Eczema & Atopic Dermatitis
Eczema, or atopic dermatitis, is a chronic inflammatory skin condition characterized by dry, itchy, inflamed skin. It affects approximately 31 million Americans, with onset commonly occurring in childhood though it can develop at any age. Eczema involves a complex interaction between genetic predisposition, immune dysfunction, skin barrier impairment, environmental triggers, and allergies. The condition often coexists with other atopic diseases including asthma, allergic rhinitis, and food allergies, suggesting shared underlying immune dysregulation.
Symptoms
- •Dry, sensitive skin with impaired barrier function
- •Intense itching, especially at night, leading to scratching and potential infection
- •Red, inflamed patches of skin that may ooze or crust when scratched
- •Thickened, leathery skin from chronic scratching (lichenification)
- •Small raised bumps that may leak fluid when scratched
- •Flares triggered by stress, allergens, irritants, or weather changes
Causes & Risk Factors
- •Genetic mutations affecting skin barrier proteins like filaggrin leading to increased permeability
- •Immune dysregulation with excessive Th2 inflammatory response and IgE production
- •Gut dysbiosis and intestinal permeability contributing to systemic inflammation and immune activation
- •Food sensitivities and environmental allergens triggering immune responses manifesting in the skin
Naturopathic Approach
Naturopathic treatment for eczema focuses on healing the skin barrier, modulating immune function, reducing inflammation, and identifying and eliminating triggers. Gut health optimization is foundational as the gut-skin axis significantly impacts eczema—addressing dysbiosis, healing intestinal permeability, and supporting beneficial bacteria reduces systemic inflammation. Probiotic therapy, particularly Lactobacillus and Bifidobacterium strains, shows benefit for eczema. Identifying and eliminating food triggers through systematic elimination protocols often dramatically improves symptoms—common triggers include dairy, eggs, soy, gluten, and nuts. Anti-inflammatory nutrition emphasizing omega-3 rich fish, colorful vegetables with antioxidants, and avoiding inflammatory processed foods supports skin health. Targeted supplementation with omega-3 fatty acids reduces inflammation and supports skin barrier function, vitamin D modulates immune function and is often deficient in eczema patients, quercetin provides antihistamine effects, and zinc supports skin healing and immune function. Essential fatty acids including evening primrose oil or borage oil provide GLA (gamma-linolenic acid) which supports skin barrier integrity. Herbal medicines including licorice root (topically and internally) for anti-inflammatory effects, calendula for skin healing, and chamomile for soothing inflamed skin provide relief. Stress management is crucial as stress exacerbates immune dysregulation and triggers flares. Topical support includes gentle, fragrance-free moisturizers to repair skin barrier, colloidal oatmeal baths for soothing relief, and avoiding harsh soaps and irritants. Environmental modifications reduce exposure to triggers including dust mites, mold, pet dander, and harsh chemicals. This comprehensive approach aims to reduce flare frequency and severity, heal the skin barrier, modulate immune function, and improve quality of life.
Related Modalities
Frequently Asked Questions
Can eczema be cured?
While there's no definitive cure for eczema, many people achieve complete remission or significant improvement through comprehensive treatment addressing underlying triggers and immune dysfunction. Children often outgrow eczema as their immune systems mature. Adults can experience long-term control through gut health optimization, elimination of food triggers, stress management, and proper skin care. The genetic predisposition remains, but symptoms can be effectively managed or eliminated.
How is eczema related to food allergies?
Eczema, food allergies, and other atopic conditions share underlying immune dysregulation. Many people with eczema have food sensitivities or allergies that trigger or worsen symptoms through systemic inflammation and immune activation. Common culprits include dairy, eggs, soy, wheat, and nuts. Elimination diets identifying and removing food triggers often significantly improve eczema. Food allergy testing and systematic elimination protocols can identify specific triggers.
Why do topical steroids stop working over time?
Topical steroids provide symptom relief by suppressing inflammation but don't address underlying causes. Long-term use can cause skin thinning, increased sensitivity, and rebound flares when discontinued. The body may also develop tolerance requiring higher doses. Naturopathic approaches focus on addressing root causes—gut health, food sensitivities, nutrient deficiencies, and immune function—allowing many people to reduce or eliminate steroid dependence while achieving better long-term control.
How long does it take to see improvement with natural treatment?
Response varies based on severity and underlying causes. Some interventions like intensive moisturizing and trigger elimination provide relief within days to weeks. However, healing gut permeability, modulating immune function, and fully identifying food triggers typically takes 2-3 months. Skin barrier repair and reduction in flare frequency often shows progressive improvement over 3-6 months of consistent treatment. Severe or long-standing eczema may require 6-12 months for optimal results.
References
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Dr. Sanika Kshirsagar, ND
Doctorate of Naturopathic Medicine (ND)
Bastyr University, Kenmore, WA
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