Atopic Dermatitis Alternative and Complementary Therapies Everyday Health

Atopic Dermatitis Alternative and Complementary Therapies Everyday Health

Atopic Dermatitis: Alternative and Complementary Therapies Everyday Health MenuNewslettersSearch Eczema

Alternative and Complementary Therapies for Atopic Dermatitis

By Joseph Bennington-CastroMedically Reviewed by Ross Radusky, MDReviewed: August 9, 2021Medically ReviewedIn addition to prescription medication, complementary eczema treatments, like coconut oil, baking soda, and bleach baths, may be effective for some people.iStock (2)People with atopic dermatitis, the most common form of eczema, suffer from very dry, itchy skin and rashes on various parts of the body, according to the National Eczema Association (NEA). (1) These symptoms typically are not constant, and they instead go through alternating flare-ups and remissions. While many children will outgrow atopic dermatitis, there is no cure for the chronic (long-lasting) disorder. (2) Treatment focuses on managing symptoms, reducing inflammation, healing injured skin and preventing further damage, and preventing and controlling flare-ups. (1) "People with atopic dermatitis have to make many extra efforts in their day-to-day lives to take care of their skin," explains Kanwaljit K. Brar, MD, a pediatric allergist and immunologist at NYU Langone in New York City. "People joke about their prolonged skin care routines, but for people with atopic dermatitis it is the difference between a comfortable night or a night of scratching and sleep loss." In additional to strict skin-care routines, conventional treatments may include: (1,2)Topical steroids and non-steroidal anti-inflammatoriesOral or injectable immunosuppressantsAntibiotics for skin infectionsPhototherapy In recent years, however, complementary and alternative therapies have grown in popularity for numerous conditions. In fact, about one-half of patients with atopic dermatitis have reportedly used alternative and complementary treatments, per the NEA. (3) While some of these therapies appear promising, it's important to note that most are understudied and require more research.

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Atopic dermatitis causes defects in the skin barrier — the outermost layer of skin that both protects the skin from invading microorganisms and allergens and helps retain moisture. Because of this issue, the skin becomes very dry, notes the NEA. (4) One way to combat this dryness and put moisture back into the skin is through proper bathing or showering treatments. The NEA recommends:Bathing or showering in lukewarm (not hot) water for no longer than 10 to 15 minutesWashing with a gentle cleanserPatting the skin dry with a towel and applying prescription topical medication to the skin as necessaryLiberally applying moisturizer within three minutesDressing only after a few minutes when the moisturizer has had time to absorb into the skin In addition to these general guidelines, some complementary bath treatments might help ease eczema symptoms and assist the skin with moisture retention. According to the NEA, these include adding (not at the same time):Gentle bath oils (specifically those with no fragrances or bubble bath solutions) to the bathwater to keep you moisturizedOne-quarter cup of baking soda to bathwater relieve itchingOne-quarter cup of household bleach to a full tub of bathwater to decrease inflammation and bacteria on the skinOne cup of table salt to bathwater to reduce the sting of the lukewarm water if you have a severe flareOne cup of vinegar to bathwater help kill bacteriaThe 7 Types of Eczema

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The NEA also suggests adding oatmeal to bathwater (or directly to skin) to relieve itching, but Dr. Brar stresses this could be dangerous for some people. "The use of food products on the skin, such as oatmeal baths, is not recommended as this may increase the risk for food allergy, or may cause skin irritation," she says.

Natural Topical Ointments for Atopic Dermatitis

Doctors recommend prescription topical ointments to treat atopic dermatitis, but some alternative topical treatments may also help if they are used in tandem with prescription medication, or as complementary treatments. Research suggests coconut oil (virgin or cold-pressed) has various properties that may make it an effective eczema treatment for some people. For example, one study published in January 2019 in the Journal of Traditional and Complementary Medicine found that coconut oil has anti-inflammatory and skin protective properties. (5,6) Other studies have suggested that coconut oil has antibacterial qualities and helps the skin retain moisture. (7) Sunflower seed oil may also be beneficial in treating atopic dermatitis (unless you are allergic to it). (8) One study found that sunflower seed oil can help restore the skin barrier and improve skin hydration. (9) A number of other plant-based oils are also under investigation as potential treatments for eczema symptoms, but more research is needed, according to a review published in July 2016 in the American Journal of Clinical Dermatology. (10) According to the NEA, cardiospermum (a flowering tropical vine from India and Africa) and topical vitamin B12 may be effective for eczema symptoms. (11) A review of the literature published in August 2017 in the journal Allergologie Select also noted that topical vitamin B12 shows promise according to small studies, but stresses that larger studies are needed to verify those results. (12)

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Acupuncture and Acupressure to Relieve Itching

Acupuncture, in which needles are inserted into specific points on the body depending on the underlying issue being treated, is frequently applied to allergy- and itch-related conditions. It has not been studied extensively for atopic dermatitis treatment. Single studies, however, have found that acupuncture can significantly reduce allergen-induced itch and itch related to kidney issues (uremic pruritus). (10) And a pilot study found that acupressure (in which small titanium beads are used to apply pressure instead of needles) can help reduce eczema-related itch, though the study lacked a placebo and had few patients. Another preliminary study (which also had few participants), published December 2018 in the journal Complementary Therapies in Medicine, found that acupuncture may help improve symptoms in people with atopic dermatitis. (13)

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The Mind-Body Approach to Atopic Dermatitis Treatment

Some complementary and alternative treatments for atopic dermatitis focus on helping patients get a handle on their stress. This mind-body approach is predicated on the fact that stress is a common trigger for eczema flares, likely because it produces inflammation, an underlying cause of atopic dermatitis symptoms. (11) A small study involving children found that massage significantly reduced atopic dermatitis symptoms, including itch, scaling, and redness, as well as anxiety. (10) Adding essential oils to massage had no additional benefit (and may even sensitize the skin to the oils), according to another study. Patients should be careful with essential oils (not to be confused with common bath oils), Brar notes. "Families will often try homemade concoctions of multiple essential oils that I recommend against," she says. "Essential oils may cause contact dermatitis and the fragrance may irritate the skin." Other studies have found a potential benefit to hypnotherapy and biofeedback (a relaxation or awareness technique that involves a physiological feedback device combined with directed thoughts). These two treatments appear to reduce skin damage through relaxation. Research, such as a study published in April 2018 in the journal Cognitive Behaviour Therapy, has also shown that exposure-based cognitive behavioral treatment (which uses mindfulness to increase tolerance for itch and distress during exposure to atopic dermatitis triggers) may reduce symptoms and anxiety. (14)

Probiotics and Vitamin D Supplements for Atopic Dermatitis

Researchers have investigated numerous oral supplements to treat atopic dermatitis, but most have been shown to be unhelpful. However, some evidence suggests probiotics and vitamin D might be helpful. "A diet rich in omega-3s, vitamin D, and probiotic-containing foods can have benefits to the skin," Brar says. It's well-known now that the microbiome — the trillions of microorganisms living within the human body, particularly the gut — plays a substantial role in our overall health. A number of studies have therefore looked into whether improving the health of the microbiome with probiotics can reduce inflammation and eczema symptoms. Though some studies suggest probiotics are effective, literature reviews, such as a meta-analysis published in September 2017 in Frontiers in Cellular and Infection Microbiology, have yet to reveal a clear benefit to the treatment. (15) For instance, a November 2018 Cochrane Review of randomized controlled clinical trials concluded that currently available probiotic strains make little to no difference in improving eczema symptoms, but probiotics generally don't cause significant side effects. (16) Vitamin D supplements have similarly gained a lot of research attention because people with vitamin D deficiency appear more likely to have atopic dermatitis and to develop a more severe form of the disease. But individual studies have had mixed conclusions. One literature review of randomized control trials, published in October 2018 in the journal Pediatric Dermatology, found that there is definitely a link between vitamin D levels and atopic dermatitis disease severity. (17) It also found that there's "weak evidence" that vitamin D supplementation improves symptoms in children, though it noted that only six studies were included and they were inconsistent in design and methods. Another review, published in September 2016 in Nutrition, also noted this inconsistency. (18) The authors concluded that vitamin D can potentially improve atopic dermatitis symptoms, but this finding will need to be confirmed with larger-scale studies conducted over a longer period of time. The bottom line: Complementary therapies work best in tandem with traditional treatments. Before trying one, be sure to have a discussion with your dermatologist. NEWSLETTERS

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Editorial Sources and Fact-Checking

Prescription Topical Treatment. National Eczema Association.Topicals, Oral Medicines, and Phototherapy: An Overview of Eczema Treatments. National Eczema Association.Complementary, Integrative and Alternative Medicine 101. National Eczema Association.Eczema and Bathing. National Eczema Association.Varma SR, Sivaprakasam TO, Arumugam I, et al. In Vitro Anti-Inflammatory and Skin Protective Properties of Virgin Coconut Oil. Journal of Traditional and Complementary Medicine. January 2019.Get the Facts: Coconut Oil. National Eczema Association.Evangelista MTP, Abad-Casintahan F, Lopez-Villafuerte L. The Effect of Topical Virgin Coconut Oil on SCORAD Index, Transepidermal Water Loss, and Skin Capacitance in Mild to Moderate Pediatric Atopic Dermatitis: A Randomized, Double-Blind, Clinical Trial. International Journal of Dermatology. December 2013.Natural and Alternative Treatments for Eczema. National Eczema Association.Danby SG, AlEnezi T, Sultan A, et al. Effect of Olive and Sunflower Seed Oil on the Adult Skin Barrier: Implications for Neonatal Skin Care. Pediatric Dermatology. September 2012.Vieira BL, Lim NR, Lohman ME, Lio PA, et al. Complementary and Alternative Medicine for Atopic Dermatitis: An Evidence-Based Review. American Journal of Clinical Dermatology. July 2016.Complementary and Alternative Treatments. National Eczema Association.T. Schafer. Complementary and Alternative Medicine for Atopic Dermatitis: An Evidence-Based Review. Allergologie Select. August 2017.Kang SH, Kim YK, Yeom M, et al. Acupuncture Improves Symptoms in Patients With Mild-to-Moderate Atopic Dermatitis: A Randomized, Sham-Controlled Preliminary Trial. Complementary Therapies in Medicine. December 2018.Hedman-Lagerlöf E, Bergman A, Lindefors N, Bradley M. Exposure-Based Cognitive Behavior Therapy for Atopic Dermatitis: An Open Trial. Cognitive Behaviour Therapy. April 2018.Huang R, Ning H, Minxue Shen M, et al. Probiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in Cellular and Infection Microbiology. September 2017.Makrgeorgou A, Leonardi-Bee J, Bath-Hextall FJ, et al. Probiotics for Treating Eczema. Cochrane Database of Systematic Reviews. November 2018.Huang CM, Irene Lara-Corrales I, Elena Pope E. Effects of Vitamin D Levels and Supplementation on Atopic Dermatitis: A Systematic Review. Pediatric Dermatology. October 2018.Kim G, Bae JH. Vitamin D and Atopic Dermatitis: A Systematic Review and Meta-Analysis. Nutrition. September 2016.Show Less

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