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Eczema can be unbearable, especially for children. Yes, creams provide short-term relief but when it comes to a long-term cure, your diet and the health of your gut play a more important role than you might think. Here’s why:
Not a single day goes by where I don’t see multiple cases of eczema. For some, it’s merely an irritating inconvenience but for many others, it can have a devastating impact on their quality of life.
My medical school training taught me to use steroid based creams and emollients (moisturisers) to treat the skin rashes and to be aware of possible triggers such as dust and biological washing powders.
For many years, that was how I managed eczema but I was finding more and more patients – particularly children – who were not responding to these strategies.
Then my own son started to suffer from eczema and as a concerned father I started looking for solutions. I wanted to address the root cause rather than simply suppressing his symptoms with steroid creams.
Eczema is a very common skin condition characterised by inflammation of the skin. Classic symptoms are redness, itching and dry skin. While the cause is not yet fully understood, it’s thought to be a mixture of genetics and environmental pressures. More and more studies show that our diet as well as the balance of bacteria in the human gut can affect the health of our skin.
I think of eczema as a form of immune dysfunction. Indeed, for severe cases of eczema, dermatologists often use strong immune suppressant drugs. While they can be effective, they can also have significant side effects.
When you are born, your immune system is relatively naive. During the first few years of life, exposure to foods, bacteria and other environmental triggers help to mature and educate your immune system.
Ideally, you want your immune system to become tolerant so that it doesn’t react to everything. You want it to react appropriately. Your gut houses approximately 70 per cent of your total immune system and the majority of the time, you want your immune system NOT to respond.
It is speculated that there are more immune reactions in your gut (to things like food) in a single day than there are in the rest of the body in its entire lifetime!
The food you eat, their interactions with your gut bugs and the subsequent effect on your immune system can have a very powerful effect on your overall health, including your skin. One way of thinking about this is that our immune response is matured by gut bacteria and then made fitter by the foods that one eats.
In the second episode of Doctor in the House, we meet five-year-old Lucas. He suffers from gastro-oesophageal reflux, severe eczema and recurrent abdominal cramps that keep him off school. When we first started working together, I discovered that he was on three different medications from three different doctors.
He was also a very fussy eater and 95 per cent of his diet consisted of wheat and dairy. Interestingly, when he got a cold and went off food for a few days, his skin got better.
I told his parents that I believed all three problems had one common root cause – the health of his gut. I believed that all three problems could be successfully treated by addressing his gut. Within a few weeks of excluding problematic foods and adding in helpful foods, as well as the short term use of supplementation to help mature his immune response, this little boy’s symptoms almost entirely cleared up.
In August 2015, a research paper reported that the bugs in our gut not only affect our susceptibility to infections and inflammatory diseases (such as eczema), they also shape the development of our immune system. The paper goes to say that a key component of this interaction is secretory IgA (sIgA) and deficiencies here can adversely affect our immune response. It states that sIgA production is a hallmark of the human immune response.
Although not covered in the TV show, I measured Lucas’ sIgA levels. They were very low and consistent with the immune system of a newborn. After a few weeks of diet changes as well as specific supplementation, his levels had almost doubled although they had not yet reached target levels for a five year old . Despite that, he still showed a dramatic clinical response to all of his symptoms. In addition, he was becoming a less fussy eater and starting to expand his food choices.
It was hugely rewarding to change the health trajectory of a little boy (same age as my son!) in just a few weeks.
Oh, and in case you were wondering – I managed to completely cure my son’s eczema by changing his diet and by improving the health of his gut.
— Dr Chatterjee