A.Vogel Talks Asteatotic Eczema

An introduction to asteatotic eczema

Asteatotic eczema, or eczema craquelé, was first diagnosed in 1907 by French dermatologist Brocq. The name derives from the French word for ‘cracked’ due to the way that its symptoms present themselves on the skin.

This form of eczema is closely associated with dry skin, usually caused by a lack of essential oil. Asteatotic eczema commonly appears in those over the age of 60 and men are believed to be more predisposed to the condition than women.¹ 

¹http://www.dermnetnz.org/dermatitis/eczema-craquele.html

The causes of asteatotic eczema

There is no definitive cause of asteatotic eczema but the condition has been connected to dry skin, usually caused by a lack of moisture or fatty acids.

This then reduces the production of essential skin oil, leaving the epidermis more exposed to damage, irritants and potential pathogens.

Nevertheless, it is important to recognise how your skin can become dry and what factors can exaggerate any unpleasant symptoms associated with the affliction so that you are prepared to avoid them in the future.

• Weak immune system: Your immune system is essential when it comes to maintaining your overall health and protecting us from invasive pathogens. If your immune system is weakened, either by your diet, stress or a pre-existing health condition like hypothyroidism, then it is very likely that our skin will be impacted as a result. The immune system, if placed under considerable stress, can become over-stimulated and release too many IgE antibodies that will inevitably overreact to skin irritants, causing an outbreak of eczema. Having an overactive or underactive thyroid gland  is another important trigger when it comes to asteatotic eczema. If patients suffer from hyperthyroidism then this can lead to thyrotoxicosis, where there are too many thyroid hormones in the blood, causing itchiness and dry skin. Hypothyroidism can also stimulate skin damage as the skin may only receive a quarter of the blood supply that it needs, making it sensitive, brittle and dry²

• Poor nutrition: If you are suffering from asteatotic eczema then it is very important that you consider your diet. If your immune system is under stress then your diet could be causal factor in exacerbating this fatigue. Foods such as alcohol, caffeine, refined sugars and processed fats are rich in an inflammatory chemical called histamine. If you consume a diet that is high in these substances, then it will cause your immune system to release more inflammatory chemicals, worsening your systems and eventually slowing down your immune responses. Your nutrition can also affect your digestive system, with refined sugars influencing the population of bad bacteria in your gut, making it more difficult to break down foods and expel toxins. It is also vital that you drink plenty of water during this time as dehydration can contribute towards making your skin dryer, more sensitive and more prone to eczema

• Stress: Stress might not be the primary cause of asteatotic eczema, but it can be an important factor, exaggerating your symptoms and weakening your immune system and stomach function. When your body recognises that you are in a stressful situation, it will enter a ‘fight or flight’ state, releasing inflammatory chemicals, increasing your heart rate and causing you to sweat more. Eventually, your immune system will start to become fatigued and unable to keep up with the demands of producing these chemicals, ultimately worsening your eczema symptoms and leaving you vulnerable to further infections. Your digestion will also be interrupted by this process, as your body will not be interested in expelling waste during this time, leading to bouts of constipation and diarrhoea that can cause the impurities to linger in your system, possibly impacting the strength of your skin cells

• Low humidity: When the air is less humid, such as during the winter months, it can take a toll on your skin, especially if you are prone to using heater that blast hot, dry air. Your skin can become more brittle, deprived of moisture, damaging the epidermis and allowing irritants and bacteria to permeate your skin. This can cause further damage, making you more susceptible to episodes of eczema or vulnerable to secondary bacterial infections

• Irritants: If the epidermal layer of your skin is compromised then it can become more open to irritation. The harsh chemicals found in some detergents, bleaches, soaps or cosmetics can stimulate itching, strip our skin of essential oils and cause it to become dry and brittle. In these cases, even wearing coarse material or drying yourself too vigorously with a towel can exacerbate damage and cause your skin to become rough and flaky

• Medication: There are some medicines that can trigger an outburst of asteatotic eczema, such as some variants of blood pressure medication like Calcium Channel Blockers.³Diuretics can also pose a problem as they essentially drain the body of fluid, potentially causing further dehydration that can dry out your skin. There are also some retinoids that can in fact be detrimental for your skin, either due to their chemical compounds or the way an affected area reacts to them topically.

²http://www.flawlessprogram.com/thyroid-and-eczema-the-importance-of-balancing-hormones/

³http://thedermblog.com/2008/01/08/eczema-associated-with-certain-blood-pressure-medications/

The symptoms of asteatotic eczema

The symptoms of asteatotic eczema are commonplace throughout the different variants of the eczema skin condition, although there are a few distinctive indicators that can help you to achieve a diagnosis.

• Cracked skin: The most common symptom of asteatotic eczema, cracked skin usually presents itself in a paving pattern across the skin, separated by red lines that spread, giving the appearance of fractured porcelain. Usually this manifests in the lower legs or the upper thighs, although sometimes it can appear in the upper arms as well

• Skin discolouration: Discolouration and redness normally become visible when the melanocytes in your skin become overstimulated by the inflammatory chemicals released by your immune system. Erythema, or a rash usually develops during this time caused by histamine stimulating the blood capillaries to dilate

• Inflammation: Inflammation commonly occurs as a reaction to inflammatory chemicals such as histamine, which are produced by the immune system to combat potential pathogens and to repair any damage

• Itchiness: Itchiness is usually considered the most infuriating symptom associated with asteatotic eczema, disturbing sleep patterns and exacerbating stress. It is important though, to try and resist the urge to scratch as dry skin as it can damage the epidermis even further and leave you vulnerable to a secondary bacterial infection

• Stress: When you suffer from highly visible skin conditions such as eczema, it is natural that your confidence and self-esteem might suffer as a result, as you can feel more exposed and vulnerable during this time. However, if you are constantly feeling anxious and apprehensive about your appearance or the irritability of your symptoms, it can have a negative impact on your psychological state, prompting your immune system to release more inflammatory chemicals that will only exacerbate your physical symptoms

• Sleep deprivation: Sleep deprivation is prevalent in almost all forms of eczema, due to the psychological and physical stresses of the condition. Itchy skin and an anxious psyche can often prevent you from getting a good night of sleep, affecting your emotional wellbeing and ultimately placing more pressure on the immune system.

Home remedies

When it comes to treating asteatotic eczema there are many different tried and tested home remedies.

It is important to appreciate though, that these are not universally agreed methods and if you notice that your symptoms are changing for the worse, you should go and speak to your doctor immediately.

• Relax: Feeling stressed during an outbreak of eczema might seem like a natural, knee-jerk reaction but in reality, it can have dire consequences for your immune system, placing it under additional pressure during an already tiring time. Instead of worrying about your symptoms, you should try to relax instead, no matter how impossible it might seem. Try reading a good book or watching your favourite television programme – so long as you set aside at least an hour a day for yourself. You could try meditation as this is good for teaching you proper breathing techniques and can help you to calm your mind

• Good nutrition: Your diet can have a big impact on your eczema symptoms, so it is important that you try to consume food products that will help support the  immune system. This can mean that you might have to cut out foods that contain inflammatory chemicals like histamine, reducing your intake of refined sugars, caffeine and alcohol and instead replacing them with anti-oxidant rich fruit and vegetables. In asteatotic eczema it’s also vital that you consider foods that contain high levels of fatty acids, as these can help to stimulate the production of oil on your skin, so flaxseeds, kidney beans and squash vegetables should be back on the menu. If you are suffering from hypothyroidism then leafy green vegetables can be a critical source of iron and vitamin B12, which can help to aid the production of thyroid hormones. Drinking plenty of water is also essential during this time, to prevent skin from becoming dehydrated

• Avoid irritants: Asteatotic eczema is renowned for occurring in those that have dry, sensitive skin. When your skin becomes dry and brittle, the epidermis is damaged, making your skin more susceptible to irritants. It’s important therefore, that you take care of your skin at this time and avoid anything that might stimulate an episode of eczema, such as branded cosmetics or harsh chemicals. Instead it might be worth switching your detergent or changing our cosmetics to organic and fragrance-free as these are generally gentler on sensitive skin

• Coconut oil: Coconut oil is chockfull of anti-oxidants and is a natural anti-bacterial and anti-inflammatory agent. It can work to soothe, dry damaged skin by rehydrating it and stimulating new skin cell growth. Coconut oil can be taken internally to support the immune system or applied topically to the affected area. Check out Your Health Food Store for its range of coconut oils

• Aloe vera: Aloe vera is famous for soothing mild burns but it can also be used to treat the symptoms of eczema. The plant is a rich source of nutrients and anti-oxidants, having both anti-sceptic and anti-inflammatory qualities. Using aloe-vera topically may reduce the risk of you developing a secondary bacterial infection and can ease the itchiness associated with eczema. If you decide to try and take the plant internally as a juice, it can have a beneficial effect on your stomach, cleansing your digestive tract and preventing a build-up of toxins

• Honey: Raw, unprocessed honey is not something you’d probably ever want to lather over your skin, but it is very good at keeping skin hydrated and protected. When applied topically it can help to strengthen the epidermis and help to prevent irritants and allergens from permeating the skin. Manuka honey is the best variety for this, and you can find it at Your Health Food Store.

Herbal remedies

If you find that conventional medicines are not helping your eczema symptoms, then you can always try our herbal remedies, aimed at targeting inflammation and itchiness.

However, if you find that these solutions are not working for you, then do not hesitate to speak to your GP.

• Neem Cream: Neem cream is produced from extracts of neem leaves, a plant that is renowned for its ability to soothe skin irritation. This formula can be applied directly to your skin to ease any inflammation or dryness

• Vitamin C: A potent vitamin C supplement, Nature-C is a chewable capsule made using natural fruit extracts and can be taken daily to support the immune system and encourage skin regeneration as well as iron absorption. The remedy is suitable for anyone over the age of 6, although you should speak to your doctor first if you are pregnant or breastfeeding

• Molkosan^®: Around 70% of your immune cells inhabit your gut, so keeping this area of your body healthy can have a very positive impact on your symptoms. Molkosan^® is a pre-biotic that contains high levels of L+ lactic acid and can work to create a healthy environment for the friendly bacteria in your gut. This remedy is lactose-free and suitable for children over the age of 2, although it should not be taken if you are pregnant or breastfeeding

• Viola tricolor: Viola tricolor is made from natural extracts of wild pansy and contains high amounts of flavonoids, which can regulate the capillary membranes. The remedy is often recommended for inflamed skin conditions like eczema, as Viola tricolour has natural anti-inflammatory and purifying qualities. This treatment is suitable for anyone over the age of 2 but should not be used by pregnant or breastfeeding women

• Stress Relief Daytime: Stress Relief Daytime is a natural stress remedy that works to help you cope with any emotional stress that you may be dealing with. This solution can work fast and help you feel more in control of your symptoms, enabling you to deal with your stress in difficult situations

• Dormeasan^®: Dormeasan^® works to restore a natural sleep cycle and is a non-drowsy formula that won’t leave you feeling disorientated the next day. Made from extracts of Valerian and Hops, Dormeasan might not be suitable for pregnant women or those whose medication is affected by the consumption of alcohol.

Conventional medicine

Conventional medicines are often many people’s preferred method for tackling eczema and it is always important that you consult your doctor about any uncomfortable or painful symptoms that you might be experiencing. Nevertheless, it is also important to recognise that some medication may not be compatible with your body and can cause detrimental side-effects of their own.

• Emollients: Emollients function as a powerful moisturiser, and are usually implemented to treat dry, cracked and irritated skin. There are many different variants of emollients, some of which may be specific to a particular skin condition. However, not all emollients will necessarily suit your skin type and some may even cause an allergic reaction to occur

• Topical steroid creams: Steroid creams are normally considered to be more intense than emollients and are usually prescribed by your doctor to be applied topically to the affected area. These creams might work well to ease inflammation, but they should also not be taken persistently or for a prolonged period of time. This is because most steroid based medication can cause a range of unpleasant side-effects if taken too regularly, and might even exaggerate your existing symptoms

• Anti-histamines: Anti-histamines are commonly available over the counter at most pharmacies and do not normally have to be prescribed by your doctor, although they may advocate their usage. In most cases, anti-histamines work to reduce the swelling and itching associated with a skin condition like eczema, but they can also cause drowsiness, making them an unsuitable choice if you plan on driving or operating machinery

• Anti-depressants: If your physical symptoms are starting to influence your psychological stability then your doctor might prescribe you a course of anti-depressants. These can be used to regulate your moods but anti-depressants also come in a variety of subtypes that may not agree with you, inspiring side-effects that may compound your eczema symptoms and work to worsen your mental health.