Managing eczema

Sarah Buckingham discusses how homeopathy can have more to offer than conventional treatment and includes case studies from Sara Eames and Jayashree Shah

It is no surprise that eczema is the most frequently referred condition to the homeo­pathic hospitals. If you have suffered with eczema you will know that conventional medicine struggles to deal with this often very uncomfortable illness, and treatments are palliative rather than curative. Anti­biotics, antihistamines and steroids are on offer to manage symptoms and these may help in the short-term, but can become in­effective over time or less well tolerated. Recently, new “immunosuppressive” drugs have been introduced to tackle severe eczema, including what are known as topical calcineum inhibitors (tacrolimus, pimecrolimus). But a report in the British Medical Journal in 2006 judged that the “formal evidence is lacking… for the efficacy of these agents in patients who have failed to respond to topical steroids.” Patients are also worried about the long-term effects of using strong topical corticosteroid cream, which can cause atrophy or thinning of the top layer of the skin.

Eczema varies in severity from a few small patches of dry, itchy redness to an extreme skin condition which can cover most of the body. In acute cases there may be weeping, crusting and bleeding. Atopic eczema is the most com­mon form. The genetic pre-disposition to develop allergic reactions to substances, or “atopy”, is known to run in families and atopic eczema sufferers will often have rel­atives who suffer with the condition too, and perhaps also have asthma or hay fever. Other types of eczema include contact dermatitis which is caused by environmental or occupa­tional factors and seborrhoeic eczema, which occurs mainly on the scalp and face, often starting off in the form of dandruff which progresses to redness, itching and scaling.

The National Eczema Society (NES) esti­mates that up to one in five children and one in 12 adults will experience the condition in one form or another. Severe eczema in a child can have a massive effect on the whole fam­ily and parents are understandably worried about using large amounts of steroid creams to keep it under control. A regime of apply­ing emollients and steroid creams coupled with complicated bandaging is time-con­suming; children are often irritable and eat poorly as they feel so uncomfortable. Severe itching can interrupt sleep for everybody and children can feel stig­matised at school if their rash is visible. For all these reasons people often seek homeopathic treatment.

Homeopathic treatment
There is evidence from both clinical trials and patient outcome studies to show that homeopathy can have great results in eczema. A recent study of 118 eczema patients published in Complementary Therapies in Medicine journal reported that homeopathy was as effective as standard conventional treatments in the short-term and more effective than them in the longer term. In addition, patients themselves have reported improvements in their condition after homeopathic treatment: at Bristol Homeopathic Hos­pital a six-year study of patient outcomes found that 82 per cent of eczema patients under 16 said they felt “better” or “much better”. Similar results have been reported at the other homeopathic hos­pitals. There are many possible causative factors in a case of eczema which can affect the choice of homeopathic medi­cine, so it is essential for the homeopathic doctor to collect as much information as possible during the consultation.

As already mentioned, eczema is fre­quently linked with other conditions and so it is valuable to spend plenty of time finding out about all the medical prob­lems in the family. The consultation might involve going into detail about the pregnancy, birth and early years of the patient and finding out about sig­nificant events in their life.

A number of homeopathic medicines are known to have an affinity with the skin and there is a variety of approaches that can be used specifically in eczema. One of the most successful methods is to find and prescribe the “constitu­tional” remedy, that is, the remedy that fits the overall person – their mental and emotional state, their likes and dislikes, and what makes their condition (and themselves) worse or better – as well as their local skin symptoms. Sulphur, Natrum muriaticum and Arsenicum album are examples of homeopathic medicines prescribed in this way for the eczema patient.

Whilst finding the constitutional remedy for the patient is the optimum way to treat eczema, it is not always pos­sible, especially in babies. Fortunately there are other therapeutic models in homeopathy that have great usefulness in eczema cases. Parents have often already made some link between an event in their child’s life and the onset or worsen­ing of their eczema. These can be sig­nificant events such as separation from a parent or carer, the birth of a new baby in the family, the introduction of new foods into the diet, a seemingly unre­lated illness, or an accident. There is a range of homeopathic medicines known to be useful in these situations, so that when there is a clear link with the onset or worsening of symptoms, this approach is particularly successful. Natrum muri­aticum can be useful after a child has been separated from the mother, and Pulsatilla is indicated if the onset of symptoms happens around puberty.

As well as using these approaches it is useful to add localised treatments, because eczema can be such a distress­ing condition. These can be in the form of homeopathic medicines based on the presenting symptoms, rather than, or in addition to, the constitutional method. A remedy such as Graphites is useful for a crusty, cracking eczema which oozes a sticky, honey-coloured fluid. Sulphur might be indicated for a red, burning itchy rash, worse for heat and water. Localised treatments can also be applied directly to the skin, in the form of ointments, tinc­tures and creams. A combination of Calendula and Urtica urens is a really helpful mixture to sooth the skin.

Trigger factors
It might also be useful to look at envir­onmental factors that may be triggering or aggravating the eczema. House dust mites, pets, mould, heat and humidity are all aspects of the home environment that can trigger a flare-up. There may be circum­stances in the workplace that have an effect too – occupations at greatest risk of developing contact dermatitis for exam­ple are chefs, hairdressers, metal workers, nurses, cleaners and construction workers.

According to the NES children under five are at greatest risk of having their symptoms worsened by food allergies and it is thought that in around 30 per cent of children with eczema, food may be a contributing factor. It probably goes without saying that a healthy diet based on fresh, additive-free foods is beneficial. In addition some people are allergic to specific foods – a combination of homeo­pathic treatment, improved nutrition and desensitisation should help to calm aller­gic reactions. 
Ten helpful tips from the National Eczema Society

  • Bath in warm water, not hot. Heat increases the itch. Do not use bubble baths which contain detergents and will irritate the skin.
  • Avoid soap which is drying to the skin, use a soap substitute instead.
  • Apply emollients frequently and liberally.
  • Immediately after bathing apply emollient as this will help trap the water under it and thereby aid re-hydration.
  • Small children and the elderly should use a bath mat as emollients can make the bath slippery.
  • Wash clothes in the minimum effective quantity of non-biological, un-perfumed washing powder. Give clothes an extra rinse. Avoid fabric conditioners.
  • Wear cotton or silk next to the skin. Wool and man-made fibres can irritate the skin. Use cotton sheets and duvet covers.
  • Keep bedrooms cool, overheating makes eczema worse. Warm, moist environments also encourage house dust mites.
  • Keep pets out of the bedroom, animal dander can make eczema worse.
  • Regular damp dusting and vacuuming will help to keep the dust levels down.

Eczema case study 1
Melody Baker decided to seek out homeopathic treatment for her son after little success down the conven-tional avenues. Drew’s eczema had started around the age of one, at first in small patches on the insides of his elbows. These never went away and then gradually the eczema spread down his forearms to his hands, which were very bad by the time he was two and a half.

Melody took Drew to the GP who prescribed steroid cream and wraps. These did not help his skin and Melody tried Chinese medicine to find a cure. On the whole this was not effective, though one of the treatments did result in Drew being quite free of eczema for a few years.

However, Drew’s eczema came back with a vengeance when he started secondary school. It appeared on his hands, spread up his arms to his chest, neck and face and also to his tummy and legs. He was covered in it. Melody asked their GP for help but he could only offer a stronger steroid cream, which she did not want to use on her son’s skin. She asked for a referral to the Royal London Homeopathic Hospital (RLHH) and Drew’s homeo-pathic treatment started in January 2008.

Dr Sara Eames saw Drew, now 14, at the RLHH and after only three appointments there was a very significant improvement. The eczema cleared from his face, chest, tummy, neck and arms. He still has some on his hands, but Melody feels the homeopathic medicine and cream are really helping him.

Homeopathic treatment will often result in an all-round improvement and an increase in the sense of well-being, alongside improvements in the main symptoms. This is certainly what Drew found. “I like having the homeopathic medication because it’s natural and since taking it, it has made me feel better on the inside as well as the out-side. I would describe it as feeling fresh inside.”

Melody was grateful to get a referral for her son on the NHS. “I feel so lucky. The treatment really does seem to be helping Drew’s eczema and I feel reassured that there are no side-effects and there will be no long-term damage to his skin”. Drew is much happier too: “My skin is not as dry and doesn’t feel tight anymore. The eczema has totally cleared from my chest and stomach area and improved in other places.”

Eczema case study 2
Waqas’ case was quite similar to Drew’s in that his eczema was much worse in the summer and it flared up badly when he was under pres-sure or was anxious. Waqas had suffered from eczema since the age of two and his condition was described as “intractable” by his doctors.

After many GP visits for creams, emollients and steroid treatment, followed by a full dermatology consultation and a stay in hospital, Waqas’ skin was no better and his mother, Rubina, was at her wit’s end: “We’d given up.”

During a very bad flare-up at age 13, Rubina was approached by Dr Jayashree Shah, a GP at the same NHS practice who had just completed her Faculty-accredited homeopathic training. When Dr Shah heard about Waqas’ case she suggested they might try using homeopathy.

Waqas and his mother had barely heard of homeopathy and Rubina admitted she and her husband were sceptical. “To be honest, we thought it was a bit of a gimmick and wouldn’t have chosen the treatment ourselves!” But after their first consultation, at which Waqas told his own story to Dr Shah, Rubina noticed a difference in him. After three appointments spread over a period of four months, Waqas experienced a gradual improvement, was able to stop using his creams and for an 18-month period was completely free of eczema. “It was as if he had never had it.”

Since then there have been few flare-ups and Waqas has learned to observe the signs of a flare-up in his condition through the better understanding of his emotional side that has come through his homeopathic encounter. Through GCSEs and A Levels, he has managed the flare-ups himself with his individually prescribed homeopathic medicine.