How to Choose The Best Treatment for Your Eczema

According to the American Academy of Dermatology, people in the U.S. spend about $440 million dollars each year on lotions, powders, and prescription medications for the treatment of eczema.(1) If you have eczema, you know how important it is to find just the right products and go-to treatments for the dry skin and burning that can prevent you from enjoying life. But how do you know what treatment is right for you? Here is a rundown of the most common ones and how to determine which one may work for you.   

What Are the Different Types of Eczema?

First, let’s talk about eczema in general. Did you know that there are actually seven different kinds of eczema as well as quite a few other skin conditions that are related to it?(2)  Rash, red spots, dry skin patches, and even blisters as well as discolorations are telltale signs that you or someone you care about may have the condition. In these hot spot areas, the itchiness as well as burning can not only be painful, but it can also be debilitating at times as well. 

The most common form of eczema is called atopic dermatitis (AD) and the National Eczema Association reports that about 16.5 million adults have it.(3) Roughly 6.6 million of these individuals report having moderate-to-severe symptoms. 

Other forms of eczema include neurodermatitis, dyshidrotic eczema, nummular eczema, and contact dermatitis, hand eczema, and stasis dermatitis. Close cousins to the various forms of eczema are other skin conditions including psoriasis and rosacea. 

For a long time, experts were unsure exactly what caused eczema. Recent research, however, has shown that eczema (and likely many other related skin issues) can be autoimmune in nature.(4) This means that what causes eczema for many is an overwhelmed immune system that senses it is under constant attack and keeps producing pro-inflammatory compounds. As a result, inflammation levels rise in the body and substances that the immune system would normally target flourish. 

What Ingredients are Bad for Eczema?

Since eczema can be autoimmune in nature, many people with eczema will have certain non-skin related symptoms in common, namely systemic inflammation and Leaky Gut.(5) The key to finding relief for eczema has to start on the inside by eating a whole foods diet that does not contain foods and other substances which may cause a negative reaction, i.e. more inflammation, in the body. 

Each person is unique. The perfect diet for you may not work for your cousin or best friend. In general, however, most people with autoimmune conditions do well by eating a gluten-free diet. This is because mechanisms within gluten (which is in bread, baked goods, and other wheat products) have been found to contribute to intestinal permeability. This can catapult you into heightened inflammation and a dreaded eczema “flare-up” when you least expect it. 

In addition, there are some harsh chemicals that have been shown to be especially reactionary for people with eczema. These chemical additives are typically found in commercial sundry products and can cause flare-ups and even increase the severity of symptoms. Some of them include:(6)

  • -Fragrances (including essential oil)
  • -Urea
  • -Retinoids
  • -Lanolin
  • -High % of Alcohol (ethanol, etc.) 
  • -Propylene glycol
  • -Foaming agents

Many of these substances can be found in over the counter (OTC) dry skin lotions and even OTC and prescription topical eczema treatments too. Use caution when getting products that contain them, however. Even fairly benign substances that are typically soothing for skin, such as lanolin, can exacerbate eczema-related issues. But just like food, what topical ingredient(s) will cause a flare-up is highly variable, so cautiously testing simple, clean formulas is usually best. 

What Ingredients are Good for Eczema?

Whether it is what you eat, or what you put on your skin, there are definitely some substances that have proven to be gentle and very nourishing for people with eczema. 

First of all, similar to what to avoid, there are certain whole foods that can be healing for anyone with autoimmune issues. Foods such as olive oil and salmon that contain high amounts of omega 3 fatty acids have been shown to help heal the gut, lower inflammation, and cool autoimmune reactions.(7) 

In addition, there are certain substances found as typical eczema cream ingredients that have proven to be both gentle and nourishing as well. 

Hemp oil, as well as hemp seed oil, are substances that stand out amongst others for their inflammation-lowering characteristics as well as for overall skin healing. Hemp is a natural source of omega 3 fatty acids, which has proven to be beneficial on all levels, including for the immune system, for the nervous system, and the heart. Hemp oil in particular contains naturally-occurring CBD. CBD has proven to be a powerful anti-inflammatory, a super antioxidant, and helps to fortify the endocannabinoid system and nervous system. A 2014 review published in the journal Pharmacognosy Review found that hemp oil helped significantly with a variety of common skin conditions, including atopic dermatitis, psoriasis, and acne rosacea.(8)  

Medical marijuana has also been proven to help with the underlying mechanisms that may trigger eczema. Medical marijuana health benefits are well known for a variety of conditions. For skin-related issues, a variety of anecdotal reports have said that it can help with the itching and anxiety of eczema and related conditions. THC and CBN’s sedative properties, two compounds found within medical marijuana, may help with sleep disorders, which are closely tied to those suffering from chronic itchy skin. More studies are needed to see what specific strains or cannabinoids are most beneficial. 

Other natural substances can have amazing healing effects for eczema when applied externally as well. Some of these include aloe vera, jojoba, honey, borage oil, apple cider vinegar, baking, and organic honey.

What Are the Different Treatments for Eczema?

Experts say that the best treatment for eczema is to prevent a breakout BEFORE it happens. You can do this, as we just discussed, by avoiding substances like the ones mentioned above as well as eating an anti-inflammatory, autoimmune-healing diet.  

Another natural treatment for eczema that many experts recommend is healing soaks and wet wrap therapy. Dilute bleach baths or Apple Cider Vinegar (ACV) and baking soda can be used for luxurious, calming, and skin-healing soaks and ACV in particular can contribute greatly to keeping pH levels balanced to prevent flare ups. Wet wrap therapy is usually used during times of intense breakouts as well. Fabric is soaked in water and then applied to the affected area. The best time to do a wet wrap is either after taking a healing soak, or after applying medication or another natural healing substance. 

You can also prevent eczema flare ups by avoiding particular situations that may trigger autoimmune reactions like eczema. These may include temperature extremes as well as situations that stress the body in general. Several studies over the last decade have found that stress can cause spikes in cortisol (i.e. the “stress hormone”) which can, in turn, cause fluctuations in pH levels and a buildup of sebum on the surface of the skin.(10) Other studies have suggested that stress can cause eczema flare ups to last longer and also makes it harder for the skin to recover afterwards.(11) 

Over the Counter Vs. Prescription?

Of course, there are direct modalities, drugs, and natural formula products designed to help with eczema, both internally and topically. Some of these products you can purchase over the counter. Others require a prescription. But how do you know which one is right for you? You should always consult with your dermatologist, but here is what you may hear. 

The most common modality that conventional doctors and dermatologists recommend for eczema is topical ointments and creams that contain “corticosteroids.” Corticosteroids are designed to help calm inflammation as well as reduce the activity of certain mechanisms of the immune system. Sometimes antihistamines are recommended if the itching and burning at night prevents sleep. 

Most corticosteroid creams can be bought over-the-counter (OTC). Sometimes when certain OTC products do not work, stronger corticosteroid formulas as well as immune-mediating pharmaceuticals may be prescribed. There are dozens of these stronger drugs available via prescription. Dupilumab, a newer biologic agent, sold under the name Dupixent, is a game-changing biologic medication for some suffering from eczema. However, it is very expensive, costing upwards of 30k per year at list price with no insurance. 

If you decide to go the conventional route for your eczema, whether you get an over the counter cream or a prescription will be up to your doctor and will also be based on the severity of your condition. 

Many people use corticosteroids for eczema and it has been used in this capacity for decades. You should know, however, that corticosteroids do come with some known side effects. Long-term use can result in hormonal imbalances as well as issues with immune function. Steroid drugs can also hinder healthy stress responses and set a person up for other disease conditions.

Besides pharmaceutical options, there are many quality eczema relief creams that rely exclusively on natural substances such as hemp or cannabis-based CBD, jojoba, sunflower seed oil, and others. Many of these natural formulas rely on the natural ingredients mentioned above. What’s more, a quality natural eczema relief cream,  when coupled with a healthy diet and lower stress, may prove to be just as effective as pharmaceutical options for eczema, minus all of the side effects! 

The journey from breakout to “break through” when it comes to eczema can be a long one, and sometimes a confusing one as well. We hope that this article has helped you with the knowledge you need to not only make good decisions but also to know that you are in control and that you can heal eczema one day at a time! 

References: 

  1. https://www.aad.org/media/stats-numbers
  2. https://nationaleczema.org/eczema/types-of-eczema/
  3. https://www.aafa.org/media/2209/Atopic-Dermatitis-in-America-Study-Overview.pdf
  4. https://www.sciencedirect.com/science/article/pii/S0091674914014833
  5. https://pubmed.ncbi.nlm.nih.gov/22109896/
  6. https://nationaleczema.org/8-skincare-ingredients-to-avoid/
  7. https://pubmed.ncbi.nlm.nih.gov/12480795/
  8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931201/
  9. https://pubmed.ncbi.nlm.nih.gov/23889474/
  10. https://pubmed.ncbi.nlm.nih.gov/17340019/
  11. http://www.ingentaconnect.com/content/mjl/adv/2010/00000090/00000004/art00005
  12.  https://www.npr.org/sections/health-shots/2017/03/01/517933633/targeting-the-immune-system-may-help-stop-the-itch-of-eczema

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