What is Eczema

Eczema also knowns as atopic dermatitis (AD) is the name for a group of conditions that cause the skin to become itchy, inflamed, or have a rash-like appearance. It usually begins in childhood and can range from mild to severe symptoms.

The rate of eczema has increased from 10 million Americans in the 1970s to over 30 million today. There has been a rise in inflammatory diseases overall in the past 50 years, and functional medicine is determined to get to the root of it.

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Eczema Signs & Symptoms

People with eczema have damage to the skin barrier function (the “glue” of your skin). This loss of barrier function makes your skin more sensitive and more prone to infection and dryness.

• Dry skin
• Itchy skin
• Red rashes
• Bumps on the skin
• Scaly, leathery patches of skin
• Crusting skin
• Usually in skin creases, elbows, hands, knees, or face

Eczema Possible Causes

While the exact cause of eczema is unknown, researchers do know the immune system is undeniably involved.  In my experience, I’ve seen eczema go hand in hand with food allergies, food sensitivities, compromised digestive health, and FLG gene mutations.

Food Allergens

Food allergens which cause IgE mediated responses contribute to approximately 40% of eczema cases in infants. Many of these patients also develop allergic asthma and allergic rhinitis. This is called the atopic triad. The common link among these allergic disorders is the predisposition for IgE-mediated responses to stimuli.

Food Sensitivities

A recent study showed that children with eczema had higher IgG-mediated reactions to food sensitivities (which are different than food allergies). Dairy, gluten, and eggs were the most common foods that patients were highly reactive to.

Compromised Digestive Health

Many studies have shown that eczema patients commonly have dysbiosis (unbalanced gut bacteria). Dysbiosis is a reaction to what we ingest as well as what gut bacteria we receive from our mothers during birth.

Vaginally born babies get most of their gut bacteria from their mother (which can be a good or bad thing depending on the mother’s gut health)? And cesarean babies had more gut bacteria associated with the hospital environments they were born in.

Infancy is where we see most eczema cases arising. This could be due to the gut dysbiosis patterns passed down from birth.

FLG Gene Mutation

The FLG gene is responsible for making cells that make up the outermost layer of skin (the epidermis). We all have this gene. But approximately 70% of patients with eczema have a genetic defect in the FLG gene.

This is where I believe Functional Medicine shines. Instead of just slapping steroid cream on a patient, Integrative Practitioners look for the root cause of the disease.

Functional Medicine Labs to Test for Eczema

There are no current, reliable lab biomarkers to diagnose and differentiate atopic dermatitis (eczema) from other similar skin conditions. But many practitioners will test for IgE levels.

Comprehensive Stool tests, Food Allergy (IgE), and Food Sensitivity (IgG) testing are my go-to when I see an eczema patient.

Comprehensive Stool Tests

A comprehensive stool test can give you insights into dysbiosis patterns (balance of gut bacteria), inflammatory markers, and zonulin (a key biomarker in detecting leaky gut). Many studies show a direct correlation that improving gut barrier function can improve skin barrier function.

Food Allergy Test

A food allergy test can detect IgE-mediated responses to foods. Once identified, these foods should be removed entirely from the patient’s diet, lowering the total IgE response in the body.

Food Sensitivity Test

Food sensitivity tests can detect IgG-mediated responses to foods that are causing inflammation in the body and should be removed and reintroduced later once the patient is no longer reactive to those foods.

Functional Medicine Treatment for Eczema

Nutrition

A low inflammatory, whole food diet with the elimination of IgE and IgG-mediated foods is the first step to reducing overall inflammation in the body and allowing the skin barrier to heal.  The patient should also remove dairy, gluten, and eggs and decrease processed foods. Adding in higher-fiber foods can help feed beneficial gut bacteria.

Supplements

• L-Glutamine and Collagen help soothe and heal leaky gut.
• Vitamin D and Curcumin have been shown to decrease inflammation in the body.
• High-quality probiotics can help rebalance gut bacteria. A comprehensive stool test will show what bacteria you are low in and, if any is overgrown. The probiotic strain Lactobacillus rhamnosus has been shown to reduced the incidence of atopic dermatitis in at-risk infants through the age of 7 years.

Herbs

Traditional Chinese Medicine (TCM) and Ayurveda are forms of medicine that consider all aspects of the body when managing health issues.

Any herbs prescribed for skin disorders will focus on the root cause of the disease itself alongside herbs to treat individual symptoms.

In the case of red, itchy, dry eczema, herbs that reduce heat and inflammation are prescribed.

In cases of oozing eczema, herbs that dry “damp” will be prescribed.

Some practitioners will also prescribe topical herbs to help with the moisture barrier and ease discomfort.

Phototherapy

Phototherapy is commonly used in combination with other treatments to help calm eczema symptoms.

UVB and UVA light have been shown to reduce inflammation, decrease itching, increase vitamin D production (which can help with healing), and help the skin fight bacteria.

Topical Treatments

• Keep Skin Moist. Use dermatological products that contain ceramide. These moisturizers replace some of the “glue” (the barrier) missing from your skin.
• Oatmeal Baths. Colloidal oatmeal can protect the skin and soothe itching and irritation from eczema.
• Use mild soaps and other products free of perfumes, dyes, and alcohol.

Summary

Ok, that was a lot of background and may be overwhelming for many.  But understanding exactly how the body works makes it easier to understand how to treat it.

Eczema has been on the rise over the past 50 years, and I genuinely believe it has a lot to do with gut health. Genetics also play a role, which could be due to the pass down of the mother’s gut bacteria during birth.

Controlling gut inflammation, balancing the gut microbiome, and decreasing IgE and IgG responses have significantly reduced eczema symptoms in many of my patients.