Question: Dr. Harris, is there anything beyond allergy medications to help a child with eczema?
Answer: Recently, a friend from medical school asked me a question about eczema. He is an orthopedic surgeon in the Navy, and his son has allergies. It seems that every night his son awakens with itching all over his body from his eczema. His son uses topical steroid medications regularly, and Benadryl at bedtime prevents the severe eczema flairs, but his son has been taking it about every night. His son also takes Allegra and Singulair for his allergies and eczema. My friend was wondering if there was anything beyond allergy medications he could do to help his son.
The medicines and medical care his son was getting were excellent. Allergies and eczema can be very frustrating as there really is no cure. The goal of eczema and allergy care is to minimize symptoms and improve lifestyle. The chronic nature of the condition can become very frustrating, especially for parents who want to help their children.
Allergies, eczema (which is also called atopic dermatitis), hives (urticaria), and asthma are all part of a condition called atopy. Atopy tends to run in families and can present as any combination of allergies, eczema, hives, or asthma. There has been an increased incidence of atopy-related conditions, especially in children, over the past twenty years. Research has not been able to identify the reason for the increased rates of these conditions, and the cause is likely multi-factorial.
What we do know about atopy is that all these conditions are caused by inflammation. The inflammation affects the skin in eczema, the lining of the lung airways in asthma, and the linings of the nose and eyes in allergies. This inflammation causes swelling and irritation which lead to itching and skin redness in eczema; wheezing and coughing in asthma; and sneezing, runny nose, and itchy eye in allergies. Individuals with atopy have inflammatory cells (white blood cells) in their skin, nasal passages, and lungs which will react whenever the immune system flares up resulting in eczema, allergies, or asthma. Typically this inflammation is riled up by pollens, grasses, pet saliva or dander, dust mites, certain foods, smoke, stress, and weather changes. Illness and infection can also cause flares of allergies, asthma, or eczema because inflammation begets inflammation in the body. Chemicals and hormones released by white blood cells in response to illness and infection stimulate inflammation, even in distant locations, where inflammatory cells are lying in wait.
The key to improving inflammatory conditions like eczema, allergies, and asthma is to ensure proper nutrition. After spending some time once again trying to get my friend to read the SuperfoodsRx books, I recommended some changes to his son’s diet. The macronutrients in the superfoods are not only antioxidants, they have anti-inflammatory effects as well. I started by encouraging him to ensure his son was eating oranges, berries, tomatoes, carrots, and other fruits and vegetables. Additionally, the two things I thought would be the most helpful to his son’s eczema and inflammation are 1) Fish or Fish oil and 2) Yogurt with active cultures.
“Omega-3”, or omega-3 polyunsaturated fatty acid, is a type of fatty acid found predominantly in fish. Omega-3 is an essential fatty acid, which means it is required for normal cellular functioning and yet cannot be made in the body. Both omega-3 and omega-6 fatty acids are used as precursors in the production of inflammatory hormones and signals for white blood cells. The problem is that when omega-6 fatty acids are used to make inflammatory hormones they tend to cause more inflammation than hormones made from omega-3. Since our western diets rely more on animal protein, our diets are higher in omega-6. Including fish and seafood in our diet improves the relative amount of omega-3 and helps limit inflammation. So, I encouraged my friend to increase the amount of fish in their diet or start giving his son fish oil supplements.
The active cultures in yogurt are “good” bacteria that help balance the intestines. Our immune system is hard at work in our intestines protecting us from toxins and bad bacteria in the food we eat. Bacteria in our intestines are a normal and healthy part of digestion, covering the entire lining of the intestine. The important thing is to ensure that the bacteria are “good.” If yeast or unhealthy bacteria cover the intestines, the immune system flares up to protect the body. If “good” bacteria cover the intestine, the immune system can remain healthy and avoid causing unnecessary inflammation. So, I encouraged my friend to add yogurt with active cultures to his son’s diet.
I don’t think that adding superfoods to his son’s diet will totally cure his eczema. I do think that a better diet containing lots of superfoods,, fish oil, and the active cultures in yogurt will help minimize flare-ups and help the medicines control the inflammation better. These simple changes may help keep the household sane and prevent middle-of-the-night scratch fests.