By: @drmelissacugliari
Eczema, also known as atopic dermatitis (AD), is a very common condition that stems from a variety of causes. Eczema results from an interplay of three factors: genetics that disrupt moisture retention within the skin barrier, immune system dysregulation that leads to inflammation, and environmental triggers.
Symptoms include chronic, itchy and inflamed skin most commonly found in the folds of the elbows or the backs of the knees, although it can occur elsewhere. Eczema lesions can be scaly, red, and have small bumps that may or may not weep. The skin can become dryer, rougher and appear thicker after healing from an eczema breakout.
Someone is more likely to suffer from eczema if he or she has a family history of eczema or allergies. There are numerous other reasons for why someone may have eczema including a food sensitivity, chronic antibiotic use, and whether someone was birthed vaginally and breastfed.
Treating eczema can be a challenge because each case is unique - the causes and triggers can vary from person to person dramatically. Below are a few treatment considerations.
Routine Moisturization
Keep the skin well moisturized. Since eczema can be caused by a genetic mutation that prevents the skin from holding on to moisture, using topical moisturizers is an absolute necessity to support the skin’s hydration. During an active breakout, the affected skin must be moisturized 4-5x per day. Once the lesions begin to heal and are under control, maintenance should be 1-2x per day. Not all moisturizers are created equal and it is important to select one that contains ceramides and/or other skin-identical ingredients. Always speak to your doctor to understand the best recommendation for you.
Avoid Heat
This includes hot showers, baths, and saunas. The heat may aggravate the skin and increase the rate of transepidermal water loss (i.e. the rate at which you lose water through the skin). Skip the heat and use lukewarm water only and avoid overly hot environments when possible.
Address Diet
Consider switching to a hypoallergenic or elimination diet. This diet is designed to remove potential allergens from the diet for a period of time with slow, gradual reintroduction. This should be done very intentionally and under medical supervision to ensure that the diet is still providing adequate nutrition and reintroduction is done in a way that triggers can be well-identified. Virtually any food could be a potential trigger and if done improperly, it can be hard to differentiate which foods are problematic.
Support Immune Function
Eczema is an allergic, inflammatory condition. The immune system is what triggers allergies and creates inflammation in the body. Some of the best ways to support immune health and calm inflammation is to avoid all processed sugars, sweeteners, juices, and alcohol. Instead, opt for fresh or frozen whole fruits. I also recommend eight to nine hours of sleep per night, especially while the skin is healing.
Colloidal Oatmeal
This natural ingredient contains anti-inflammatory compounds like beta-glucans that can help protect and hydrate the skin. This ingredient can be very calming and it is found in many over the counter moisturizers.
Skin can be stubborn and takes time to heal. Consistency is key with whichever therapeutics you and your doctor choose. In my practice, I have great success treating this without the use of topical steroids or other medications, but some individuals find great relief with these medications when used appropriately and in combination with naturopathic care. Either way, you must find what works best for you and your lifestyle.
It is important to remember that each person is unique and what works for one person’s skin may not work for you. When it comes to your skin, seek the help of a licensed medical provider to determine your individual needs and receive a tailored treatment plan.
