Atopic eczema (also known as ‘atopic dermatitis’) is a non-contagious condition of the skin that results in dry, red and itchy skin. The skin tends to flare up and settle down and is commonly seen in infants and young children, although for some it continues into adulthood.
(To keep it simple from here on, I’ll refer to it as simply ‘eczema’. )
Eczema also can affect sleep and therefore energy and quality of life.
“I don’t know what is triggering it exactly.
Terrible sleeper… bloody torture.”
Sound familiar? I hear it from exhausted and frustrated parents all the time.
Sleep deprivation due to eczema doesn’t only impact the child, but the entire family who may also experience sleep interruption too. Fatigue and lack of energy become part of this cycle and can contribute to overwhelm, stress and feeling like there is no other way.
Much of the blame for eczema points to genetics. Yes, researchers have found over 80 genetic variations associated with eczema .
But having the genetic variation(s) that predisposes you eczema doesn’t mean you’ll necessarily have the condition. This has been shown in twin studies, with identical twins (who share the same genes) may have one twin with eczema and the other without . It is clear that other factors must play a part in the development of eczema.
The danger of not looking past genetics leads to a failure to address the bigger picture, including the known triggers.
Blaming genetics alone does not give parents hope for improvement other than ‘growing out of it’, even though it is clear that eczema is a condition that has a complex relationship between genetics and environmental factors .
While we cannot change the genes we are born with, we can influence the way that our genes are expressed.
This exciting field of science is known as Epigenetics. It means that even if your child has the genes that predispose them to having eczema – and they do have eczema – positive steps can be taken to enhance gene expression and cellular function.
Epigenetics means that our gene expression is influenced by lifestyle, stress, environment and diet/nutrition. These are areas that can be assessed and addressed.
Furthermore, these factors as well as indoor air pollution, antibiotic use and low levels of vitamin D are also associated with eczema .
“The prevalence of eczema has been increasing too rapidly to be accounted for by shifts in genetic variation” , which encourages sufferers of eczema to address areas outside genetic variation.
The diagnosis of childhood eczema predisposes a child to other potential health issues like asthma.
Many parents are looking for a different way to help their child. So many have done everything they’ve been told to do, feel like they’re not being listened to and are realising that they want a safe and new way forward for their family.
Read further below for various contributing factors for eczema.
So… what does this mean?
It means, that even if you or your child has eczema, not is all lost!
Let’s take a look into some of the lesser known truths about eczema so that you can see what else can be done to help yourself or your child.
1. DIET AFFECTS THE SKIN
Yes, this is a controversial one!
Despite the controversy, a group of doctors lead by Guibas published a review in 2013 reporting on the disparity in eczema research published in dermatology compared with immunology (allergy) journals . He found that there were 10 times the number of research papers on the relationship between eczema and food in the immunology journals than the dermatology journals.
Research in immunology journals reported improvement in skin with the removal of certain foods. Dermatology case studies, opinions and few research papers tended to discourage the removal of foods from the diet as an approach to managing eczema.
While there were appropriate cautions against removing foods without professional advice due to the potential for malnutrition, many research studies have demonstrated that food can be a potential trigger for eczema.
2. GUT HEALTH IS IMPAIRED IN PEOPLE WITH ECZEMA
So what is this ‘gut health’ that many people are talking about?
Many people relate ‘gut health’ with having symptoms in the gut – e.g. reflux, constipation, and bloating. While impaired gut health can lead to some of these symptoms, it is not always the case. This isn’t the whole picture.
Our gastrointestinal tract contains many trillions of microorganisms that have a significant role in our immune system. These microorganisms are involved in many different functions in our body and are vital to health.
Children with eczema have a different gut microbiota profile than those without eczema. Improving gut health may improve eczema – it is certainly been our personal experience and those of many others.
3. PROBIOTICS AREN’T THE FULL PICTURE
Some probiotic research shows an improvement with eczema, however this is not consistent across the board. A recent Cochrane Systematic Review pooled all of the research on probiotics and eczema and found that there was no overall improvement in taking probiotics alone for eczema .
While this conclusion is disappointing, don’t give up!
As no two people have the same gastrointestinal microbiota, it may require a more targeted and individual approach to improve gut health. Stool microbiota testing can help indicate where the imbalances are (and potential overgrowths of ‘bad’ bacteria). This can guide a more individualised approach including specific prEbiotics (‘food’ for the beneficial bacteria). Gut health may also be improved by adding in other nourishing support like gelatin and a wide variety of colourful vegetables, fruits, nuts, seeds and grains.
4. ‘GUT HEALING’ FOODS MAY BE DOING MORE HARM
Fermented foods such as sauerkraut, kefir and yoghurts are food that may be beneficial our gut health. They contain billions of beneficial bacteria, however they are also high in a naturally occurring chemical called histamine.
Histamine can also be a trigger for those with eczema. If you’re starting out with these foods, start slow, one at a time, and monitor for symptoms. There are some genetic variations that affect the body’s ability to break down histamine and may require additional support to do so or an alternative way to improve gut health.
5. THERE’S NO MAGIC MOISTURISER
Moisturisers are an important part of eczema management. It minimises the moisture loss from the skin and maintain an intact skin barrier. They can also help soothe the skin, however since they are often the main recommendation along with a prescription, there is a lot of focus on the perfect moisturiser that will fix it all.
I was on a forum the other day and this is what I came across:
“We’ve tried sooo many brands…. We are still trying to work it out…”
“So far I’ve used 1kg tub of cream with not much effect.
What else can I try?”
Unfortunately, that moisturiser that’s made of unicorn tears (yes, someone wrote that on a forum recently as well!)… the one that will cure all – doesn’t exist.
So you can stop the search party. What works for one person doesn’t necessarily work for all, either. Sorry to be the bearer of this news! (You may have already discovered this anyway after trialling a dozen different creams….)
Yes, moisturisers are a good place to get right first as they are typically applied several times a day to most of the body. It is therefore important to ensure that the moisturiser itself isn’t a trigger.
But buyer beware! Even though a product is on the shelf in the shop, doesn’t mean it is safe! !! Some products contain known skin irritants – and that isn’t even the worst of it – but it is a crucial step to cross-check the ingredients on EWG.org for their safety and the presence of skin irritants.
Although many of us are looking for something that is ‘natural’, avoid food-based products as this may lead to the development of an oral allergy.
AND…. as you’re probably realising, the moisturiser isn’t the whole picture.
So once you’ve found a moisturiser, move on to spending more time on addressing gut health, nutrition, and the triggers that you can do something about.
6. HOME ENVIRONMENT
Indoor air is reported to be more polluted than our outdoor environment, with many invisible triggers indoors than just the house dustmites. Other areas within our homes that should be audited include (but are not limited to):
- Candles, soy melts, reed diffusers, synthetic room sprays and wall plug ins
- Chemicals in the water including chlorine – think drinking and bathing water
- Mould and mycotoxins – bathrooms, roof leaks. This needs to be addressed ASAP
- Cleaning chemicals
- Personal Care Products
- Skin Care Products
7. HAVING ECZEMA SAVES WATER
Well, it should! Tap water contains chlorine which can irritate the skin. Water also is more alkaline than your skin (which is naturally acidic). Our skin microbiota – the protective microorganisms on our skin – like a more acidic environment. Increase the pH of our skin may affect our skin microbiota, allowing more pathogenic (aka “bad”) bacteria to thrive.
Reduce the frequency and duration of the bath/shower may help to minimise this, as well as having the water at a cooler temperature (this means shorter time to heat up, right?).
Stress is a commonly reported trigger for eczema and therefore managing stress is a key approach.
Good quality sleep/rest, connection, nutrition and support are key in reducing and managing stress. Audit for areas in your life that can increase stress in you or your child and brainstorm ways to reduce it. This might include daily meditation, exercise, grounding, singing/dancing, use of essential oils, getting out in nature.
Do you ever worry about the weather and its effect on eczema skin? Worry about the Summer coming up, or the winter and the drying heating, or even whether going on holidays will mean a flare up or an improvement?
The heat, the cool weather, heating, cooling, humidity and dry air can all be triggers for eczema. Some people find their eczema is worse in Winter, with others worse in Summer. The key here is to recognise the weather trigger and be prepared.
Whatever the case, if you are travelling to a different area, ensure that you are prepared for a flare up and bring whatever you require for a flare up. Even though our son no longer deals with eczema any more, we do find that being in a different environment sometimes dries his skin.
It may be the different bed sheets washed in commercial cleaning detergents, or the increase in gelati / fish and chips in the diet (!), sunscreens or the daily swimming in chlorine. So we bring our soothing essential oils, moisturisers, and barrier creams (for pre-swimming) just in case.
We CAN Be Proactive With Eczema and Regain Control
Although eczema is a complex condition, identifying triggers and minimising or removing them, and addressing eczema at the underlying causes allows us to regain control of a challenging condition.
Making changes one step at a time reduces the overwhelm, and multiple tweaks over a few weeks and months can add up to make a significant difference to the lives of those with eczema.
So…. if you’re wanting to regain control of your child’s eczema and are ready to have the right tools to story, click here to make a time to chat.