Eczema

Eczema is a non-contagious inflammatory skin reaction. These are symptoms that can appear next to or after each other, such as redness, scales, itching, blisters, pustules, scabs, coarsening of the skin (lichenification).

Eczema often refers to atopic eczema. There is a link between people with atopic eczema, asthma and allergic rhinitis. About 50% of patients with severe atopic eczema will develop asthma and 75% will develop allergic rhinitis.

Atopic eczema occurs in 15-30% in children and 2-10% in adults. About 60% of cases develop in the first year of life. Eczema is more common in rural than in urban areas.

There are two types of eczema that are most common.

Atopic eczema, is present at birth. The cause is a combination of genetic predisposition, irritation, allergy and inflammation. Genetically there is a shortage of, among other things, filaggrin protein, which is located in the top layer of skin. A deficiency of filaggrin is caused by a genetic mutation that occurs in 8 to 10 percent of the population. The skin of these people does not retain moisture in the skin well, which leads to eczema. When the skin lacks this protein, its ability to protect against environmental influences is reduced. It can be triggered by cold weather, infections, dry air, irritating skin products, and stress.

Irritant eczema, is caused by continuous or prolonged exposure of the skin to an irritating substance. This can be a solid (for example a piece of clothing), a liquid (for example shower gel or hot water) or a gas (for example smoke and soot). The eczema develops in places where the skin is exposed to the substance. Irritant hand eczema is the most common form.

Other eczema forms:

Contact eczema, occurs in people from 6 years old and known to have eczema or from 40 years old without a history of eczema. There is a relationship between contact with a certain substance and eczema. It sits always at the place where the substance comes into contact with the skin. Examples are nickel, fabrics in shoes, clothing, cosmetics, cleaning products.

Dry skin eczema (asteatotic dermatitis), caused by excessively dry skin. Most often occurs on the forearms and lower legs.

Coin-shaped eczema, coin-forming eczema on the extensor sides of arms and legs, it also occurs on the trunk.

Seborrhoeic eczema, occurs after the 12th year of life with an increase in sebum. The cause of this eczema lies in the sebum composition. This sebum gives rise to an inflammatory reaction of the skin, in which certain skin yeasts also play a role.

Hypostatic eczema, caused by varicose veins in the legs. In addition to eczema, there is fluid in the legs and varicose veins.

Perioral dermatitis is a rash most commonly seen in women between the ages of 16 and 45. But children between the ages of 7 months and 13 years are not spared either. The skin condition consists of small inflammatory papules and pimples and/or red/pink scaly areas around the mouth or eyes. More about dermatitis perioralis

Swimmer’s eczema is not actually eczema but a fungal infection between the toes and the side of the feet.

The major difference between dry skin and eczema is the presence of inflammation (inflammation). In eczema, the skin barrier does not work properly, which leads to moisture loss from the skin and disturbances in the top layer of skin (epidermis). If your skin is red, itchy, and flaky, it’s probably more than just dry skin and you probably have eczema.

Another important clue between eczema and dry skin is that eczema gets worse if not treated properly. It can then lead to other complaints such as tears, cracks, skin thickening and intense itching. People with eczema are also more prone to skin infections due to a disrupted skin barrier.

If areas such as elbow creases, knee hollows are also affected. So red, scaly and itchy then chances are it is eczema.

If you notice that there is a relationship between contact with certain substances and a skin rash, there is a good chance that it is eczema. The eczema patches are always located where the substance comes into contact with the skin.

People who suffer from eczema know that skin sensitivity and inflammation can lead to discomfort and frustration. Fortunately, certain supplements and nutrients can make a difference in managing the symptoms of eczema. Here are some essential nutrients and supplements for eczema sufferers to consider:

Omega-3 Fatty Acids: These fatty acids, commonly found in fish oil, have anti-inflammatory properties that can reduce the inflammation and redness of the skin associated with eczema. In addition, they contribute to strengthening the skin barrier, which is essential for managing eczema.

1. Quality of the supplement: Choose a high-quality omega-3 supplement from a reliable manufacturer. Verify that the supplement has been independently tested for purity, potency, and absence of contaminants such as heavy metals and PCBs.

2. Type of omega-3 fatty acids: Omega-3 fatty acids are divided into EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). Look at the ratios of these two fatty acids in the supplement. While both are important, they may have different health benefits.

3. Source of Omega-3: Omega-3 supplements can come from fish oil, algae oil or other sources. If you follow a vegetarian or vegan diet, algae oil is a suitable option because it is plant-based and rich in DHA.

   There are several natural food sources of omega-3 fatty acids, varying depending on the type you’re looking for. These fatty acids exist in three major forms: alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA).

   ALA, a plant-based omega-3 fatty acid, is mainly present in foods such as flaxseed, flaxseed oil, walnuts, walnut oil, rapeseed oil, soybeans and pumpkin seeds. Your body can partially convert ALA to EPA and DHA, but this process is not very efficient.

   EPA and DHA are animal omega-3 fatty acids that are mainly found in oily fish such as salmon, herring, mackerel, sardines and eel, as well as in shellfish such as oysters, mussels, shrimps and prawns.

Probiotics: Improving the intestinal flora with probiotics can lead to a reduction of inflammatory reactions in the body, which can indirectly help reduce the symptoms of eczema. A healthy gut balance is vital for healthy skin.

There are several probiotic gut bacteria that may be beneficial in treating eczema.

1. Lactobacillus rhamnosus GG: Some studies have shown that it may help reduce the severity of eczema symptoms in children and prevent recurrent flare-ups. However, a meta-analysis published in 2018 showed that LGG was not effective in reducing eczema.
2. Bifidobacterium lactis: This strain has anti-inflammatory properties and may contribute to a healthy gut microbiome. It may help reduce inflammation and strengthen the skin barrier, which may be indirectly beneficial in the treatment of eczema. However, there is no direct evidence that this strain can cure eczema.
3. Lactobacillus casei: This strain has immunomodulatory properties, meaning it can regulate the immune system. It can help reduce the inflammatory reactions that cause eczema.
4. Lactobacillus plantarum: This strain has shown anti-allergenic properties in mice and may help reduce allergic reactions that can exacerbate eczema.

More on Importance of a healthy gut microbiome

Vitamin D: There is more evidence that vitamin D may help reduce eczema symptoms. Studies suggest an inverse relationship between vitamin D levels and eczema severity in adults. Adequate levels of vitamin D can therefore have a positive impact on skin health.

An exciting study from 2019 examined the links between eczema and vitamin D in both white and dark-skinned people.

The risk of eczema was found to be highest around 45 nmol/L of vitamin D in the blood, and this risk decreased as the value was both higher and lower. Interestingly, this correlation was not observed in people from non-Hispanic black backgrounds.

This suggests a relationship between vitamin D levels in the body and the risk of eczema. At a vitamin D level of about 45 nmol/L, the risk of eczema was highest. If vitamin D levels were higher or lower than this level, the risk of eczema decreased. However, it is interesting to note that this relationship was not observed in the non-Hispanic black population, which may indicate that other factors influence eczema risk within this group.

Vitamin E: Is a powerful antioxidant, has the potential to reduce inflammation and help repair the skin. It is a valuable part of eczema management because it can support the skin in the recovery process.

The recommended dosage of vitamin E can vary, but usually a daily dose of about 15 to 30 milligrams is recommended. The maximum upper limit vitamin E per day is 300 milligrams.

As for the form of vitamin E, the most common forms are alpha-tocopherol and gamma-tocopherol. Alpha-tocopherol is the most common and best-studied form of vitamin E.

When choosing vitamin E keep in mind:

Natural vitamin E: Natural form is obtained from natural sources, such as vegetable oils, and is referred to as d-alpha-tocopherol, d-alpha-tocopherol acetate or d-alpha-tocopheryl succinate. It exists in eight different forms, including alpha, beta, gamma and delta tocopherols and tocotrienols. The most biologically active form of vitamin E is alpha-tocopherol, the preferred form of vitamin E that is better absorbed and utilized by the body.

Synthetic vitamin E: Synthetic form is chemically recognized as dl-alpha-tocopherol or another variation beginning with dl. It is produced from petrochemicals and is referred to as dl-alpha-tocopherol. Synthetic vitamin E is more suitable as an antioxidant in oils used in products.

Natural vs. synthetic vitamin E: Natural vitamin E is considered superior to synthetic vitamin E because it matches what the body expects and is better absorbed and utilized than its synthetic counterpart. Research on vitamin E has shown that the body retains natural vitamin E in tissues longer than the synthetic form, and natural vitamin E is twice as effective as the synthetic form. Natural vitamin E is also more bioavailable to the body.

Zinc and don’t forget copper: Is important for skin health and helps repair and protect the skin from infections. It also helps maintain a healthy skin barrier, which is especially important for people with eczema, as a strong skin barrier helps reduce irritation and inflammation. Copper is also essential for the skin because it contributes to the production of collagen and elastin. A balanced ratio of zinc to copper is recommended for optimal absorption and balance.

The recommended ratio of zinc to copper varies in different sources. Some sources suggest an 8:1 ratio (zinc to copper), while others recommend a 10:1 ratio (zinc to copper). The ideal ratio may also depend on individual needs and health conditions.

Zinc and copper can interact with each other, and high doses of zinc can lead to copper deficiency. Therefore, it is important to maintain a balanced ratio of zinc and copper and not exceed the recommended doses.

The basic steps of eczema care are:

1. Calming inflammatory reaction of the skin
2. Improve skin hydration simultaneously for soft and supple skin
3. Maintaining the skin optimally, just like brushing your teeth, skin care is also part of the routine

For the active eczema spots themselves, in addition to a basic cream, a medicinal ointment is also required. First choice are the dermatocorticosteroids, also called ‘hormone ointment. Dermatocorticosteroids come in four different strengths and can be used safely.
Another possibility is pimecrolimus (Elidel) cream and tacrolimus ointment (Protopic). These are hormone-free ointments that can inhibit mild to moderate eczema. These remedies are not powerful enough to treat severe eczema. And they can cause burning and itching at the beginning. These symptoms disappear the longer you lubricate.

A basic skin care cream or ointment is necessary against dry skin, even on skin where no eczema is present. When the eczema is calm, it is important to continue to care for the skin. Various studies show that eczema stays away longer with good skin care. More on lotion, cream and ointment what are the differences?