The most common form of eczema is atopic eczema, sometimes also called atopic dermatitis.  According to the Canadian Dermatology Association, 17% of Canadians suffer from atopic eczema at some point in their life.   This is the type of eczema that begins in childhood.

Cause

There is a genetic component to atopic eczema.  It is associated with asthma and hayfever.  Evidence suggests that good management of the atopic eczema will actually reduce the likeliness that a child will develop asthma or hayfever later in life.

The latest thinking about the cause of atopic eczema is an inherited genetic mutation in a skin protein called filagrin.  Filagrin’s normal function is allowing skin cells to adhere tightly to one another.   In a healthy individual, these proteins allow cells to form a strong defensive barrier, so that the skin is impervious to irritants, allergens and bacteria.  It also minimizes the loss of moisture from inside the body.  In an atopic eczema patient, the filagrin is defective resulting in a defective skin barrier function.  This permits allergens, irritants and bacteria greater access into the skin, resulting in irritation and inflammation.  Moreover, by failing to lock in moisture inside the body, the skin becomes dry and dryness then leads to itchiness.  Scratching the itch results in damage to the skin which makes it all the more easier for irritants, allergens and bacteria to further harm your skin.  This is termed the itch-scratch cycle.  The key to controlling any type of eczema is to stop the itching.  If the itching stops, the body’s natural healing ability will be able to repair the damaged and inflamed skin.

Chinese Medicine & Eczema

Eczematous skin problems in Oriental medicine are called Dampness rashes.  Dryness and Dampness are intimately related in the body.  We have more or less a fixed amount of fluids inside our body.  If for some reason one area of the body is too dry, then some other region in the body must be too damp.  Similarly if one part of the body is too damp, then another area must be too dry.  From an Oriental medicine perspective, eczema is related to improper fluid balances in the body.  Oriental medicine recognizes a few different types of eczema-like rashes.

Blood Heat Eczema

Dry itchy eczema that is not associated with weeping fluid, is due to heat in the blood, which in conventional medicine would be akin to the idea of inflammation.  Therefore there is much redness in this pattern of eczema.  This type of rash does not have a clearly defined separation between the healthy skin and sick skin.  Blood Heat eczema is often linked to emotional triggers.  Treating this pattern will involve the use of herbs that cool the blood, calm the emotions, combined with herbs that stop itching.

Damp Heat Eczema

This type is associated with weeping fluids or dried crusts attributed to Dampness and red inflamed skin attributed to Heat.  Treating Damp Heat eczema will involve using combination of herbs that have the function of clearing heat and simultaneously draining dampness.  Dr. Poney Chiang may dispense herbal powders and herbal compresses that can be applied to the rash to dry up the weeping from the outside, which will complement the drying effort from oral herbs taken internally.

Blood Heat & Damp Heat Combination Eczema

Unlike the Blood Heat pattern, the combination type has a clearly defined separation between the healthy and sick skin.  Naturally herbs that cool the blood and herbs that treat Damp Heat will be used to treat this mixed type of eczema.

Qi & Blood Deficiency

This type is associated with chronic eczema.  It is not terribly itchy and the rash is only a pale red instead of an intense red seen in the Blood Heat type.  There is typical thickening of the skin called lichenification as a result of the body trying to protect itself from damage to the skin due to persistent scratching.  The way this type of eczema is treated is to build up the blood in the body, so that it can moisten the skin to prevent dryness.  Dryness needs to be managed to prevent the itching that triggers the itch–scratch cycle which damages the integrity of the skin, leaving the body prone to infections.