Eczema
Both zinc and Vitamin D are essential for skin healing, immune function, and reducing inflammation. Often one or both are found deficient, and repleting stores can ease skin symptoms. While not often tested, omega-3 fatty acids, vitamin E and vitamin A are also important nutrients for healing the skin barrier.
Stress Management
As stress can lower the threshold for system wide inflammation and lead to poor lifestyle habits (ie. Hydration, movement, sleep, etc.), this is often front of mine when working with someone to find relief.
Topicals
Naturopathic doctors are experts in botanical medicine. Many herbs have vulnerary properties that promote healing of the skin surface, and can be used as creams, salves or poultices. A few of my favorites include:
Avena sativa or Oat
Calendula officinalis or Marigold
Symphytum officinalis or Comfrey
Achillea millefolium or Yarrow
Aloe vera
References:
Silverberg, JI. Howe, W. Atopic dermatitis (eczema): Pathogenesis, clinical manifestations, and diagnosis. UpToDate. Literature review current through: Feb 21025. Topic Updated: April 24, 2024.
Nemeth, V. Syed, HA. Evans J. Eczema. Stat Pearls. Last Updated: March 1, 2024. https://www.ncbi.nlm.nih.gov/books/NBK538209/
Wrześniewska M, Wołoszczak J, Świrkosz G, Szyller H, Gomułka K. The Role of the Microbiota in the Pathogenesis and Treatment of Atopic Dermatitis-A Literature Review. Int J Mol Sci. 2024;25(12):6539. Published 2024 Jun 13. doi:10.3390/ijms25126539
Kalashnikova IG, Nekrasova AI, Korobeynikova AV, et al. The Association between Gut Microbiota and Serum Biomarkers in Children with Atopic Dermatitis. Biomedicines. 2024;12(10):2351. Published 2024 Oct 15. doi:10.3390/biomedicines12102351
Liu Y, Du X, Zhai S, Tang X, Liu C, Li W. Gut microbiota and atopic dermatitis in children: a scoping review. BMC Pediatr. 2022;22(1):323. Published 2022 Jun 2. doi:10.1186/s12887-022-03390-3
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