Overview 

Eczema is a term that can be applied to a wide range of inflammatory conditions that affect the outer layer of skin. A form of dermatitis, eczema is characterized by red, dry, itchy, and sometimes oozing patches of skin that may appear anywhere on the body. However, the areas most commonly affected are the hands, elbows, knees, chest and arms, as well as areas where creases in the skin exist, including the toes and feet. 

Also known as atopic eczema or atopic dermatitis, eczema usually makes its first appearance in infancy, which has earned this condition the additional common name of infantile eczema. Although unsightly and uncomfortable for the baby, these rash-like outbreaks are often temporary and rarely lead to scarring. However, eczema may persist into adulthood in some people. 

Types of Eczema 

There are numerous forms of eczema, which are generally categorized according the area of the body in which it appears. In addition, some forms of eczema have different causes, while some occur more frequently than others. 

Atopic eczema, the name given the most common form, is used interchangeably with the terms infantile eczema and atopic dermatitis. This form of eczema tends to run in families and may be allergy-driven. Typically, atopic eczema appears on the face, scalp, inner elbows, behind the knees and, sometimes, on the buttocks. 

Contact dermatitis occurs as the result of coming into contact with either an allergen (i.e., poison ivy) or an irritant, such as a chemical. 

Seborrhoeic dermatitis is a form of dandruff that often affects infants, which is why it is commonly known as cradle cap. Greasy, pimply patches on the scalp that eventually become crusty characterize seborrhoeic dermatitis. Usually, this condition resolves itself without intervention. 

Xerotic eczema is simply dry skin that becomes irritated by cold, dry weather. For this reason, it is most commonly referred to as winter itch. However, if left untreated, this condition can escalate to a more severe form of eczema that can crack the skin. 

There are various other forms of eczema, although they are much less common. For instance, neurodermatitis can occur as the result from repeatedly rubbing or scratching the same area of skin. Dyshidrosis, also known as housewife’s eczema, affect the hands and feet, with scaly patches appearing between the fingers and toes. Venous eczema refers to a specific form of eczema that impacts the older population that may be prone to varicose veins and poor circulation.  

Symptoms and Diagnosis 

Obviously, the tell-tale symptom of any form of eczema is redness and inflammation that may include a persistant rash that itches and turns scaly. However, physicians use a variety of methods to identify the particular type of eczema involved and its potential causes. One of these methods is the use of SCORAD, a specially developed scoring system that can help to evaluate the severity of the condition. 

Certain risk factors may also be taken into consideration during evaluation, such as: 

Allergies

Family history

Nutritional status

Lifestyle

Occupational or environmental hazards (i.e., chronic exposure to irritants, etc.)

Medications 

If an allergy is suspected as the root cause for a case of eczema, various tests may be undertaken. These include: 

RAST (aka Radioallergosorbent Test) is a test that exposes the blood to a certain set of allergens and then measures the presence of certain antibodies. 

Immunoglobulin tests that look for the presence of IgEs, or specific antibodies. These tests may also be used to measure levels of certain white blood cells known as eosinophil granulocytes. 

Skin patch tests involve exposing the skin to a suspected irritant, which is ‘patched’ to the site for a period of 24-48 hours. Usually, a second patch without any substance applied to it is also adhered to the skin as a control. A positive test results when nothing occurs under the control patch and an inflammatory response is observed on the site where the test patch was applied.

Natural Treatment and Management of Eczema 

The best approach to self-care and successful management of eczema depends on keeping the skin in optimum condition and avoiding potential irritants. The following measures can be applied to help achieve relieve from itching and excessive dryness. 

Frequent moisturizing of the affected area.

Avoid soaps and detergents that can strip the skin of its natural oils.

Use soaps and cleansers that are scent-free and which contain an oil or fat base. Goat’s milk soap is an excellent choice. If skin is very sensitive, plain yogurt may be substituted.

Avoid exposure to irritants in the home and workplace whenever possible.

Eat a diet rich in whole grains, fresh vegetables and fruits. However, you may need to adjust your dietary habits if food allergies may be involved. Animal products, in particular, contain inflammatory mediators, such as arachidonic acid. 

Recommended Supplements in the Treatment of Eczema 

Probiotics 

Feeding your ‘gut’ beneficial bacteria can help to balance the ratio of ‘good’ to ‘bad’ intestinal flora, as well as promote the elimination of toxins. Studies on the effects of Lactobacillus GG, Lactobacillus acidophilus and Bifidobacterium lactis in the treatment and prevention of eczema have yielded very positive results. Organic, natural yogurt is a good source of such helpful bacteria. Probiotic supplements are also available as soft gel capsules. 

Quercetin 

Quercetin is a flavonoid that can help to deter local inflammation by reducing IgE  levels and inhibiting the release of histamines and leukotrienes from mast cells and specialized white blood cells known as basophils. Quercetin has also been shown to inhibit the enzyme 5-lipoxygenase, which has the effect of reducing leukotriene synthesis. 

Alpha-linolenic acid (ALA) 

ALA demonstrates anti-inflammatory activity by inhibiting certain biochemical actions that promote inflammation. Specifically, ALA decreases nitric oxide production, as well as inhibiting nitric oxide synthase. ALA also deters cyclooxygenase-2 (COX-2) and TNF-alpha gene expressions.  

Herbs Used in the Treatment of Eczema 

Turmeric 

The active component of turmeric is curcumin, which has been shown to possess anti-inflammatory properties. Studies have found that curcumin significantly interferes with the inflammatory action of arachidonic acid, as well as reducing the expression of COX-2 and 5-lipoxygenase. 

Clove 

Eugenol, the principal constituent of cloves, has also demonstrated the ability to impair the pathway of pathway of leukotriene synthesis by inhibiting 5-lipoxygenase and leukotriene-C4 at receptor sites. 

Green Tea 

Epigallocatechin-3-gallate (EGCG), a polyphenol found in green tea is a potent anti-inflammatory agent. Studies have shown that EGCG works in a number of ways to reduce inflammation. For example, it suppresses nitric oxide production and cyclooxygenase-2 (COX-2) expression, thereby inhibiting arachidonic acid metabolism. In addition to EGCG, green tea contains another type of polyphenol called proanthocyanidins. These agents also offer anti-inflammatory benefits. In particular, prodelphinidin B-4 3'-O-gallate (PDG) provides inhibitory effects on cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase by the downregulation of the TAK1-NF-kappaB pathway.