Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

Eczema is a non-contagious skin rash with a number of possible causes such as a change in the weather, temperature, the intensity of light, foods, clothing fabric, chemicals, cosmetics, etc. There is a familial likelihood of developing the disease, and some people are apparently born with sensitized skin. Any material which touches the skin, even a steering wheel, could cause eczema. Study your environment to see what you frequently touch. Then avoid those things that cause eczema. The appearance of skin lesions on the scalp may differ greatly from eczema on the face or groin.

Eczema may occur from the age of infancy to old age. Three types of eczema deserve special mention: allergic dermatitis, infantile eczema, and sensitivity eczema such as dishpan hands.‍

Infantile Eczema

‍Infantile eczema is a manifestation of allergy, either contact or internal. Symptoms include redness of the skin with itching, cracking with weeping, oozing, crusting, scaling, thickening, dryness, and sometimes intense itching. Small blister-like bumps may occur at the edges or in the beginning stages. Babies may develop a red, itching rash, which may involve only the cheeks, or it may spread to the entire body. This disorder begins about the age of two months, and usually lasts until the child is about two years of age. These children are more likely to develop asthma or hay fever in the future.

‍Prevention of Infantile Eczema

1. Avoidance of salt or sugar in the diet of infants is mandatory. (This may help adults as well.)
2. Breastfeeding is recommended. Infantile eczema is much more likely to occur in non-breast fed babies, and in families having a history of allergy.
3. Milk, eggs, chocolate, soybeans, citrus, wheat, seafood, pork, green beans, chicken, tartrazine, artificial flavorings and colorings, peanuts, benzoate, and preservatives in the diet, or in the mother's diet of breast-fed infants have been found to cause the development of eczema. Calcium supplementation may, in some patients, worsen eczema (Pediatrics News, 25:18, March 1993). It may also be that mothers taking calcium supplements during pregnancy may make their newborns at risk of getting infantile eczema.
4. Do not use soaps, bubble bath, or bath oil for infants, bearing in mind that nothing is on the baby's skin that cannot be removed by plain water.

Acrodermatitis enteropathica‍

This rare kind of eczema-like disorder has symptoms of dermatitis, diarrhea, and loss of hair. The symptoms do not appear in breast-fed babies, but generally within the first four to ten weeks of life. Within a week or so after the introduction of cow's milk, the disease begins.

It has been discovered that impaired zinc absorption is probably the underlying problem in acrodermatitis enteropathica. Aspirin, calcium supplements, soy milk protein, and cow's milk interfere with the absorption of zinc, and should be avoided. The mother should make a Herculean effort to re-establish breastfeeding, even if it has been several weeks since the baby was weaned. Herbs to encourage breastfeeding are blessed thistle, milk thistle, and red raspberry leaf. They may be used singly or mixed. Use one heaping teaspoon of each of the herbs to one cup of boiling water. These should be used as teas rather than as capsules or tablets. Take three to four cups per day for six weeks or more. Exercise and sweating promote milk production.

A daily dose of zinc of around 15 milligrams can be given to infants. The zinc supplements dramatically reverse the eczema symptoms. A behavioral change is usually the first sign of improvement. The infant is less irritable, less anxious to be held, and a better sleeper within one or two days. The skin clears, the appetite returns, and diarrhea stops within a few days. The dosage can be reduced to 5-10 milligrams daily for about one month as soon as symptoms begin to improve. Perhaps by that time the infant can get along without the zinc and it should be stopped. You may be able to get zinc liquid from a drug store, but, if not, you can make up your own liquid using a 50 milligram tablet or capsule dissolved in one tablespoon of warm water. Give the baby one teaspoon of the liquid each day, which will contain 15 milligrams per teaspoon.

The mother should use a diet high in legumes and whole grain products which are high in zinc. Many types of greens have large quantities of zinc. Dandelion tea and dandelion greens added to other greens, or to salads, can be very helpful in the mother's diet. Popcorn and pumpkin seeds are high in zinc.

‍Treatment for All Types of Eczema (and Dermatitis)

‍Begin any treatment routine with an "Elimination and Challenge Diet." Even breast-fed babies may become sensitive to the foods eaten by the mother. It may be difficult to identify the particular food which is responsible for the eczema, but a very careful "Elimination and Challenge Diet" must be performed on the mother, watching for signs of clearing in the infant. The top ten allergy producing foods are as follows: milk (responsible for 60% of food allergies), the chocolate/caffeine group (cocoa products, coffee, tea, and colas), citrus fruits, tomatoes, cinnamon, and artificial food colorings.

Reducing the salt or sugar intake can be of great help to individuals with allergic dermatitis or atopic dermatitis. Some improvement in itching usually occurs after three to four days of salt restriction, but the major improvement occurs after about three or four weeks (Lancet. 344:1516, 11-26-94).Use a vegan diet of fruits, vegetables, grains, and a few nuts. Use no more than three simple dishes at a meal and follow the two meal a day plan.

Many drugs cause eczema, and even if they are not the cause, they may prolong or worsen eczema. Try to test all medications, nutrient supplements, and herbal remedies to see if any are involved in the eczema.

Common inhalant allergens such as house dust, pollens, animal dander, smoke fumes, etc., can all cause a problem with eczema. Carefully avoid exposure to grasses, pollens, and plant secretions in the garden, yard, and woods. Remove decaying leaves or rubbish from your premises.

Avoid the use of chlorinated water for bathing, drinking, or cooking. Use bottled water, distilled water, purified water, or slurry water which is made by adding a tablespoon of powdered activated charcoal to a gallon of water. Shake or stir to mix and allow it to settle and use the water on top of the sediment.

The application of oils such as evening primrose oil, olive oil, or a mixture of olive oil and lime water shaken together, may be used as lubricants or as healing agents. Plain castor oil has been used on eczematoid rashes (scaling, cracking, and reddening of skin) with good success by some patients. Apply two or three times a day in covered areas, but after every hand washing for eczema on hands. Evening primrose oil applied to the inflamed skin after the soothing baths can be very effective. It may also be taken internally, as it is a rich source of gamma-linolenic acid, an essential fatty acid, and is a precursor of certain prostaglandins.

The most effective treatment we have found for the hands is Vaseline milk. Vaseline milk has helped many to heal from eczema. While the hands are still wet from washing or from the bath, a lump of petroleum jelly is taken between the palms and rubbed vigorously to mix with the water still on the hands. For a child also still wet from the bath, the milky fluid developed from rubbing petroleum jelly vigorously must then be gently smoothed over the skin of the child, the motion of the smoothing being in the same direction as the lines of the skin. If the direction is across the skin lines, it will tend to break open the eczema and make microscopic cracks which can be more easily irritated by a sensitizing agent. Only a thin coating is required.

A wonder formula for eczema consists of four parts soybean or similar oil; one part cocoa butter; one part strong comfrey root tea; one part Aloe vera gel (99% pure, bottled kind). Melt the cocoa butter and combine the ingredients. Unrefrigerated, it will keep about three days, and in the refrigerator about a week. It will separate and must be stirred or shaken, and it is gooey, but it works well. Use in the evening before bed, and cover the area with a towel, cotton glove, or sock, or whatever is appropriate for the area, until the mixture is absorbed into the skin.

Red clover, goldenseal tea, comfrey tea, or witch hazel tea, may all be applied to inflamed areas to prevent itching or advance healing. Red clover and goldenseal tea may be used as cold compresses for their astringent action. Apply compresses for 20 minutes four times a day. Drink one glass of either red clover or goldenseal tea daily for two weeks only.

Strict regularity in mealtimes, bedtimes, elimination, and a daily bath will pay big dividends in the treatment of eczema.

For eczema which covers most of the body, take daily baths in hot water for three minutes at about 106° F (41° C). The method is submerging oneself for three minutes in the water, stepping out of the bath water for one minute, then re-submerging oneself three additional times for a total of twelve minutes in the 106° F (41° C) bath. If the eczema is located only on the hands, a similar treatment of hot and cold hand baths could be applied to the hands as a trial to see if it helps (Journal of Medicine. 25:333; 1994).

Charcoal tub baths, putting one-half cup of powdered charcoal in a small tub of lukewarm water, 30 minutes twice daily. Finish with a tepid rinse to remove much of the charcoal and pat dry. Some residue will remain on the skin, and while this treatment is being used, clothing may be stained, and the same clothing can be freshly laundered and reused. Charcoal poultices are excellent for infections and for toxic dermatitis.Various other baths are helpful including such as oatmeal baths and Epsom salts baths (put one to two tablespoons in each gallon of water). An alkali such as baking soda can be added to the bath water. If the climate permits, one can then dress without drying to allow the alkaline water to moisten the clothing a bit. For some, vinegar (acid) baths are best, for some alkaline baths. A starch bath may be effective to relieve itching and weeping in the wet lesions, and often also in the dry lesions as well.It is important to prevent bacterial growth or yeast infections in the skin lesions. This may be done by frequent bathing in warm water to which one-half cup of vinegar has been added to a baby's bathtub of water, and equivalent quantities for adult eczema. If showers are preferred, pour a quart of water over the skin after the shower to which has been added four tablespoons of vinegar.

Avoid overexposure to water if the eczema is dry, but weeping eczema can be dried by the use of wet dressings or frequent warm baths, every one to three hours. The old motto "If it is dry, wet it; and if it is wet, dry it" applies very nicely to eczema. Oil should be applied to dry lesions.

Avoid all cosmetics, lotions, scented soaps, and perfumes. Use bland coconut soap for cleansing the skin of face, hands, feet, groin, and underarms. The remainder of the body is cleansed with water and a clean wash cloth.

Flare-ups of eczema can be stopped by using a fever treatment. See the book Home Remedies by Agatha M. Thrash, M.D. for instructions on how to give the treatment.

Cotton or silk clothing should be worn next to the skin, and synthetic fabrics should be avoided. Nylon and wool should be avoided next to the skin if one has the slightest tendency to sweat or to be sensitive to these fabrics. Suede can also be irritating, and elastic in clothing is always suspect as a cause of rashes. Dyed clothing may cause eczema, and all new clothing should be washed thoroughly and rinsed an additional cycle before touching the person struggling with eczema, particularly a child. Bed linens should be soft and laundered without detergents.

Costume jewelry containing nickel sulfate is prominent in the cause of allergies.

The next most important thing is to avoid scratching. While scratching does not cause the disease, it keeps it going. For children, they must wear gloves covered by mittens or socks, and if necessary the hands must be tied with restraints during the night to prevent scratching the lesions during sleep. Trim the fingernails right down to the quick to avoid daytime scratching. Rubbing across the skin lines must be avoided, and the application of any kind of medication must be done in the same direction as the skin lines to avoid opening them up and causing microscopic cracks.

Keep the skin temperature warm at all times, as chilled skin does not heal readily. The extremities must be scrupulously warm at all times, both winter and summer, to promote the best of health. This is more important than it would seem to be. The metabolism and the skin's healing mechanisms are impaired by chilling.

If all else fails to control itching, a brief hot bath lasting two to four minutes will almost always control itching for several hours.

Sunlight will benefit some people with eczema, but in some it causes the condition to get worse.

Maintain excellent bowel habits by the use of much fiber and strict adherence to all dietary principles.

Vigorous exercise is important. For a healthy young person, the equivalent of walking three miles daily is minimal.‍

Case Report 1

‍We had a patient who came to Uchee Pines Institute with severe eczema which he had had most of his life. He was a Black man, 17 years old, had just graduated from high school, but because of his eczema, which gave him an unsightly whitish flaking of the skin, he withdrew from social contact and remained indoors with the plan never to leave the house again. He was a heavy user of dairy products, was not very careful with his diet, and he was overweight. After coming to the Institute, we started the warm charcoal bath remedy by putting 1/2 - 1 cup of charcoal powder in a tub of lukewarm water. He soaked in this once or twice daily for an hour or two, finishing with a tepid shower (no soap!). Within three weeks, his eczema had cleared completely for the first time since he was two years old. He has remained symptom free since then.‍

Case Report 2

‍We had a young patient, age 14, with a severely swollen, red, scaling eczema on her left nipple and the surrounding pigmented area measuring approximately three inches in diameter. She had had the eczema for over two years and had gone to three different dermatologists and had faithfully taken every medicine that had been recommended. The eczema was as bad or worse than when she saw the first dermatologist. We prescribed for her bee propolis dissolved in Eucerin cream; as much as she could dissolve and still have it creamy so that she could easily rub it on. This was to be applied two or three times daily. She was instructed never to scratch the area, not even through her clothing. Additionally she was given an "Elimination and Challenge Diet" that was salt-restricted and fat restricted (no free fats added). She was prescribed a totally vegan vegetarian diet with an emphasis on fruits and vegetables, except for those restricted in the "Elimination and Challenge Diet." Within a month, her eczema was markedly improved, and by six weeks she had no rash left.