Look beneath surface to treat skin conditions
By Dr. Martin Gleixner, MSc, ND
Eczema (atopic dermatitis), acne, psoriasis, rosacea, rashes and other types of dermatitis are common skin conditions affecting many Canadians.
Because they often affect areas on our face, arms, legs and hands, such visual manifestation can create social and self-esteem problems. Skin conditions can also be incredibly itchy and as a result can interfere with sleep and daily living.
The No.1-prescribed medication for skin conditions is hydrocortisone cream. This cream can be very effective in the short-term since it provides such a strong anti-inflammatory action. Unfortunately, this treatment approach suppresses skin inflammation and does not promote true health because ultimately it does not address the underlying problem, i.e. the actual cause(s) of one's skin condition.
This raises important questions:
- Are skin conditions actually a skin problem? Although the symptom appears at the skin, is it possible that most skin conditions are actually caused by internal versus external problems?
- Since blood circulating from internal organs eventually circulates to the rest of the body (including the skin!), is it not possible that the health of our digestive tract, liver and other organs can also influence the skin?
- If a hydrocortisone cream is used for extended periods to mitigate skin symptoms, is it possible for underlying internal cause(s) to become a more serious problem down the road (since they remain untreated)?
So that we can better understand such questions, let’s review one of my unique concepts, called the bucket analogy.
In previous articles, I used the bucket analogy to explain detoxification, how one can prevent unpleasant symptoms after smoking cessation, and to help understand the root causes of allergies, and depression and anxiety.
Let me review this analogy again to help us understand the true underlying causes of skin conditions. Let's think of our body as a bucket. Generally we are born in a state of health; our bucket is empty. As we go through life, a number of factors can interfere with our health. Perhaps it's a lack of sleep or exercise, a stressful job, pushing oneself too hard, feeling exhausted, excessive worrying, genetic predispositions, food sensitivities or poor dietary choices that can contribute to increasing the level in our bucket. The level in our bucket represents our health status. Declining health comes with rising levels, an indication that the body is out of balance.
We are also exposed to a great number of toxins during the course of our lifetime. All our cells create waste products that also need to be dealt with. Our lungs, kidneys, digestive tract, and liver (as shown on the bottom left corner of the bucket diagram) can normally remove most toxins and wastes on a daily basis, but sometimes these detox mechanisms become inefficient or overwhelmed.
Sometimes our own internal organs can be an important source of inflammatory waste products. Because our digestive tract is such as big organ with tremendous blood flow requirements, its health can influence other systems in the body. I have successfully treated a significant number of eczema cases by addressing digestive problems. By solving food sensitivities and healing the digestive tract, it no longer creates inflammatory wastes that can end up affecting the skin. Read below for more details.
In addition, key systems in the body (such as immune or hormonal systems) can become imbalanced which can put the 'squeeze' on the bucket thereby significantly contributing to raising the level in the bucket. A female patient with acne for example often indicates that their skin worsens during the week before their menses (i.e. as occurs in PMS). A child with immune related problems such as food and/or environmental allergies is at greater risk of asthma and skin conditions such as eczema.
Eventually, our bucket can overfill, leading to symptoms such as fatigue, aches and pains, unexplained weight gain, insomnia and changes in our mood. In addition, our skin can become irritated. This can lead to symptoms related to inflammation such redness, itching, and swelling. Our skin attempts to heal, leading to raised bumps, thickening of the skin, flaking of dry skin, pus and other secretions.
So what can one do to address an overfilled bucket? We don't want to put a lid on the bucket by suppressing symptoms. Such quick fixes or band-aid solutions rarely work for the long-term and do not enhance overall health status. Rather, a more long-lasting way to improve skin conditions is to address all aspects that are causing our bucket to overfill.
Step 1: Rule out pathologies that are linked with specific skin conditions.
Too commonly patients are treated for skin conditions without sufficient detective work. Discuss with your medical doctor or naturopathic doctor to investigate any pathological causes for your skin disorder. These can include: skin cancers such as melanoma, skin infections of all sorts, thyroid disease, drug side-effects, auto-immune diseases (e.g. lupus), digestive tract inflammation (e.g. Crohn’s, ulcerative colitis, or celiac disease), etc. Even milder forms of digestive tract inflammation such as those diagnosed with irritable bowel syndrome (IBS) should be evaluated and treated accordingly (see below for more detail).
Step 2: Address lifestyle factors.
Improving our nutrition and sleep, reducing stress, and decreasing our exposure to toxins are important steps to healing skin conditions.
Nutritional deficiencies can occur with dietary restrictions, insufficient whole foods, and excess intake of inflammatory foods (junk food, refined foods, etc…). Addictions such as cigarette smoking, excess alcohol or other recreational drugs can cause further depletion of many nutrients that are important for skin health.
Step 3: Optimize organ and immune system function.
Many of our organs have the main role of taking in what the body needs (water, nutrients, oxygen) and removing what it doesn't need (excess water, metabolic waste products, toxins and carbon dioxide). Since a healthy skin is best obtained through a healthy body, improving the function of the lungs, kidneys, digestive tract and liver is very important.
Our immune system orchestrates inflammation in the body. If it becomes imbalanced or hypersensitive, the immune system can have increased reactivity to foods and other allergens. Likewise, it may not be able to shut off or control it’s own inflammatory processes. Such imbalances can be important contributors to skin problems. There are several natural treatment options to help balance or modulate the immune system. Talk to your naturopathic doctor about options that are specific for your needs.
Step 4: Diagnose and address food sensitivities.
In my medical experience, the digestive tract is a common source of inflammation for the rest of the body: remember that blood circulating from your digestive tract eventually circulates to the rest of your body. As discussed earlier, poor food choices, food allergies/sensitivities, and certain diseases can lead to gut inflammation and cause the release of inflammatory molecules into the blood stream. This in turn can have a negative impact on skin.
Determining and avoiding foods that cause inflammation and immune system responses is therefore one of the most important strategies to addressing many skin problems. Talk to your naturopathic doctor about different options to determine your food sensitivities. An elimination/challenge assessment or a blood test for IgG antibodies against many common foods are some of the methods that can be used.
Please note that the use of the term ‘food allergy’ is technically reserved to IgE antibody (versus IgG antibody) related reactions. IgE food reactions are responsible for the immediate skin reactions (e.g. hives) or anaphylaxis symptoms (e.g. throat swelling) that can be tested via the skin scratch test or blood test at hospitals. Such tests if required should be referred by your MD.
The IgG reactions are termed ‘food sensitivities’ to differentiate from the IgE reactions. The IgG food sensitivity blood test offered at the Moncton Naturopathic Medical Clinic is the most important test to determine the cause of chronic (versus acute) skin conditions. Many of my patients have completely resolved their eczema for example by eliminating their IgG foods sensitivities. Although, foods such as grains (especially gluten containing grains), dairy, eggs, corn, nuts and soy can be important culprits, this test measures blood concentrations of IgG antibodies for a large number of foods; in fact it can tests for 96 or 184 different foods (depending on the panel chosen).
Step 5 - Give relief while addressing causes
Because of the unpleasant nature of skin symptoms, providing relief is also important. Naturopathic medicine has options to help minimize and manage the symptoms giving you time to ‘empty your bucket' and heal the skin.
As always, a combination of naturopathic approaches tailored to each individual provides the best clinical results. Assessing for food sensitivities and creating a feasible eating plan is paramount. The use of specific vitamins or minerals in medicinal doses (antioxidants for example) and individualized herbal or homeopathic combinations can address inflammation and can help control skin symptoms. Naturally-based creams are equality important to repair the skin, mitigate unpleasant symptoms and speed up the healing process.
Treating skin conditions is a whole body approach. By treating factors that aim to decrease both the level in our bucket and address the underlying causes, we can find a long-term solution to your skin problems.
Published by Dr. Gleixner on Wednesday, December 12th 2012 in Times & Transcript.
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