My Family's Eczema Treatment Plan
My Family’s Eczema Treatment Plan
My family has had the enormous project of dealing with my son’s eczema and asthma. It began as soon as he turned 3 months old (just like with my older son). However, his condition lasted way past the 18 months of age that my pediatrician and I hoped for, that would mark it as transient infant eczema. It was also much more severe. I could write at length about how harrowing his eczema and asthma was, especially for a mother, watching her child writhing in pain, seeing blood patches on his pillow and sheets, nebulizing him morning, noon, and night because he would wheeze if he ran around the house once. I want to focus on what information I have acquired over the two years we have dealt with this.
I am not a physician nor a pediatrician. So, the treatments I am recommending are from what I have gathered from my pediatrician, “Dr. Google”, and in talking to others about eczema and asthma. And I did not seek approval from our pediatrician before starting each one of these therapies. This is written by a mom who knows her son, agonized over his pain, and determined it was unacceptable that her child exist in a state of such mental and physical anguish.
Two major pieces of information that serve as the core for these suggested therapies:
- Eczema and asthma are connected. They are on the same gene. So what triggers one, often triggers another. As I see now in hindsight, this is true for our son.
- Eczema is not a dermatologic condition, it is a gastrointestinal condition. Strange, right? It starts with a severe imbalance in the intestinal bacterial balance. See the section on Probiotics for the explanation and details.
Here are the highlights of what I have put together as the treatment plan for our son.
- Food dyes/colors: This was an amazing (and terrifying) revelation with our son. After consuming foods with dyes or colors, he would vomit, break out in hives, and wheeze severely. His eczema would flare in minutes and he had chronic thick, intensely itchy, red patches on his wrists, ankles, and on the back of his neck. The first time, we went to the emergency room. The two times that it happened, a multi-colored cereal and jelly beans (exactly 3 jelly beans) were the culprits. In my research, the top offending colors are Yellow No. 5 & Red No. 40. I was amazed how many foods have dyes once I started reading labels. In low chronic doses, food colorings can aggravate the skin. It may not always cause an acute or life-threatening allergic reaction, but will constantly aggravate eczema and make it harder to treat.
But it is not as simple as looking for colors with numbers on food labels. Caramel is a color additive that people can be reactive to. Cereals, soy sauce, even pickles have food colors. Eliminating food dyes and colors can be a huge shift in the food shopping paradigm. At least, it was for me. My recommendation is to start small – read labels, eliminate obvious colors and caramel. See the references section for a complete list of food colorings and additives.
So, how do you shop with these restrictions? With two kids and an adoption in progress, being economical is a priority. What I have found helpful is to stick to more natural foods – the less processed, the less likely to have additives. Start enjoying fruits and veggies. Get a steamer for vegetables and then season yourself. Instead of flavored yogurts, get plain greek yogurt and add honey or fresh fruits. The absolutely most economical place to shop is at a farmer’s market. But, here is my short list of grocery stores that are committed to dye free foods (among other quality commitments):
- Kroger’s Natural Food Section
- Whole Foods
- Trader Joe’s
- The Fresh Market
- Dietary triggers:
- Azodicarbonamide: This a bit controversial. This compound has been banned in Europe. However, I do not have concrete evidence that this compound is problematic. But, in some studies I read, this whitening chemical has been shown to trigger asthma in children. (And remember, what triggers asthma, can trigger eczema, since they reside on the same gene.)
- Tomato/acidic foods: Acidic foods tend to flare eczema. My son flares after tomato sauce, oranges, or even fruits that naturally bright red in color, like cherries or watermelon.
Note: We had our son allergy tested. He tested negative for everything (milk, nuts, wheat, cotton, pollens, etc.) The important point here is that food allergy testing obviously cannot test for everything, like food coloring. In addition, allergy tests only trigger a small part of the immune system, so other parts of the complex human immune system may be triggered that cannot be tested or measured.
- Probiotics: (Lactobacillus & Bifidobacterium) These two bacteria are more commonly deficient in children and adults with eczema. From my research, eczema is primarily a gastrointestinal disease. Many children are on repeated antibiotic regimens for ear infections. This causes an imbalance in intestinal bacterial balance. Some pediatricians will recommend a probiotic for children with eczema. Most probiotics found in pharmacies and groceries stores have only one subtype of one bacteria – Lactobacillus acidophilus. However, there are 6 different subtypes among these two that children and adults with eczema are shown to be deficient in. The brand that was recommended to me by the herbal store I went to is Flora Udo’s Choice Infant’s Probiotic. The reason the employees recommended this one to me is because it retains the most live bacteria after manufacturing. Remember, probiotics are live bacteria, or inactive ones that are supposed to activate once ingested. This is a delicate and scientific process, and not all brands are effective because of this.
- Supplements: Herpanacine: This is a supplement that is a mixture of Vitamin A, Vitamin E, Zinc, and Selenium, along with other antioxidants that have been shown to help the skin’s natural barrier layer, and which people with eczema tend to lack. Remember, vitamins and nutraceuticals effect change in the body, just like medications. Especially, with children, who have different requirements than adults and are growing, I highly recommend consulting a pediatrician before starting any vitamin supplementation, so as not to overdose or create a toxicosis.
- Hydroxyzine (Antihistamine): This helps block the histamine release, which promotes itchiness and the drive to scratch. Make sure to consult a pediatrician for a prescription and dosing recommendation.
- Bleach baths: People, especially children, who have eczema tend to have a higher population of Staphylococcus aureus , which is a natural bacteria on the skin. Because eczema leads to dysfunction in the barrier layers of the skin, these bacteria can infect eczematic lesions. This can make eczema harder to treat. Reducing the bacterial population can make eczema easier to treat. Swimming in chlorine pools has the same effect.
- Pour ½ cup of bleach in a full bath tub of water OR ¼ cup in a half tub. Soak for 10-15 minutes. Avoid getting the solution in the eyes and rinse well.
- Salt baths: It might seem counterintuitive to use salt with such a sensitive skin condition, but at the right dilution, the salt bath doesn’t sting. We discovered this when we went on a family trip to the beach for five days and my son’s skin improved tremendously after playing endlessly in the ocean. The sodium in salt helps draw in water to the skin, which is one of the problems with eczema (lack of water retention ability). Rinse the salt off well and then seal in the moisture with lotions and oils.
- Pour ½ cup of non-iodized table salt in a full bath tub of water OR ¼ cup in a half tub. Soak for 10-15 minutes. Avoid getting the solution in the eyes and rinse well.
*Note: Steer clear of washcloths during baths. Stimulating the skin irritates hair follicles and causes more reaction. After a bath, gently pat the skin dry – no rubbing.
- Scratch-Me-Not Sleeves: Finding the right sleeves took us a few tries. These sleeves are the best ones we found because the fabric holds memory, doesn’t stretch out, and the silk mittens are made of sturdy material. Also, they can be worn underneath clothing and the mittens flipped out to expose little hands without taking them off. The company also makes a full-sleeve onesie, so it can be worn as a shirt.
- Trim Fingernails: And I mean SHORT – this helps immensely to prevent self-trauma. I trim my toddler’s nails about every 3 days. Their nails grow so fast. But keeping fingernails short is so important. My son would scratch himself bloody within the time I took off his sleeves to apply lotion to his hands and then put his sleeves back on again. I have also talked to adults with eczema who have said keeping their nails short greatly reduces the flare-ups associated with creating abrasions in the skin from scratching.
- Vitamin D/Sunshine: The sun activates Vitamin D3 in our skin. This vitamin is very important for supporting the natural barrier layers of the skin. For adults, some sources recommend ultra short periods in tanning beds. Of course, this would not be recommended for children. However, try to get children out in morning or evening sun. Always wear sunscreen and take this suggestion with caution if you or your family is prone to sun burn or have a history of dermatologic cancers.
- Topicals/Lotions/Ointments: This list literally could be endless. My family has been through at least twenty ointments, lotions, creams, etc. What I will say about this is that traditional lotions are not enough. There are two types of topicals that we have had the most success with – emollients and oils. Oils are the best for eczema skin.
- Emollients/Lotions – Because they are water based, lotions help to replenish lost hydration. However, lotions absorb quickly and need to be reapplied frequently, even every 4-6 hours. We have found applying lotion to hydrate the skin and then sealing it in with oils helps our son the most.
- Oils – There is a myriad of oils that can help eczema. The purest oil, in my opinion, is coconut oil. It is incredibly hydrating, a natural anti-inflammatory, and has been used in ancient cultures for centuries, ingested or applied..
- Petroleum – This was a very eye-opening topic. I do not have a web/article resource for this one. I spoke with employees at a homeopathic/herbal store I went to when I was looking for supplements and probiotics. What I was told was that petroleum creates too much insulation for the skin and it cannot breathe. The skin is a living organ, with blood supply and oxygen requirements. Petroleum-based products were the mainstay of therapy for our son in the beginning. However, once I talked to the herbal store employees, I discontinued the petroleum topicals. I switched to oils and lotions and noticed a difference. With the petroleum products, the skin was redder and more weepy. With the oils and lotions, it would dry faster (so we reapplied more frequently), but the skin scaled and shed more. This produced healthier skin underneath and the skin was more normal looking and felt more natural.
- Detergents: Anything with fragrance can trigger eczema. Also, powder detergents can leave residue flakes that can irritate skin. Use a hypoallergenic liquid detergent and set for “extra rinse” (or 2 rinse cycles). Do not use fabric softeners.
- Mold: This may seem out of left field, but there are numerous reports about house mold aggravating eczema and asthma. This can be easy to spot or much more subtle. My recommendation is to get an independent inspector to check for leaky pipes,, gutter clogs, and inadequate ventilation. Also, for front loading washers, keep the door open to ventilate to prevent mildew and mold buildup, and occasionally clean with Affresh tabs or run an empty bleach cycle with hot water.
I hope this article helps you and your family. Again, I am a veterinarian, not a physician. The Do’s and Don’ts are written as suggestions and what we have found to work for my family and son, and extrapolating some things I have seen in my pet patients over the last decade. Now, even when my son has a flare-up from eating something he shouldn’t, or if he scratches his skin open because I forgot to trim his nails, his skin heals so much more quickly. It used to take 4 or 5 days just to get back to his normal state of eczema. Now, it takes 2 to 3 days to return to clinically normal skin and to only need his scratch sleeves at night. I feel like I have my son back, and he is a much happier child with better sleep and fewer tantrums. If you have specific questions or need more references, please email me at email@example.com.
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The recommendations contained in the Scratch Pad are those of the contributor. NEA provides health information from a variety of sources; this information is not intended as medical advice. Persons with questions regarding specific symptoms or treatments should consult a professional health-care provider.