By Tami Bronstein, BSc Phyt (Hons), MNIMH, AHG (Bio Below)
Relief; something we desperately seek when suffering. Skin, as the largest organ of the body, can be an all-consuming suffering when eczema is in the picture. As adults, we learn to distract ourselves from discomforts to some degree; children don’t understand, they simply succumb to the overwhelming and all-consuming frustration of not feeling well.
That said, regardless of age, eczema is deeply troubling for anyone who experiences it.
At its worst, eczema causes skin to chronically inflame, weep, crack and bleed to the point of secondary widespread bacterial and fungal infection. The skin is our barrier to resist opportunistic infective microbes of our environment, and its integrity is compromised when chronically inflamed. It goes deep.
Why the vicious cycle? Why won’t topical preparations work long-term? The answer is deep. The answers are internal. The answers are complex and unique to the individual, and not simply solved with remedies found on health food store/pharmacy shelves or in a conventional prescription tube. These conventional topical preparations often contain petrochemical ingredients, toxic preservatives, and are related to a litany of potential and common side-effects –of which cancer is included.
Plant-based crèmes and homeopathic preparations may ease the flare-ups temporarily, but patches of eczema stubbornly linger or return in short-order.
So, what are we to do?
Certainly as we can observe, topical remedies ease and soothe the symptoms of this condition, but they fall-short of getting to the causative factors. When I see an Individual for eczema, I like to establish a foundation in understanding the skin as an organ of the body and its basic physiology (its functioning), on its own and as a part of the entire body. From the basic concepts, I find it useful to explain the various factors that can contribute to the condition.
The first take-away: Skin conditions such as eczema are a symptom of something more systemic, rather than simply a superficial dysfunction of the skin itself. That is to say, it indicates some other internal disruption that the skin is reflecting, reacting or responding to. So, you can repeatedly apply any crème or ointment you wish to manage the inflammation, itchiness, and other unpleasant symptoms, but it will return until you address what is going on at a deeper level of the brain and body.
The Organism and Neuro-Endocrine connection
Even if it seems like a foreign language and impossible for the Individual to remember the details, I find that a general sense of the bigger picture empowers a person with insight and more efficient management of recurring flare-ups, should they occur along the way. First we begin by seeing skin as a functioning organ, our physical barrier to the external world, and one of the largest channels of waste elimination. It is amongst other waste-management organ systems including
- digestive (bowels)
- respiratory (lungs and sinuses)
- urinary (kidneys)
Skin acts to help regulate body temperature, excrete waste products of metabolism/environmental exposure, and functions as a metabolically-active envelope to contain/protect muscles, bones, organs and connective tissues within our bodies as a functionally-integrated organism.
To help Individuals understand the role of skin as part of the integrated picture, it is important to discuss the core collaboration between physical function (physiology) and its nuances that regulate the entire body. We look to the ultimate brain-body connection:
- Central Nervous system (brain) and
- Endocrine system (hormones/neurotransmitters)
This core collaboration coordinates the function of every cell in the body, and fluctuates in response to being at-rest versus responding to the demands of life. There is a feedback loop of information returning from the body to the central nervous system to complete the circuit between brain and body. Let’s touch upon a few key realms we must explore in getting to the cause of eczema in order to resolve the condition, keep the tendency at-bay and/or manage what does surface.
This is where I channel an inner Sherlock Holmes…
Okay, I will admit to a personal fascination with the current television series on Masterpiece Mystery of “Sherlock”, featuring Benedict Cumberbatch. I also enjoyed the series “House, MD”, featuring Hugh Laurie (which mirrored the Sherlock Holmes storyline, in its own clever way).
Getting to the cause of a dysfunction requires quite a bit of medical detective work, and perhaps why these shows are compelling to me. This is what makes my work uncommon, methinks; the conventional world dwells upon symptoms, separating care of organ systems rather than seeing their integration, and limiting insight to the bubbling source of the recurring condition. Just like Sherlock, it is my job to be the detective and examine every subtle (some seemingly insignificant) nuance that leads to the Nemesis.
If any two individuals who suffer from eczema were to stand side-by-side, the causative picture for each is different. Each Individual’s experiences are the result of a unique mosaic, a woven tapestry, of factors discovered when I am exploring a thorough medical history. Some exploration delves back into their history by decades! This is evident when you have tried everything your friends, family, online blogs or health food store clerks have recommended to no avail. Individual treatment sees results.
A review a few of these clues that I find when solving an individual’s unique mystery.
The Nemesis is typically a composite of factors, rather than one source. So, let’s have a look at a few common areas that I must explore when managing eczema in an individual:
- Environmental Allergies: Airborne mold spores and general seasonal allergies are a common trigger alongside other factors of allergic eczema, and individuals often benefit from air filtration in the home. Air filters on the central heating/air-conditioning units can be found with HEPA qualification down to 3 microns, and must be changed regularly, every few months. Additional stand-alone air purifiers can be of use, as well. Frequent saline nasal flushing can reduce allergens that affect mucous membranes of respiratory system via allergic reaction, which compromises one of the 5 major channels of elimination (lungs/sinus) and triggers skin dysfunction.
- Food Allergies and Leaky Gut Syndrome: Food allergies often compromise lower bowel function; As one of the 5 major channels of waste elimination having reduced efficiency, skin can react to bowel inflammation and disruption.
Have your physician test for the major food allergy culprits, such as: gluten, dairy, wheat, soy/legumes, citrus, shellfish, nuts, MSG derivatives, etc (to begin with). Allergy testing can get fairly overzealous at times with some practitioners, overwhelming an individual with limitations. Starting just with the most common allergens reveals enough to make a difference and get a handle on primary irritants. The best approach: eliminate the primary irritating food allergens indicated via testing and vary daily food choices, as much as possible; Eating the same foods day after day can be problematic over time. Leaky Gut Syndrome is often a result of chronic bowel inflammation from concerns such as food sensitivities, repeated antibiotic use and yeast overgrowth; once the bowel membrane lining is inflamed and weepy, large protein molecules cross bowel walls into the bloodstream, tipping-off a hyper-immune response. Reviewing bowel function is a significant review point when I am going over the medical history.
NOTE: To those gluten-intolerant, watch nutritional supplements as the excipients [base ingredients] may contain fillers possibly contaminated with gluten (xanthan gum a possible source) and some individuals react to corn sugars in a similar way to gluten sensitivity.
- Chronic Constipation: Chronically sluggish bowel motility can trigger skin issues as well, because the bowels can re-absorb toxins back into the system while bowel movements await evacuation. This can be most commonly due to poor dietary habits, lack of activity, antibiotic use, Candida (yeast) overgrowth, excessive dairy intake, unmanaged stress, and dehydration. Repopulating the bowels with a refrigerated, enteric-coated Probiotic is helpful, even with a significant gap of time since taking the antibiotics. Candida (yeast) overgrowth from repeated use of antibiotics and diets high in sugars can be a relatively silent contributor to the picture, and must be considered. [Note: non-organic foods contain pesticides like glyphosate, which can disrupt the natural bacterial flora of the lower bowels, contributing to digestive disorders; probiotics are useful in diets high in non-organic foods]
- Chemicals and Heat : Unlike simple Contact Dermatitis, reactivity to irritating chemicals in laundry or body care detergents, many typically benign body care ingredients that are synthetic can be activated to irritate by the addition of heat and friction (exercise-related or in warmer seasons). Eczema tends to flare in skin folds when the body heats up, so using commercial products with synthetic ingredients and fragrances can set-up a perfect environment for an extraordinarily troubling flare-up where the body’s heat is concentrated. This includes the scalp, inside/behind ears, eye folds, inside elbows, backs of knees, and underarms. Carefully selected plant-based, chemical-free & hypoallergenic hair, skin and body products keep potential irritants out of the picture.
Rule of thumb: When you have eczema keep product use simple.
- Acid/Alkaline balance: Diets high in acidic or acid-forming foods favors general inflammation in the body, which feeds inflammatory skin conditions. I advise keeping a more neutral diet by increasing alkaline foods, reducing all sugars (including fruit sugars), minimizing dairy, reducing animal meats, avoiding processed meats (such as smoked or cured) and eating more vegetables, whole grains and raw or dry roasted nuts/seeds (as tolerated). Proper hydration supports acid/alkaline balance, improves bowel function, and sustains skin moisture.
- Chronic inflammation: By-products of inflammation add to general metabolic wastes that the lymphatic system must work to drain for excretion out of the body. Extended, repeated periods of inflammation place an ongoing load on the lymph glands to drain the tissues bogged-down with waste products, and must be supported in expediting the healing of eczema flare-ups. The lymphatic system is not only part of waste removal, but also a primary immune system contributor. Lymph glands produce immune cells to fight infection, and when inflammation of the skin compromises its integrity as a barrier to germs, lymph glands activate to mount an immune response toward invading viruses, bacterium and fungus. Chronic environmental and food allergies are in-fact excessive or hyper-immune responses to allergens, and so demands on the lymphatic system are consistently elevated during eczema flare-up. Immune support becomes a focus, but rather than stimulating an already over-stimulated immune system, we look to modulate immune activity. This is a largely misunderstood but critical variation between stimulating and modulating immune functions when working with chronic or autoimmune conditions.
- Adrenal fatigue : Chronic stress, lack of restful sleep, excessive scheduling of activities, corticosteroid use, excessive sugar/caffeine intake, and additional factors play-into adrenal gland depletion. A constant state of “fight or flight” and excessive activity drains the adrenals of its hormonal output. This affects all inflammatory conditions, as adrenal cortisol manages inflammation. When we consistently withdraw from the resource “bank” of the adrenals without putting those funds “back in the bank”, we are unable to properly respond to new stresses and demands for activity. It is important that children are not over-scheduled with physical activities such as sports, and to watch sugar & caffeine intake as all of these deplete tiny bodies with already-rapid metabolisms.
- Anxiety : Anxiety contributes as an ongoing source of adrenal depletion via increased demand for “fight or flight” output. Sometimes an individual can experience more anxiety when adrenals are depleted; Equally, anxiety can exist and be a primary source of adrenal fatigue. Anxiety must be managed, as it alters pH (acid levels increase) in the digestive system, favoring inflammation and constipation; Irritated, frazzled nerves as a result of Chronic Anxiety on quality of sleep feeds eczema flare-ups.
- Puberty and Menopause: Permanent hormonal transitions at certain stages of life can trigger eczema, as the Neuro-Endocrine balance is challenged to find a new norm. We can work to minimize the effects of these transitions.
I just learned how a Medical Herbalist looks at #eczema. WOW! Take a look. @eczemacompany @sundancetami #herbalism
The detective deduces…
I see many people who fill their cupboards with various pricey supplements that are randomly or partially used. It is an experimentation process much like throwing spaghetti against a wall and seeing which noodles stick. There is a more direct and methodical road to recovery. While it may take a bit more time than popping a corticosteroid pill, with attention to subtle influences, individual compliance, consistency of dosage and reformulation of herbal medicines as the body evolves, we can use whole plants to give the body what it needs to normalize itself.
The role of the Medical Herbalist is to explore all subtle and overt influences of the condition, taking great time and care to listen and mind even the smallest details that truly do matter to healing and recovery. Following a full medical history review, herbal medicine formulations (fluid extracts, syrups, teas, powders) are typically compounded by-hand (although some practitioners do send the formula out to a compounding dispensary elsewhere), and follow-ups are booked to monitor progress. Changes in the formula(s) are made as the body evolves along the way until resolution. Some individuals require ongoing support depending upon medical history details, but ultimately we seek the cause to resolve symptoms.
Meanwhile, if you have found some plant-based topical preparations that give you temporary soothing relief, keep up with it. Internal therapy with Herbal Medicine takes some time, as we work together to peel back the layers of contributing factors; it is helpful to know there is something on-hand to soothe the steadily retreating symptoms as we go.
I enjoy donning my proverbial Sherlock Holmes hat and getting to the bottom of solving a well-care mystery.
Bio: Tami Bronstein is a Medical Herbalist, qualified in East Sussex and London, England (UK). Her ongoing post-graduate work with doctors from Paris, France focuses on plant remediation following the evaluation of neuro-endocrine (hormonal) sources of disease and imbalance, known as Endobiogenic Medicine. She consults individuals cross-country privately by phone and in-person from her organic dispensary in Highland Park, NJ. Tami can be reached by phone 908.915.1998 or at email@example.com. Connect with Tami on Twitter and learn more about her on her website.