Healing eczema

A typical eczema rash. [Image source: Flickr]

Eczema, or Atopic dermatitis, is a chronic or recurring inflammatory skin disease that affects both children and adults. It usually begins in childhood and can last until adulthood, or even manifests the first time in adulthood. This condition is getting more common now as it affects up to 20% children and 3% of adults worldwide [1].

An outbreak of eczema is characterised by red and itchy skin, sometimes with blisters. The blisters can break and weep. The skin can become dry, thickened, rough, and cracked. The itchiness that accompanied with this flare-up can be unbearable [2]. Eczema normally comes and goes, sometimes it gets better and sometimes worse.

What Causes Eczema?

Genetic and immune responses

The complex interplay between genetic and immune system reactions is the leading cause of eczema. Genetically, it has been demonstrated that the loss-of-function mutations in the filaggrin (FLG) gene, which encodes an important skin barrier protein, are associated with eczema [3]. Lower expression of FLG may lead to skin barrier dysfunction and prone to damage from environmental factors or mechanical scratching.  Damaged skin exposes skin’s resident antigen-presenting cells (APCs) to allergens, bacterial and viral antigens as well as other environmental toxins. These APCs became activated and travelled to the lymph nodes to trigger the immune system T cells to release pro-inflammatory cytokines as a response to cause inflammation on the skin surface [3]. Prolonged and frequent inflammation can cause changes in the skin structure and immune hypersensitivity, leading to recurring episodes of eczema outbreaks.

Lost of function in the expression of filaggrin (FLG) gene can lead to eczema.

Environmental factors and epigenetics

The prevalence of eczema has increased by 2- to 3-fold during the past decades, especially in industrialized countries [1]. Environmental factors, especially those associated with modern urban living, including air pollutants, contact allergens and skin irritants, ingredients in cosmetics and personal care products, and food additives, have been shown to be major contributors to the triggering and aggravation of eczema [4]. Some common environmental chemicals that can trigger eczema are shown in the following table:

Household chemicals can influence our gene expression!

It is still not clear how these environmental factors can cause the increase in the prevalence of eczema, however, recent progresses in the understanding of epigenetic have provided insights [5]. Epigenetic studies how modification of gene expression, rather than alteration of the genetic code itself, changes the living organisms. The genetic code that is stored in DNA in every cell of the body does not change throughout one’s life. It is the blueprint for the generation of a functional gene product, or protein. The process of using the information in a gene to generate a gene product is called gene expression. Environmental factors have been found to influence and induced changes in gene expression. Changes in gene expressions related to the immune system and skin barriers (e.g. FLG), due to environmental chemicals, have been found to contribute to the development of eczema [6].

Gut Health

The composition of gut microflora can affect the skin health

Research has also shown that the gut flora composition plays an important role in the development of eczema. Bacteria in the gut are colonized through environmental exposures. They play an important role in defending the body from invading pathogens and harmful agents. In fact, the gut flora of infants and children with eczema has a higher count of bad bacteria, such as coliforms and Staphylocccus aureus and a decreased proportion of the good ones such as Lactobacilli, or Bifidobacterium [7]. Exposure to microorganisms is important in shaping the immune system and overexposure to certain bad bacteria, such as Escherichia coli increases the risk of eczema [8]. Furthermore, microbial metabolites can also influence epigenetic pathways that linked to gut and skin health [9]. As such, the use of probiotics has been increasingly recognized as a potential strategy to prevent and treat eczema [10].

Dietary factors

Allergy food

Eczema is related to food allergy

Diet can also trigger the exacerbation of eczema, especially in infants and children. Food allergy and eczema are highly correlated. Food items that may cause allergic reactions include peanuts, tree nuts, cow’s milk, eggs, soy, wheat, seafood, and shellfish [11]. The development of food allergy is, in fact, also related to the complex interaction of our immune system with nutrition, diet, pollutions and other environmental factors, with epigenetic alterations being recognised as an important cause [12].

At present, there is no effective diagnostic test for food allergy. Skin prick test or serum IgE test, while commonly used, are not reliable.  A “double blind, placebo-controlled food challenge” in clinic or hospital is considered the best approach to determine food allergy [11]. However, this is very time consuming. It involves excluding a suspected food for a period of 4 to 6 weeks, before testing for any reaction after taking the food. A reaction to food may not result in immediate flare-ups of eczema. Latent reaction up to two days from the ingested food is also possible [11]. Therefore, it is very hard to determine the exact food that can trigger eczema. Food avoidance based on allergic testings has also been shown to be not effective in many cases.

Is it possible to heal eczema?

There is no cure for eczema from the medical standpoint. Standard treatment for the condition, mainly with topical corticosteroids, aims to heal the affected skin and to prevent` and prevent flaring of the symptoms [13]. I have seen many parents and patients trying to look frantically for alternative medicine to cure eczema after losing hope in standard medical treatment and the seemingly ineffective search for trigger food. Being affected by eczema during adulthood for several months previously, I can empathize with them. I personally find the bouts of eczema flare-ups to be highly frustrating and demoralising (See my previous post: Recovering from eczema). There is, nonetheless, no quick remedy for eczema.

Healing of eczema requires addressing the root cause of eczema which lies the gene expressions. Since we know that dietary and environmental factors plus gut health can influence epigenetic modifications of gene expression, it is only logical to focus these factors to induce positive epigenetic changes and promote healing. Ultimately, eczema can only be self-healed with the help of nature.

In here, I will describe an approach to support patients with eczema to walk their healing journeys, by empowering them with the right information to make the right dietary and lifestyle choices.

Personalised epigenetic report

Hair analysis using Cell Wellbeing S-Drive interface

How environmental factors influence one’s health can be assessed through a hair analysis using the Epigenetic mapping technology by Cell Wellbeing Ltd. As hair follicles store the signature waves of the body and its resonance with the environment, hair is a medium for which the bio-resonance information can be captured. Requiring only a minimum of four strains of hair, the Cell Wellbeing S-Drive interfacing device can digitalise and transmit the bio-resonance information of the hairs to the Epigenetic mapping servers in Hamburg, Germany for immediate analysis. A personalised report is generated and send back within 15 minutes. The whole process is fast, non-invasive, and convenient.

Nine areas of analysis with different level of individual importance

The analysis covers nine key areas that affect the quality of individual cell renewal. Among them include six nutritional aspects: vitamins, minerals, essential fatty acids, antioxidants, and amino acids; and three environmental concerns: toxins, microbiology, as well as electromagnetic fields (EMFs) and extremely low frequencies (ELFs). Not all areas are of equal importance to a patient at any one time. The report will prioritise areas that need to be addressed based on the signature wave resonance intensity. The report also provides suggested nutrients and a food intake program for one to address the underlying issues.

Such report is highly relevant for an eczema patient as it highlights the priority areas of immediate attentions, suggests food to avoid, and nutrients to increase intake.  For a naturopath like myself, the report also assists me in the planning of a targeted supplemental strategy using herbs and nutritional products for the patients, after comparing and cross-examining with patient’s history as well as presenting signs and symptoms. I will illustrate a clinical case here as an example.

A case illustration

A nineteen-year-old student who was suffering from eczema since she was a baby came for consultation. She described her condition as stable with no major flare-ups. She had patches of rashes, which could be itchy at times, but she had grown used to them. She found her immune system to be especially low lately with frequent infections such as urinary tract infections and tonsillitis.

Her hair analysis epigenetic report revealed that her priority areas were as follows:

Not surprisingly, “toxins” ranked on the top of the priority list someone with eczema. For this patient, it is toxic metals that she should be most concerned with. Noticing her wearing multiple ear- and body-piercing, my immediate advice to her was to consider removing those piercings. Metal piercing, especially those containing nickel, can cause eczema, which has been proven beyond doubt [14].

The report also indicated the types of vitamins and minerals most required by this young patient for cell renewal and growth. A list of suggested food sources was provided for increasing intake.

Foods that this patient should avoid for the next ninety days are shown in the following table.

It is important to note that this is not a food allergy test. The food items indicated are those that may cause stress to the body’s digestive and immune system based on their bio-resonance. Basically, they are not compatible with the body’s need now and are recommended to avoid for a minimum of ninety days.

Healing the skin with care

Basing on the analysis of the report and case taking, the following supplements were recommended for the patient to support her current needs:

  1. Echinacea tablets – for immune modulation
  2. Chlorella tablets – for chelating of toxins metals and promote detoxification pathway
  3. Activated vitamin B complex – for immune system, skin, and prevention of anaemia
  4. Vitamin D spray – for immune system, skin, and prevention of anaemia
  5. Probiotics – for healthy gut flora.

Other recommended lifestyle changes include:

  1. Drink at least 2.5 litres of clear filtered water a day
  2. Avoid processed food as much as possible
  3. Remove all metal piercings and avoid exposure to potential sources of toxic metals in daily life, e.g. aluminium pots, canned food, old furniture, paints, exhaust gas, etc.
  4. Use only natural facial, body, and hair care products that are known to be free from toxic metals and chemicals
  5. Consider joining a detox camp during school holidays

With the suggested changes. The patient is responding well to the program and is currently on her path to healing.

Conclusion

Even though genetics play a role in the development of eczema, a chronic inflammatory skin condition that is considered incurable from the current medication standpoint, environmental and dietary factors together with gut health can influence epigenetic modifications of gene expression that lead to eczema.

Eczema can only be self-healed with the help of nature. A personalised epigenetic report based on hair analysis can be a useful tool as it helps to highlight the priority areas of immediate attention, suggested food to avoid, and suggested nutrients for increasing intake. Coupling with nutritional supplements targeted for the individual’s condition, a patient can be supported to walk the healing journey.

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References

[1]         S. Nutten, Atopic dermatitis: Global epidemiology and risk factors, Ann. Nutr. Metab. 66 (2015) 8–16. doi:10.1159/000370220.

[2]         A. Paterson, Therapeutic properties of biobran MGN-3, Posit. Heal. (2002). http://www.positivehealth.com/article/nutraceuticals/therapeutic-properties-of-biobran-mgn-3.

[3]         W. Peng, N. Novak, Pathogenesis of atopic dermatitis, Clin. Exp. Allergy. 45 (2015) 566–574. doi:10.1111/cea.12495.

[4]         K. Kim, Influences of Environmental Chemicals on Atopic Dermatitis., Toxicol. Res. 31 (2015) 89–96. doi:10.5487/TR.2015.31.2.089.

[5]         Y. Liang, C. Chang, Q. Lu, The Genetics and Epigenetics of Atopic Dermatitis—Filaggrin and Other Polymorphisms, Clin. Rev. Allergy Immunol. 51 (2016) 315–328. doi:10.1007/s12016-015-8508-5.

[6]         R. Feil, M.F. Fraga, Epigenetics and the environment: emerging patterns and implications, Nat. Rev. Genet. 13 (2012) 97–109. doi:10.1038/nrg3142.

[7]         J. Penders, E.E. Stobberingh, P.A.V.D. Brandt, C. Thijs, The role of the intestinal microbiota in the development of atopic disorders, Allergy Eur. J. Allergy Clin. Immunol. 62 (2007) 1223–1236. doi:10.1111/j.1398-9995.2007.01462.x.

[8]         C.W.H. Chan, R.S. Wong, P.T.W. Law, C.L. Wong, S.K.W. Tsui, W.P.Y. Tang, J.W.H. Sit, Environmental factors associated with altered gut microbiota in children with eczema: A systematic review, Int. J. Mol. Sci. 17 (2016). doi:10.3390/ijms17071147.

[9]         M.A.J. Hullar, B.C. Fu, Diet, the Gut Microbiome, and Epigenetics, Cancer J. 20 (2014) 170–175. doi:10.1097/PPO.0000000000000053.

[10]      I.A. Rather, V.K. Bajpai, S. Kumar, J. Lim, W.K. Paek, Y.H. Park, Probiotics and atopic dermatitis: An overview, Front. Microbiol. 7 (2016) 1–7. doi:10.3389/fmicb.2016.00507.

[11]      R. Katta, M. Schlichte, Diet and dermatitis: Food triggers, J. Clin. Aesthet. Dermatol. 7 (2014) 30–36. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970830/

[12]      X. Hong, X. Wang, Early Life Precursors, Epigenetics, and the Development of Food Allergy, Semin Immunopathol. 34 (2012) 655–669. doi:10.1007/s00281-012-0323-y.Early.

[13]      J. MacIntosh, Eczema: Causes, symptoms, and treatments, Med. News Today. (n.d.). http://www.medicalnewstoday.com/articles/14417.php (accessed May 24, 2017).

[14]      F. Torres, M. Das Graças, M. Melo, A. Tosti, Management of contact dermatitis due to nickel allergy: An update, Clin. Cosmet. Investig. Dermatol. 2 (2009) 39–48. doi:10.2147/CCID.S3693.

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