Of Weeds and Weans Joseph Nolan

Eczema, dry skin, and kids

Joseph Nolan

Skin problems can be so distressing. They can be itchy, painful or both; they can be unsightly; they can be inexplicable and intractable; avoiding irritants can be burdensome, and treatment regimens can be messy and time consuming. Skin problems are a drag for children and their parents, no doubt about that. At a rough estimate, half of my paediatric practice is concerned with skin problems, and the largest part of that is eczema. So, let’s talk eczema and its less annoying sibling, dry skin.

Dry skin is just that. Eczema comes with intense itching and obvious inflammation, dry skin doesn’t. Often it is flaky, somewhat itchy, it may crack or feel tight, but it doesn’t erupt with inflammation like eczema. However, people with eczema often have dry skin too, so it is worth discussing them together. Eczema is an atopic condition, meaning that it is due to a heightened inflammatory immune response— similar to that you get with an allergy. People with atopic conditions often also have multiple allergies and intolerances, demonstrating the close link. In eczema, inflammatory overreactions show up in the skin, with dryness, itching, cracking, bleeding, blistering, and weeping. The itching can be maddening, and many people will scratch until it bleeds. Wearing thin cotton gloves at night can help with nocturnal scratching. Exacerbating factors include:  Heat— being tucked up in bed or overdressed  Chemical irritants— soap, hand sanitiser, swimming pools, and the well-intentioned application of essential oils  Wet wearing— wet clothes or sweaty synthetic fabrics, being overheated and sweaty, hot water, frequent washing. Why do children get it? In short, no one is quite sure. Certainly, family history is often a factor, but I have seen many children who are the first in their families to suffer with atopy. Diet and nutrition, the child’s environment, medications, other health conditions, and stress, also contribute. So, here are some things you can do at home to help:

Topical Treatments Topical applications are obvious with skin problems: you see them, they are uncomfortable, you want to put something on them. Certainly, to manage the itching and pain, something must be put on. Let’s think this through... If you have a hot, itchy, irritated, possibly bleeding, weepy thing, what do you want to use on it? Oil holds heat— it’s great for basting meat and warming up grandma’s arthritic knees, but do you really want it on itchy inflammation? Aloe gel is cool and soothing when fresh, but it dries tight and hard, removing oil from the skin. Great for hot, blistered, weeping skin; not so great if it is dry, flaking, and cracked. Cream is the thing. Cream is a mixture of oil and water, and it possesses the perfect blend of cooling moisture and softening oil. The drier the skin, the richer the cream it needs; hot and weepy requires light and cool.

Wearing cotton clothing, avoiding overdressing, changing nappies as soon as they are wet or soiled, nappy-free time, and using natural fibre cloth nappy covers, all make a difference, too.

Diet and Nutrition With eczema, avoiding three key things almost always makes a big difference: cow’s dairy (milk, cheese, yogurt, ice cream), tomatoes (pasta sauces, pizza, ketchup, chilli, curries, etc.), and sugar (sweets, biscuits, cakes, diluting juices, fruit juice, fizzy pop, hot chocolate, flavoured milk, etc.). The dairy connection is generally well known. Avoid it all together and instead go for any of the many excellent available substitutes (excepting soya milk, which has its own issues and propensity to cause allergies and reactions.). Tomatoes, especially tinned or cooked, are high in various acids and have a relatively low pH. An issue here is that inflamed tissue is already acidic: inflammation reduces blood flow into and out of an area, allowing acidic cellular wastes to build up (think lactic and pyruvic acids, and carbon dioxide). Eating low pH foods, like tomatoes, means acidifying the tissue further and exacerbating the inflammation. And thirdly, sugar. Well, sugar is proinflammatory, so any bit of inflammation in the body is going to be worse after eating it. It is an addictive stimulant, with a great deal of research establishing links between sugar, systemic inflammation, and a who’s who of modern health horrors, including obesity, diabetes, and cancer. It really has to go. How long these foods need to be avoided— excepting sugar which should just go —is a matter of some experimentation. Some children find they can, once their skin is clear, have modest quantities of these foods fairly regularly without apparent reaction; other children cannot.

We tend always to focus on what to cut out, what to avoid. Adding things is every bit as important, arguably more so. So, what do children with eczema and dry skin need? They need nutrients so their livers— responsible for detoxifying many of the products of inflammation -—can function optimally. They need nutrients to build healthy skin. They need vegetables. Brassicas like broccoli, cauliflower, kale, and cabbage, are packed with nutrients and aid detoxification. Spinach, carrots, peppers, peas, corn, sweet potatoes, cucumbers, fresh beans, lettuces, etc. are full of nutrients and anti-inflammatory compounds, and they fill up space in little bellies where cookies might otherwise feel good.

Healthy skin needs a lot of fat to maintain its suppleness and elasticity, and to function as a watertight barrier. So, children need healthy fats to repair and maintain their dermises. As a side note, healthy fats are also vital for optimal functioning of the brain and nervous system, so with children for whom stress is a factor, adequate lipid intake is doubly important. Good sources of healthy fats include hemp and flax oils, shelled hemp seeds and milled flax seed, nuts, seeds like sunflower and pumpkin, sesame and poppy seeds, avocados, olive oil, coconut oil, etc. The catch is that cooking destroys the healthy fats in these oils and renders them unsuitable for purpose. So, the nuts, seeds, fruits, and oils, must be added to food after it is off the heat. Ghee— which contains neither lactose nor milk protein —very rarely causes reactions in people with dairy intolerances, and cold-water oily fishes— like mackerel and salmon —are also good sources of healthy fats.

Drinking plenty of water is essential. Yes, the skin needs water and oil to maintain its texture but, most importantly, water transports body wastes. Water in blood and lymph, and then in urine, faeces, and sweat moves waste products through and out of the body. If water in in short supply, elimination suffers. Hydrate, hydrate, hydrate!

Herbs When treating dry skin and eczema, you are encouraging the body to build and maintain healthy skin, reduce inflammation, and optimise immune function. Trifolium pratense

(Red Clover) is one of the herbs I use most. It is sweet and moistening, and rich in nutrients. The nutrients in Clover help the body to both build and maintain healthy skin. The herb also has an affinity for the lymphatic system, helping carry away waste products and modulate the inflammatory immune response. Eczema frequently appears in spots with a high concentration of lymph nodes— the backs of knees, the neck, the abdomen, the armpits — and often has a yellowish colour. Both location and colour indicate that the lymphatics need a boost. Red Clover is anti-inflammatory and gently improves circulation, bringing water and nutrients to the skin to aid repair and rebuilding. Plus, Red Clover tastes lovely, mild and sweet. It’s a pretty pink thing, too. Use Red Clover in tea and tincture.

Glycyrrhiza glabra (Liquorice) is an unbeatable anti-inflammatory. It is sweet and moistening and helps— to my mind —to improve the flavours of other, more challenging, herbs. Children often like sweet things, and Liquorice can be very helpful for that, alone. But the antiinflammatory action makes it really indispensable for eczema. Used topically in a cream, it can stand in quite well for steroid creams, and I often use it to prevent the flareups that you get when steroids are stopped. It helps to reduce inflammation in the skin. As a ‘moistening’ herb, Liquorice helps lymph flow, bringing water to inflamed areas and improving waste removal. As we’ve seen, optimising lymphatic flow also helps modulate the inflammatory immune response. Use Liquorice in tea, tincture, glycerite, and cream.

Achillea millefolium (Yarrow) is one of Scotland’s most useful medicinal herbs. It does nearly everything, and is ubiquitous. In the context of skin and eczema, I use it partly for its mineral content— helping repair and rebuild healthy skin. Being bitter, Yarrow also improves liver function and lipid absorption for those healthy fats. It has an affinity for the inflammatory immune response, and I also use it for hay fever and other allergies. Like Calendula officinalis and Sambucus nigra flos., with whom I often combine it for hay fever, Yarrow helps to strengthen the skin and improve both its structure and function. The herb also modulates circulation and the functionality of blood vessels, bringing blood and nutrients to the skin to aid repair. Give Yarrow in tea, tincture, and aromatic water.

Topically for itchy dry skin, I use Stellaria media (Chickweed) cream. Chickweed helps to improve lymphatic flow, thereby reducing inflammation and itching. It’s a very gentle herb, ideally suited to children. Chickweed creams tend to be on the lighter side, and they work very well for dry and itchy skin, although it isn’t really enough for inflamed eczema, and you will need to go bigger. For eczema itself, I typically recommend a cream with Calendula, Matricaria recutita (Chamomile), or Borago officinalis (Starflower, Borage) seed oil. The first two, in particular, are usually made as thick, rich creams and work well for very dry and inflamed conditions.

Lastly, there is another simple and easy home remedy for dry, itchy, and inflamed skin: Oat Baths. Avena sativa (Oats) is a wonderful skin remedy. Eat them of course, but also put them in the bath. Here is how:  Take a couple of handfuls of porridge oats and tie them in an old sock.  Run hot water into the bathtub, steeping the sock like a giant teabag. After a few minutes of soaking, massage the sock until the water gets milky.  Bathe as usual. With dry skin and eczema, soap exacerbates the problem, so avoid it if possible. In children, this is not usually a problem, although older kids, teens, and adults, will need to use a little here and there. You can also add Epsom or Dead Sea salts to the bath for an extrasoothing boost.

Happy Herbing!