--- title: "Eczema – dry, itchy skin!" entity: "blog" canonical_url: "https://www.andreaproulxnd.com/blog/eczema-dry-itchy-skin" markdown_url: "https://www.andreaproulxnd.com/llms/blog/eczema-dry-itchy-skin" lastmod: "2018-07-22T18:07:00.000Z" --- ## Eczema – dry, itchy skin! Red, itchy, dry skin – What do to about your eczema? Eczema, more specifically atopic dermatitis is a condition where skin gets red, itchy, dry and flaky. Often found on the front of elbows and wrists, the back of knees, around eyebrows and sometimes along the hairline. Even though your skin is dry, part of the problem with eczema is that your skin has lost the ability to retain any moisture. Then with frequent scratching, the dry itchy skin becomes flaky, maybe with blisters and oozing. Over time, the skin thickness will change and you may see deeper “wrinkles” or lines in your skin. #### A possible genetic link to eczema? Atopic dermatitis has many possible causes and contributing factors. In 2006, researchers discovered a genetic mutation that causes a functional loss of a skin protein, filaggrin (FLG). This protein is partly responsible for creating the keratin filaments that make up the skin barrier to protect us from our external environment. With the loss of this protein, our skin becomes more susceptible to external toxins, chemicals, allergen and pathogens like bacteria. Through genetic testing, researchers have determined that the risk of atopic dermatitis if you have this mutation in 40-50%, however not all patients with eczema carry this mutation. In the clinical setting, genetic testing is not performed since it does not affect the treatment. #### A Healthy Skin Barrier Beyond genetic mutations, there are many ways by which our skin’s ability to act as a barrier may fall short. A defective skin barrier that is compromised will lead to cascading reactions by the immune system. First, we see the inflammatory reaction of red, itchy skin. These same mechanisms cause a loss of skin hydration and thus dry skin. Sadly, this dry skin is more vulnerable to cracking or damage, further exacerbating the immune response. #### Blame the Environment? Our urban lifestyles also contribute to skin function changes. Tobacco smoke, traffic-related air pollution (nitric oxide and carbon monoxide) may be to blame for higher rates of eczema in urban settings. Then we look to our homes. Phthalates, “are a group of chemicals that can make products (usually plastics) softer and more flexible. They are sometimes called plasticizers, but many other chemicals are also called plasticizers.” (Canadian Cancer Society). Heating foods in plastic containers or putting hot left-overs immediately into plastic containers can increase your exposure to this group of chemicals. Many personal care products such as soaps, moisturizers, shower gels and shampoos contain phthalates. In a twist of fate, phthalates actually reduce skin natural moisture in can trigger an allergic sensitization – setting the scene for atopic dermatitis. In addition to your hygiene products, phthalates can be found in various foods such as margarine, cooking oils, red meat, poultry, and fish. #### Allergies and Food In naturopathic medicine, we also deal with the allergic responses of the digestive system. A defective skin barrier also means the ‘skin’ of your digestive track is compromised facilitating allergen sensitization. At social events I am frequently asked how I feel about this food, or that food. The audience seems to hope I will condemn a specific food. However, the truth frequently lies with the defective skin barrier, and not simply with the food. That said, with atopic dermatitis in children, there is a link with cow’s milk products, eggs, wheat, soy, peanuts and fish. The easiest way for both adults and children to assess the impact of that food is to completely, 100%, avoid it for 3 weeks. However, with the natural ebb and flows of eczema, something the results of eliminating the potential offending food are not clear. Blood-based food antigen tests, such as the IgG tests, can also be used to help identify possible causes. #### Can Supplements Help? The skin-barrier can be improved with appropriate vitamin D. Suboptimal and deficient levels of vitamin D have been recognized as risk factors for atopic dermatitis. Your ND or MD can check your vitamin D levels for you. While we Canadians do need some supplementation in the winter, be careful not to over do it as chronic elevated vitamin D levels have been linked to cardiovascular disease. It has been demonstrated numerous times that giving probiotics to a pregnant woman decreases the risk and intensity of eczema in the infant. The probiotics convey positive immune effects to the gut-bacteria environment. For example, Lactobacillus acidophilus inhibits growth of “bad” bacteria such as E. coli, Staphylococcus, Streptococcus who are responsible for many of the secondary infection that develop on the broken, cracked eczema ladder skin. These bacteria also improve immunity by increasing activity of macrophages & lymphocytes – essential “soldiers” of the immune force. However, L. rhamnosus GG and Bifidobacterium lactis have been shown to be the most effective strains of bacteria for atopic dermatitis. While shopping the aisles of the health food store, the shelves of supplements and herbal remedies boasting ‘natural remedies’ for atopic dermatitis may seem overwhelming. It has been my clinical experience that there is no one magic product or vitamin. The skin is constantly regenerating itself. Every 7 years you have a whole new ‘set’ of skin! For this reason, clinically I have found that treatment protocols need to keep evolving with the patient and their skin. While 1 herbal or topical product may yield great results, a few months later it is no longer helpful. The skin barrier is forever undergoing renovations and repairs. The foods we eat, the vitamins we take and the chemicals we exposure ourselves to will affect the quality of these skin renovations. #### Tips for Prevention - Seek out your local naturopathic doctor to put together a complete treatment plan as well as a maintenance and prevention plan. - Get you vitamin D from the sun in the morning or evening as to avoid excess of SPF sunscreen. Take a vitamin D supplement in the winter and have blood levels checked. - Take omega-3 fatty acids AND eat fish regularly. Don’t believe the marketing when food labels tout “omega-rich”. - Consider a daily low dose probiotic which contains rhamnosus GG and Bifidobacterium lactis - Do an environmental assessment of your home and cosmetics. Avoid all products containing phthalates, perfumes, fragrances. Have an environmental pollutants or urinary phthalate test performed by your naturopathic doctor. - Avoid your food allergens and increase consumption of whole, fresh foods. There are many causes and contributing factors to atopic dermatitis. However, with a complete treatment plan, it is possible to greatly reduce the intensity of the dry-redness and even to be completely free of that eczema itch! #### Great resources on environmental chemicals – Phthalates Chemicals in Your Cosmetics. [David Suzuki Foundation website](https://davidsuzuki.org/queen-of-green/dirty-dozen-dibutyl-phthalate/) Phthalates. [Environmental Defence](https://environmentaldefence.ca/?s=phthalate) Shocking Report on Chemicals in Products from the Office of the Auditor General. [Environmental Defence.](https://environmentaldefence.ca/2016/06/08/shocking-report-chemicals-products-office-auditor-general/) Something Toxic In Men’s Bathrooms? Dr Andrea Proulx ND #### References Canadian Cancer Society NDNR – Naturopathic Doctor News & Reviews. Volume 12, Issue