Mary T., 6 years old, had been brought in by her mother complaining of recurrent itchy skin rashes at her elbows and knees. Mary’s case history revealed that she had suffered with infantile eczema at the age of 6 months and this persisted till 2½ years of age when a mild case of hay fever (allergic rhinitis) began. Repeated prescriptions of corticosteroid creams, emollients and anti-histamines had offered some relief for her early episode of eczema but it had seemed to have resolved spontaneously at the time.
Around 3 years of age, Mary’s hay fever aggravated and she still suffered severely with her bouts of sneezing in the morning, runny nose and itchy red eyes. She had been using an anti-histamine syrup for the past 3 years and at times would have to use a steroid nasal spray. About a year ago, Mrs. T. noticed that Mary’s hay fever began to subside a little and her eczema started again. The recent onset of her eczema was quite unbearable as there were times when Mary would scratch her skin till she bled.
The itching was usually worse at night, especially after bathing or when lying in bed and the rash was now red with tiny pustules that appeared very inflamed. Mary was recently complaining of burning and pain at the elbows and behind the knees and the inflammation from the elbow had spread down the forearm. The corticosteroid cream assisted with symptomatic relief but the rash seemed to be aggravating further.
Examination of Mary’s skin revealed that her eczema lesions were now infected, most likely with Staphylococcus aureus, a common bacteria on the skin. It was essential that the skin infection be treated first before the eczema could be addressed. Mary was advised to return to her general practitioner for a course of antibiotics and topical antimicrobial cream.
Mary returned two weeks later, the skin infection resolved and her chronic eczema presenting as it usually did. Further case taking revealed that Mary was not breast fed as a child and at the age of 6 months, her mother decided to introduce her to small amounts of regular food. This included very small portions of dairy (cow’s milk) although Mary’s paediatrician had advised her mother not to allow dairy into her diet until the age of 1 year. By 10 months of age, Mary had already began to consume small amounts of meat, processed foods, sodas and wheat products. Mary tended to favor dairy products and her mother reported that it was difficult to discontinue dairy from her diet although she was advised accordingly by many medical practitioners.
Mary’s previous allergen tests revealed a significantly raised immunoglobulin E (IgE) which is expected in long term allergy cases as well as sensitivity to dairy, wheat, dog hair, house dust mite and cockroaches. Mary’s mother was also concerned about her puffy eyes which she believed was due to the lack of sleep caused by the itching as well as the episodes of itchy eyes every evening.
Naturopathic Advice & Natural Treatment
- Asthma, hay fever (or post nasal drip) and eczema are usually caused by allergies (immune mediated hypersensitivity) affecting different areas of the body. This allergic triad of conditions often plagues a person for a lifetime especially if it commences in infancy. Resolution or amelioration of one condition may often be followed by the onset or aggravation of another condition within this triad. In severe cases like Mary, two of these conditions were affecting her simultaneously, namely the hay fever and eczema.
- Treating the hay fever or eczema symptomatically would only offer temporary relief and Mary’s hypersensitivity had to be addressed once both conditions were more effectively managed.
- A child suffering with allergies needs to be placed on an allergen-free diet immediately. This may be difficult to negotiate as the child gets older but it is an essential part of any allergy management. In Mary’s case, dairy and wheat had to be stopped immediately. Soy milk or goat’s milk may be viable alternatives for regular diary (cow’s milk). Rice and potatos were advisable to replace bread and pasta as a source of starch in the diet. Pre-packed crisps, canned foods and sodas have to be discontinued immediately along with any food containing monosodium glutamate (MSG), sodium benzoate, sulphur dioxide, tartrazine and any other food preservatives, additives or colorants.
- Mrs. T. was advised to replace the water based creams that she was using as an emollient with an oil based cream. Soap was discontinued from Mary’s bath time and instead aqueous cream should be used to ‘lather’ her for bathing. Mary’s skin had to be moisturized with a suitable emollient as often as possible, especially after bathing or at night. Mrs. T. was also advised not to discontinue the steroid cream immediately but rather wean Mary off it and use it in cases of aggravations. Petroleum jelly was advised if it did not aggravate the itching to protect Mary’s skin at night and reduce the damage caused by her scratching her skin when asleep.
- The night and early parts of the morning is often a time of aggravation for many allergy sufferers due to house dust mite. Most mattresses are infested with the house dust mite, a common allergen, and complete eradication of house dust mite (HDM) from the living quarters is virtually impossible. Instead conservative measures would reduce the HDM population. Mary’s mattress should be flipped around every 3 or 4 days to cut off the food supply of human skin cells to the HDM in the mattress. Bed linen should be changed daily and the mattress exposed to sunlight during the day if possible. Carpets, thick curtains, fluffy toys and blankets should also be removed from the bedroom as HDM tends to thrive in these objects.
- Mary was prescribed an immune modulator and homeopathic anti-itching remedy. This would be followed with a course of homeopathic desensitization therapy after 6 weeks if Mary’s eczema showed signs of improvement.
- Mrs. T. was also advised to start Mary on a zinc supplement or foods high in zinc due to the anti-inflammatory effects of zinc on the skin.