In Depth Healing Strategies for Chronic Skin Disorders
Between three and seven percent of Americans suffer from eczema, a skin rash characterized by itching, swelling, blistering, oozing, and scaling. The connection between allergies and eczema is strong: Many people with eczema also suffer from hay fever, sinusitis, and/or asthma, and approximately eighty percent have elevated levels of IgE (antibodies involved in allergic reactions). The genetic link is also undeniable-sixty to seventy percent of people with eczema have at least one family member with the disease.
Eczema is characterized by four criteria:
- Dry skin. As the disease progresses, the patient’s noticeably dry skin begins to crack open, most often around the joints, where the skin is constantly stretched. For some unknown reason, the sebaceous glands, which naturally secrete sebum to lubricate the skin and hair, don’t work properly, and the skin dries and cracks.
- Itching. The unrelenting urge to itch and scratch the inflamed areas is the cruelest symptom of all; for some people, the itching never goes away, and a good night’s sleep is a distant memory.
- Rash. Eczema is derived from a Greek word that means “to boil,” and the inflamed lesions literally seethe and bubble, causing severe itching and pain. The rash may be limited to small patches behind the elbows or knees or on the hands, feet, or neck, but for some unfortunate individuals, the lesions literally cover the entire body.
- Thickening skin. Over time the dry patches thicken to form crusty layers of skin.
The causes of eczema remain elusive, but many factors appear to be involved including:
- Allergies. Numerous research studies point to a strong connection between eczema and allergies in general, and specifically to certain food allergies or intolerances. People with eczema typically suffer from seasonal allergies, and many are asthma victims as well. (The allergic connection with asthma is well established; see pages 229 to 230.)
- Weakened immune response. The white blood cells in the skin itself seem to have a reduced ability to destroy bacteria, which leads to chronic bacterial infections that can aggravate and prolong the disease.
- Nutritional deficiencies. The typical Western diet-high in fat and refined carbohydrates, low in complex carbohydrates and fresh fruits and vegetables -appears to aggravate eczema. Dietary changes can significantly reduce the inflammation and itching of eczema.
- Stress. Emotional, mental, and physical stress often trigger flare-ups of eczema.
Contact dermatitis (also called allergic eczema) is an allergic reaction to a topical irritant such as poison ivy or a seemingly benign substance such as a cosmetic, laundry detergent, polyester fabric, or nickel or chromium button or jewelry. Hydrocortisone creams and oral steroids such as prednisone help to cool down the inflammation. Skin infections, usually caused by excessive itching, are often treated with antibiotic creams and lotions.
The more insidious type of eczema, and the one that we cover in this chapter, is called atopic eczema (or atopic dermatitis), an intensely itchy, inflammatory disease of the skin with no known single causal factor. Treatment usually involves the use of topical creams and lotions; the most effective creams are steroidal, but these medications can create dependence, requiring more frequent application to achieve the desired relief. If the creams don’t work, oral corticosteroidal drugs may be used for short periods of time.
If the skin lesions become infected (either from itching, which introduces bacteria into the open sores, or as a natural consequence of severe eczema), topical and oral antibiotics may be prescribed.
Baking soda baths (one cup of baking soda in a tub of lukewarm water) and oatmeal baths offer temporary relief of symptoms.
Psychotherapy is often suggested to help the patient deal with the emotional stress associated with eczema.
Vaccinations should be avoided during eczema flare-ups. In all autoimmune diseases the body generates large amounts of autoantibodies; vaccinations intensify the activities of these antibodies, which can overstimulate the immune system and cause an acute flare-up of the disease.
Three percent of the U.S. population suffers from psoriasis, a chronic, recurring skin condition characterized by bright red patches covered with silvery scales. While most people’s skin cells grow, mature, and die every month or so, with psoriasis the skin cells divide at a greatly accelerated rate-up to one thousand times faster than normal. The dead and dying cells pile up on top of each other, creating the silvery scales that are the tell-tale sign of psoriasis.
The areas underneath the scales are often red and inflamed and may become infected when the skin is scratched or rubbed. Lesions appear most often on the knees, elbows, and scalp, but other commonly affected areas include the chest, abdomen, backs of the arms and legs, palms of the hands, and soles of the feet. In acute flare-ups, the red patches and silvery scales can cover more than half of the body surface.
The cause of psoriasis is unknown, although a strong genetic predisposition exists: Fifty percent of people with psoriasis have a family member who also suffers from the disease. The disease strikes early; most people experience the first symptoms before the age of twenty. Psoriasis often occurs with rheumatoid arthritis, although the connection between the two diseases remains unclear.
While a precise cause continues to elude medical science, many clinicians and researchers believe the disease is connected to a combination of the following:
- Food allergies and/or sensitivities. A particular food causes an allergic reaction, which directly affects the skin.
- Faulty protein metabolism. Undigested proteins leak into the body fluids, creating an allergic reaction.
- Intestinal toxins. Harmful bacteria are absorbed through the intestinal walls into the bloodstream, causing an immune reaction that can exacerbate psoriasis.
- Stress. Psoriasis flare-ups occur during periods of intense stress, although stress is considered contributory rather than causative.
Just as the cause of psoriasis remains elusive, so does the cure. Treatments are basically geared to symptom relief and may include:
Topical creams and ointments (often steroidal), to help relieve pain and inflammation
- Sleeping pills, if insomnia is a problem
- Anti-depressant drugs, to elevate mood and treat depression
- Warm salt baths, to soothe the inflamed lesions
- Sunlight and ultraviolet light therapy, to reduce the replication of skin cells, relieving many of the symptoms
- Stress-reduction techniques, to alleviate anxiety and tension
- Psychotherapy, to help the patient cope with the stress of chronic illness
TRADITIONAL CHINESE INTERPRETATION (ECZEMA AND PSORIASIS)
According to traditional Chinese medicine, the most likely cause of chronic atopic eczema and psoriasis is a deficiency of Liver chi and blood, which allows Heat to build up in the blood. As the Heat accumulates, the body tries to eliminate it through the skin, which leads to inflammation, skin rashes, pain, and itching. To further complicate the situation, deficient Lung and Kidney chi inevitably weakens the wei chi, leaving you more vulnerable to attack.
The Chinese also interpret contact dermatitis (contact eczema) as an invasion of the Wind and Damp Devils as well as Heat; they penetrate the Skin and create numerous problems. The Wind Devil causes itching, while the burning and inflammation are attributed to the Heat Devil, and the “weeping” (oozing) skin results from the Damp Devil. If the external Devils get “under the skin” and penetrate deeper into the system, they can cause or exacerbate eczema or psoriasis.
If asthma is involved in either eczema or psoriasis, the Lung/Kidney deficiency is addressed first, with acupuncture and herbal therapies selected to strengthen and support those organs. If the individual is hypersensitive or experiences arthritic symptoms, the Liver is given prompt and immediate attention.
For both psoriasis and eczema, nutrition is the key to treatment. Once again, as with so many chronic illnesses, the possibility of food allergies or sensitivities should be immediately addressed. The foods most likely to cause problems include dairy products, wheat products, citrus fruits, nuts, and corn. If you avoid these common food allergens, the chances are good that your symptoms will be significantly reduced or eliminated. Most people who suffer from eczema and psoriasis experience dramatic improvement when they eliminate common food allergens from their diet.
Most allergies are caused or aggravated by incomplete digestion of food. If your digestive system is not working properly, “renegade” (incompletely digested) proteins are assimilated into body fluids. The immune system recognizes these “renegade” proteins as enemies and initiates a full-scale campaign to get rid of them. The frenzied activities of the immune system create an allergic reaction.
Saturated fatty acids in meat and dairy products tend to stimulate a general inflammatory response that manifests in the skin, giving you one more reason to avoid these problematic foods. polyunsaturated fats, which are chemically altered to behave like saturated fats, can also aggravate eczema and psoriasis and should be strictly avoided; these fats, also known as trans-fatty acids or TFAs, are found in margarines, vegetable shortening, and all foods labeled “partially hydrogenated vegetable oils.”
Avoid cooking with polyunsaturated vegetable oils, which become highly unstable when heated; use olive oil instead. Olive oil is high in monounsaturated fats, which have an anti-inflammatory effect and can dramatically reduce the symptoms of inflammatory diseases such as eczema and psoriasis. (People who regularly use olive oil also have lower rates of cancer and heart disease.) Buy extra-virgin olive oil, which is extracted without the use of high heat or chemical solvents.
Strictly avoid stimulants like sugar, caffeine, alcohol, and tobacco products, which can exacerbate skin conditions.
Concentrate on a well-balanced diet with plenty of whole grains, vegetables, fruits, and fiber-rich foods. Meat, chicken, turkey, and lamb are much less likely to cause you problems than beef and pork; whenever possible, choose organic meats that are completely uncontaminated with chemicals or hormones. Rice, potatoes, pears, apples, and most vegetables are generally nonallergenic, highly nutritious foods. Beware of citrus fruits, which can exacerbate both eczema and psoriasis.
Drink at least eight to ten 8-ounce glasses of water daily, to support the Liver and Kidney in their detoxification and elimination duties.
The Chinese believe that both eczema and psoriasis are caused by constrained Liver chi and a buildup of Heat (toxins) in the blood. Because regular movement stimulates Liver chi and helps to “move” the blood, supporting and increasing its circulation to all areas of the body, exercise is considered an important part of prevention and treatment for both eczema and psoriasis. Exercise also promotes perspiration, which assists the body in its efforts to eliminate toxins through the skin.
Both yoga and tai chi exercises stimulate the flow of energy and blood; these ancient healing methods also help “still” the mind, removing distracting thoughts and emotions.
- Beta-carotene: This substance, once it is converted in the intestines into vitamin A, supports and nourishes the skin and maintains the structural integrity of the cells and membranes of the body, particularly the skin and mucous linings. Take 25,000 I.U. daily.
- Vitamin C: This amazing all-purpose vitamin has antioxidant and antihistamine actions that make it an essential part of treatment for eczema and psoriasis. In double-blind studies vitamin C significantly improved the symptoms of people suffering from severe eczema. If you are taking antibiotics for skin infections, vitamin C will boost your immune response so that you need a lower dosage of the drug for a shorter period of time. Take 2,000-4,000 mg. daily.
- Quercetin / Bromelain: This bioflavonoid has strong anti-inflammatory and antihistamine actions. Take 150-250 mg. three times daily. Quercetin is often combined with bromelain, a digestive enzyme, to aid absorption.
- Zinc: Zinc helps the body heal from wounds and lesions and is useful in any kind of skin disease, but it seems particularly effective in treating eczema and psoriasis. Take 20-40 mg. daily preventively and up to 60 mg. daily during acute flareups. Zinc gluconate is particularly well tolerated and easy to absorb. Whenever you supplement zinc, you should take extra copper to maintain a healthy balance between the two minerals. The ratio of zinc to copper should be fifteen to one; thus, if you take 30 mg. zinc, take 2 mg. copper. Caution: Because zinc can be toxic in large doses, do not exceed 100 mg. daily.
- Hydrochloric acid (HCl): This supplement aids digestion and can help eliminate the “renegade” proteins that leak into the body’s fluids and provoke allergic responses. Studies show that the majority of people with eczema and psoriasis have a deficiency of hydrochloric acid in their stomachs. Furthermore, as Melvyn Werbach, M.D., states in his book Healing Through Nutrition, “the lower the acid level, the worse their skin problems, and the more likely they are to complain of gastrointestinal symptoms.” Take one five-gram tablet of betaine HCI before each meal, or as directed on the product label. Caution: Because hydrochloric acid can be irritating to the digestive tract, take it only with food or just after eating, and always use it under the supervision of a qualified professional. Don’t use hydrochloric acid if you have a history of ulcers.
- Omega-3 fatty acids (eicosapentaenoic acid or EPA): These fatty acids promote the health and integrity of the immune system and have significant anti-inflammatory effects. Numerous studies show that people with skin diseases experience significantly less itching and scaling when they use EPAs. The best food source of omega-3 fatty acids is certain oily fish-salmon, sardines, herring, mackerel, bluefish, and albacore tuna. Eat fish rich in omega-3’s three times a week, or supplement your diet with 1,500 mg. daily. If you can’t tolerate fish oil because of allergies or a general intolerance for the fishy aftertaste, flaxseed oil is a good substitute; take one tablespoon daily. Because flaxseed oil can quickly go rancid, be sure to refrigerate it and store it in an amber, light-protective container.
- Gamma linoleic acid (GLA): GLA is a valuable ally in protecting your cells from degenerative changes and reducing inflammation throughout the body. Numerous research studies support claims that GLA reduces the symptoms of arthritis, lupus, inflammatory skin conditions (eczema and psoriasis), premenstrual syndrome, and bowel disease (Crohn’s and ulcerative colitis). GLA is found in oil of evening primrose, borage seed oil, and black currant seed oil. Take 1,500 mg. daily.
Chinese Patent Remedies
For general support, we recommend the following:
Shou Wu Chili (“polygonum Multiflorum Juice”): This wonderful tonic is traditionally used to help people “age gracefully.” Used widely throughout China, it nourishes the yin (Water) reserves throughout the body, supports the blood, increases circulation, nourishes the Liver and Kidneys, relaxes the muscles and tendons, improves vision, keeps the skin moist and the hair lustrous and healthy, and strengthens the bones. Although this formula was not created specifically for the skin, its ability to nourish the yin and strengthen the blood helps keep the skin moist and healthy.
The Emperor herb in this formula is polygonum, which nourishes the Kidneys and is said to promote longevity; eight attending herbs support the digestion, cleanse the blood, and provide general support. Take 1-2 tablespoons three times daily.
For symptomatic relief of itching, we recommend:
Chuan Shan Jia Qu Shi Qing Du Wan (“Armadillo Counter Poison Pill”): This famous formula consists of twenty herbs to cool the heat and dispel the chronic itch of eczema. Although the constant need to itch and scratch is less common in psoriasis, this remedy is recommended for both diseases. The animal parts in the formula-armadillo scales (the “Emperor” ingredient) and tortoise shell-are credited with relieving the itching and inflammation; the attending herbs (codonopsis root, rehmannia root, ox gallstone, euphorbia leaf, hydnocarpus seed, astragalus, dictamnus root, smilax root, chrysanthemum flower, xanthium fruit, ligusticum root, fritillaria bulb, forsythia fruit, arctium fruit, cnidium fruit, scutellaria root, peony root, and lonicera flower) work together to nourish and “move” the blood, support the immune system, and strengthen Kidney and Liver chi. During severe flare-ups take four pills three times daily for one or two weeks. This formula is not appropriate for long-term use. Caution: Because this is a blood-moving formula, it should not be used during pregnancy.
These Chinese patent remedies can safely be combined with any of the following herbs:
The following herbs can be used alone or combined in a single formula. Popular formulas available at health food stores offer different combinations of these herbs, or you can contact a qualified herbalist, who will mix up a formula tailored to your specific needs. If you need help choosing the most effective formula or combination of herbs for your symptoms, consult an experienced herbalist.
- Licorice (Glycyrrhiza glabra): Licorice suppresses inflammation and has been used with great success in the topical treatment of eczema and psoriasis. Its adaptogenic effects on the adrenal glands and its anti-allergic actions make it doubly effective for skin diseases.
- Burdock (Arctium lappa): This blood-cleansing herb, which helps the cells eliminate toxins, has been used for thousands of years to treat skin conditions. Its gentle diuretic and laxative qualities and supportive actions in the Liver help encourage the elimination of toxins. Burdock also has anti-inflammatory and antimicrobial actions.
- Yellow dock (Rumex crispus): This liver-tonifying herb and gentle blood cleanser has a mild laxative action. Yellow dock combines well with burdock- it helps stimulate the removal of toxins that burdock works to dislodge.
- Red clover (Trifolium pratense): A gentle blood cleanser, red clover has been used extensively with great success for skin diseases and cancer.
- Dandelion (Taraxacum officinalis): Dandelion is the archetypal Liver tonic. An extremely nourishing herb, rich in vitamins and minerals, it offers general support to the Liver, encouraging the removal of toxins from the blood and allowing the skin to heal.
- Dong quai (Angelica sinensis): Dong quai is the most important blood tonic in Chinese medicine and is now used extensively in the United States and Europe. It invigorates and “moves” the blood, helping to eliminate Damp/Heat or Wind/Heat from the blood, which relieves many of the symptoms of eczema and psoriasis. Caution: Because dong quai is a blood mover, it should never be used during pregnancy. Shou Wu Chih can be substituted for dong quai, or you can combine the two remedies for enhanced effectiveness. Dosage: If you purchase your herbs in a health food store (either in tincture form or, as dried herbs, in capsule or pill form), follow the dosage instructions on the label. Because herbs in dried form tend to lose their potency rather quickly, be sure to check the label for the expiration date.
- Spleen 6 (“Three Yin Meeting Point”): This is one of the most popular points in acupuncture because of its many and diverse functions. Primarily used to support the yin essence (it is located at the point where three yin channels intersect), Spleen 6 strengthens Spleen and Stomach energies, aids digestion and metabolism, and helps to resolve damp conditions, particularly Damp/Heat. When this point is stimulated, obstructions in the blood are removed, and heat is dispelled. Location: Spleen 6 is located on the inner lower leg, approximately three inches above the inside ankle bone, in the depression just on the inside of the bone.
- Spleen 10 (“Sea of Blood”): This point is used to move and invigorate the blood, harmonize the Spleen energies, support menstruation, facilitate blood flow, and remove Heat from the blood. It offers fast and effective relief for virtually any skin disease or inflammation, including eczema, psoriasis, hives, and herpes zoster (shingles). Location: With your knee flexed, move your fingers along the inner ridge of the kneecap, stopping about two inches above the upper part of the kneecap in the bulge. This point is universally painful to the touch.
- Large Intestine 4 (“Great Eliminator”): This point is used to disperse “stuck” energy, heat, or wind from the upper part of the body and helps to relieve the Wind/Heat symptoms of eczema and psoriasis. Famous for draining toxins and breaking through obstructions, it is also used to relieve headaches and/or congestion in the head and neck. Location: Large Intestine 4 is located on the top of the hand, in the webbing between the thumb and index finger.
Other Complementary Strategies:
- Zinc spray: Relatively new on the market, the zinc spray called Skin Cap has been studied extensively in clinical trials in Spain and has recently been imported to this country. I’ve used this spray, which consists of only one active ingredient, zinc pyrithione, with severe cases of eczema and psoriasis and achieved impressive results. After only a few weeks of daily treatments, the skin lesions and associated inflammation, itching, and pain are significantly improved.
- Moisturizing baths: Excessive dryness is a symptom of both eczema and psoriasis. Soaking in a bath treated with a natural emulsifier, which locks the water into the skin, temporarily relieves the itching and discomfort of these diseases. Eucerin, Alpha Keri, Aquaphor, and Unguentum lotions and creams are common store brands; mix two tablespoons into a pot of boiling water, stir until mixed, and then add to your bathwater. Oatmeal baths can help relieve the itching and moisturize the skin. Tar baths have been used for psoriasis with excellent results; tar, a derivative of coal tar, is available from health food stores and pharmacies. A ten-to-fifteen-minute warm-water salt bath (use a pound or more of sea salts, mineral salts, or table salt) may also help people with psoriasis. (After you take a salt bath, be sure to rinse off with a quick, cold shower.) For eczema, baking soda baths are soothing; put one cup of baking soda in your bathtub, and soak for as long as you want. For both psoriasis and eczema, try adding five drops of German (high-quality) chamomile oil to warm bathwater, and soak for at least ten minutes.
- Creams and ointments: While numerous commercial brands of moisturizing creams are available, natural creams and ointments may offer you better results in the long run. For fast, effective relief for the itching of eczema, nothing comes close to chickweed (Stella ria media) cream or ointment. Other gentle yet effective herbal creams include calendula ointment, Self-Heal Salve (a combination of prunella, burdock, St. John’s wort oil, and calendula), vitamin E and aloe ointment, and Purple Gold Ointment, a Chinese herbal preparation. These products are available in many health food stores, or they can be ordered (see Appendix I). Many eczema and psoriasis patients find zinc oxide ointment effective in healing their skin lesions. Zinc oxide is available without a prescription. In Europe the main topical herb for psoriasis is cleavers (Galium aparine), which is also an excellent herb for internal use in skin conditions of all kinds; a topical cream or ointment for psoriasis might include both chickweed and cleavers. Although these ointments are not curative, they can provide significant temporary relief.
- Sunlight: Sunlight and ultraviolet light stop the skin cells from replicating at such a furious pace, relieving the symptoms of psoriasis. People with eczema also often find that their problems are alleviated during the summer months, when they spend more time in the sun. Try to spend a few minutes every day in the sun, but remember to avoid prolonged exposure to sunlight, and use sunscreen whenever appropriate. You might also consider purchasing a special light box that creates a full-spectrum light, to use in your home to help relieve the symptoms of psoriasis and eczema. Research indicates that you will get as much benefit and significantly less radiation from an ultraviolet B (UVB) lamp.
- Hypoallergenic products: Chemicals added to laundry detergents, cosmetics, soaps, shampoos, underarm deodorants, and virtually every cleaning substance we use in the home can cause irritation and allergic reactions. Switch to hypoallergenic products for all your personal hygiene needs, and use mild detergents such as Ivory Snow for washing your clothes. Avoid perfumed products like scented toilet paper and fabric softeners.
Questions to Ask Yourself
On a metaphorical level, you can conceive of skin irritations and diseases with a strong itching component as the body’s way of saying, “I need to let something out.” The disease might also be asking you to look at your relationships and your need-or, conversely, lack of desire-for contact with others. The following questions will help you to look at your disease as a constructive process that seeks change and redirection, rather than a completely evil force to be eliminated as soon as possible.
- I’m itching to let people know what I’m thinking or feeling: How can I express myself clearly and forcefully?
- I’m burning up inside: How can I cool things down?
- I tend to hide inside myself: What am I afraid of? What will happen to me if I “expose” my thoughts and feelings?
- Why do I prevent myself from making contact with other people?
- How can I let people under my skin and into my heart without letting them irritate me?
- How do my symptoms support me? What do they give me that is positive and enlightening? What are they asking me to do, to say, to become?
Skin conditions are often associated with Metal and Wood imbalances. Metal types might benefit by asking questions that focus on grief, loss, and the need for order and control:
- What past loss am I still grieving over?
- Can I find a way to let go of my grief?
- How can I bring some sense of order and routine back into my life?
- What can I control in my life? What can’t I control?
For Wood types, feelings of being stuck, blocked, or impeded often lead to physical and emotional problems. Ask yourself:
- How am I holding myself back?
- Where do I feel stuck physically, mentally, emotionally, and spiritually?
- What can I do to break through the obstacles confronting me?
- How can I use my creativity to move forward in my life?