Eczema and Psoriasis
Eczema and psoriasis are two words seldom mentioned without the other, but many are unsure of the difference between the two skin complaints. Both are types of dermatitis with shared symptoms of redness, inflammation itchiness and discomfort, however there are some key differences between the two conditions. Eczema is considered to be more of a symptom than a condition and it usually implies there is another underlying health condition causing the flareup. It can be triggered by allergies, such as wheat, dairy, chemicals in toiletries, pollen, mould, pets and house dust mites. Psoriasis on the other hand is a condition. It is linked to genetics, with one in three people with the condition having a close relative who also suffers[1]. It is linked to the immune system as it occurs when T-cells, part of the body’s defence system, mistakenly attack healthy skin cells. Whilst eczema and psoriasis conditions may look similar, the most common type of psoriasis, plaque psoriasis, has silver plaques that form over the top of the redness. Psoriasis can be aggravated by outside irritants, including the aforementioned eczema triggers.
Sufferers of eczema and psoriasis can be left feeling depressed and in some cases even isolated. In a study of people with skin disorders including vitiligo, eczema and psoriasis, 64% of people said that their skin disease affected their socio-economic activity and 40% of people felt that their social life was affected as well as evidence of particular stresses and demands in personal relationships.[2]
Whilst most know that our skin’s appearance and health is partially down to our genes and diet, the products consumers put on their skin are a serious business. Skincare is a multibillion dollar industry worldwide[3], and many customers, particularly those with skin complaints or conditions including eczema and psoriasis, can find selecting the right product for them from the plethora on shelves in shops a most daunting task.
But what switches consumers on to products? According to a recent survey by Euromonitor, price is the most important factor. Nearly 75% of developed market consumers mark price as being the most important factor when shopping, whilst one point that comes across in all markets is that consumers are looking for proven results in their skincare products. Older consumers are more switched on to how their skincare products are made and as their skin tends to be more sensitive to harsh chemicals and allergens, they are more likely to be swayed by key words including “natural” and “organic” used in the advertising and on pack copy of products[3].
As the number of sufferers of skin conditions such as eczema and psoriasis grows, so too does the number of products on the market to treat them. The traditional prescribed topical treatments of emollients and topical steroid creams may work to a point, but they do have their downsides and the concern about these amongst consumers are growing. When it comes to emollients in all their guises – soap substitutes, bath oils and creams, you will often find petrochemicals or ingredients derived from petrochemicals because they are cheap. Even if an emollient is derived from a natural ingredient (such as coconut, jojoba, olive) these synthetic emollients are produced at such high temperatures that all goodness in them is destroyed – nutrients, antioxidants and essential fatty acids. Another concern is that the ingredients may be contaminated with substances from the production process, including metal catalyst residues, carcinogens, and petrochemicals[4].
An emollient’s job is to soften and soothe the skin whilst also forming a filming over the skin to reduce water loss and increase moisture levels in the skin. This helps decrease the desire to itch and allows the skin to repair, however if the emollient is petrochemical-based, the skin may not be able to function properly. The correct use of emollients can help reduce an individual’s reliance on steroid creams, which I will come on to in a moment. There are some great natural products out there, including skin balms and creams, that can work wonders as natural emollients. Look for ones that include nurturing, hydrating and moisturising ingredients such as butters and oils from fruits and nuts – mango, shea, olive, grapeseed for example – and even individual ingredients can be considered such as coconut oil (with antimicrobial and antibacterial properties it helps prevent infection as well as calming inflammation), shea butter, sweet almond oil and apricot kernel oil. It’s worth consumers trying out different natural products to find what works best for them.
Hydrocortisone or steroid creams are topical ointments that are applied to affected areas to help reduce inflammation and break the itch-scratch-itch cycle. They can be useful for treating certain types of eczema and psoriasis however as they can thin the skin they are not recommended for long periods of use. Over-the-counter low strength products should not cause side effects if used carefully and only when needed. Other health problems, including thinning skin, spider veins, and stretch marks, or glaucoma and cataracts, are more likely to come from high-strength prescription products used over long periods of time. Often known as nature’s cortisone, liquorice root in products is an excellent and safe natural alternative to cortisone creams as it reduces inflammation, offering pain and itch relief.
When it comes to cleansing products, consumers should be looking for something that is soap-free. Soap can be irritating to both eczema and psoriasis. Products that contain skin health-promoting ingredients such as gentle, calming calendula, which also promotes cell regeneration; manuka honey, to guard against infection whilst healing; and soothing, nutrient-rich aloe vera.
When it comes to diet and environment, there are several ways that individuals can eat and live to help improve and manage their conditions. A 2013 study in the US demonstrated a reduced eczema prevalence in areas with high relative humidity, high UV index, high mean temperature, reduced precipitation and fewer days of central heating use[5]. Whilst relocating to sunnier climes may not be an option, there are some steps that can be taken including –
- control the humidity in the home. For dry eczema conditions or psoriasis symptoms that worsen seasonally may benefit from a humidifier set to around 35-45% humidity in the cold and dry months, and a dehumidifier in the hot, humid summer months.
- Increase exposure to UV. Those suffering from eczema and psoriasis should try to get thirty minutes a day out in the sunshine. This can be a great healer for eczema and psoriasis. They must be careful not to overdo it however as too much UV can lead to flare ups, particularly with psoriasis. For the winter months when it is cold and the sun is lower in the sky, consumers may wish to invest in a UV lamp to allow this type of therapy to continue.
- Remove as many elements of stress from life as possible, if stress is a trigger for the condition. High cortisol exacerbates inflammation throughout the body, including in the skin.
- Switch to natural products for all cleaning and personal care products, especially if an association between exposure to the products and irritation has been made.
When it comes to diet, there are certain foods that can trigger an allergic reaction and immune response exacerbating eczema because certain proteins are not digested properly. These foods include milk/dairy, eggs, nuts, soy, wheat/gluten, corn and other grains. The best way to test for these allergies is to eliminate all the aforementioned foods from the diet for 30 days, and then introduce them back into the diet one by one. This way it can be determined if a particular food group is causing a reaction or flare up. Just like applying topically to the skin, drinking licorice tea has an anti-inflammatory effect. Eating a diet rich in healthful fats is also important. Good sources of these include coconut oil, olive oil, avocado and Omega 3 rich foods such as wild salmon, walnuts and grass-fed meat (and dairy if its not a trigger food). Finally, incorporating home-made bone broths into the diet, as this nutrient dense food helps heal the gut and improve skin health.
There is also something of a miracle food blend that you can consider for treatment of these two skin conditions as well as other chronic diseases; flax seed oil and cottage cheese. This concoction was created by German biochemist Johanna Budwig, who recommends a daily portion of 2 tbs cottage cheese to 1 tbs flax seed oil; blend until the consistency is the same throughout. The key components of these foods are the electron-rich unsaturated fats in flax seed oil and sulphur protein in cottage cheese as the reaction between these two chemicals makes the oils water-soluble which means they can permeate the cell membranes and rebalance the electron charge in the cells, thus reducing inflammation and aiding in the healing process of the skin.
Finally, when it comes to supplementation, pharmacists may wish to recommend the following products –
- Vitamin D3 – between 5,000 and 10,000iu daily. The majority of these studies indicate an inverse relationship between the severity of atopic dermatitis and vitamin D levels. Studies have also shown that in individuals with eczema who are deficient in vitamin D, repletion of vitamin D results in decreased severity of disease[6].
- Fermented Cod’s Liver Oil – rich in essential fatty acids, as well as vitamin A and D, all great for skin health and immunity.
- Digestive Enzymes – take with meals to help with the breakdown of food.
- Probiotics – to encourage a healthy gut.
- Pycnogenol – a French maritime bark extract that has been studied and found to be efficacious in improving control of the most common aspects of psoriasis and in reducing oxidative stress[7].
[1] http://www.nhs.uk/Conditions/Psoriasis/Pages/Causes.aspx
[2] Skin disease and handicap: An analysis of the impact of skin conditions by Sandra Jowett and Terence Ryan Department of Dermatology, Slade Hospital, Headington, Oxford, England
[3] Selecting the Right Skin Care Product: What Matters Most? Euromonitor Survey 2014
[4] Stay Healthy. An Organic Guide to Healthy Skin: It’s All in the Ingredients, Northwestern Health Sciences University, accessed May, 15, 2009
[5] Climatic Factors Are Associated with Childhood Eczema Prevalence in the United States
Journal of Investigative Dermatology (2013) 133, 1752–1759; doi:10.1038/jid.2013.19; published online 21 February 2013 Jonathan I Silverberg1, Jon Hanifin2 and Eric L Simpson2
[6] Update on the role of systemic vitamin D in atopic dermatitis
Pediatr Dermatol. 2013 May-Jun;30(3):303-7. doi: 10.1111/j.1525-1470.2012.01850.x. Epub 2012 Sep 7.
[7] Pycnogenol improves psoriasis symptoms
http://www.nutraingredients.com/smartlead/view/931278/2?c=x3SkI7TCvuwX5l9JsU08O9y3Vg9n5oy9
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