• Oral use of
Eczema is an allergic reaction that occurs in the skin. It consists mainly of itchy, inflamed patches on the face, elbows, knees, and wrists. Eczema is most commonly found in infants and young children. Eczema is closely associated with asthma and hay fever. All together, they are called atopy. Atopy tends to run in families.
Medical treatment for eczema consists mainly of antihistamines and topical steroid creams.
Principal Proposed Natural Treatments
Probiotics are health-promoting bacteria. The most famous probiotic is Lactobacillus acidophilus , used to make yogurt. Probiotics are thought to have immune-regulating actions. Use of probiotics during pregnancy and after childbirth may reduce risk of childhood eczema, presumably by, in some unknown fashion, normalizing immune response.
In a very large, long-term, double-blind study, 1,223 pregnant women were given either placebo or a probiotic mixture (containing lactobacilli and bifidobacteria) beginning 2-4 weeks before delivery.
In addition, some but not all double-blind trials have found evidence that infants and children who already have eczema may benefit from the use of probiotics.
If probiotics are beneficial for childhood eczema, they are probably more effective at preventing the condition rather than treating it. A carefully conducted review of numerous studies cautiously concluded that probiotics may help reduce the risk of eczema in infants and children, particularly those at high risk.
For more information, including dosage and safety issues, see the full
Early exposure of the infant to allergenic substances found in infant formula may play a role in the development of eczema.
A large study lends credence to this theory.
The results showed that women encouraged to breastfeed were much more likely to do so than other women. Furthermore, children of women in the intervention group showed almost a 50% reduction in the incidence of eczema.
Interpreting this study is trickier than it might appear. Technically, it does not prove that breastfeeding reduces risk of eczema. Rather, it shows that counseling to breastfeed reduces risk of eczema. However, the implication is fairly compelling: if you breastfeed your child, he or she is less likely to develop eczema.
Chinese Herbal Medicine
A combination of traditional Chinese herbs has shown promise as a treatment for eczema. This proprietary formula contains
Each study enrolled approximately 40 people and used a cross-over design in which all participants received the real treatment and placebo for 8 weeks each. Use of the herbal combination significantly reduced eczema symptoms compared to placebo.
However, a subsequent study of similar design performed by a different research group failed to find significant benefit.
In a 12 week, double-blind study, a different traditional Chinese herbal formula also failed to prove more effective than placebo for treatment of eczema.
Asian herbal creams marketed for eczema have often been found to contain high potency corticosteroid drugs that are not listed on the label.
For more information, including safety issues, see the
Topical creams made from
A study by the same authors (also not double-blind), involving 72 individuals with eczema, found somewhat odd results. In this trial, chamomile was not significantly more effective than placebo, but both were better than 0.5% hydrocortisone cream.
A double-blind study of 30 people compared 1% and 2%
Another placebo-controlled, double-blind study, enrolling 49 people with eczema, found benefit with a cream containing
A double-blind, placebo-controlled study of 88 people with eczema tested a cream containing extracts of
Evening Primrose Oil/GLA
Evening primrose oil, taken orally, has been widely used in Europe for the treatment of eczema. Evening primrose is a rich source of the essential fatty acid
A review of all studies reported up to 1989 found that oral use of evening primrose oil reduced the symptoms of eczema after several months of use, with the greatest improvement noticeable in the level of itching.
Better designed studies published subsequent to this review have not shown promising results. A
Only one double-blind trial performed subsequent to the 1989 review found therapeutic benefit with evening primrose oil, but it used very high doses of the supplement and found only marginal benefits.
The bottom line: At the present time, the balance of the evidence suggests that GLA taken orally is probably not effective for treating eczema.
However, an interesting double-blind study tested the use of undershirts coated with borage oil for treatment of eczema.
For more information, including dosage and safety issues, see the full
Other Proposed Natural Treatments
A cream containing red vine leaf and licorice
Similarly, an 8-week, double-blind trial of
A widely publicized study supposedly found oral use of the plant sea buckthorn (
) helpful for eczema, but in fact placebo treatment proved equally or more effective.
Although it is widely believed that food allergies are a major contributor to eczema, this assumption may be incorrect.
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14. Aertgeerts P, Albring M, Klaschka F, et al. Comparison of Kamillosan cream (2 g ethanolic extract from chamomile flowers in 100 g cream) versus steroid (0.25% hydrocortisone, 0.75% fluocortin butyl ester) and non-steroid (5% bufexamac) external agents in the maintenance therapy of eczema [translated from German]. Z Hautkr. 1985;60:270-277.
19. Von Berg A, Koletzko S, Grubl A, et al. The effect of hydrolyzed cow's milk formula for allergy prevention in the first year of life: The German Infant Nutritional Intervention Study, a randomized double-blind trial. J Allergy Clin Immunol. 2003;111:533-534.
30. Stucker M, Pieck C, Stoerb C, et al. Topical vitamin B—a new therapeutic approach in atopic dermatitis—evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial. Br J Dermatol. 2004;150:977-983.
31. Takwale A, Tan E, Agarwal S, et al. Efficacy and tolerability of borage oil in adults and children with atopic eczema: randomised, double blind, placebo controlled, parallel group trial. BMJ. 2003;327:1385.
35. Belloni G, Pinelli S, Veraldi S, et al. A randomised, double-blind, vehicle-controlled study to evaluate the efficacy and safety of MAS063D (Atopiclair®), in the treatment of mild to moderate atopic dermatitis. Eur J Dermatol. 2005;15:31-36.
36. Shapira MY, Raphaelovich Y, Gilad L, et al. Treatment of atopic dermatitis with herbal combination of Eleutherococcus, Achillea millefolium, and Lamium album has no advantage over placebo: a double blind, placebo-controlled, randomized trial. J Am Acad Dermatol. 2005;52:691-693.
38. Kukkonen K, Savilahti E, Haahtela T, et al. Probiotics and prebiotic galacto-oligosaccharides in the prevention of allergic diseases: A randomized, double-blind, placebo-controlled trial. J Allergy Clin Immunol. 2006 Oct 27. [Epub ahead of print]
39. Folster-Holst R, Muller F, Schnopp N, et al. Prospective, randomized controlled trial on Lactobacillus rhamnosus in infants with moderate to severe atopic dermatitis. Br J Dermatol. 2006;155:1256-1261.
40. Taylor AL, Dunstan JA, Prescott SL. Probiotic supplementation for the first 6 months of life fails to reduce the risk of atopic dermatitis and increases the risk of allergen sensitization in high-risk children: a randomized controlled trial. J Allergy Clin Immunol. 2007;119:184-191.
41. Hon KL, Leung TF, Ng PC, et al. Efficacy and tolerability of a Chinese herbal medicine concoction for treatment of atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol. 2007 May 14. [Epub ahead of print]
42. Abrahamsson TR, Jakobsson T, Bottcher MF, et al. Probiotics in prevention of IgE-associated eczema: a double-blind, randomized, placebo-controlled trial. J Allergy Clin Immunol. 2007;119:1174-1180.
43. Brand PL, Vlieg-Boerstra BJ, Dubois AE. Dietary prevention of allergic disease in children: Are current recommendations really based on good evidence? Pediatr Allergy Immunol. 2007 Jun 11. [Epub ahead of print]
45. Kanehara S, Ohtani T, Uede K, et al. Clinical effects of undershirts coated with borage oil on children with atopic dermatitis: A double-blind, placebo-controlled clinical trial. J Dermatol. 2007;34:811-815.
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Last reviewed April 2009 by EBSCO CAM Review Board
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