Eczema is known as one of the atopic diseases. Atopic diseases include eczema, asthma and hayfever and they occur when a person's immune system reacts in a way that is not in proportion to the irritant or trigger they have been exposed to. There is a strong genetic component to atopic diseases with children having a 40% chance of developing atopic disease if both parents have a history of it (Gold & Kemp, 2005). Eczema is typically the first of the atopic diseases to become evident with up to 40% of children affected developing asthma and/or hayfever thereafter (Gold & Kemp, 2005).
Eczema affects the skin, typically in the creases of the elbows, behind the knees, on the wrists and ankles, however, it can be more widespread and is often found on the face and neck of small children (ASCIA, 2019; Healthdirect, 2022). It is a result of the skin not being able to retain moisture properly which makes the skin more susceptible to allergens and irritants. The skin is dry, itchy and uncomfortable and sometimes may become infected especially with scratching. Sometimes the symptoms worsen and this is called an eczema flare up. Some people will grow out of eczema whilst others continue to experience it in adulthood (Chidwick et al., 2020).
Treatment
The mainstay of treatment for Eczema is the management of symptoms as there is no known cure for eczema. Treatment involves:
- Using a low irritant fragrance free moisturiser at least twice a day to the face and body.
- Avoid triggers and irritants such as allergens, soap, perfumes, overheating, exposure to prickly fabrics and too much stress.
- Maintain treatments even when skin is healthy or during flare ups.
- Treating flare ups as soon as they occur.
- Intermittent treatment with steroid creams as prescribed by your pharmacist or doctor.
- Antibiotic treatment when prescribed by a medical practitioner if the skin becomes infected.
A Complementary Approach
Studies have shown that probiotics may have a positive impact on the development of eczema in children (Kalliomäki et al., 2001). Specifically, Lactobacillus rhamnosus (L. rhamnosus) GG reduces the risk of eczema in randomised control studies (Kalliomäki et al., 2007). For children at risk of developing eczema, that is children for whom both parents, or 1 parent and at least 1 sibling, have a history of atopic disease, using L.rhamnosus GG in the weeks before birth and during the first few months of infancy has been shown to significantly reduce the risk of eczema in the first 7 years of life (Kalliomäki et al., 2007). Before deciding to commence a probiotic regardless of your age, it is important to speak with your pharmacist or medical practitioner.
Whilst studies into other complementary medicines for the treatment of eczema are limited, many show promise and further investigations are continuing (Schlichte, Vandersall, & Katta, 2016; Wollenberg & Feichter, 2013). Speak with your pharmacist or medical practitioner for more information about these complementary medicines. For people with a diet that may be lacking in essential nutrients as determined by the Australian Dietary Guidelines or who are on strict diets, it may be beneficial to speak with your medical practitioner to see if supplemententation is suitable.
*Always check with your pharmacist or medical practitioner before trying complementary medicines as certain vitamins and supplements may be harmful when taken together or with prescribed medication. Please make sure your health professional is aware of all medications and treatments someone with eczema is using.
REFERENCES
ASCIA. (2019). Eczema (Atopic Dermatitis). Retrieved from https://www.allergy.org.au/patients/fast-facts/
Chidwick, K., Busingye, D., Pollack, A., Osman, R., Yoo, J., Blogg, S., Rubel, D., & Smith, S. (2020). Prevalence, incidence and management of atopic dermatitis in Australian general practice using routinely collected data from MedicineInsight. The Australasian Journal of dermatology, 61(3), 319–327. https://doi.org/10.1111/ajd.13268
Gold, M & Kemp, A. (2005). Atopic disease in childhood. Medical Journal of Australia, 182(6), 298-304. https://doi.org/10.5694/j.1326-5377.2005.tb06707.x
Heathdirect. (2022). Eczema. Retrieved from https://www.healthdirect.gov.au/eczema
Kalliomäki M., Salminen S., Poussa, T. & Isolauri E. (2007). Probiotics during the first 7 years of life: A cumulative risk reduction of eczema in a randomized, placebo-controlled trial. Journal of Allergy and Clinical Immunology, 119(4),1019-1021. https://doi.org/10.1016/j.jaci.2006.12.608
Kalliomäki M., Salminen S., Arvilommi H., Kero P., Koskinen P. & Isolauri E.(2001). Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 357, 1076-1079. https://doi.org/10.1016/S0140-6736(00)04259-8
Schlichte, M. J., Vandersall, A., & Katta, R. (2016). Diet and eczema: a review of dietary supplements for the treatment of atopic dermatitis. Dermatology practical & conceptual, 6(3), 23–29. https://doi.org/10.5826/dpc.0603a06
Wollenberg, A. & Feichter, K. (2013). Atopic dermatitis and skin allergies – update and outlook. Allergy: European Journal of Allergy and Clinical Immunology, 68(12), 1509-1519. https://doi.org/10.1111/all.12324
