Treating eczema from the inside out

Eczema is chronic skin condition which is characterised by dry, itchy, inflamed skin. Conventional methods often include a number of lotions and potions from the doctor that may help to temporarily treat the problem from the outside. Steroid creams, for example, work by suppressing the immune response which causes the symptoms in the first place. 

However, if the creams stop, the symptoms often return with vengeance – basically the treatment is only superficially masking the problem, rather than treating the underlying issue.

What’s the gut connection?

Now, although the underlying cause of eczema isn’t well understood, we know that the symptoms occur as a result of an over-sensitive immune response. We then know that this, in turn, gives rise to an inflammatory response, which presents itself in our skin. 

Now, we also know that up to 80% of our immune cells reside in the gut, and we also know that in the case of food intolerance or allergies, activation of the immune system starts in the digestive system. Immune cells present in the gut wall react to a harmless food molecules such as lactose or gluten, and can give rise to local effects such as bloating, pain or diarrhoea. However, in some cases it also seems apparent that these reactions to certain foods are connected to more systemic effects, such as rashes or headaches. 

So, it appears that in many cases, food intolerance and allergic reactions are often connected with skin conditions such as eczema too. So, taking all of this into account, could this be the common link, and might the gut be a good place to start in terms of the treatment of skin conditions such as eczema, more generally?

Then there’s our gut bacteria

As well as our immune cells helping to protect us from pathogens in the gut, we also rely on our own little army of bacteria called our microbiome. If these fall out of balance, the bad bacteria and pathogens can potentially damage our gut wall. This can progress into a condition called leaky gut which results in a vicious cycle, in terms of the balance of bacteria in the gut and systemic inflammation.

So, what factors could be aggravating skin conditions?

1. Factors that affect your gut bacteria

An imbalance in gut bacteria is thought to have implications for a number of conditions from skin health, to issues with mood and weight management. A number of factors can have adverse effects on the good bacteria in your gut:

• Overuse of antibiotics – Although antibiotics are intended to treat infections caused by bad bacteria only, unfortunately they can also have adverse effects on your levels of good bacteria. For certain conditions such as cystitis, antibiotics may not always be necessary, so best to discuss this with your doctor if you are in any doubt

• Weak stomach acid – Although too much stomach acid is a common diagnosis, having too little isn’t so commonly recognised. However, we need our stomach acid to help break down the foods we eat and absorb the nutrients they contain. Stomach acid is also important for keeping pathogens under control, so without sufficient levels, we can risk upsetting the balance of bacteria throughout our digestive system

• Stress – With chronic stress we risk upsetting our digestive functions. Gut contractions can speed up and stomach acid levels can decrease long-term which can exacerbate dysbiosis and conditions such as leaky gut

2. Foods that can exacerbate the condition once leaky gut is established

Once leaky gut is established certain food triggers may be more likely:

• Lactose – Many of us struggle to digest lactose anyway as we lack the enzyme lactase required to break it down. However, Lactose also falls into a group of foods called FODMAPs which travel into the gut partially undigested. If leaky gut is present then consuming dairy products can be especially problematic

• Gluten – One of the most common allergens, gluten, can be found in grains including wheat, barley and rye which means it is partially undigested when it reaches the large intestine - this won’t result in a happy gut if the structure of your gut wall is compromised

• Other FODMAPs – The list of high FODMAP foods is extensive and varied, from different surprisingly healthy fruit and vegetable options to artificial sweeteners. So, there might be a number of foods that you might want to consider limiting whilst your gut heals.

What can be done to help?

When it comes to chronic skin conditions, often treating the condition from the inside out can be helpful. My top tips are as follows:

1. Keep a food diary

If you can identify any food triggers, then this can help to keep inflammation to a minimum whilst you work on healing the gut 

2. Heal the gut

Giving the gut time to rest will help support the healing process so avoid food triggers, as well as any inflammatory foods including red meat, alcohol, caffeine and refined sugar. The amino acid L-glutamine may also help to support the healing process

3. Balance your bacteria

Balancing your bacteria is often a pivotal step in the management of skin conditions such as eczema. Support the gut initially with a prebiotic such as with a source of L+ lactic acid, and then from children up to adults, adding a suitable probiotic could help to further improve symptoms.

4. Topical skin creams as the final step

Once you’ve got the main part of your treatment plan underway and your gut is well on the road to recovery, skincare products may then be introduced to help your skin get back to normal. Try Neem Cream to help calm dry, irritated skin.