Eczema

What is Eczema?

If you have experienced eczema you are uniquely aware of the challenges it presents in your life.

You often start to feel itchy even before your skin looks any different, and that frenzied compulsion to scratch can take over your life, and distract you from the things most important to you. On top of that, as the rash gets bigger it becomes harder to conceal it, and you’d rather not have people staring or mistakenly thinking you’re going to infect them with something.

Eczema happens for several different reasons, which is why it can be so tricky to treat effectively.

Skin and the Immune System

Eczema sometimes has an allergic component to it, where antibodies to specific allergens deposit in the skin (may also affect other areas of the body) and cause a reaction. This is often referred to as “atopic” eczema. Atopy is most common in children, especially if they have been born by C-section, or were extensively formula fed. In these cases, eczema is commonly the first step in developing a triad of immune system imbalance, where the next steps in progression are environmental allergies, and asthma. Helping your body to properly control immune responses, and the resulting inflammation is very important in preventing progression.

Inflammation can have many other triggers that aren’t necessarily related to allergies. Certain foods like refined sugar can up-regulate the inflammatory mechanisms of your immune system, as can stress, and even hormones. Keep reading for more information.

Your intestinal microflora play a huge role in immune system regulation. They have a large interaction with the immune system as it’s cells pass through the gastrointestinal blood vessels, and they can actually communicate with immune cells to tell them

whether they should turn the inflammation up or down and whether certain substances should be attacked or not. This is why there is a higher likelihood of getting allergies if you were born by C-section, or were primarily formula fed. These are the very first sources of a baby’s bacterial ingredients for a healthy microflora, which they do not receive if they do not pass through the vagina, or consume breast milk. Instead, the first bacteria they ingest comes from the skin of the doctors and nurses, and the bacteria that live here are very different from what lives in a healthy intestinal tract. This

means the normal communication with the immune system is not happening to the same degree, and can make you more susceptible to multiple conditions, one of which is eczema.

The Skin Barrier

Your skin is the largest organ in your body, and is also your main interface with the outside world. This means that your skin is exposed to hundreds of substances every day – chemicals, pollens, dust, bacteria and more, and it is normally very adept at sorting through which substances to allow in through its walls, and which to take a hike.

What if your skin was unable to maintain the integrity of it’s walls? This happens in many cases of eczema, the skin is compromised, either because it is too dry, leading to cracking, or because it does not have the supplies needed to build and maintain the skin barrier (vitamin, fat or mineral deficiencies). In some cases, substances in your body can even interfere with the normal wall-building process, as is the case in someone whose diet is too high in saturated and trans-fatty acids (the wrong kind of fat for a cell wall is crowding out the right kind of fat).

When this happens, it leaves your skin vulnerable to attack as things from the outside world can get through the skin much more easily. This leave you open to skin infections (bacterial, fungal or viral/warts), makes you dehydrated due to excess water loss through your skin, and may even trigger your immune system to generate a new allergy to something that is absorbed through that leaky skin layer.

What does diet have to do with it?

What you put in your body influences almost everything your body does, and skin rashes are no different. Eczema is often exacerbated by reactions to food, and this is normally the case when digestion is not functioning optimally. When this happens, foods that may otherwise have been tolerable can contribute to inflammation and damage in the intestinal lining, which makes little holes that larger, incompletely digested food particles can travel through into the blood. When this happens, your immune system recognizes these large particles as something that shouldn’t be there, and causes an inflammatory reaction to destroy them and clean up the mess. When this happens in your inflamed eczema patch it can make the symptoms much worse. In general, food reactions are not the cause of the eczema, but a trigger that makes it worse, and an indication that something is going on in the digestive system that needs to be dealt with.

Detoxification

Did you know eczema can be related to your hormones? There are actually estrogen and progesterone receptors in your skin, and on mast cells (the things that bust and cause all the unpleasantness of an allergic reaction) that can be activated when your hormones are not properly balanced in your body. You might notice in these cases that your eczema gets worse around your period.

One of the most common factors in balancing hormones is effective liver metabolism. The live is where used up hormones are sent to be broken down for elimination, and if your liver is not functioning at its best, this can cause a backup, meaning those hormones stick around for longer than intended to have a continued effect.

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Another extremely important hormone to consider in eczema is cortisol, your stress hormone. Cortisol levels influence the immune system, so when cortisol levels are imbalanced (they do not follow the normal circadian rhythm variations) it can create excess inflammation, or improper immune regulation.

Testing

Eczema is easily diagnosed from visual inspection and a brief health history, but further investigation is beneficial in helping to determine the cause of your eczema for better success in treatment. Some examples of testing we might consider doing in your case are listed below:

Blood testing to assess your immune system’s allergic activity. This will help to determine if your eczema is “atopic” (linked to allergies, and the intestinal microflora)

Allergy scratch testing to help identify specific allergies that my be contributing to eczema severity

Food sensitivity testing may be helpful in some cases, although these test results need to be interpreted with some restriction as they are not always the best representation of your body’s immune activity. Please make an appointment to discuss whether food sensitivity testing would be beneficial in your case.

Hormonal testing to assess how your body is managing stress, and whether this is a significant contributor to your eczema. Testing your sex hormones (estrogen, progesterone, testosterone) may also be beneficial to determine if your eczema is a result of a hormonal imbalance

Oxidative stress testing to determine how that is affecting your skin. Oxidative damage is expected to be present in eczema, and this test is useful to determine the severity of the damage, and to track improvements during treatment. This test may also be useful when your skin has cleared to determine the potential for a future flare up, which may indicate the need for preventative treatments.

Treatment

Treatment varies depending on the cause of your eczema. Therefore, the most important step in a successful treatment protocol is to determine which factors are specifically affecting you and your skin. Once we know that, we can design a treatment protocol that will address the deficiencies and imbalances in your body that are causing you to want to scratch your skin off.

Here is an example of some of the treatment goals we may work towards:

We will put together a topical treatment regimen that you can apply to your skin in order to relieve the severity of itching and the appearance of the rash while we work on healing the deeper issues. These treatments may also have some benefit to solving the deeper pathological issues, for example keeping the skin hydrated and providing nutrients for repair, but a topical treatment plan alone is insufficient to completely heal eczema.

Diet changes may be necessary to remove foods that contribute to inflammation, or may be disrupting normal cell membrane synthesis, and to add foods high in nutrients, and antioxidants to protect the skin from continued damage from inflammation.

Supplements may be recommended to correct nutrient deficiencies, balance hormones, or support the immune system and the microbiome during healing.

Techniques to manage stress are extremely important, and depending on the magnitude of effect cortisol may be having on your immune system, further support to balance cortisol secretion throughout the day may be necessary.

We will also need to supply nutrients that will assist in healing the skin barrier to strengthen the integrity of your skin. This may include vitamins like A, C and E, as well as an appropriate balance of Omega-3 fatty acids and other nutrients important for skin wall synthesis.

In children with atopy, it is important to work on balancing the immune system so they don’t progress to the full atopic triad (see above).

Gut healing to deal with any digestive dysfunctions, and incomplete detoxification processes that may be contributing to eczema. This may involve diet and lifestyle changes as part of a specific, short term protocol, or intravenous therapy to support appropriate liver metabolic pathways.

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