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Despite millions of dollars of research and some of the best and brightest minds working on the problem of eczema, we still do not fully understand the disease, nor do we yet have a cure. The conventional treatments are very helpful for the vast majority of patients, but some continue to suffer despite the best medications, and others suffer side-effects from therapies that are far from totally safe.
Thus, it is no surprise that more than half of all eczema patients have reported using some form of alternative medicine, and that the majority continues to search for new and better treatment options.
A practical way to define alternative therapies is treatments and systems that do not (yet) have enough evidence to be recommended, either due to not having been tested sufficiently, or having been tested and found convincingly not to work.
The problem is that there are an overwhelming number of systems and non-systems with overflowing anecdotal evidence, and simply not enough resources to test them all properly. Sadly, it seems that there is no easy solution for this, and thus many alternatives will remain that way for at least quite some time.
Although it lives on the edge of conventional and alternative therapies, for eczema there is some evidence that it is helpful. Although it can be expensive and time-consuming, it appears totally safe and can also help with stress reduction and behavioral components to the disease.
May work via nerve pain and itch modulation, but also has global effects on the body, decreasing stress and improving the sense of well-being. Also very safe, but can be expensive as it is often not covered by insurance.
A very difficult area to study, since herbs are not given for “eczema” per se, but rather for the underlying imbalances in the body that lead to eczema. There are a number of small papers showing positive effects and there may well be something to this. However, it is difficult to know which particular combination might be effective and an individual patient’s outcome may be related to skill of their practitioner. There is also some concern about heavy metal contamination of certain imported herbs, and even pure herbs have very real side effects that must be considered.
Many plants and natural substances fall into this category, making it extremely difficult to parse out what actually works. Sunflower seed oil applied topically appears to have some very favorable properties in terms of itch, inflammation, and improvement of the skin barrier function. Coconut oil has antibacterial effects, which may also be of great benefit in eczema. A recent paper suggest that borage oil and evening primrose oil now have enough evidence to be convincingly shown as not helpful treatments for eczema, and these should probably be excluded from further discussion.
Many patients and practitioners feel that diet is the secret of eczema, and most of us wish it were so simple. The truth is that there are many types of diets that are recommended for eczema, including: dairy free, gluten-free, low-allergen, no sugar, no dyes, no yeasty foods, alkaline foods, and many, many more. The reality is that, aside from avoiding foods that one is truly allergic to, of course, diets seem to have less effect in the real world than they seem to on the internet. There is no doubt, however, that some foods seem to be inflammatory, particularly in some people, and so gluten-free and dairy-free may make a difference in some. Avoiding processed foods is also generally a good idea, even if it does not help the eczema much. Eating natural, organic, and balanced foods is a win-win, so rather than argue against it, it is better to encourage it! However, it is always frustrating when a patient has been assured that diet is the solution and—despite their best efforts—the eczema seems to disagree.
Healthy bacteria which makes sense given there is clearly disrupted bacteria both on the skin and in the gut of patients with eczema. However, it doesn’t play out so simply when studied in the real world: it does seem to help prevent some eczema when given to pregnant mothers, but has limited effect in children and adults once they have developed eczema.
There are a number of vitamins that may help with eczema. Vitamin D supplementation, though still a bit controversial, is quickly becoming more mainstream as studies show both that supplementing vitamin D can help eczema, and that more severe eczema is correlated with lower levels of vitamin D. Safe and inexpensive, it seems a reasonable consideration for most patients. Topical vitamin B12 has been studied and has some compelling evidence that it is helpful. However, there is no commercial product as of this writing, and so it must be compounded in order to be used which can be expensive.
“Alternative Therapies” encompasses an enormous amount of possibilities that can be overwhelming for patient and provider, alike. Finding a provider that has experience with eczema, is reliable, and is willing to admit when something is not working is critical to success, whether alternative or conventional medicine is being used.