Benefits and Drawbacks of Eczema Topicals

If you suffer from eczema then you know what a struggle it can be to find the right topical support for relief. I  say “support” instead of “remedy” because when we’re treating our skin topically, it’s going to be supportive rather than curative, which remedy implies.

So, where do you even begin??

With the enormous amount of treatments out there, it can be daunting to find the one that’s right for you. You almost have to treat it like a process of elimination to see what works with your particular brand of eczema.

For the most part, I’m a middle of the road person when it comes to medications, natural remedies, and OTC’s. I don’t believe there’s one best way or best system. If you’ve got asthma, you’re probably going to need an inhaler until you actually get the underlying inflammatory process under control.

There’s nothing worse than when you’re in the middle of an eczema flare. Your skin is an itchy oozy mess, you feel horrible, and all you need is something to help calm it down.

So let’s talk about what you can put on your skin to help tame the flame and itch!

Prescription Medications

Steroids.Topical steroids are very common when it comes to treating an eczema flare. They work by reducing inflammation which calms the itch and gives your skin a chance to heal. Like over-the-counter (OTC) cortisone, prescription steroids work similarly to the anti-inflammatory hormone cortisol made in your body, but they’re much stronger.

As a general rule of thumb, it’s best to start with a lower potency in short bursts and then stop once the flare settles.

While I think steroids can be helpful in the short-term, I’m not in favor of long-term use. They can have detrimental effects such as thinning of the skin, acne or stretch marks. It basically decreases the integrity of the skin which is the exact opposite of what we’re trying to achieve when treating with eczema.

In some rare cases, steroids can induce other skin conditions like rosacea. The last thing we want to do is add another inflammatory skin issue to the one we’re already dealing with.

In addition to these side effects, there’s also a skin condition associated with excessive topical steroid use called Topical Steroid Withdrawal (TSW). The symptoms are actually similar to eczema– dry, itchy, red, burning skin in mild cases and oozing, bleeding skin in the its more severe form.

Eucrisa. Similar to steroids, Eucrisa alters the body’s natural inflammatory process that triggers eczema symptoms. The main ingredient, crisaborole, is combined with an emollient-rich ointment that helps keep the skin moisturized.

But like most prescription medications, you run into possible side effects. The more common ones include burning or stinging when the medicine is applied.

Here’s the thing with prescription medications– they’re often designed to shut down biochemical pathways by blocking enzymes, so they basically turn off your natural processes. This alters your biochemistry causing shifts in the inflammatory processes and the immune system.

In the case of Eucrisa, it blocks the enzyme PDE4 (phosphodiesterase-4) which shuts off certain inflammatory signals, effectively decreasing or stopping the process.

The goal is to give the skin more support and heal it, rather than shut off biochemical pathways. Not to mentioned the many underlying causes that aren’t addressed when the inflammatory process (read: body’s danger signal) is artificially blocked.

Like I said, I’m a middle-of-the-roader when it comes to prescription topicals. I think they have their place, but not when it comes to finding a long-term solution. It’s important to get to the root cause of why you have certain things going on in your body.

OTC Medications

Most practitioners can’t speak with insider knowledge of the over-the-counter lotions and potions- but I can because one of my first jobs out of undergrad was in the formulation department for a very well-known personal care and paper products company (yes, it was a long and winding road for me to get here!!).

My job was on the microbiology and chemistry side, so I got to experience firsthand what types of chemicals were used and the effects they can have. This was one of the many things that actually drove me to wanting to go more natural!

Even though I’ve seen the negative side of OTC’s, I do think they have their place when it comes to finding immediate relief.

Hydrocortisone cream. Cortisone creams relieve eczema bouts the same way most prescription topicals do. Synthetic cortisone mimics the actions of cortisol, your main anti-inflammatory hormone, but is more pronounced. It works by suppressing the inflammatory signals that get triggered and block the symptoms caused by inflammation.

Helpful in the short term? Possibly, yes.

Long term solution? NO.

Benadryl cream. Antihistamines such as Benadryl (diphenhydramine) cream are very common when it comes to soothing the itch that comes with eczema. They’re generally used to treat allergies by blocking the effects of histamine– an immune system protein and signaling chemical. The body can mistake things like pollen as a harmful substance in the body and then releases histamine to fight it off. This is what causes the itchy eyes and runny nose. Even though eczema isn’t an allergy, antihistamines do have a sedating and anti-inflammatory response that helps relieve itching.

The downside to OTC medications is that they just work as a band-aid instead of solving the actual problem. They’re very accessible and inexpensive so it’s easy to become reliant on them rather than find a solution to the root cause.

Conventional Topicals

Eucerin. This is a well known brand that creates creams and lotions specifically for dry skin and eczema. Eucerin contains emollients which promote moisture and increases the skin’s capacity to hold onto water. Keeping the skin moisturized can provide some itching relief and give it a chance to heal.

Cetaphil. Cetaphil is another brand that has a line of lotions made primarily to help treat eczema. Their eczema specific moisturizer has an active ingredient called filaggrin which is an essential protein for skin hydration and barrier function. Many people with eczema have mutations in the filaggrin gene which is why they are prone to eczema, rashes and general skin irritation.

Petroleum jelly/Vaseline. Petroleum jelly is a topical that dermatologists recommend frequently because people with sensitive skin can generally tolerate it. It locks in moisture and protects against outside allergens. It’s a highly process petrochemical that many sensitive people react to, not to mention the environmental impact.

Most conventional topicals are going to provide some support and dampening of the inflammatory feeling on the skin. The downside is that most of them contain synthetic ingredients like sodium dodecyl sulfate (SLS), isopropyl palmitate, parabens, and preservatives to name a few. These chemicals are known toxins or irritants so it’s important to remember that anything you put on the skin will get absorbed into the body.

Some of these chemicals are also endocrine disruptors which is something you don’t want to mess with. They are stored in fat cells and alter normal hormone biochemistry, especially estrogens and estrogen hormone pathways.

Natural Topicals

The last area I wanted to touch on are the natural remedies. And as always, you have to find what works for you.

I’ve tried so many over the years I’ve lost count. We hear the same thing from our patients as well.

I always kid around when we have the, “what have you tried?” conversation because most of us have a lotions and potions graveyard. You know… the drawer where all of your partially used topicals go to die!!

Herbal Treatments. Moon Valley Organics has EczaCalm and Herbal Heal. I use both of these depending upon my needs. I’ve been using Herbal Heal over EczaCalm because lately I feel like that’s been working really well for me. Both of these have about 12 different ingredients made with organic carrier and essential oils, as well as many herbs that are anti-inflammatory.

They both contain calendula which is known in the herbal world to be very nourishing to the skin. It’s a pretty awesome ingredient because there are no known side effects, it’s incredibly healing, and it can be used across all age ranges. You’ll see it in some of the more natural baby diaper creams— Bottom Balms, for example. It really can be used in a wide array of applications.

You can also make up your own. I talk about it more in this post.

Essential Oils. Lavender, frankincense, myrrh (we’re getting a little Christmas-y)—and tea tree oil are all very soothing for eczema.

The beauty of using EO’s is that they have multiple avenues of how they’re helping. Some of the most common mechanisms of action are antimicrobial, anti-inflammatory, calming, analgesic (pain eliminating), and skin supporting. You’re going to get a little more bang for your buck with the cross-functional types of support they provide.

Frankincense, also known as boswellia, is my FAVORITE! It’s a potent anti-inflammatory that has lots of research behind it. It’s also a great immune booster, stress reducer, and healing to the skin. It’s steroid-like structure is thought to be one of the reasons it’s so effective. I use it topically, aerosolized in a diffuser, and internally for treating all types of inflammatory conditions, not just eczema. Frankincense is literally the Swiss Army knife of the anti-inflammatory world!

Lavender is calming, sedating, and has some inflammation relieving properties. It’s also well tolerated by most people, including children and babies. A little at bath time (for kids and adults) helps soothe the skin and the mind.

Myrrh is another cross-functional heavy hitter like Frankincense. It has all of the “anti’s”… antioxidant, anti-inflammatory, and antimicrobial to bacteria, parasites, and fungi (like Candida). A bonus is that it has anti-cancer properties as well. Historically it has been used to heal wounds and cracked/chapped skin.

Tea tree oil, like Frankincense and Myrrh, has many beneficial properties, but it’s broad spectrum antimicrobial actions are what make it famous. It’s active against a wide array of microorganisms (bacteria, yeast, other fungi, parasites, and viruses) making it a very useful tool. Staphylococcus aureus and yeast based infections such as Candida, jock itch or ringworm (yes, it’s a fungus- not a worm) are sometimes implicated in eczema, and research shows tea tree oil to be effective against them.

Please note that sometimes, especially when used in excess, essential oils can be irritating to the skin. I always tell people to be very careful when they’re first starting to work with them. If you’re making a batch of something yourself or adding them to a bath, start off with just a couple of drops to see how your skin responds.

Organic Healing Balm. Dr. Bronner’s has an Baby Unscented Organic Magic Balm. I use this on my kids for everything. I sometimes use it on my eczema- it just depends on the severity of the itch.

A lot of people with eczema like Bronner’s, but some people find it a little bit irritating. I’d say stay away from the peppermint one and stick with the unscented balm.

All Good’s Goop is another good option. It has lots of herbs, olive oil, and coconut oil to soothe the skin.

Cleansing Oil. Another company that I really like is FatCo. I use their products myself and have heard from a lot of my clients that they love their facial cleansing oil. I’m an advocate of using oils because they don’t strip the skin like detergents found in other products.

They also have this myrrhaculous face cream. It has myrrh and tallow which are the main components in their lotions and creams. It’s highly supportive and nutritive to the skin. Speaking subjectively from my own experience (and the experience of a lot of the people that I work with that have used this), it’s just really supporting and nourishing to the skin.

Sea Salt Spray. This is something you can easily make yourself with some water and some sea salt at home. A lot of people who have eczema benefit from going into the ocean and salt water. Dead sea salt works really well because it’s packed with minerals that help balance the pH in your skin.

Kamedis. Kamedis has a complete eczema line from washes to lotions. I learned about this from patients that raved about it. They have created plant-based treatments for eczema that combine botanical extracts with OTC ingredients.

Theramu. Theramu is another one of my favorites. They’re also all-natural and use a combination of CBD  and emu oil which provides bioavailability so it works where your skin needs it most. Both the CBD oil and emu oil are soothing so it’s one of the go-to’s in our clinic as a first line therapy to try out.

Summary

With a condition that is so highly individualized, you have to play around and find what works for you. Some topicals will work better than others and some will work for a short period of time.

While that can be frustrating, the great news is that true healing can be accomplished and you can banish the topicals forever!

The goal is to always get to the root cause of what’s going on, but if you’re in a really bad state, topicals can be the way to go to find immediate relief. And that’s okay! You can always transition and switch off of them as you work on your underlying causes.

Which topicals have worked for you? We’d love to hear!

9 Healing Baths to Calm the Eczema Itch

Finding Relief From The Outside-In

If you’ve ever suffered from an eczema flare, then you’re probably familiar with the burning, itching, crawling sensation on your skin. And, you know how horrible it is!!

Your immediate instinct is to calm what’s happening on the outside… you just want to stop the scratching and bleeding and oozing.

In functional medicine, the goal is always to address the root causes and heal from the inside-out.

But when it comes to eczema… I know you need to have some relief on the outside first so that you can focus on the actual underlying causes— not just the symptoms.

What I’ve seen with skin issues, especially eczema, is that there’s no one-size-fits-all remedy.

Something that really irks me is when you go to message boards and people are like, “Oh, (insert favorite remedy) is my miracle cure….” or “I use dead sea salt baths” or “I use coconut oil” or “I use apple cider vinegar.” Don’t get me wrong, these things are all helpful, but everybody is so highly individualized that it’s hard to say any one thing will work across the board.

Eczema is more specific to the individual than any other condition we treat in our clinic, so we encourage people not to get caught up in other people’s hype. Do the work to heal inside, but in the meantime you can find ways to help soothe the rash.

9 Healing Bath Options

Something I’ve used myself, and have gotten back feedback from patients and colleagues alike is on the benefit of a healing bath. There are lots of different things you can put into a bath, but these are my top 9:

  1. Magnesium sulfate/Epsom salt. These minerals can be very soothing for an eczema flare for a couple of reasons. Epsom salt helps decrease inflammation which can reduce the swelling of lesions and calm itching. It also has antimicrobial properties keeping your skin free of bacteria.
  2. Dead Sea Salts. I’ve gotten a lot of positive feedback about this one which is in the mineral category. Dead Sea Salts aid in hydrating dry skin and can provide some itching relief with it’s anti-inflammatory properties. And more than Epsom salt, it’s packed with lots of minerals that help balance pH.

I like to add dead sea salts with baking soda or Epsom salt with baking soda to my bath— usually a cup of each if the itch is bad. You can buy them at any natural food store or on Amazon.

  1. Borax/Boron. You might be familiar with Borax (sodium tetraborate) as a cleaning agent, but it can also be very soothing for an eczema flare. It helps lower inflammation and can be used to treat infection.

You’re probably starting to see a pattern that most of these have an anti-inflammatory response which helps decrease itching (but it’s all about finding out which ones work best for YOU).

Read here for further information on the many benefits of Borax, because like many of these remedies you can use it for many application.

  1. Essential Oils. Essential oils (EOs) have a variety of healing benefits, but you have to be very careful because for some people they can incite more of a flare. Even if they’re used in small, diluted quantities in the bath, they still can be a little caustic to the skin.

I tell people to use them very sparingly if you’re going to use them. Tea tree oil or lavender oil are the two that I tend to use most frequently and recommend starting out with.

Of all the EOs, tea tree oil is one of the best for treating eczema symptoms. It has antibacterial components that help fight infection and stop it from spreading. It also has antifungal and anti-inflammatory properties that reduce itching.

Lavender oil can be calming for both your mental and physical state. It helps restore and balance healthy nutrients in the skin which reduces irritation. Bonus- lavender also minimizes the stress that goes along with an eczema flare.

  1. Sitz Baths, Herbal Blends, and Chamomile Tea bags. If you’ve ever given birth, sitz baths are commonly recommended for their healing properties. I used them after both of my births and they significantly helped with the soothing and healing my skin.

I had an “A-ha” moment with my second baby last year because I’d had an eczema flare because of the hormones during pregnancy. I thought to myself, “Hey, I can probably use this for the eczema too,” so I tried it.

I actually bought Earth Mama Angel Baby (which just recently changed its name just to Earth Mama) since they make pre-made sitz bath pouches. I bought those because, quite frankly, who has the time to make them when you’ve got a new baby or kids or just have a busy life?

I also augmented it with dried chamomile that I got from a natural food store that I put that in cheesecloth or a sock if you don’t have cheesecloth. Soaking with those for about 20 minutes really soothes my skin (and my mind). Chamomile tea bags also work instead of preparing the dried herbs.

Bonus tip— sitz herbs are also recommended for hemorrhoids and diaper rash!

  1. Colloidal Oats. I put a big asterisk by this one because of the *gluten issue*, but some of my patients have experienced healing benefits from colloidal oats or oatmeal so I didn’t want to exclude it.

Many people with skin and gut issues tend to have problems with gluten internally and sometimes externally. Those with Celiac can get a skin manifestation called dermatitis herpetiformis. I’ve seen people who have not been diagnosed with Celiac, but do have the dermatitis herpetiformis and it’s misdiagnosed as eczema.

Now, the cool thing is, really, it doesn’t matter what you label something on the skin. You’re going to end up treating it essentially the same especially because these are all in the autoimmune realm.

Like I said, I’m really careful when it comes to recommending anything that is grain-based, but this is where bio individuality comes into play. One person’s poison can be another’s medicine. If you’re going to do this, make sure it’s gluten-free. If gluten is an issue for you, and you don’t know it yet, you want to make sure you’re not adding fuel to the fire.

You can read more about the uses and benefits of colloidal oats here.

  1. Hydrogen Peroxide. Most of us have this under our bathroom sink to clean out cuts or as a natural cleaner. When added to a bath, it helps disinfect eczema sores and promotes new cell growth.

Be sure to use a food grade hydrogen peroxide and add no more than one cup to your bath. I recommend starting off a little slower with maybe ½ cup to see how you tolerate it.

  1. Baking Soda. This is another household item that has many uses. I buy a giant bag at Costco because of the quantities I use and it’s way more economical. I add this to almost every bath for myself and kids even when I don’t have a flare because of its other benefits.

As I mentioned in #1, combined with Epsom salt it makes for a great detox bath.

  1. Apple Cider Vinegar. Similar to the previous point, apple cider vinegar is also multifunctional. It has compounds like riboflavin, vitamins, enzymes, and mineral salts which can improve the quality of your skin.

It acts as an astringent and helps remove surface bacteria that shows up when the skin is compromised from a flare.

Experiment with the quantities that work for you, but I would start by adding ½ – 1 cup to your bath.

Bottom Line

Many of these are items you likely already have in your home for other reasons, or you’ve built yourself a “natural medicine cabinet.” Start with one ingredient at a time. Go slowly by using ¼- ½ cup with of the powdered ingredients or single drops of essential oils initially, then work up to the full dose you need from there.

If something completely doesn’t work for you, try something else from the list. Remember that it may take some time to see what works for you and dial in your recipe. You can always tweak it once you see what works for you.

Most people will get some type of relief from something on the list, even if it’s only a small amount.

Resist the urge to go hog wild with any of the ingredients because you could end up stoking the flames and adding fuel to the fire. It’s so easy to go overboard when you finally find a remedy that provides some relief. But heed my words… don’t do it!! (I know from personal experience and it was a disaster!)

There’s no one blanket approach to calm an eczema flare which is why I like to suggest a variety of options. All of these are going to provide different healing properties. Some are going to balance the pH while others will have antimicrobial effects, but they’re all going to be anti-inflammatory to some extent.

Have you experimented with any of these healing baths? Let us know in the comments section!

3 Natural Eczema Remedies to Start Healing

Have you tried the drug store potions, over the counter (OTC) medications, or even prescriptions only to have little to no improvement in your eczema?

This is a common theme in my virtual clinic. We see many people that’ve tried everything, including things we recommend like diets or supplements, only to have a small change in their eczema. So, what’s going on??

The truth is that eczema, like any other chronic inflammatory or autoimmune condition, is complex and the causes are different for each person. This makes it difficult to treat, especially self-treat.

Super frustrating, right?

There’s a small percentage of people that can eliminate the common food triggers and take a couple of supplements, and achieve resolution of eczema. However, this is rare. If they don’t maintain their diet or have a major stressor, the eczema usually returns because they haven’t addressed the underlying causes.

You might be thinking- what do I do?

Addressing the root causes like stress, hormone imbalance, diet, gut infections, nutrient/vitamin deficiencies, and immune dysfunction provides long term resolution, but in the meantime here several natural eczema remedies to help control the symptoms and start healing.

Topicals

Don’t: Petroleum jelly goes under many names such a Vaseline®, petrolatum, mineral oil, or paraffin, and it’s a byproduct oil refining that contains compounds such as hydrocarbons that are harmful to health. It also seals the skin, trapping potentially harmful bacteria and letting the skin breathe.

Even worse, it can cause collagen breakdown which is the opposite of what you want if you have eczema.

Do: Shea butter, cocoa butter, coconut oil, and jojoba oil are all great options and each their own benefits. Some people find they work well alone, but in practice we’ve seen that people usually benefit from a combination.

You can purchase one like Moon Valley Organics EczaCalm (there are many other options available and we’ll be doing a review of our favorites so stay tuned).  You can also customize a blend of your own with our Healing Salve recipe. The recipe can be altered with different base butters, oils and essential oils.

Remember, topicals help soothe the skin, but real healing comes from inside the body.

Supplements

Supplements seem to be an obvious starting place for natural eczema treatment, but in reality are a complex task to tackle, especially alone.

Don’t: Sadly, we see many people that are either on 20-30 supplements at once (YES…this is real unfortunately) and have no relief and lots of wasted money!!

The truth is this could be making the situation worse since you don’t know what ingredients are helping or hurting. Plus, there are the fillers, binders, and additives to consider as well as the active ingredients that could be causing issues.

Do: Start simply. Use single or few ingredient products that are clean, well sourced, and have a good reason for you to invest in them.

Here are two great options that have worked well in our clinic:

Collagen Protein has many benefits. It’s a critical building block of our skin that is compromised with eczema and it helps heal the gut which is a primary root cause in eczema and other autoimmune conditions.

Bifidobacterium based probiotics reduce histamine and can help heal the gut. This 2008 study shows using B. infantis and B. longum reduced histamine signaling which can translate to less itching.

Diet

Again, diet is often difficult to navigate on your own (even harder than supplements). We’re all different and for some just taking out a couple of foods or food categories may work, but no one will ever respond to the same exact diet (not even identical twins).

Don’t: Taking on too many dietary changes at once can be overwhelming and lead to unnecessary (and unwanted) stress. Don’t try removing gluten, dairy, salicylates, and histamines all at once. This will leave you with nothing to eat and likely cause confusion.

Do:  Take baby steps with diet and monitor closely so you know what’s going on. An easy stepping stone is to remove all gluten or dairy products for 3-4 weeks minimum (you can do both if you’re willing). When you re-introduce them watch for reactions not only on your skin, but digestion, headaches, runny nose, fatigue, and achy muscles or joints.

Eggs, soy, corn, or nuts might be good options for you to test eventually too. If you find the main food allergens and sensitivities aren’t your problem, then it might be time to look at broad categories like salicylates or histamines.

The Bottom Line

These are all good, natural eczema remedies to start with and are things we recommend in the clinic while we’re working on reversing the root causes since the ultimate goal is healing on the inside and outside.

We’d love to hear what natural remedies have worked best for you?