A practical guide to dermatitis and skin care

Although this information leaflet is based on a general skin condition known as Dermatitis', the advice and practical measures can often be relevant to many forms of skin pathologies and sensitivities.

Eczema (or as sometimes referred to Dermatitis) is one of the most common irritating, distressing and often unsightly skin conditions, having far-reaching effects on the sufferer’s health, happiness and lifestyle. As many as 1:10 people in the UK may be affected at some time in their lives, often in childhood, but the condition can also develop later in adult life.

The physical appearance of skin when affected by eczema is dry, red, inflamed, often scaly, flaky patches and sometimes accompanied by small blisters. These can weep, leading to scabs, leaving patches or raw skin. The skin can itch constantly and may feel sore.

Septic spots may develop if blisters become infected. Scratching can also encourage secondary infection, or cause dry, hard, thickened patches. In severe cases, especially if the sufferer has been scratching, raw or broken skin may bleed. There are three basic types of eczema:

A. Irritant contact eczema

Usually develops over a period of time.
This is the most common form in adults, but can also occur in children.
The hands are most often affected due to exposure to irritants i.e. detergents, oils, other caustic substances whether at home or at work.
May spread to other parts of the body not normally exposed.
If extreme may develop into general exfoliative dermatitis or erythroderma.

B. Allergic contact eczema

Usually affects adults.
Less common but similar to irritant eczema.
May be provoked by stress, fatigue or strongemotions.
Re-exposure and reaction to irritantsdevelops much more rapidly.
Sufferers often react to more than one substance.
Common culprits include: sticking-plasters, cosmetics, metals, plants, rubber, glue, dyes and resins.
In some cases symptoms may develop a long time after initial exposure.

C. Atopic eczema
This group has a genetic predisposition and tend to develop a triad of related conditions:
  eczema
  asthma
 hay fever
This type is most common in children and starts by the age of two.
More common in bottle-fed babies.
Tends to improve with age, significantly reduced by puberty.
If it starts after puberty it may then be persistent.
Worse in cold, sweaty or humid conditions.
May be exacerbated by anger or stress.
Eczema may improve by age five but asthma and hay fever may then develop.
Atopic children often have milk sensitivities.
20 years ago only 1 in 10 were affected, now as many are children are sensitive to cow's milk it has increased to 1 in 3

D. Seborrhoeic eczema
This type of eczema is slightly different in children and adults.
In infants this is known as cradle-cap (thick, brown, grey scales on scalp and forehead).
In infants it usually clears up on its own but may become infected if scratched.
In adults it is linked with overactive sebaceous (oil glands).
The scalp may look like dandruff.
May cause skin infections like Candida(yeast)

PREVENTION AND TREATMENT
The most obvious way to relieve eczema is to identify the trigger factors such as irritants, allergens, foods, cosmetics, stress factors and avoid them. To facilitate the body’s cleansing and detoxifying process specific herbal remedies may be prescribed along with suitable diet and supplementation regime.
Patients undergoing this form of holistic treatment may initially encounter a worsening or their condition. It is important not to be alarmed by this temporary relapse. In fact this is usually the sign that the body is reacting to the change and dealing with the condition. The herbal medicine and the new diet are placing a demand on the body’s systems to eliminate the toxins or irritants that may have built up over the years. The skin is one of the routes for excreting unwanted substances along with the more obvious means like the bowel and urinary systems.

Initially the practitioner may advise to avoid the most commonly known allergens from the diet but also those that come in contact with skin. (These are listed below).

However, as each of us are unique in this condition there will be substances which will be more allergic and others more tolerable. The process to identify these substances is usually lengthy and involves a detective-like approach.

One of the ways to achieve this is to go on a very simple diet or a total food fast for 2-3 days and then gradually start re-introducing various foods, starting from the most simple and bland i.e. rice, then potatoes, then fish, then other vegetables etc. whilst allowing at least one day between each. When a reaction is observed then (from the notes you have been making) identify the last foodstuff eaten
and exclude or re-test. However, this procedure is not as simple as it seems.
Caution: do not attempt a total food fast without professional advice.

Quite often more than one allergen may be involved or even the way there are combined and of course other external allergens may be implicated. Furthermore, the patient’s emotional or mental state of health may often be a predisposing or aggravating factor i.e. stress and anxiety.

COMMON SOURCES OF CONTACT ALLERGIES
Jewellery, especially nickel.
Drugs and medicines including unsuitable skin creams.
Cosmetic products (i.e. make-up, soap, perfumes, dyes).
Household products (i.e. bleaches, washing powder, polishes).
Sunlight (intense exposure).
Perfumed sun screen products
Wool.
House dust mite.
Animal hair, feathers and excrement.
Certain house plants.
If one of the partners works in an environment where there may be exposure to allergens (i.e. a hairdresser), they must ensure that a shower is taken on arriving home. Failure to do so may precipitate an allergic reaction to themselves or to their partner especially if sharing the same bed.

AREAS OF BODY AFFECTED AND POSSIBLE CAUSES

Scalp
Shampoos, hair-dyes, hats; headbands.
Ears
Earrings, spectacles, ear-drops, scalp applications.

Eyes
Eye drops, dusts, pollen, cosmetics

Face and mouth
Cosmetics, toothpaste, foods

Skin- folds (e.g. arm pits)
Clothes/fabric/dyes, washing powder, deodorants

Hands
Cleaning materials, occupational hazards, pets, rubber gloves, bracelets

Trunk
Similar to skin folds

Whole body
Probably something eaten, drunk or drugs

HINTS AND TIPS ON THINGS TO AVOID AND USE

Always check labels for constituents and additives.
Use non-biological detergents.
Use an unperfumed, non-coloured, non-soap based cream for body. Do not use any detergents on face. Men should use emulsifying ointment or cream for shaving.
If you have to use cosmetics test them on a small part of your skin first for a few days.
Use gentle soaps like Simple shower cream' and Simple shampoo'. Use just a small amount.
Wear only cotton or silk next to skin.
If food allergy is suspected avoid the above-mentioned foods.
Do not use fan heaters or humidifiers.
Avoid condensation in the house.

How to deal with house dust

Always damp-dust all surfaces

Vacuum clean at least once a week especially the bedroom and under the beds
Shake quilts and rugs outside and leave them hanging outside especially on breezy or sunny days to kill mites.
Avoid feather quilts and pillows or woollen blankets
Wet wash carpets at least once every six months or yearly.
Clean curtains frequently.
Maintain a good fresh air circulation in all the rooms.
Keep the bedroom as cool as possible.
Avoid the build-up of dampness.

Skin care and protection

Ensure the skin is not allowed to become dry, chapped or broken. This will make the condition even worse as more moisture will escape.
After washing, before going out or when the skin is dry, apply cream.
For simple moisturising purposes, use a light simple cream such as Diprobase, or Simple.
If there is evidence of active eczema, a cream contains herbal extracts may be applied. A qualified medical herbalist may advise you on suitable remedies.
For washing use a non-soap based cream, without bleach, colours or perfumes
Do not apply any detergents on the f ace. For shaving work up a lather using a small quantity of emulsifying ointment. Use warm water and rub your palms rigorously to develop a light creamy texture.
Avoid tight-fitting clothes, synthetic fabrics or woollens
On holidays, protect skin from excessive sun exposure and always build up a suntan gradually. Remember that most creams with sun screen will irritate the skin unless they are truly hypoallergenic. Aim to the white pasty-like screens containing zinc oxide.
Use non-perfumed antiperspirants
Do not scratch
Do not use bubble bath
Do not over-wash
Do not wear jewellery

You may also consider buying an ionizer especially for the bedroom. These devices cause changes in the electrical charges or airborne dust and smoke particles causing them to settle on surfaces rather than float in the air. The cost start from £20.

Dietary suggestions

Evidence from a number of studies has led to the understanding that some eczema sufferers may benefit from a specific dietary programme. A number of foods have been identified as detailed below.

Eat fewer animal products and fats
Eat more fresh fruit and vegetables esp green leafy variety.
Reduce consumption of tomatoes, eggplants, peppers.
Peel fruits with thick skin esp apples
Avoid processed or junk food
Avoid milk and dairy products especially confectionery
Avoid regular consumptions of spicy food, coffee and tea
Cut down on sugar, salt and alcohol

INCREASE

Consumption of cold pressed vegetable oils
Eat more oily fish
Eat carrots, raw or cooked
Go on a total fast for a day or two periodically (but seek advice on this first)
To reduce the reaction from eating allergic food, take a teaspoon of baking soda in water but not on a regular basis!
Get a copy of our therapeutic smoothie recipes!

Nutritional supplements

Evening primrose, borage, linseed or safflower oils
Vitamins A, B and E
Zinc, Selenium and Magnesium

When to seek further advice

If a new rash does not clear up in a few days.
If you are in doubt about what it is.
If it covers a large area.
If it oozes or weeps, especially in a child.
If it gets worse despite self-help measures
If it comes back after a recent successful treatment.
If treatment has no effect.
If your doctor has prescribed special medication for your condition then ensure that you follow the instructions.

It is the author’s opinion that prolonged application of corticosteroid or antihistamine creams should be avoided or kept to the minimum. If you have to use these medications then apply them thinly and sparingly and for a minimum period only. However, do not stop any medication before discussing this with the prescriber or a trained healthcare professional.

Any attempt to address this seemingly stubborn disorder must first be aimed to identify and eliminate the aggravating factors and these are unique for each individual. Any subsequent treatment must be based on holistic healthcare principles. These include all aspects of healthy living such as diet and nutrition, relaxation, exercises and with the assistance of natural remedies which aim to assist the body in the cleansing and recovery process. There are countless testimonials of people whose symptoms have been significantly improved or even eliminated following a comprehensive natural healthcare programme.

Always consult a qualified and registered healthcare professional.
The information provided above is not intended diagnose or treat your condition.