Eczema

Eczema is a chronic and recurrent inflammatory skin disease that usually appears in early childhood. Eczema is most common in infants where it occurs in approximately one in five children under 2 years of age. The condition can also occur in older children and adults. The prevalence of infantile and childhood eczema is increasing in industrialised countries where the condition tends to persist into adulthood. One in three Australians are affected by eczema at some stage throughout their lives.

The symptoms of eczema vary depending on the person and on whether it is an acute flare-up or a chronic phase, but include:

• Dry, reddened skin that itches or burns
• Blisters and/or oozing lesions
• Dry and/or scaly, thickened skin
• Moderate to severe itching

The skin lesions of eczema commonly appear on the face and neck, and at the inner elbow, behind the knees, wrists and ankles.

From a Chinese Medicine perspective, an incompetence or over-reacting immune system originates in the digestive system, and involves a weakness in the Spleen organ. A weak Spleen is not efficient in assimilating and converting nutrients into wei qi, or defence qi, which protects the body against toxins and harmful allergens in the environment. Poor levels or weak regulation of wei qi is the root cause of development of various allergies.

In Chinese Medicine Internal Organ theory, the skin is governed by the Lung organ. The symptoms of reddened, dry or scaly, blistering or oozing skin lesions in eczema is a manifestation of an accumulation of heat, phlegm and toxin pathogens in the Lung and along its meridian pathway.

The Lung organ is a container for dampness and phlegm pathogens produced by a weak Spleen. The Lung is also a receptor for heat and toxin being introduced into the body by way of vaccination, contact with chemical substances, and suppressive therapies such as corticosteroid ointments.

These heat, phlegm and toxin pathogens block clear blood flow to the skin layer. The Western theory says that the skin of people with eczema lack the ability to repair damage to the skin barrier as a result of a mutation in the gene called filaggrin. In Chinese Medicine physiology, a lack of healthy blood flow to the skin causes poor nourishment and an inability to repair damage, hence manifesting as dryness, thickening and chronic local inflammation.

The emptiness in the meridian pathway coupled with weak wei qi allowed external wind evil, which corresponds to environmental allergens in Western theory, to invade the skin, causing the typical symptoms of extreme itching and skin redness in eczema.

The genetic component in allergic diseases, and the tendency for eczema to first appear during early childhood, reflect a weakness in the Kidney qi. The Kidney in Chinese Medicine stores congenital essence which relates to the genes inherited from our parents. The Kidney also governs the growth, development and maturity of other organs systems. In the case of people with eczema, congenital weakness in Kidney qi is not supporting the proper functioning of the Spleen and Lung organs.

Different treatment focus for acute and chronic eczema

Chinese Medicine uses a combination of herbal formulas and acupuncture in the treatment of acute flare-up and management of chronic eczema. During the acute stage where there is severe skin itching, blistering and oozing lesions, treatments focus on expelling the pathogens to provide symptom relief. Between flare-ups and in cases of chronic eczema, emphasis is placed on treating organ deficiency and expelling lingering pathogens residing in the deep levels of the body system.

Aggravating factors need to be addressed in eczema treatment

Eczema patients with similar main complaints and symptoms may each have a different pattern of disharmony. Various aggravating factors need to be addressed in the treatment. Body areas where skin lesions manifests help to identify the affected internal organs and meridians. For example, eczema appearing around the scrotum and genital areas indicates that the Liver and Gallbladder organs and meridians need to be treated. The skin symptoms may be aggravated by emotional stress and repressed anger, overeating of hot and spicy food, as well as premenstrual hormonal changes.

Chinese herbal medicine treats the root cause of eczema

In our clinic, Chinese herbal medicine is an integral part of an eczema treatment program. Our herbal formulas are customised based on individual body constitution and pattern of disharmonies. To achieve this, herbs are subtracted or added to classical or contemporary formulas which have been proven effective in treating the condition. Commonly used foundation formulas in the treatment of eczema are:

• Xiao Feng San (Wind-Dispelling Powder)
• Si Wu Xiao Feng Yin (Eliminate Wind with the Four Substances Decoction)
• Long Dan Xie Gan Tang (Gentiana Purge Liver Decoction)
• Bei Xie Sheng Shi Tang (Dioscorea Decoction to Leach Out Dampness)
• Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction)
• Huang Lian Jie Du Tang (Coptis Decoction to Relieve Toxicity)

Allergic conditions with a genetic component originate from a deeper level of the body system. Depending on the severity of symptoms, chronicity of the condition, and the complicity of aggravating factors, repeated courses of treatment ranging from three months to one year are needed to successfully bring the condition under control.

Acupuncture for acute symptom relief and maintenance

Acupuncture is effective in supporting herbal treatments during both the acute and maintenance stages of an eczema treatment program. During an acute flare-up when symptoms of itchiness and blistering are severe, weekly acupuncture sessions provide rapid symptom relief, by draining heat and toxin from the meridians which pass through the affected skin areas. Each acupuncture point prescription is further assisted by empirical points that stop itchiness and mental-emotional points that calm the mind.

A maintenance acupuncture treatment program is essential in cases of eczema and any other genetically linked allergic conditions. It is recommended that eczema patients with symptoms under control undertake acupuncture session once every six to eight weeks, focusing on stimulating the normal functioning of the Spleen, Lung and Kidney organs. This approach not only prevents future flare-ups, also reduces the chances of developing associated allergies such as hay fever and food sensitivities.

Dampness and phlegm are the predominant pathogenic factors causing eczema in both children and adults. Certain foods are damp and phlegm-producing in nature, others are difficult to digest hence straining the already weaken digestive system of people with immune incompetency. Eczema patients undergoing Chinese herbal medicine and acupuncture treatment programs should avoid dairy products, refined carbohydrates and fruit juices. They should also avoid certain foods which are known to cause reactive responses in skin disease patients, such as food additives, eggs, corn, glutinous wheat, shellfish (shrimp, crab, lobster, etc), peanuts, peanut butter, spicy food, fermented vegetables, alcohol, coffee and chocolate.

Beneficial food for eczema patients are those which are rich in vitamin A and beta carotene, such as carrot, squash and pumpkin. Leafy green and seaweed purify the blood and eliminate toxin therefore should be added to the diet. Mung bean is cooling and detoxifying and is an important ingredient in Chinese dietary therapies for skin diseases presenting with heat and toxin.

Eczema patients who also has constipation should place particular priority in changing their lifestyle and diet in order to regulate their bowel movements. The Lung and Large Intestines belong to the same physiology system in Chinese medicine. Toxins that are not being efficiently eliminated from the Large Intestines tends to flow back into the Lung system, and either aggravates existing skin condition or causing it be become resistant to treatments.

Older children and adults whose eczema flare-ups are triggered by emotional problems should learn stress coping strategies and incorporate mind-calming activities into their daily routine.