Atopic eczema
Introduction
Atopic eczema, also known as constitutional eczema or atopic dermatitis, is a chronic inflammatory disease of the skin. Itching is usually the most important symptom. The skin can also be dry, red, scaly or thickened and during a flare can also cause bumps, bladders, crusts or wet spots.
Atopic eczema often starts at a young age and usually has a varying course with quiet periods and flares. Hereditary predisposition plays an important role. Asthma, hay fever and other atopic disorders occur more frequently in people with atopic eczema and within their families.
Acupuncture and Chinese herbal medicine can be tailored to the phase of eczema, skin appearance, severity of itching and underlying TCM pattern.
Common symptoms
The appearance of atopic eczema can change with age. Common features are:
- dry skin;
- itching, sometimes very severe;
- red or irritated skin;
- small bumps or blisters;
- scaling;
- wet spots during active flares;
- crust formation;
- Scratch marks and crevices;
- thickening and roughening of the skin in the event of prolonged complaints;
- disturbance of sleep due to itching.
In babies, the face, scalp and sometimes torso and limbs are often affected. The eczema can be moist and wet as well as dry.
In children, the eczema is common in the elbow and knee cavities and around the neck, wrists and ankles. In adolescents and adults, especially the folds, neck and sometimes the hands are affected. Long-term crabs can lead to increasingly thicker and rougher skin.
Possible causes
Atopic eczema is created by a combination of factors. Genuine predisposition is important. The skin barrier works less well, making the skin easier to lose moisture and more sensitive to external stimuli. In addition, a disordered immune response in the skin plays a role.
Several factors may provoke or worsen symptoms. Examples include heat or cold, sweating, dry air, wool or other irritating materials and certain skin products. Stress can also induce a flare in some people or strengthen existing itching.
Scratching further damages the skin, causing an itching-crab cycle. The damaged skin is also more sensitive to bacterial and viral skin infections.
How can acupuncture help with atopic eczema?
Within Chinese medicine, treatment is tailored to the phase and appearance of the eczema. An acute flare with a red, warm and moist skin is assessed differently than chronic eczema where mainly dryness, scaling and thickening are present.
Depending on the picture of complaints, treatment may be directed at:
- reduce itching and skin irritation;
- reduce redness and heat;
- reduce skin discomfort when wetting or blistering;
- support dry and fragile skin;
- support the skin for prolonged thickening and scaling;
- supporting sleep when itching disturbs it;
- help reduce the frequency and severity of recurrent flares.
If the skin image changes, the treatment can also be adjusted.
How can Chinese herbal medicine help with atopic eczema?
Chinese herbal medicine is at atopic eczema tailored to the same differences in skin image and TCM pattern. This allows two people with the same diagnosis to get different herbs.
Depending on the grievance picture, herbal treatment may be aimed at:
- reduce severe itching;
- soothe red, warm and irritated skin;
- reduce vesicles and wet skin defects;
- support dry and scaly skin;
- treat prolonged skin problems and recurrent flares.
Herbs can be used daily between acupuncture treatments. Within the Chinese dermatology, external herbal treatments are also used in eczema, for example in the form of washings, compresses or ointments. The choice depends on the skin image and condition of the skin.
TCM vision on atopic eczema
Within traditional Chinese Medicine, atopic eczema can have different patterns. Age, phase of the condition and appearance of the skin play an important role in this.
In young children Dampness-Heat can be at the forefront. Dampness is associated with moisture, vesicles and wetting skin abnormalities; Heat with redness and inflammation. The Spleen plays an important role in this because this TCM organ system is involved in the processing and distribution of moisture.
In case of long-term complaints, the pattern may change. Chronic inflammation and recurrent flares according to the TCM may eventually lead to insufficient nutrition and moisturization of the skin by Blood and Yin. The eczema then gets drier, rougher and thicker.
Wind plays a role in the strong itch that is so characteristic of atopic eczema.
A TCM organ system describes a group of related body functions and is wider than just the anatomical organ with the same name. Read more at TCM basics .
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance is likely to contribute to the complaints. Read more at TCM basics .
Below are only the most common patterns discussed. Other patterns are possible and multiple patterns can occur at the same time. This allows you to recognize yourself in different descriptions. Also, someone with a certain pattern does not have to have all the symptoms mentioned. The pattern is determined on the basis of the overall picture of complaints.
Most common TCM patterns in atopic eczema
Damp-Heat
Short explanationDamp-Heat occurs especially when the eczema is active, red and moist. This image is mainly described in babies and children, but the pattern can also occur in other stages of life.
Common symptoms
- red skin;
- severe itching;
- bumps and blisters;
- wet skin abnormalities;
- crust formation;
- sometimes erosions by crabs;
- in children, sometimes disturbance of sleep;
- sometimes yellow urine or constipation.
Spleen-deficiency with Dampness
Brief explanation
In this pattern, the Spleen does not work and distributes according to the TCM moisture sufficiently. This makes it easier for Dampness to survive. The skin image is often less inflamed than with pronounced Dampness-Heat and the complaints can be of a recurring character.
Common symptoms
- recurrent eczema;
- vesicles or any moisture formation;
- itching;
- decreased appetite;
- bloating;
- soft or loose stools;
- fatigue.
Spleen-deficiency with Blood-Dryness and Wind
Short explanationThis image is mainly described in older children, adolescents and adults. Due to insufficient nutrition of the skin, Dryness develops. Wind contributes to the persistent itching.
Common symptoms
- dry skin;
- scaling;
- strong or recurrent itching;
- raw skin;
- thickening of skin;
- cavities;
- scratch marks;
- little or no wet skin abnormalities.
What can you do for yourself?
Limiting skin irritation is important in atopic eczema. Try to avoid known personal triggers as much as possible and prevent the skin from drying out or getting damaged unnecessarily.
Avoid very hot water and products that you notice irritating the skin. Also wool, strong heat and excessive sweating may exacerbate the itching in some people. Regular use of a suitable fatty ointment or cream can help to support the skin barrier.
Try to limit crabs as much as possible. Especially in children, keeping the nails short can help to reduce skin damage during scratching.
Outlook
Atopic eczema usually has a chronic and variable course. The symptoms can almost disappear over longer periods and flare up later. Moreover, the appearance and locations can change as someone gets older.
The treatment course depends on the age, severity, duration and phase of the eczema and the underlying TCM pattern. An acute, active flare requires a different approach than prolonged dryness and thickening.
As a directive, acupuncture can be used once a week in the initial phase. When complaints are reduced and stable, the frequency can be reduced. Chinese herbs can be used daily between treatments when appropriate.
Medical safety
In atopic eczema, good skin care and regular medical treatment is important, especially when the symptoms are extensive or severe. Let the eczema assess when the diagnosis is not clear or when the symptoms increase significantly despite treatment.
Contact your doctor if you experience rapid redness, pain, pus, extensive yellow crust formation, fever or feeling sick. This may indicate skin infection. Also rapidly expanding painful vesicles or wounds, especially in combination with fever or being ill, require rapid medical assessment.
Use prescribed medications, including corticosteroid ointments, as agreed with doctor or dermatologist and do not change them independently.
Contact
Do you suffer from atopic eczema and want to know if acupuncture and/or Chinese herbal medicine can fit with your complaints? During a first consultation we discuss, among other things, when the eczema originated, the locations and characteristics of skin abnormalities, the severity of itching, possible triggers and other relevant symptoms.
On the basis of the overall complaint picture, it is considered which TCM pattern is likely to be at the forefront and which treatment fits in with it.