Eczema is a condition of the skin and there are a number of different types. One of these commonly seen in kids is called ‘atopic dermatitis’. It affects approximately 20% of kids and often develops in the first few months of life. It is characterised by dry, itchy, red and oozing skin, often in the creases of the elbows and knees or all over the body. It is variable in nature with flare ups from time to time.
(Note: for ease, from here on I’ll refer to atopic dermatitis as simply ‘eczema.)
While it is a condition of the skin, it can also affect sleep –your child’s and yours – which in turn can lead to fatigue, difficulty concentrating and learning. In addition, watching your child suffer can increase stress and worry about your child and their future.
Eczema is a complex mix of various factors including genetics, the immune system/gut health, diet, lifestyle and environmental influences. By understanding these contributing factors, we can help improve our child’s skin by targeting the things that we can change.
Our skin is covered in helpful bacteria and other microorganisms (most of the time this is a good thing!) known as the skin microbiota. The skin is the largest organ in the body and
together with the skin microbiota helps to keep us healthy. When in balance, the other skin bacteria and microorganisms limit the growth of potentially damaging bacteria on the skin.
Chemicals (such as chlorine), soaps and other personal care products may alter the skin microbiota. There is a greater number of a bacteria called staphylococcus aureus on the skin of those with eczema compared with those without eczema. This bacteria impacts on the barrier function of the skin and is associated with eczema flare ups.
There are certain conditions that make it more favourable for potentially bad bacteria to grow. Skin pH is normally acidic (less than 7) and staphylococcus aureus prefers skin that is dry with a higher pH (i.e. more alkaline). It is therefore important to keep the skin moisturised without using drying skin care products. Avoid soaps, bubble baths and other skin care products containing skin irritants or with a pH that is too high.
Research shows that eczema may be better controlled when the skin is moisturised. Here are some tried and tested tips:
- Avoid moisturisers with ‘parfum’ and ‘fragrance’
- Moisturise more often than you think you need to
- Apply straight after bath/shower – pat skin dry with a towel and apply moisturiser to damp skin
- Ensure your moisturiser doesn’t contain skin irritants or other nasties!
- Don’t be afraid to trial different moisturisers – what works for one doesn’t necessarily work for another
- Be aware that a moisturiser alone is not the key to dealing with eczema at the root cause – so ensure that you focus on other areas such as triggers, nutrition and gut health
- Be careful regarding hygiene and application of moisturisers – bacteria can enter the moisturiser bottle/tube, particularly if infection is of concern
- If you’d like to make your own moisturiser, it can be easy, economical and fun to make. Plus you have 100% control over exactly what is in it!
Moisturisers are a mainstay of eczema treatment to maintain an intact skin barrier, however there is a lot more that parents can do to take back control and guide their child to a brighter future.
Food and Eczema
Research suggests that food is often a trigger for many children with eczema – identifying and avoiding these food triggers may help reduce inflammation and flare ups too.
Use of a food diary may help you determine if eczema is worsened by certain food(s), food chemicals, additives, or preservatives. Long term food avoidance (unless known allergies or food additives) may be harmful to your health, so it is crucial the you have health professional guidance with this.
Avoid processed food – they commonly contain additives and preservatives which may negatively impact on gut health (and therefore worsen eczema).
Naturally occurring food chemicals
Even unprocessed foods can contain naturally occurring food chemicals like salicylates, oxalates, glutamates and amines. Some of these may make eczema worse, and can
be more tricky to work out as they are in many different foods.
It can be overwhelming when there are several food triggers and you feel like your child is missing out, or feeling like there are limited options. In the short term, make a list of the foods that your child CAN have to help focus on the positives.
Please note, that a restricted or ‘elimination diet’ should be only be short term, with focus on improving gut health and reducing other triggers alongside the elimination diet. Long term restricted diets can worsen gut health (see below) and have the potential to lead to nutritional deficiencies.
The health of our Gut Microbiota (bacteria and other microorganisms living in the gut) is linked to eczema and many other health conditions, including asthma, allergies, mental health conditions and diabetes.
Research shows that gut health is impaired in those with eczema. Normally, the gut microbiota help to protect the lining of the gut. In those with impaired gut health and ‘leaky gut’, the cells that line the gut develop gaps in between them. These tiny gaps allow materials to pass through from the gut into the blood stream, that would normally not be able to pass through if these junctions were tighter. This results in an immune response and inflammatory response, which may lead to flares in eczema.
Our gut microbiota is influenced by many different factors including diet, use of antibiotics and other medications, chemical exposure, and stress. A diet rich in wholefoods – leafy green vegetables, nuts, seeds, organ meats, fresh pasture-raised meat, wild-caught seafood, fermented foods and avoiding pesticides/herbicides may help to improve gut health.
The use of probiotics to improve health has been increasingly researched in the last two decades. Certain probiotics like Lactobacillus rhamnosus GG has been studied in those with eczema. A systematic review of the research on probiotics and eczema doesn’t support the use of probiotics alone to help with eczema, however this may be due the complexity of eczema which needs a multi-faceted approach to management.
Fermented foods are foods (such as cabbage) that undergo a ‘fermentation’ process by living microorganisms such as yeasts or bacteria. There are different types of fermented foods and drinks – these include yoghurt, sauerkraut, miso, water and milk kefir, kombucha, and kim-chi. These foods are high in various bacteria which may help with gut health. Please note that not everyone will tolerate fermented foods as they can be high in histamines which can worsen eczema or asthma. However if they are tolerated, a small amount eaten with meals may improve gut health.
Environmental Factors and Everyday Products
The effects of everyday products and the environment on eczema are often overlooked. This may be because often these environmental triggers may be unseen, or not been mentioned in the usual approach for eczema.
Some environmental and everyday products that may directly impact the skin itself or interfere with gut health include:
- Chemicals in clothing – e.g. fire retardant in pyjamas
- Air conditioning or heating
- Perfumes, room sprays, reed diffusers
- Volatile Organic Compounds
- Insect Repellents
- Ingredients in Moisturisers
- Bubble bath and soaps
- Shampoos and Conditioners
- Electromagnetic radiation
A FEW LAST TIPS
Eczema is a complex condition with many different contributing factors. It’s also important to understand that nothing works in isolation. Each child will have different triggers and contributing factors: it is important to assess these individually and manage appropriately.
- Clothes/fabrics can also affect your child’s skin – ensure breathable fabrics with minimal chemical sprays used in farming or during manufacture
- Assess if your child’s skin is worse in the morning, through the day, or in the evening – is there a pattern?
- Use a food diary for potential for food/food chemical triggers
- Assess bedroom environment for triggers
- Manage stress and worry for you and your child
- Seek the advice of a health practitioner that you trust. You don’t need to be on this journey alone.
If your child has eczema or allergies and you’d like to start rewriting your child’s future so that you can all start living your lives again beyond eczema and allergies, join our supportive community of like-minded parents at: facebook.com/groups/eczemaallergiesasthma.
For further information, visit https://yourjourneytohealing.net.