Atopic dermatitis (usually referred to as eczema) is a common condition that affects roughly 3 to 8% of the population.
Present studies indicate that atopic dermatitis is, at least partially, an allergic disease because:
- Levels of serum IgE, which is a type of antibody, are increased in 85% of atopic dermatitis patients.
- All atopic dermatitis patients have a positive allergy test.
- There is a family history in 2/3 of atopic dermatitis patients.
- Many atopic dermatitis patients eventually develops hay fever and/or asthma.
- Those who have the condition improves with a diet that wipes out common food allergens.
Atopic dermatitis is also distinguished by a variety of physiological and anatomical abnormalities of the skin. The major abnormalities are:
- A greater impulse to itch
- Dry, thickened skin that has very little water-holding capacity.
- An increased impulse of the skin to thickened further from scratching and rubbing.
- The skin being overgrown by staphylococcus aureus bacteria
The hidden abnormalities leading to atopic dermatitis arise primarily in the immune system and structural parts of the skin. For example, the allergy-related antibody IgE is increased in up to 85% of people with atopic dermatitis because of an increased activation of a particular type of white blood cell. Additionally, mast cells (specialized white blood cells) from the skin of the individuals with atopic dermatitis have abnormalities that cause them to deliver higher amounts of histamine and other allergy-related compounds compared with individuals without atopic dermatitis. These compounds also result in inflammation and itching characteristic of atopic dermatitis.
Another immune-system anomaly is a weakness in the ability to kill bacteria. This weakness in immune function, in connection with scratching and the predominance of the bacteria Staphylococcus aureus in the skin flora in 95% of atopic dermatitis patients, leads to an increased susceptibility to potentially serious staph infections of the skin. There are also other immune defects in patients with atopic dermatitis that lead to increased susceptibility to other infections of the skin.
A genetic basis for atopic dermatitis has long been acknowledged. A family history of allergic disease such as atopic dermatitis and asthma is a huge risk factor. In addition to possible weakness in immune function, one of the major genetic defects appears to be in the manufacture of filaggrin, which is a protein that helps proper uprightness and moisture of the skin.
Treatments for atopic dermatitis
Many research have recorded the major role that food allergy plays in atopic dermatitis. Research has also shown that women who breastfeeds will offer powerful protection against babies developing atopic dermatitis as well as allergies in general. What’s fascinating is that studies suggest mothers of breastfed infants with allergies should stay away from the common food allergens (especially milk, eggs, and peanuts and, to a lesser extent, fish, soy, wheat, citrus, and cocoa) themselves, to inhibit traces of food antigens from showing up in their breast milk. Maternal restraints of these common allergens are associated with total resolution in the bulk of cases.
In older or formula-fed infants, milk, eggs and peanuts appear to be the most common food allergens that lead to atopic dermatitis. In one study done, these three foods were involved in 80% of all cases of childhood atopic dermatitis, while in another study 65% of children with severe atopic dermatitis had a positive food challenge to one or two of the following: eggs, milk, nuts, fish, wheat, or soybeans. One randomized, controlled trial discovered that people with a positive reaction to eggs on a radioallergosorbent test, an egg-free diet was correlated with improvement in the severity of atopic dermatitis. The greatest effect was witnessed in those most severely affected. Although eggs are a major source of the condition, virtually any food can be the offending agent.
An overgrowth of the ordinary yeast Candida albicans in the GI tract has been suspected as a causative factor in allergic conditions including atopic dermatitis. Increased levels of antibodies against candida are frequent in atopic individuals, indicating an active infection. Moreover, the severity of wounds tends to be associated with the level of antibodies to candida antigens. The bottom line is that wiping out candida results in compelling clinical improvement of atopic dermatitis in some patients.
Because the intestinal flora has a part in the health of the host, mainly regarding atopic dermatitis, probiotic therapy is particularly indicated. Studies demonstrate that adding the probiotic Lactobacillus rhamnosus alone or in combination with Lactobacillus reuteri to infants with atopic dermatitis and cow’s milk allergy showed significant reduction of the severity of atopic dermatitis.
Essential fatty acids
Before, it was thought that supplementing the diet of people with atopic dermatitis with evening primrose, borage, or blackcurrant oil might be helpful. Actually, a few double-blinded studies with evening primrose oil (typically 3,000 mg daily) did show benefit. Nevertheless, overall the therapeutic conclusions appear to be more approving with omega-3 oil supplementation from fish oils than with evening primrose oil. Many studies with evening primrose oil failed to display any therapeutic benefit over a placebo.
In comparison, supplementing with fish oil that provides EPA and DHA showed significant protective effects against allergy development. Fish oil contains mainly long-chain omega-3 fatty acids which are further down the anti-inflammatory alley, while evening primrose oil includes both omega-3 and omega-6 fatty acids and gamma-linolenic acid at the front of the omega-3 anti-inflammatory chain.
The use of botanical medicines in atopic dermatitis can be broken up into two categories: internal and external. Licorice appears to be valuable in either application. Internally, it can exert anti-inflammatory and anti-allergic effects. These benefits are possibly best illustrated in several double-blind studies featuring a Chinese herbal formula that contain licorice. Interest in this herbal formula by a group of researchers happened after a person with atopic dermatitis experienced a huge improvement after taking a decoction prescribed by a Chinese physician.
With regards to using licorice on the skin, the best results are expected to be obtained by using commercial preparations featuring pure glycyrrhetinic acid. A few studies have demonstrated glycyrrhetinic acid to bring on an effect similar to that of topical hydrocortisone in the treatment of atopic dermatitis and psoriasis. In one study, 10 of 12 patients with atopic dermatitis unresponsive to other treatments noted marked improvement, and three noted mild improvement when an ointment containing glycyrrhetinic acid was applied on the skin. In another study, 90% of the patients with atopic dermatitis who applied glycyrrhetinic acid demonstrated improvement in comparison with 80 using cortisone.