Eczema

Eczema is an allergic reaction shown in the skin. It consists mainly of itchy, inflamed patches on the face, elbows, knees, and wrists. Eczema is most commonly found in infants and young children. Eczema is closely associated with asthma and hayfever. All together, they are called "atopy." Atopy tends to run in families.

Medical treatment for eczema consists mainly of topical steroid creams.

Treatment

Principal Proposed Treatments for Eczema:

Evening primrose oil, a source of the essential fatty acid GLA (gamma-linolenic acid) is widely used in Europe for eczema; however, the evidence that it really works is mixed, and more recent studies have not found it to be effective. However, treatment with friendly bacteria (probiotics) may be beneficial for both treatment and prevention. Avoiding cows milk may help as well.

Evening Primrose Oil/GLA (Treatment of Eczema)

A review of all studies reported up to 1989 found that evening primrose oil frequently reduced the symptoms of eczema after several months of use, with the greatest improvement noticeable in the level of itching. However, this review has been sharply criticized for including poorly designed studies and possibly misinterpreting study results.

A recent, properly designed, double-blind study that followed 58 children with eczema for 16 weeks found no difference between the treated and placebo groups. A 24-week double-blind study of 160 adults with eczema, who were given either placebo or GLA from borage oil, also found no benefit. In addition, negative results were also seen in a 16-week double-blind placebo-controlled study of 102 individuals with eczema. Another double-blind trial followed 39 people with hand dermatitis for 24 weeks. Evening primrose oil at a dosage of 6 g daily produced no significant improvement as compared to the placebo.

One recent double-blind trial did find a therapeutic benefit with evening primrose oil, but not for itching.

This information is a bit confusing, and at the present time it isnt clear whether evening primrose oil is effective for treating eczema.

For more information, including dosage and safety issues, see the full GLA article.

Avoiding Cows Milk

While the cause of eczema is not known, early exposure of the infant to allergenic substances found in infant formula may play a role. Breast-feeding might, therefore, help prevent eczema.

A recent large study lends credence to this theory. More than 17,000 women in the republic of Belarus were enrolled. About half were entered in a program that encouraged them to breast-feed (the "intervention group"), while the other half were enrolled in a different program that did not instigate any particular method of infant feeding (the "control group").

The results showed that women encouraged to breast-feed were much more likely to do so than other women. Furthermore, children of women in the intervention group showed almost a 50% reduction in the incidence of eczema.

Interpreting this study is trickier than it might appear. Technically, it does not prove that breast-feeding reduces risk of eczema. Rather, it shows that counseling to breast-feed reduces risk of eczema. However, the implication is fairly compelling: if you breast-feed your child, he or she is less likely to develop eczema.

If you do breast-feed, you might be able to further reduce risk of eczema (and atopy in general) by eating less saturated fat (animal fat).

Another option might be to use special infant formulas that are based on purified amino acids.

Probiotics

Probiotics are health-promoting bacteria. The most famous probiotic is Lactobacillus acidophilus, used to make yogurt.

Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema. In a double-blind placebo-controlled trial that enrolled 159 women, participants received either placebo or Lactobacillus GG capsules beginning 2 to 4 weeks before expected delivery. After delivery, breast-feeding mothers continued to take placebo or the probiotic for 6 months; formula-fed infants were given placebo or probiotic directly for the same period of time. The results showed that use of Lactobacillus GG reduced childrens risk of developing eczema by approximately 50%.

Small double-blind trials have also found evidence that use of probiotics (Bifidobacterium lactis, Lactobacillus GG) may help treat existing eczema.

Topical Herbal Creams

Topical creams made from chamomile, licorice, or calendula, alone or in combination, are widely used in Europe to treat eczema. One double-blind study of 161 individuals found chamomile cream equally effective as 0.25% hydrocortisone cream for the treatment of eczema. However, the report didnt state whether doctors or patients were blinded as to which treatment was which, so it isnt clear how reliable the results may be.

Another double-blind placebo-controlled trial by the same authors, involving 72 individuals with eczema, found somewhat odd results: In this trial, chamomile was not significantly more effective than placebo, but both were better than 0.5% hydrocortisone cream. It is difficult to interpret what these results actually mean, but they certainly cannot be taken as proof that chamomile cream is effective.

Other Proposed Treatments for Eczema:

The herbs burdock, red clover, and Coleus forskohliiand the supplements quercetin and zinc have also been recommended for eczema, but there is as yet little evidence that they really work.

In some individuals, eczema may be related to food allergies or sensitivities.

A small 30-day double-blind trial failed to find vitamin B6 at a dose of 50 mg daily helpful for eczema.

Similarly, an 8-week double-blind trial of zinc at the high dose of 67 mg daily failed to find any beneft for eczema symptoms.