A.Vogel Talks Contact Eczema

An introduction to contact eczema

Contact eczema affects approximately 9% of the UK population every year, and there are two distinct subtypes of the condition – allergic contact eczema and irritant contact eczema.¹

It is estimated that 80% of contact eczema cases are due to the latter form, where abrasive substances are able to permeate the epidermis causing damage and inflammation.² 

The symptoms of irritant contact eczema present themselves quite quickly, sometimes almost instantly whereas allergic contact eczema can be slower because of the time it takes for the immune system to recognise allergens.³ 

Neither form of contact eczema is considered to be contagious, but it is always advantageous to be aware of your symptoms and their causes so you can achieve a quicker diagnosis and take preventative steps to protect yourself against the condition in the future.

¹http://www.eczema.org/contact

²http://www.nhs.uk/conditions/eczema-(contact-dermatitis)/Pages/Introduction.aspx

³http://www.webmd.com/skin-problems-and-treatments/contact-dermatitis

The causes of contact eczema

Contact eczema has no discernable cause but it usually triggered either by allergens or skin irritants. Recognising what materials and chemicals that your skin is sensitive to can help us to avoid them in the future and take precautions against contracting the condition.

• Genetics: Your genes can play a role in your susceptibility towards eczema, particularly the contact and atopic variants. It has been established that there is a link between eczema and a filaggrin deficiency.⁴ If you are born with a defective gene that can influence your production of filaggrin – an essential protein that can influence your lipid, or fats. When you lack this protein, your skin can become weaker and lose its ability to retain moisture, becoming more brittle and vulnerable to irritants

• Weak immune system: The immune system acts as the body’s primary defence mechanism against invasive germs, bacteria and fungi. When you are under threat, the immune system will release a wave of anti-bodies to fight off pathogens, or discharge inflammatory chemicals to the site of an injury to accelerate the healing process. However, if your immune system is weakened, either by an existing illness or lifestyle factors such as your diet or stress, then it will struggle to respond adequately to the situation. It might become over-stimulated and react disproportionately to potential irritants or allergens, releasing too many IgE antibodies that will inspire an episode of eczema. On the other hand, the immune system could also become fatigued and find it difficult to muster a proper autoimmune response, allowing your body to become overwhelmed by pathogens or irritants

• Poor nutrition: When it comes to keeping our immune system healthy your diet can be especially significant, having the power to either support your immune system or place it under a substantial amount of pressure. If you follow a diet that includes copious amounts of caffeine, alcohol, refined sugars, processed fats and other food products that contain histamine, then you will start to produce more of the inflammatory chemical, and your symptoms will worsen. Refined sugars can also act as a source of food for the bad bacteria in your gut, affecting your digestion which can have a knock on effect on your symptoms as over 70% of your immune cells are found in your gut. Dehydration is another culprit when it comes to weakening your immune system and the health of your skin. If you don’t consume enough water then your immune system will struggle to function and your skin will lack moisture,  with the epidermal layer becoming dryer and more vulnerable to irritants and allergens

• Stress: Stress might not be a definitive cause of any skin condition but it certainly won’t alleviate your symptoms and can in fact, make them much worse. This is because stress stimulates a ‘flight or fight’ response from your immune system, causing it to release inflammatory chemicals such as histamine and adrenalin into your body to dilate the blood vessels in preparation for physical activity. Eventually, these chemicals will exaggerate an existing skin condition and cause your immune system to become overly sensitive to pathogens, over-reacting to the slightest threat. Stress can also affect your digestion, inhibiting the breakdown of food and the expulsion of waste products, causing bouts of diarrhoea and constipation

• Low humidity: A dry atmosphere and drastic changes in temperature can trigger an episode of contact eczema. This is because extreme cold or extreme heat can dry out skin and remove the essential oils that keep skin hydrated and protected against external pathogens. This is especially the case during the winter months when you turn to heating systems to keep your house warm. These systems usually expel dry air, lowering the humidity in your home and sucking the moisture out of your skin

• Irritants: If your skin is dry and sensitive, it can become more prone to eczema, particularly if your epidermis comes into contact with irritants. These irritants can include washing detergents, disinfectants, shampoos, perfumes, rough clothing or even washing your hands too often. If the chemical compounds inside these produces are too abrasive then your skin will start to become inflamed, and painful. In these instances, the epidermal layer will become damaged and more vulnerable to a secondary bacterial infection

• Allergens: People, who are already predisposed to an atopic condition like hayfever, can be more prone to contact eczema. This is because your immune system recognises the particular allergen as a threat and will eventually respond by releasing inflammatory chemicals. In hayfever, for example, your allergies are caused by an immune reaction to pollen. Therefore, if your skin comes into contact with certain pollen species, it might prompt an allergic response from your immune system, triggering eczema like symptoms. Another example could be with specific types of metal, such as nickel, which can stimulate an allergic reaction when it comes into direct contact with your skin or certain types of cosmetics that contain products or chemicals that your immune system identifies as allergens

• Medication: There are certain types of medication that can cause an episode of contact eczema, due to their effect on your body. Diuretics, for example, can cause the body to expel fluid, dehydrating the skin and making the epidermis more susceptible to irritation. Other medicines, such as retinoids which are often used to treat skin conditions, can make them worse as the chemicals they contain either damage your skin or stimulate an allergic reaction.

⁴http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378480/

The symptoms of contact eczema

The symptoms of contact eczema can vary depending on which subtype you are suffering from. In irritant contact eczema, symptoms can be more painful but are usually limited to the affected area, whereas in allergic contact eczema, a greater emphasis is on itchiness, with skin discolouration often spreading all over the body. If you can identify which symptoms are more prevalent, then you will be able to get an idea about the treatment methods that will work best for you.

• Inflammation: Inflammation usually appears when your immune system releases inflammatory chemicals such as histamine. These chemicals are produced to fight off allergens or to accelerate the healing process of a wounded area. For example, in irritant contact eczema, if the epidermis has been damaged by harsh chemicals, then it might start to become inflamed very quickly as the skin reacts to this injury

• Itchiness: Itchiness is usually a response to dry, flaking skin and is more commonly associated with allergic contact eczema. It can cause further problems for the body though, as continual scratching can damage the epidermis and leave you more vulnerable to a secondary bacterial infection

• Blistering: Blisters area commonplace symptom in most variants of eczema and can cause mild distress, being uncomfortable and sometimes painful to experience. In irritant contact eczema, blisters normally form in the affected area, sometimes appearing quite swiftly depending on the level of damage done to the epidermis. In allergic contact eczema, the placement of blisters can be more sporadic, sometimes in the folds of the skin, and they are often itchy, leaking fluid or pus when they are scratched

• Rash: This can develop with contact eczema as histamine causes the blood capillaries to dilate in order to allow more nutrients to enter the affected area. In irritant contact eczema, this rash is usually just limited to the area that has had contact with an irritant but in allergic contact eczema, the rash can spread to other areas of the body

• Stress: Suffering from a skin condition like eczema can take its toll on our emotional wellbeing. The physical symptoms can be painful, aggravating and highly visible, making you feel more exposed in public and having a negative effect on your self-confidence. However, stress can be harmful to the immune system, placing it under additional pressure during a difficult time, leading into a vicious cycle where your psychological and physical symptoms inspire and influence one another

• Sleep deprivation: If your skin is continuously itchy and irritated then it can disrupt your sleeping pattern and make us feel more fatigued and drained the following day. This can have a detrimental impact on your psychological symptoms, making you feel disorientated and anxious, ultimately worsening your sleep habits and putting your immune system under additional stress.

Home remedies

There are plenty of tried and tested home remedies that are suitable for sufferers of contact eczema. It is still important though, that if you feel your symptoms are worsening or becoming more persistent, that you seek advice from your doctor. 

• Relax: Stress might seem like a natural response to having a skin condition like eczema, but it can be very detrimental for your immune system, causing it to become restless or fatigued. Instead of spending time ruminating on your symptoms, it might be best if you to focus on yourself and what makes you happy, whether its reading a good book or binge-watching your favourite television show on Netflix. You could even try practicing yoga or mediation as both have been shown to relax your mind and teach you useful breathing exercises

• Good nutrition: What we eat can play an integral role in influencing our eczema symptoms so it is important that we avoid triggers like caffeine and alcohol and instead focus on foods that are rich in anti-oxidants, beta-carotenes and omega 3 fatty acids. Minerals such as magnesium and iron can be particularly beneficial and are found in food products like bananas and avocados. You could try blitzing up one of our healthy smoothies, which are chockfull of nutrients, containing plenty of portions of fruit and vegetables. Ginger is another great ingredient to incorporate into your diet and has natural anti-inflammatory properties. Try to avoid products that might stimulate your atopic allergies. Drinking enough water is also imperative as it can prevent skin from becoming dehydrated and keep your immune system strong and healthy

• Avoid irritants: In episodes of contact eczema, your skin can become damaged and sensitive, with essential oils often being stripped away by harsh chemicals and irritants. It’s imperative that you are able to recognise any potential triggers and take the necessary steps to avoid them in your everyday life. If you find that a particular brand of soap or detergent is bothering you, then you should consider switching to an organic make that uses natural ingredients and is unscented. These types of products are considered to be gentler on sensitive or dry skin and might be less likely to inspire a flare-up of eczema

• Avoid allergens: Contact eczema usually occurs in people that are predisposed towards atopic conditions like hayfever, asthma or atopic eczema. If you suffer from seasonal allergies, such as hayfever, then it might be worth taking action to minimalise your contact with pollen spores by keeping your windows closed and or not hanging your clothes outside to dry. Try to avoid contact with flowering or abrasive plants like nettles or poison ivy and be aware of any additional stimulants like nickel or certain cosmetics

• Turmeric: Turmeric is famous for being a popular spice contained in most curries; however the spice can also be very useful when it comes to treating the symptoms of eczema. This is because turmeric has anti-inflammatory and anti-bacterial qualities, and can be taken internally as a supplement or externally as a paste. To take externally, make sure the spice is diluted first with a little milk or water. If you want to try a turmeric supplement, there are a range of choices available at Your Health Food Store

• Aloe vera: Aloe vera has been praised for centuries for its positive, soothing effect on minor burns and irritations. Now it is commonly found in most skincare products and is often used to treat damaged or burnt skin. Extracts of the plant have proven to be very good at hydrating skin, reducing inflammation and relieving any burning or itching sensations. You can apply aloe vera topically to an affected area. Check out the range of aloe vera products available at Your Health Food Store

• Magnesium baths: Bathing can irritate some people’s eczema symptoms but magnesium baths are known to be quite soothing for your skin and can help to encourage the healing process. Simply add a cup of magnesium flakes to your evening baths and avoid using conventional bubble baths. Instead maybe opt for an essential oil, like lavender oil, if you are not pregnant or breastfeeding. Magnesium is also known to have a very positive effect on gut problems, so a magnesium bath may potentially ease this difficulty as well.

Herbal remedies

There are a great range of herbal remedies available to soothe and relieve the unpleasant symptoms of contact eczema. Just be sure to contact your doctor if you notice that your symptoms are deteriorating or becoming more prolonged.

• Neem cream: The comforting properties of neem have been praised for decades when it comes to skin care. Neem cream is produced using extracts of neem leaves and works to soothe and reduce redness, inflammation and dry skin. You can apply this formula topically to the affected area but be aware that it may not be suitable for pregnant women or those who suffer from nut allergies

• Vitamin C: Nature-C is a natural and organic vitamin C supplement made from fruit extracts. Vitamin C is an essential vitamin when it comes to supporting your immune system and the health of your skin, being vital for the absorption of iron and rich in anti-oxidants. This solution is suitable for children over the age of 6 but they should not take any more than one tablet daily

• Molkosan^®: Around 70% of your immune cells are contained in your gut, so supporting this area of your body can be extremely beneficial for your immune function and skin. Molkosan^® is a lactose-free prebiotic that contains high levels of L+ lactic acid and can work to create a healthy gut environment for your friendly bacteria, improving your digestive system and preventing your skin from having to act as a elimination organ

• Viola tricolour: Viola tricolor is often recommended for inflammatory skin condition like eczema, and is rich in flavonoids. This tincture is made from extracts of wild pansy and can have a depurative effect on the bloodstream, removing impurities and toxins. Viola tricolor can be taken by anyone over the age of 2  but is not advised for pregnant or breastfeeding women

• Stress relief daytime: Stress Relief Daytime is a gentle stress remedy, made from extracts of Valerian and Hops. This formula works to soothe symptoms of stress and mild anxiety, naturally supporting your mood and allowing you to take control of your eczema symptoms

• Dormeasan^®: Eczema symptoms are very good at disrupting your natural sleep cycle and keeping you awake throughout the night. Dormeasan^® is a non-drowsy herbal sleep remedy, specifically designed to restore your sleep cycle and leave you feeling refreshed and invigorated the next morning.

Conventional medicine

Conventional medicines are still the go-to option for treating eczema, and while it is always important to consult your GP about your skin condition, you should be aware that some medication can cause a range of unpleasant side-effects.

If you feel as though your symptoms are getting worse after starting a course of treatment then you should go back to your doctor immediately.

• Emollients: Emollients are normally the first solution that your doctor will recommend to you as they can act as a powerful moisturiser, rehydrating dry skin and reducing inflammation. However, not all emollients will agree with your skin type and some can even inspire an allergic reaction. If you feel that emollients are exaggerating your symptoms then you should always go back and speak to your doctor

• Steroid creams: Steroid creams are slightly stronger than emollients and are typically prescribed by your doctor to reduce swelling and itchiness. Nevertheless, steroid based medications should not be continuously taken over a prolonged period of time as they can stimulate a range of unhappy side-effects, like acne

• Anti-histamines: Anti-histamines are usually advised to relieve inflammation and they can be bought over the counter without a prescription. However, some variants can cause drowsiness so it is not recommended that you take them if you plan on driving or operating heavy machinery

• Anti-depressants: If your eczema symptoms are starting to have a negative impact on your emotional wellbeing then your doctor might prescribe you some anti-depressants. There are many different types of anti-depressants, and not all of them with be compatible with you and can sometimes even make your psychological symptoms worse.