Two views: Eczema


TRADITIONAL: ELIZABETH O’BRIEN, dermatologist at the Montreal General Hospital and Quebec director of the Canadian Dermatology Association

Eczema is genetic: Recent research suggests that a malfunctioning gene affects the barrier function of the skin, which is supposed to prevent water loss and protect against irritants and infection. We call eczema “an itch that rashes”: Most people start to itch, they get microscopic blisters, and their blood vessels dilate. This causes redness and disrupts the skin, making the cells shed abnormally, which results in scaly skin.

Mild eczema can be treated by your family doctor, who will prescribe mild cortisone cream. Often eczema responds quickly, improving within a couple of weeks and clearing completely a few weeks after that. But it’s a chronic condition. Most patients have had it since childhood and will have periodic flare-ups.

Sometimes severe eczema doesn’t improve after that, so we use stronger cortisone creams. These can have side effects, such as thinning of the skin and easy bruising, so we try to limit the use of those creams to a few weeks.

For general maintenance, keep in mind that water is drying and soap is irritating. Wear gloves when washing dishes, use soap sparingly and reduce the length and number of showers and baths, especially in the winter. Avoiding chemicals may help; so may wearing soft cotton clothes.

Some people change their diets, because they believe eczema comes from a food allergy. It’s true that sufferers are more likely to have hay fever, asthma and hives. But eczema is not itself an allergic reaction, so diet changes don’t work, and I don’t recommend them.

ALTERATIVE: ELENA KRASNOV, naturopathic doctor at the Toronto Naturopathic Clinic

Eczema is an allergic reaction that people are genetically predisposed to. Allergies cause inflammation, which can happen anywhere in the body. If you have allergic inflammation in your lungs, you have asthma. If you have it on your skin, you have eczema.

To treat adult eczema, I prescribe a cleanse and diet changes. If you do the cleanse and not the diet, it takes longer for the eczema to clear up; if you do the diet without the cleanse, it takes forever. Cleansing the liver involves taking supplements, such as artichoke or dandelion, and cleansing the bowel is done by taking magnesium oxide.

Then my patients go on an elimination diet: no dairy, sugar, corn, chocolate, gluten, strawberries or eggs. After four to six weeks, the patient is allowed to reintroduce the foods back into her diet, one at a time, a week apart, so we can tell what she’s reacting to. I also tell my patients they can use soothing coconut oil or vitamin E on their skin. But that’s not a treatment; it’s just a Band-Aid. Eczema comes from inside the body, so we treat it from the inside.

After the cleanse, I give my patients digestive enzymes and a probiotic called acidophilus, which repopulates their gut with friendly bacteria. And I recommend that they take fish oils, which contain anti-inflammatory omega-3s.

The diet isn’t easy, but most patients who follow it will see their eczema clear up, without medication, in four to six weeks. (It takes that long for the skin to recover.) Some of my patients had suffered from eczema for 20 years, and even they were helped.

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