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Treating your eczema ‘naturally’? Be careful.

September 23, 2019 / Duncan Fisher
Eczema isn’t simple. Alternative treatments can go wrong.

A paper came out this summer, about eczema ‘cures’ in the popular imagination.1 It was presented before the British Association of Dermatologists, a systematic tabulation of all the remedy videos that were then to be found on YouTube. On strict medical grounds, 46% of the videos were found to be misleading, and 36% contained content actually dangerous to eczema patients.

For example, patients with eczema were told, without basis, to avoid dairy or gluten, or worse, to use topical treatments and home-based phototherapies that are well known to be harmful, particularly if used wrong. Seldom was there any detailed information about dosing or duration of treatment. Furthermore, conventional medicine and advice from doctors were routinely discredited, and numerous videos promised outright a ‘fast and easy cure’, and implied that the medical establishment was either concealing this on purpose, or was too hidebound to accept the possibility that it worked.

On a human level, enthusiasm for fast and easy cures is very understandable. Eczema is a miserable disease, and doctors aren’t absolutely sure, at the level of molecular medicine, what atopic dermatitis is, or how to make it go away. Much is known about its pathways, involving cytokines and inflammatory cells, and much is known about how to manage it, through anti-inflammatory and anti-pruritic means, and others. But the disease has not been ‘cured,’ and that is frustrating to patients (and their doctors).

We live in an age of popular scepticism, too, about science, and medication, and related things, like doctors, and ‘chemicals’. That makes the YouTube ‘cures’ really flourish.

The problem with this scepticism is that it rides on lack of clarity about what science is, where medication comes from, what ‘chemical’ means, and how biology works in general.

Cellular pathways are astonishingly complex, and bench science and clinical trials are designed to pick these apart one variable at a time, which is slow going. They’re designed this way to help us build models for understanding disease that don’t rely on hearsay or anecdote, and to do no harm to patients while we’re learning. The research mills do grind slowly, which is vexing. But that’s because they grind fine. There may well be some benefit in eczema care from things found in nature. The medical world is getting around to that too. But it all takes time.

Outside the research world, it can be very tempting, meanwhile, to look for remedies that are quick and easy, and ‘natural’. The fact is, there isn’t one, and there’s not likely to be one, given the complex and subtle and multifactorial nature of eczema (and most any other disease too).

So if you’re surfing the web for eczema remedies, be careful when you see language like ‘cure’. Be sceptical when you hear ‘attacks,’ or ‘wipes out,’ or ‘instantly kills.’ Be suspicious when you’re given timeframes like ‘instantly,’ or offered treatments that ‘doctors don’t want you to know about.’

Don’t even trust a treatment just because someone says it worked for them. This is the general problem with homeopathy, a popular form of alternative medicine. There are people who feel it works for them, and indeed they may feel better after they self-treat. Data from studies, however, are inconsistent, and even contradictory. So don’t buy on the basis of customer testimony. ‘This thing I saw on TV’ is not a data set. Neither is, ‘Doctors and moms swear by it!’

Is alternative medicine all useless?

Good scientists don’t say, ‘It’s all useless.’ They say, ‘It hasn’t all been shown to be of use yet’. The mainstream medical establishment actually is interested in potential therapeutic advances from non-traditional sources. But they do want to know that they really work, and to know, as best they can, why they work.

Studies here and there are underway. Here are some of the popular treatments being examined for their genuine medical potential. It’s mixed news.

Oils. Sunflower seed oil, research has begun to show, may be a mild anti-inflammatory agent, that helps ease eczema. We don’t know why. Coconut oil, for unclear reasons, appears to lower staph bacteria levels on skin, too, which sometimes exacerbate eczema flares. The role of the bacteria ‘biome’ is really new research territory. Watch for articles about that.

Things that help you relax. Massage, acupuncture, acupressure, and hypnosis have been under clinical scrutiny for a while. Trial data do now exist, and some are statistically significant. People with eczema can indeed feel better after these treatments. Is that a surprise? Not really. Eczema is known to be mediated partly by stress.

Vitamin D. There is one recent study, though it’s small and statistically underpowered, that suggests that vitamin D has a detectable role to play in reducing eczema suffering in children.

Bathing carefully. Really careful research about baths is hard to find. Opinions divide sharply, therefore. Some people think you should bathe frequently, which may wash away irritants, or you should bathe infrequently, or your skin, paradoxically, will dry out. Everyone agrees, though, that hydration is key. So what really matters is moisturizing after that bath.

Probiotics. Coming back to bacteria, and the role of the microbiome, is it possible that we can adjust the bacterial balance in our skin by eating friendly bacteria, like in yoghurt? We don’t know. Two studies about 10 years ago seemed promising, but research since then has been pretty mixed.

Anti-yeast treatments. One form of yeast may have a role in eczema outbreaks. Itraconazole, an oral anti-fungal drug, may help in this, and so may washes with apple cider vinegar. It’s another approach, and it’s pretty safe, but statistically it’s also pretty hit-or-miss.

Skin ‘calming’ cream. Some people like to supplement topical steroids, which do help but which cause problems in the long-term, with Florasone, a cream containing Cardiospermum extract. As long as you’re not allergic to it, your doctor will probably think this is just fine, if you feel it helps.

These are not cures for eczema, though they may help people feel better. That is important by itself. But for management of eczema that’s been shown to work as well as it’s possible to show, it’s still a good idea to go to the doctor.

1Mueller SM, et al. ‘YouTube on atopic dermatitis: fiction, falsehoods and few facts.’ Paper presented at the British Association of Dermatologists’ Annual Meeting in Liverpool (2-4 July 2019).

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