As a naturopathic doctor, my goal is to find the root cause of symptoms and work to correct that first. For this reason, my approach to eczema and allergic symptoms is always first to support the body’s gut and immune system to achieve balance over time. This is most often not an overnight process and ending the cycle of eczema flares requires looking at what underlying factors may be causing the rash to break out in the first place, in addition to offering relief for symptoms in the moment.
Eczema is very common in infancy affecting upwards of 20% of children. I’ve seen many babies, some as young as 3 weeks with whole body eczema. By the time I see them the parents have often already tried everything –different soaps and detergents, different bathing schedules, and every over the counter cream money can buy. Often a pediatric dermatologist will have little to offer parents other than a topical steroid cream such as hydrocortisone, which may stop a flare up in the moment, but it doesn't fix the root cause of the issue.
What Causes Eczema
We know that eczema tends to run in families, and that having a family member with either eczema, asthma or allergies increases the risk, indicating a possible genetic component leading to the overactive immune response.
We also know that certain foods and chemicals can trigger eczema or make it worse in susceptible children. Food allergies, our IgE shellfish and peanut allergies, are known to exacerbate eczema, but IgG mediated food sensitivities can also play a role in eczema. This is due to the inflammatory effect these foods elicit in the gut, leading to an altered or exaggerated immune response, leaky gut, dysbiosis, and a slew of other gut related disturbances, all of which can contribute to eczema presentation.
What About Gut Bacteria?
The microbiome refers to the population of bacteria that live in our gut. They play an important role in mediating the immune response, especially regarding allergies and eczema.
Your gut microflora affects many aspects of your health, but one of the most important to consider is the establishment of healthy gut bacteria during infancy.
Several recent studies have found that children with eczema have a very different population of gut bacteria than those who don’t suffer eczema. One study found that infants with “low microbial diversity” at 1 month of age were more likely to develop eczema. So, what influences the establishment of gut bacteria?
Vaginal vs. C-section birth: Babies born to mothers via c-section do not get the mouthful of healthy bacteria that those born vaginally receive. Several studies have found increased risk of asthma, allergies and eczema in cesarean sections babies. Antibiotic use: During or after pregnancy by mom, as well as after birth by the baby Diet – Breastmilk is rich in probiotics and the skin-to-skin contact with the parents may also serve as a source of good probiotic exposure. An infant’s diet (once eating solid food) can also influence the population of bacteria.
How to Treat Eczema
1. Start by “cleaning house”. Get rid of any personal care products that may be irritating. Watch for irritating ingredients in bath soap, shampoo, even the parent’s personal care products- including perfume, deodorant, laundry detergent & fabric softener, fragrance or “parfum”, sodium laureth sulphate, and parabens. Check EWG.org for clean alternatives.
2. Basic nutrient supplementation Mom can have a great diet during pregnancy and breastfeeding, and their baby can still be lacking in nutrients due to todays food standards. Essential fatty acids has been shown as vital to gut and skin health. Cod liver oil is an ideal supplement for increased essential fatty acids, as it also has highly absorbable forms of vitamin A and vitamin D needed for fatty acid absorption and use. Also, supplements supportive of the immune system, such as zinc, for mom is a good idea, as small levels are transferred to baby via breastmilk.
3. Identify food allergies & Heal the Gut
To restore immune balance its necessary to remove aggravating factors on the immune system first. To do this we need to identify factors which are taxing you or your child’s immune system resulting in poorly balanced immune function.
Some common triggers for eczema include gluten, dairy, corn, soy, or eggs however some kids can also be allergic to odd foods – blueberries and oatmeal, for example. Our toxin heavy lifestyles also increase kids total body burden, leading to an increased likelihood of developing food intolerance due to a higher level of inflammation.
There are many ways to identify a food allergy: elimination diet and reintroduction with close observation, a specific food group elimination diet, or food allergy/food sensitivity testing. A qualified practitioner can help you determine which plan is best for you.
4. Stool Testing and a high-quality probiotic
A 2001 study found infants and toddlers that were supplemented with lactobacillus probiotics from birth through age two years had a 50% reduction in their rate of eczema compared to a control group. Most over-the-counter probiotic supplements do not contain real, live bacteria strains – you will want to ask your physician to supply you with pharmaceutical-grade probiotics for the best results. Also, if there is any history of gastrointestinal disturbances, an improper probiotic strain can further fuel the problem. Therefore, a microbial stool culture may be recommended to get an idea of current flora landscape before recommending introducing new cultures via a probiotic.
5. An anti - inflammatory diet
This is a great overall approach to decreasing the intensity and severity of eczema flares. An anti-inflammatory diet emphasizes fresh organic fruits and vegetables, grass-fed meat, nuts and seeds, and healthy fats such as coconut and olive oil while eliminating proinflammatory foods like sugar, grains, and dairy products. Changes such as these can have a huge effect on your child’s health - not only are they significantly improving their nutritional status, but also reducing the overall tendency of their immune system to over-react to foods and environmental allergens.
6. Avoid over washing
Hot or frequent bathing and excessive washing with soap can dry out the skin and exacerbate an eczema rash. This can be reduced by keeping bathing to every 2 or 3 days, and using a wet washcloth pat down those days between. To help keep moisture in, add 1/2 tsp of coconut oil to the bath- caution here as some kiddos react even to coconut oil when super inflamed.
7. Offer topical relief
All these changes in diet and lifestyle can take weeks or even months to see their full effect. So, what can you do to help your child feel better in the meantime? - Oatmeal bath: Oatmeal is naturally soothing and anti-itch. To create an oatmeal bath, place ground oatmeal in a clean sock or cheese cloth and place under running water as you fill a bath and let the child soak for 20-30 minutes. - Apple cider vinegar: This can be applied to a cotton ball and gently dabbed over the affected areas for mild itch relief. - A topical cream containing soothing herbs such as calendula, neem oil, vitamin E, beeswax and other natural ingredients. Remember to test out any new products on a small patch of skin before applying to the entire affected area to avoid a reaction.