Eczema (or dermatitis) refers to a group of chronic skin disorders that
primarily involve the epidermis and include atopic, contact, stasis, seborrheic,
nummular, dyshidrotic, generalized, or localized scratch dermatitis. Type
depends on cause and location on body, but treatment is generally the same.
Family history of allergic rhinitis, asthma, or atopic dermatitis often exists.
Neurodermatitis is used to describe eczematoid rashes that seem to have a major
Eczema can be caused by allergies, allergies secondary to digestive disorders
(hydrochloric acid deficiency, for example), drugs, environmental exposures, or
be secondary to immune diseases, genetic metabolic disorders, or nutritional
Inflammation exacerbated by:
- Stress or anxiety
- Allergies to ingestants (foods), inhalants, and
- Lack of sleep
- Excessive consumption of fruit, especially citrus and sour
- Underlying emotional problems, especially compulsive
|Signs and Symptoms|
- Lesions usually appear on face, neck, trunk, and genital areas. May
be characterized as: papules, oozing and crusting vesicles (infants);
induration, scaling (adults,
Various types of eczema (dermatitis):
- Contact eczema: localized rash where offending agent touched skin;
caused by irritants, allergens, light, chemicals, perfumes, metals
- Atopic eczema: patient often has a history of vitamin B12 problems,
asthma, allergic respiratory problems (hay fever), allergies
- Seborrheic eczema: on face, chest, scalp
- Nummular eczema: chronic round red spots that crust and scale;
accompanies dry skin in winter; often associated with emotional stress; usually
found in people over the age of 35
- Stasis eczema: over lower legs; associated with poor venous return;
skin turns brown
- Dyshidrotic eczema (pompholyx, vesicular dermatitis): 1 to 2 mm
"tapioca"-like vesicles found on soles, palms, and sides of fingers that may
merge to form multiloculated blisters; scaling and fissuring after blisters dry;
itching, usually occurs after age 30 and will recur
- Localized scratch eczema: patches with whitish areas surrounded by
increased pigmentation; more frequent in women age 20 to 50; allergic
components, exacerbated by scratching.
Other noneczematous disorders:
- Inflammatory tinea pedis
- Vesicular tinea
- Herpes simplex virus infection
Skin inflammation with blisters that itch, ooze, and crust over. Patient may
have a family history of asthma or food or environmental
If HSV infection suspected, a Tzanck smear is done.
Obvious physical appearance is generally basis for diagnosis. Food allergy
tests may be necessary if food allergy is suspected
Lubricate skin with oil, moisturizers
- Topical and systemic corticosteroids—apply
according to package directions for skin lesions; high-potency topical steroid
applied early may stop the itching and the attack. One percent topical
hydrocortisone for children; may use higher concentration in adults
- Disulfiram—recommended for nickel allergy or
- Oral cromolyn sodium—recommended for nickel
allergy or dyshidrotic eczema
- Zinc oxide—apply locally for severe
- Topical psoralen with special UVA light
sources—to treat hands and feet; response
|Complementary and Alternative
Eliminating allergenic foods is key in treating eczema. Following nutritional
guidelines and using herbal support as needed may be effective in reducing
inflammation and hypersensitivity reactions.
Hypersensitivity reactions may be associated with stress and anxiety.
Mind-body techniques such as meditation, tai chi, yoga, and stress management
may help reduce reactivity.
Note: Lower doses are for children.
- Eliminate all food allergens from the diet. The most common
allergenic foods are dairy, soy, citrus, peanuts, wheat, fish, eggs, corn, and
tomatoes. An elimination/challenge trial may be helpful in uncovering
sensitivities. Remove suspected allergens from the diet for two weeks.
Reintroduce foods at the rate of one food every three days. Watch for reactions
that may include gastrointestinal upset, mood changes, flushing, and
exacerbation of eczema.
- A rotation diet, in which the same food is not eaten more than once
every four days, may be helpful in chronic eczema.
- Reduce inflammatory foods in the diet including saturated fats
(meats, especially poultry, and dairy), refined foods, and sugar. Patients with
antibiotic sensitivity should eat only organic meats to avoid antibiotic
residues. Avoid caffeine and alcohol.
- Increase intake of fresh vegetables, whole grains, and essential
fatty acids (cold-water fish, nuts, and seeds).
- Flaxseed (3,000 mg bid), borage (1,500 mg bid), or evening primrose
oil (1,500 mg bid) are anti-inflammatory. Children should be supplemented with
500 mg doses of these oils bid, or with cod liver oil (1/2 to 1 tsp.
- Beta-carotene (25,000 to 100,000 IU/day), zinc (10 to 30 mg/day), and
vitamin E (100 to 400 IU/day) support immune function and dermal
- Zinc spray can heal the tissue in a subset of patients.
- Vitamin C (250 to 1,000 mg bid to qid) inhibits histamine release.
Vitamin C from rose hips is citrus-free and hypoallergenic.
- Selenium (50 to 200 mcg/day) helps to regulate fatty acid metabolism
and is a cofactor in liver detoxification.
- Bromelain (250 mg bid to qid taken between meals) is a proteolytic
enzyme that reduces inflammation.
- For eczema that is resistant to treatment consider oral
supplementation with hydrochloric acid.
- If after six weeks there is no improvement, switch oils to
omega-6/vegetable oils one to two times/day.
Flavonoids, a constituent found in dark berries and some plants, have
anti-inflammatory properties, strengthen connective tissue, and help reduce
hypersensitivity reactions. The following are flavonoids that may be taken in
dried extract form as noted.
- Catechin (25 to 150 mg bid to tid), quercetin (100 to 250 mg bid to
tid), hesperidin (100 to 250 mg bid to tid), and rutin (100 to 250 mg bid to
- Rose hips (Rosa canina) are also high in flavonoids and may be
used as a tea. Drink 3 to 4 cups/day.
Herbs are generally a safe way to strengthen and tone the body's systems. As
with any therapy, it is important to ascertain a diagnosis before pursuing
treatment. Herbs may be used as dried extracts (capsules, powders, teas),
glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless
otherwise indicated, teas should be made with 1 tsp. of herb per cup of hot
water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes
for roots. Drink 2 to 4 cups/day. Tinctures may be used singly or in combination
Herbs that support dermal healing and lymphatic drainage are useful for
relieving eczema. Use the following herbs in combination as a tincture (15 to 30
drops tid) or tea (2 to 4 cups/day). Burdock root (Arctium lappa),
yellowdock (Rumex crispus), red clover (Trifolium pratense),
cleavers (Galium aparine), yarrow (Achillea millefolium),
peppermint (Mentha piperita), and nettles (Urtica dioica). To
prepare a tea, steep the root elements for 10 minutes, then add the rest of the
herbs and steep an additional 5 to 10 minutes.
Topical applications of creams and salves containing one or more of the
following herbs may help relieve itching, burning, and promote healing.
Chickweed (Stellaria media), marigold (Calendula officinalis),
comfrey (Symphytum officinale), and chamomile (Matricaria
Marshmallow root tea (Althea officinalis) may soothe and promote
healing of gastrointestinal inflammation that is often found with this
condition. Soak 1 heaping tbsp. of marshmallow root in 1 quart of cold water
overnight. Strain and drink throughout the day.
An experienced homeopath should assess individual constitutional types and
severity of disease to select the correct remedy and potency. The use of acute
remedies may exacerbate eczema.
Starch, oatmeal, and other baths may temporarily relieve the
Acupuncture may help restore normal immune function and reduce the
- This chronic, recurring disorder can flare up with stress or exposure
to offending agents. Lesions of the hands and feet can become severe and need
- With underlying psychopathologies, short- or long-term psychotherapy,
hypnosis, behavioral therapy, or biofeedback techniques may
Conservative introduction of solid foods as child is weaning may help prevent
hypersensitivity conditions. If there is a strong family history of allergies or
atopic conditions and/or if the child's immunity has been compromised in
infancy, delay the introduction of highly allergenic foods (especially dairy and
grains) until 1 year or older.
Infants exclusively breast-fed have a lower risk of atopic eczema
development, and develop symptoms at a later age. This may reflect later contact
with cow's milk, a common sensitizer.
Continuing recurrences may accompany stress and increase levels of anxiety or
depression. Overuse of topical cortiosteroids may atrophy
Even moderate to severe cases of eczema are usually just an annoyance.
Meticulous care will control most flare-ups. Eczema is a chronic disease that
tends to lessen in severity or resolve with advancing age. Most children see
resolution by puberty.
Nutritional support and topical applications may safely relieve symptoms
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Copyright © 2000 Integrative Medicine
CommunicationsThis publication contains
information relating to general principles
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