A Naturopathic (student) Perspective on Eczema
Health condition: ECZEMA, Atopic Dermatitis = "Allergic Inflammation of Skin"
(Other types of Dermatitis, or inflammation, include contact dermatitis, seborrheic dermatitis)
Etiology of Eczema:
Atopic Dermatitis is caused by an allergic response to a substance, typically ingested food antigens. Once the food reaches our gut, the body mounts an immune response involving Thelper cells, IgG antibodies, IgE antibodies, mast cells, eosinophils and histamine. This response can occur immediately after ingestion or a more delayed-type hypersensitivity days later. The gut is home to a wide range of immune cells, that flow around the rest of the body causing system inflammation that manifests on the skin where a large percentage of mast cells reside. A defective skin barrier can also be the route through which allergens are sensitized, and infections easily develop, leading to chronic inflammatory responses at the level of the skin.
History and Developments in Understanding and Treating Eczema:
As early as the 1890s people described a chronic, puritic skin condition in patients with nervous disorders. By the early 1900s people described a similar condition in people with Hay Fever and Asthma ("The Atopic Triad"). The term "Atopic Dermatitis" was coined in 1955. Conventionally the pathogenesis is understood as a combination of a defective epidermal barrier and cutaneous inflammation, of which genetics plays the most important role.
Historically, eczema has been managed by avoiding food triggers and reducing acute itching and inflammation on the skin using topical corticosteroids. However these are not effective for long term management, have side effects with prolonged use, and DO NOT address the true etiology of the disease.
There is definitely a genetic component to eczema, but we must understand the triggers and risk factors that determine the development of the condition.
Health professions yearning to get to the root cause of the disease have explored the connection between the inside of our body's donut (gut) and the outside (skin) and have noted that digestive imbalances lie at the root of the inflammation. We know the food antigen causes the body to mount an immune response, but WHY?
Naturopaths understand that disease that manifests externally have an internal etiology because we are one long donut tube and what happens on one side of the type will reflect on all surfaces on the tube.
A gut poorly inhabited with good bacteria in its first stages of development (due to insufficient microbiotica exposure through the vaginal canal with a C-section, excessive use of antibiotics in early infancy, lack of breast feeding etc), allows the gut to be colonized with bad bacteria and causes early, chronic inflammation in the gut as the body tries to cope (out gut is our largest home for our immune system! Makes sense -- this is where the outside world comes in to our body. We need a solid army at home base!). In an inflamed gut, normal digestive functions are compromised so food is poorly broken down and poorly absorbed. These large food molecules are presented to the gut brain as unwanted foreigners that need to taken care of. Further, lacking our good bacterial colonies we can develop spaces between our gut cells ("leaky gut syndrome") allowing the large food molecules to directly enter the body, now really pissing off the immune system. This leads to internal inflammation then external inflammation.
Symptoms being addressed:
burny, itchy, dry, scaly, red rash on skin
indigestion, leaky gut
allergic and inflammatory (type 1 hypersensitivity) response in gut and on skin
stress, insomnia, irritability associated with itching
Herbs chosen to address symptoms:
Burdock root. Articum lappa
Asteraceae family
Notable constituents: polysaccharides, volatile oils, inulin, minerals, mucilage
Burdocks helps cool irritation and brings gut toxins out of the body as well as support beneficial gut flora, really getting to the root cause of eczema. As a anti-inflammatory it will also reduce inflammation that starts in the gut with food sensitivities.
Calendula flowers.
Asteraceae Family
Notable constituents: flavanoids, allantoin
Our premier skin herb for inflammation, Calendula was chosen because it is safe, has strong anti-inflammatory properties and promotes skin regeneration in cracked eczematous skin.
Chamomile flowers. Matricana chamomila.
Asteraceae family
Notable constituents: flavanoids, volatile oils, glycosides
Chamomile treats nervousness and insomnia related to irritation and itching. It can also relax smooth muscle to treat indigestion, a consequence related to the root digestive imbalance at the root of eczema. Chamomile's azulene and chamazulene have anti-allergic activity, and apigenin has anti-inflammatory activity.
Castor Oil
Castor oil reduces inflammation and speeds healing of injured skin. It was used as the oil menstruum for the salve for this reason, as well as its deeply moisturizing properties for very dry skin, forming a protective layer
Dandelion root. Taraxacum officinalis
Asteraceae family
Notable constituents: sesquiterpene lactones, triterpene steroids, inulin, sugars, vitamins, minerals
Dandelion root is alterative for chronic toxic conditions manifesting on the skin as eczema. It therefore heals for the inside (gut) out (skin).
Jojoba Oil
Very stable oil for extracting constituents and helping the skin absorb important fat-soluble constituents needed for treatment. Also use for moisturizing dry skin, and to balance the thickness of the castor oil.
Licorice root: Glycyrhizza glabra.
Fabaceae family
Notable constituents: flavanoids, glycyrrhizin, polysaccharides
- Licorice can help ween from steroid usage (due to glycyrrhic acid) as topical steroids are typically used on eczema affected skin to reduce inflammation, scaling and to protect the skin barrier. Licorice does this by extending the half life of cortisol.
- Licorice is also a powerful immunemodulator, having the ability to calm the immune response where over-recruited, and support it in the cause of infections, especially those on the skin since in eczema the skin barrier is compromised.
- Licorice is also emolient, demulcent and soothing to gut
Vit E
VItamin E is a fat soluble vitamin that has antioxidant and immune supportive properties for the skin. It is also moisturizing for dried skin, and was used a preservative for the external preparation.
Tea Tree Oil. Melaleuca alternifolia.
Myrtaceae family
As an anti-inflammatory it can help resolve itchiness and its antimicrobial activity can help ward off secondary infections from results broken skin of eczema
Why types of preparations chosen and how they should be used:
I chose one oil-based formula, and one water-based formula to ensure that a wide range of therapeutic constituents could be included in the treatment. Since the skin is the area most affected in this condition, the oil infusion was chosen to ensure lipids, gums, resins, essential oils, alkaloids, flavanoids, and mucilage can be applied directly onto the affected areas. The short infusion was chosen and the infused oil was made into a salve for its occlusive and protective effects on broken, irritated skin.
The tea was chosen as a method through which water-soluble constituents such as proteins, minerals, vitamins, enzymes, pectins, tannins, saponins, alkaloids, flavanoids, gums and some glycosides could reach the gut to nourish, heal and sooth gut epithelial cells.
Recipe and procedure:
Skin Healing Salve
Recipe:
1/4 cup castor oil
1/4 cup jojoba oil
1/3 filled 2oz jar dried calendula and chamomile flowers (equal parts)
15g bees wax
30 drops tea tree oil
1/2 tsp 32000IV Vitamin E oil
Procedure:
The short double boiler method and the folk method was utilized for my oil infusion was used:
1. Approximately 20 oz of water was placed in a double boiler and brought to a boil then put on a low simmer.
2. 1/4 cup castor oil, 1/4 cup jojoba oil measured and added to the double boiler
3. A 4oz jar was 1/3 filled with equal parts ground chamomile and calendula dried herb
4. The herbs were added to the oils in the double boiler
5. The mixture was left to simmer for 1 hour and stirred frequently to ensure that the oil covered all the herb
6. The oil was allowed to cool then strained off the mixture.
Jojoba oil added to top off to 1/2 cup.
7. The infused oil was then re-added to the double boiler with 15g of beeswax as our solidifying agent
8. The salve was stirred while cooling and a frozen spoon used to test the consistency of the salve.
9. 30 drops tea tree, 1/2 tsp 32000 IU Vitamin E oil
10. The salve was stored in a dark, sterile, 2 oz glass bottle, labeled then brought to your hands for the testing!
Gut Loving Tea
Recipe:
1 tsp licorice root
1 tsp burdock root
1 tsp dandelion root
Procedure:
1. 1 and 1/4 cups of water was placed in sauce pan and brought to a boil.
2. 1 tsp licorice root, 1 tsp burdock root and 1 tsp dandelion were added to boiling water, then reduced to a low rolling boil.
3. The preparation was covered and decocted for approximately 20 minutes.
4. The mixture was strained and brought to your bodies for healing and enjoyment!
RESEARCH ARTICLE:
Summary of Research Article:
The treatment of atopic dermatitis with licorice gel
Journal of dermatological treatment, 2003
This study evaluated licorice (specifically its constituent glycyrrhizinic acid) as a topical preparation for atopic dermatitis.
Glycyrrhiza glabra root was collected from the south of iran.
Glycyrrhizinic acid was extracted using the following method: powdered root extracted with methanol for one day, then added to acetone, washed with ethanol, ammonia, water, formalin, and titrated with sodium hydroxide
Standardized based on concentration of glycyrrhizinic acid was obtained using titremetry.
In a placebo double blind study the extraction was tested on 3 groups of 30 patients each (1 groups with 1% glycyrrhizinic acid, 1 group with 2% glycyrrhizinic acid, 1 group with placebo gel) 3 times a day for 2 weeks
They found that Licorice was more effective than placebo and 2% licorice topical gel was more effective than 1% in reducing the scores for erythema, edema, and itching after 1 and two weeks intervention (p<0.05).
References:
Garcia, C., Adams, D.J., (2005) Healing with Medicinal Plants of the West: Cultural and scientific basis for their use (2nd Ed). Ensenada, Mexico. Abedus Press.
Gaeddert, A. (2003) Healing Skin Disorders: Natural Treatments for Dermatological conditions. Berkeley CA. North Atlantic Books.
James,J.M., Burks,W., Aigenmann,P.E. (2012) Food Allergy. Elsevier.
Tilgner, S., (1991) Herbal Medicine Making from the Heart of the Earth: A home manual (1st Ed). Creswell, OR. Wise Acres Publishing.
The Naturopathic Herbalist
http://thenaturopathicherbalist.com/
(Other types of Dermatitis, or inflammation, include contact dermatitis, seborrheic dermatitis)
Etiology of Eczema:
Atopic Dermatitis is caused by an allergic response to a substance, typically ingested food antigens. Once the food reaches our gut, the body mounts an immune response involving Thelper cells, IgG antibodies, IgE antibodies, mast cells, eosinophils and histamine. This response can occur immediately after ingestion or a more delayed-type hypersensitivity days later. The gut is home to a wide range of immune cells, that flow around the rest of the body causing system inflammation that manifests on the skin where a large percentage of mast cells reside. A defective skin barrier can also be the route through which allergens are sensitized, and infections easily develop, leading to chronic inflammatory responses at the level of the skin.
History and Developments in Understanding and Treating Eczema:
As early as the 1890s people described a chronic, puritic skin condition in patients with nervous disorders. By the early 1900s people described a similar condition in people with Hay Fever and Asthma ("The Atopic Triad"). The term "Atopic Dermatitis" was coined in 1955. Conventionally the pathogenesis is understood as a combination of a defective epidermal barrier and cutaneous inflammation, of which genetics plays the most important role.
Historically, eczema has been managed by avoiding food triggers and reducing acute itching and inflammation on the skin using topical corticosteroids. However these are not effective for long term management, have side effects with prolonged use, and DO NOT address the true etiology of the disease.
There is definitely a genetic component to eczema, but we must understand the triggers and risk factors that determine the development of the condition.
Health professions yearning to get to the root cause of the disease have explored the connection between the inside of our body's donut (gut) and the outside (skin) and have noted that digestive imbalances lie at the root of the inflammation. We know the food antigen causes the body to mount an immune response, but WHY?
Naturopaths understand that disease that manifests externally have an internal etiology because we are one long donut tube and what happens on one side of the type will reflect on all surfaces on the tube.
A gut poorly inhabited with good bacteria in its first stages of development (due to insufficient microbiotica exposure through the vaginal canal with a C-section, excessive use of antibiotics in early infancy, lack of breast feeding etc), allows the gut to be colonized with bad bacteria and causes early, chronic inflammation in the gut as the body tries to cope (out gut is our largest home for our immune system! Makes sense -- this is where the outside world comes in to our body. We need a solid army at home base!). In an inflamed gut, normal digestive functions are compromised so food is poorly broken down and poorly absorbed. These large food molecules are presented to the gut brain as unwanted foreigners that need to taken care of. Further, lacking our good bacterial colonies we can develop spaces between our gut cells ("leaky gut syndrome") allowing the large food molecules to directly enter the body, now really pissing off the immune system. This leads to internal inflammation then external inflammation.
Symptoms being addressed:
burny, itchy, dry, scaly, red rash on skin
indigestion, leaky gut
allergic and inflammatory (type 1 hypersensitivity) response in gut and on skin
stress, insomnia, irritability associated with itching
Herbs chosen to address symptoms:
Burdock root. Articum lappa
Asteraceae family
Notable constituents: polysaccharides, volatile oils, inulin, minerals, mucilage
Burdocks helps cool irritation and brings gut toxins out of the body as well as support beneficial gut flora, really getting to the root cause of eczema. As a anti-inflammatory it will also reduce inflammation that starts in the gut with food sensitivities.
Calendula flowers.
Asteraceae Family
Notable constituents: flavanoids, allantoin
Our premier skin herb for inflammation, Calendula was chosen because it is safe, has strong anti-inflammatory properties and promotes skin regeneration in cracked eczematous skin.
Chamomile flowers. Matricana chamomila.
Asteraceae family
Notable constituents: flavanoids, volatile oils, glycosides
Chamomile treats nervousness and insomnia related to irritation and itching. It can also relax smooth muscle to treat indigestion, a consequence related to the root digestive imbalance at the root of eczema. Chamomile's azulene and chamazulene have anti-allergic activity, and apigenin has anti-inflammatory activity.
Castor Oil
Castor oil reduces inflammation and speeds healing of injured skin. It was used as the oil menstruum for the salve for this reason, as well as its deeply moisturizing properties for very dry skin, forming a protective layer
Dandelion root. Taraxacum officinalis
Asteraceae family
Notable constituents: sesquiterpene lactones, triterpene steroids, inulin, sugars, vitamins, minerals
Dandelion root is alterative for chronic toxic conditions manifesting on the skin as eczema. It therefore heals for the inside (gut) out (skin).
Jojoba Oil
Very stable oil for extracting constituents and helping the skin absorb important fat-soluble constituents needed for treatment. Also use for moisturizing dry skin, and to balance the thickness of the castor oil.
Licorice root: Glycyrhizza glabra.
Fabaceae family
Notable constituents: flavanoids, glycyrrhizin, polysaccharides
- Licorice can help ween from steroid usage (due to glycyrrhic acid) as topical steroids are typically used on eczema affected skin to reduce inflammation, scaling and to protect the skin barrier. Licorice does this by extending the half life of cortisol.
- Licorice is also a powerful immunemodulator, having the ability to calm the immune response where over-recruited, and support it in the cause of infections, especially those on the skin since in eczema the skin barrier is compromised.
- Licorice is also emolient, demulcent and soothing to gut
Vit E
VItamin E is a fat soluble vitamin that has antioxidant and immune supportive properties for the skin. It is also moisturizing for dried skin, and was used a preservative for the external preparation.
Tea Tree Oil. Melaleuca alternifolia.
Myrtaceae family
As an anti-inflammatory it can help resolve itchiness and its antimicrobial activity can help ward off secondary infections from results broken skin of eczema
Why types of preparations chosen and how they should be used:
I chose one oil-based formula, and one water-based formula to ensure that a wide range of therapeutic constituents could be included in the treatment. Since the skin is the area most affected in this condition, the oil infusion was chosen to ensure lipids, gums, resins, essential oils, alkaloids, flavanoids, and mucilage can be applied directly onto the affected areas. The short infusion was chosen and the infused oil was made into a salve for its occlusive and protective effects on broken, irritated skin.
The tea was chosen as a method through which water-soluble constituents such as proteins, minerals, vitamins, enzymes, pectins, tannins, saponins, alkaloids, flavanoids, gums and some glycosides could reach the gut to nourish, heal and sooth gut epithelial cells.
Recipe and procedure:
Skin Healing Salve
Recipe:
1/4 cup castor oil
1/4 cup jojoba oil
1/3 filled 2oz jar dried calendula and chamomile flowers (equal parts)
15g bees wax
30 drops tea tree oil
1/2 tsp 32000IV Vitamin E oil
Procedure:
The short double boiler method and the folk method was utilized for my oil infusion was used:
1. Approximately 20 oz of water was placed in a double boiler and brought to a boil then put on a low simmer.
2. 1/4 cup castor oil, 1/4 cup jojoba oil measured and added to the double boiler
3. A 4oz jar was 1/3 filled with equal parts ground chamomile and calendula dried herb
4. The herbs were added to the oils in the double boiler
5. The mixture was left to simmer for 1 hour and stirred frequently to ensure that the oil covered all the herb
6. The oil was allowed to cool then strained off the mixture.
Jojoba oil added to top off to 1/2 cup.
7. The infused oil was then re-added to the double boiler with 15g of beeswax as our solidifying agent
8. The salve was stirred while cooling and a frozen spoon used to test the consistency of the salve.
9. 30 drops tea tree, 1/2 tsp 32000 IU Vitamin E oil
10. The salve was stored in a dark, sterile, 2 oz glass bottle, labeled then brought to your hands for the testing!
Gut Loving Tea
Recipe:
1 tsp licorice root
1 tsp burdock root
1 tsp dandelion root
Procedure:
1. 1 and 1/4 cups of water was placed in sauce pan and brought to a boil.
2. 1 tsp licorice root, 1 tsp burdock root and 1 tsp dandelion were added to boiling water, then reduced to a low rolling boil.
3. The preparation was covered and decocted for approximately 20 minutes.
4. The mixture was strained and brought to your bodies for healing and enjoyment!
RESEARCH ARTICLE:
Summary of Research Article:
The treatment of atopic dermatitis with licorice gel
Journal of dermatological treatment, 2003
This study evaluated licorice (specifically its constituent glycyrrhizinic acid) as a topical preparation for atopic dermatitis.
Glycyrrhiza glabra root was collected from the south of iran.
Glycyrrhizinic acid was extracted using the following method: powdered root extracted with methanol for one day, then added to acetone, washed with ethanol, ammonia, water, formalin, and titrated with sodium hydroxide
Standardized based on concentration of glycyrrhizinic acid was obtained using titremetry.
In a placebo double blind study the extraction was tested on 3 groups of 30 patients each (1 groups with 1% glycyrrhizinic acid, 1 group with 2% glycyrrhizinic acid, 1 group with placebo gel) 3 times a day for 2 weeks
They found that Licorice was more effective than placebo and 2% licorice topical gel was more effective than 1% in reducing the scores for erythema, edema, and itching after 1 and two weeks intervention (p<0.05).
References:
Garcia, C., Adams, D.J., (2005) Healing with Medicinal Plants of the West: Cultural and scientific basis for their use (2nd Ed). Ensenada, Mexico. Abedus Press.
Gaeddert, A. (2003) Healing Skin Disorders: Natural Treatments for Dermatological conditions. Berkeley CA. North Atlantic Books.
James,J.M., Burks,W., Aigenmann,P.E. (2012) Food Allergy. Elsevier.
Tilgner, S., (1991) Herbal Medicine Making from the Heart of the Earth: A home manual (1st Ed). Creswell, OR. Wise Acres Publishing.
The Naturopathic Herbalist
http://thenaturopathicherbalist.com/
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