Eczema

National Eczema week is now upon us. Many people are suffering and have lost the hope of any improvement. But can we do anything naturally?

What is eczema?

Eczema is a histamine mediated condition. This means that there is too much histamine in the body and mast cells (a type of immune cells) are overly sensitive to histamine. Having high histamine levels leaves us likely to be overactive to environmental and food allergens. When we do have contact with these allergens, our body over reacts, causing inflammation and swelling of the skin cells which leads to the classic symptoms of itching, dryness, flaky skin, weeping and having lower skin integrity.

Why do we have higher levels of histamine in the body?

It all starts in the gut. The gut is where we breakdown histamine using an enzyme called Diamine Oxidase (DAO) and remove it from the body. The problem occurs when we are lacking this enzyme. Sometimes this can be genetic, however more often than not it is due to poor gut health. DAO is released by the lining of the gut wall, and therefore poor gut health may significantly inhibit the release of DAO. If the histamine is not broken down, it is reabsorbed by the body, increasing histamine levels.

What happens when there is too much histamine?

In the presence of histamine, the mast cells (immune cells) are activated. These increase inflammation within the body. Although the skin may be the only symptom, the inflammation is usually throughout the entire body.

What can I do?

The first place is to start with gut health. Having a healthy gut means that we a digesting food well, absorbing nutrients well, having a bowel movement 2–3 times per day and having enough beneficial bacteria.

We also need to look at supporting the skin and reducing inflammation within the body, as this will help to calm the immune system down and decrease reactivity.

Eliminate allergens and food intolerance. This is the first step in calming down the immune system and supporting gut health. When we eat foods we are intolerant to or come into contact with environmental allergens, our immune system is activated. Foods that we are intolerant to also need to be avoided because they cause inflammation within the gut, and prevents the naturally occurring beneficial bacteria from adhering to the gut wall. Chronic inflammation in the gut may also lead to damage and a decrease in the amount of DAO secreted.

Digestive enzymes and HCL. Being able to digest and break down foods well is the first step to gut health and over all wellness. For this we need to have enough hydrochloric acid, bile flow and digestive enzymes. If we are not digesting well enough, food may be fermented by detrimental bacteria in the gut, causing gas, bloating, increases in detrimental bacteria and a decrease in naturally occurring beneficial bacteria. This puts pressure on the gut wall and may decrease the rate in which the DAO is released.

Nutrient rich diet — This is essential to good gut health and over all wellbeing. A nutrient rich diet consists of 7 portions of vegetables per day and 2–3 portions of fruit. Healthy fats are also required in the diet such as avocados, olives, nuts, seeds and oily fish. We also require adequate protein from eggs, fish, poultry, beans, lentils, nuts and seeds. A diet like this will provide nutrients which are needed for normal skin such as Biotin, Iodine, Vitamin B2, and B3, Vitamin A, Vitamin C and zinc. Taking a good multivitamin and mineral supplement may help you achieve good intake of these nutrients. Sugar is not included in a nutrient rich diet as it robs the body of many nutrients that would otherwise be uses for the skin, the gut and the immune system. It also contributes to inflammation in the body and the skin.

Probiotics — In the gut there is a fine balance of good bacteria. We inherit this bacteria at birth from our mothers, provided we were born naturally, and it is influenced by diet and lifestyle as we grow. Sadly, our modern lifestyle full of stress, sugar, anti-bacterial agents and antibiotics can disrupt this balance in the body leading to bad gut health and a low level of DAO excretion and contributing to an overactive immune system.

Fish oil — Contains EPA and DHA omega 3. These are involved in an anti-inflammatory pathway in the body call prostaglandins. EPA is needed for prostaglandin series 3 production, which is an anti-inflammatory hormone. In eczema, it is helpful to decrease inflammation in the body and the skin. Fish oil is a type of fat called a poly unsaturated fatty acid (PUFA). This type of fat has a flexible structure, and when used by the wall of the skin cells, causes the skin cells to also become flexible. Flexibility of the skin is needed to help prevent flaking and scaling.

Vitamin D — Vitamin D is needed for a normal functioning immune system and should be considered by anyone with any immune disorder such as eczema. Vitamin D deficiency is now becoming a problem in the UK. Not only do we not get enough sunshine in the first place, when we do, we block it out with sun cream. The darker your skin tone, the more sun light you need to make adequate levels of vitamin D, leaving you more likely to become deficient. Vitamin D does get stored in the body, so it is best to get a vitamin D test so an appropriate dose can be given.

Topical applications — These are a great way to manage some of the symptoms associated with eczema. Moisture is really important in addressing dryness and flaky skin, so a good moisturiser is really important. There are creams which contain herbal extracts and address itching and inflammation, leading to more comfortable skin.

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