Eczema refers to a category of persistent skin inflammation that is characterised by red, itchy patches often accompanied by weeping, blistering and bleeding if scratched. As a form of dermatitis (inflammation of the epidermis/skin), eczema is a broad term for a whole range of various skin conditions. The common denominator in all of these problems is that they are all consistent in the patient with symptoms like oedema/swelling, dryness, itching, crusting, oozing, and blistering. Infantile eczema, for example, is a common case called atopic eczema, which is a skin disease, revolving around allergens. Believed to be hereditary, infantile eczema is often transmitted to babies through families who have a history of asthma and hay fever. Usually associated with red blotchy rashes on sensitive areas such as the head, neck, bottom, and inside the joints like between the fingers, toes, under the knees, and inside the elbows, eczema can occur anywhere on the skin.

Typically, eczema can be worsened by exposure to specific environmental factors like dust, heat and sunlight, although this differs from person to person. Sweat is also a common aggravating factor.

In mild cases, eczema is nothing more than a slightly irritating patch of sore skin, but in severe cases extensive areas of skin may become inflamed and unbearably itchy. Some people with these symptoms develop problems such as depression with low self-esteem, and have difficulty coping at school or work. People with eczema are also more prone to herpes, skin fungal and wart infections.

Up to half of all babies with widespread atopic eczema will later develop asthma and rhinitis as the eczema improves. This phenomenon is referred to as the 'allergic march'.

Types of Common Eczemas

• Atopic Eczema  (aka infantile e., flexural e., atopic dermatitis) is an allergic disease believed to have a hereditary component, and often runs in families whose members also have hay fever and asthma. Itchy rash is particularly noticeable on head and scalp, neck, inside of elbows, behind knees, and buttocks. Experts are urging doctors to be more vigilant in weeding out cases that are, in actuality, irritant contact dermatitis. It is very common in developed countries, and rising.
• Contact dermatitis is of two types: allergic (resulting from a delayed reaction to some allergen, such as poison ivy or nickel), and irritant (resulting from direct reaction to a detergent, such as sodium lauryl sulphate, for example). Some substances act both as allergen and irritant (wet cement, for example). Other substances cause a problem after sunlight exposure, bringing on phototoxic dermatitis. About three quarters of cases of contact eczema are of the irritant type, which is the most common occupational skin disease. Contact eczema is curable provided the offending substance can be avoided, and its traces removed from one’s environment.  It is often associated with asthma, hayfever or allergic rhinitis.
• Xerotic eczema (aka asteatotic e., e. craquele or craquelatum, winter itch, pruritus hiemalis) is dry skin that becomes so serious it turns into eczema. It worsens in dry winter weather, and limbs and trunk are most often affected. The itchy, tender skin resembles a dry, cracked, riverbed. This disorder is very common among the older population. Ichthyosis is a related disorder.
• Seborrhoeic dermatitis or Seborrheic dermatitis ("cradle cap" in infants) is a condition sometimes classified as a form of eczema, which is closely related to dandruff. It causes dry flakiness and itching or greasy peeling of the scalp, eyebrows, and face, and sometimes trunk. The condition is harmless except in severe cases of cradle cap. In newborns it causes a thick, yellow crusty scalp rash called cradle cap, which seems related to lack of biotin, and is often curable. It seems to be inherited and not associated with any allergy.

 Less Common Eczemas

• Dyshidrosis (aka dyshidrotic e., pompholyx, vesicular palmoplantar dermatitis, housewife’s eczema) only occurs on palms, soles, and sides of fingers and toes. Tiny opaque bumps called vesicles, thickening, and cracks are accompanied by itchy, weeping blisters on palms of hands and soles of feet, which often gets worse at night. A common type of hand eczema, it worsens in warm weather.  It is thought to be due to stress or poor diet.  It usually clears of its own accord after 2-3 weeks.
• Discoid eczema (aka nummular e., exudative e., microbial e.) is characterized by round spots of oozing or dry rash, with clear boundaries, often on arms and lower legs. It is usually worse in winter. Cause is unknown, and the condition tends to come and go.
• Venous eczema (aka gravitational e., stasis dermatitis, varicose e.) occurs in people with impaired circulation, varicose veins and oedema, and is particularly common in the ankle area of people over 50. There is redness, scaling, darkening of the skin and itching. The disorder predisposes to leg ulcers.
• Dermatitis herpetiformis (aka Duhring’s Disease) causes intensely itchy and typically symmetrical rash on arms, thighs, knees, and back. It is directly related to celiac disease and can often be put into remission with appropriate diet.
• Neurodermatitis (aka lichen simplex chronicus, localized scratch dermatitis) is an itchy area of thickened, pigmented eczema patch that results from habitual rubbing and scratching. Usually there is only one spot. Often curable through behaviour modification and anti-inflammatory medication. Prurigo nodularis is a related disorder showing multiple lumps.
• Autoeczematization (aka id reaction, autosensitization) is an eczematous reaction to an infection with parasites, fungi, bacteria or viruses. It is completely curable with the clearance of the original infection that caused it. The appearance varies depending on the cause. It always occurs some distance away from the original infection.
• There are also eczemas overlaid by viral infections (e. herpeticum, e. vaccinatum), and eczemas resulting from underlying disease (e.g. lymphoma). Eczemas originating from ingestion of medications, foods, and chemicals, have not yet been clearly systematized. Other rare eczematous disorders exist in addition to those listed here.

 Eczema usually occurs for the first time in infants, with rashes typically occurring on the cheeks, elbows or knees. Eczema, although often less of a problem in adulthood, can persist, especially if a person is exposed to allergens or chemical irritants or is under stress. In adults, eczema is commonly located on the inner elbow or behind the knee.

People with eczema frequently have family members with asthma, hay fever, or eczema.

Treatment Approach

The orthodox approach to eczema is to prescribe steroid ointment to relieve inflammation, and if necessary antihistamines and antibiotics to control itching and infection; to discover the allergens involved in contact eczema, a patch test may be necessary.  However steroid preparations should be avoided unless eczema is so bad that it is causing miserable sleepless nights, which in turn are causing stress and aggravating the eczema.

The homeopathic treatment of eczema consists first of a full consultation in which the patient will be listened to for any clues that may indicate to the homeopath a suitable treatment approach.  The patient will be questioned about all the various aspects of his/her health and well being.  I will use a sample of hair or a small spot of blood to run a BioScan, which will accurately and precisely ascertain and determine the exact underlying cause/s of the condition.  In my experience there is often an underlying toxic state, which has to be cleared.  We should not forget that the skin is an organ of detoxification and when the system is overburdened with toxins the skin can become overwhelmed with the effort of trying to eliminate the unwanted toxic burdens.  I always test for these in cases of eczema.

A useful Chinese Herbal formulation comprises of the extracts of five raw herbs that have been used in Chinese medicine for thousands of years. The concoction contains Japanese honeysuckle (otherwise known as Flos lonicerae), Peppermint (known as Herba menthae), Peony tree root bark (Cortex moutan), the underground stem of the Atractylodes herb and the bark of the Amur cork tree.

Chinese Herbal Remedies have been found to reduce the need for topical steroidal creams and also have a beneficial clinical effect on the immune system. People who suffer with eczema typically have higher levels of cytokines in the blood. These cytokines play an important role in the immune system which can trigger eczema inflammation. The Chinese herbal capsules reduced the effect that cytokines have on the inflammatory reactions that are linked to eczema.

Further testament to Chinese Herbal Medicine's effects on skin conditions in children were discovered at Great Ormond Street Hospital and for adults at the Royal Free Hospital, Hampstead. The trials were funded by the National Eczema Society and some patients with eczema responded dramatically with prescribed Chinese Herbal Medicine after failing with conventional treatments.

Nutrition too is all-important.  I always test for nutritional deficiencies and can stimulate the system to correct these by using homeopathic potencies of vitamins and minerals.  This is quite a unique aspect of my practice.  I also test which supplement combinations the patient should be taking for optimum health because I find there is, in every case, a nutritional imbalance (mainly a deficiency of the omega 3 oils, which are found in abundance in marine phytoplankton and flaxseed oil). 

Certain types of fat-metabolism malfunctions are more often found in patients suffering from eczema and psoriasis than in the rest of the population. 

Self Help

Always remember to protect your skin from known irritants - whether natural or man made chemicals; wear gloves when appropriate for example.  Always dry hands thoroughly after washing, and use a calendula cream as a moisturiser.  

If you can obtain a good quality vitamin supplement you could try taking extra Vitamins B and C, and also zinc.  You may try taking a teaspoon of flaxseed oil twice daily with food.  Safflower oil capsules can also help.