Eczema: Simple Disease or Deeper Disturbance
By Todd A. Hoover, MD, DHt
Eczema patients, as a group, represent some of the most profound examples of the benefits of homeopathy and some of the most frustrating cases I have seen in my practice. Because of the superficial nature of the problem, improvement or decline in the overall case are extremely obvious to the prescriber, to the patient and frequently to all those who know the patient.
Eczema is usually described as a skin irritation that causes dryness, itching, redness, occasionally weeping and crusting, excoriation and at times flaking. The most classic location of the eruption is in the bends of the joints, cheeks, and trunk, though it may occur anywhere on the skin. Eczema is very common affecting 10% of the population and most commonly occurring during the first year of life. Research shows it to be more common in industrialized countries, and there are ongoing projects to determine if contracting measles or getting the BCG vaccination for TB (common in developing countries) is somehow protective against eczema.
Eczema has a tremendous tendency for inheritance from your parents. If one parent has eczema, hay fever, or asthma, there is a 50% chance that the child will have one of these disorders. Samuel Hahnemann, the Father of Homeopathy, recognized both the depth of the problem and inherited tendency of this disease. He described the condition within his "miasm" of Psora (named after the disease Scabies). This Psora tendency includes mental, emotional and physical patterns that are passed down from the parents.
Other common names for the disorder include atopic dermatitis, dyshydrosis, and allergic dermatitis. Evaluation and diagnosis by a physician is appropriate in all cases of eczema. Similar skin disorders include psoriasis, dry skin of hypothyroidism, scabies, contact dermatitis (such as poison ivy), impetigo, and fungal dermatoses.
In reality, Eczema is technically not truly a "Skin Disease". Eczema is predominantly an immune system disorder characterized by over-reaction that an allergic nature. Allergy at the lung system level is called asthma, and at the eye level is called allergic conjunctivitis, and at the skin level is called eczema. Therefore, from a homeopathic perspective, while the symptoms being produced at the skin level are significant, one must consider the totality of the individual when choosing a remedy for a person with eczema.
Let us consider the subject of allergies in general first. Allergic response is essentially an immune system driven over-reaction to an external substance (usually in the form of a protein, or other molecule, called an antigen) that comes into the body through the nose, mouth, skin, etc. Typical antigens related to eczema include dairy, wheat, tree pollen, pet dander, dust and mold.
When the antigen molecule comes into the body the first time, the immune system recognizes it as a foreign substance and records a memory of the substance. In the individual with eczema tendency, subsequent exposures to this antigen cause a progressively severe immune response to this foreign substance. The time course of this response may be minutes, hours or days after the exposure, which may make identification of the offending substances difficult.
Western Medicine looks at this disorder as an aberrant dysfunction of the immune mechanism. Treatment therefore primarily focuses on suppression of the immune response. The stronger the suppressing drug, the more effective it becomes. This approach includes topical steroids, oral antihistamines, topical anti-inflammatory drugs, and oral steroids. While the drugs are used the rash improves, but when the drugs are stopped, the eczema returns. The hope is that the child will eventually "grow out" of the disease.
Homeopathic Medicine takes an opposite approach. By stimulating the body to move into a more healthy state, the over-response of the immune system may moderate and the eczema should improve. The likelihood of improvement in eczema is fairly good because the body is relatively more capable moderating an over-responsive state, than it is at improving states that result from a deficient action.
Constantine Hering, a monumental Homeopath from the 19th century, formulated a law of tendencies of cure based on his observations in clinical practice. Hering's Law suggests that as Cure progresses, symptoms will improve from those that disturb the center of the vitality to those that are more superficial: or, as it is sometimes described, from the inside out, and from the center to the extremities, and from the top down. In other words, in the patient with a general allergic tendency, we would hope to see that as the health is improving overall, the eczema improves. Frequently we will see this as a progress of the eczema improving first in the face, then the trunk and then down and out of the extremities. An opposite declination in health would be apparent in the patient who initially has eczema that is treated (or technically suppressed) and then subsequently develops a deeper problem such as chronic sinus disturbance or asthma. In such a patient, despite the fact that the original eczema has improved or actually resolved, the overall health of the individual is significantly worse.
With Hering's Law in mind, we need to be aware that many individuals have problems at multiple levels (such as sinus inflammation or asthma, in addition to the eczema). Such cases may show dramatic improvement in their asthma or general allergies, while having a worsening of the eczema. Overall, the health is dramatically better; but the part of their problem that is viewable by their friends and family now appears significantly worse. Such individuals can sometimes lose heart in the course of treatment preferring to live with a deeper illness for the sake of vanity. This may become an obstacle to cure that is impossible to overcome and these patients may not be readily treated homeopathically.
Additionally, some individuals will use suppressive therapies, such as topical steroid medicines, as a way of moderating the movement of symptoms toward the surface. Some of these patients can be treated with repetition of lower potency remedies while the usage of such suppressive medications are gradually tapered. In others, homeopathic treatment will be completely disrupted and not possible.
Lastly, Individuals who have used suppressive therapies such as steroids over a long time period may experience significant worsening of their eczema as the body pushes back against what may have been years of immunosuppression. In my own case, I was treated with oral steroids nearly every year of my childhood for severe poison ivy. When I was first treated with a constitutional homeopathic remedy for another issue, my health dramatically improved overall. But I developed severe rashes and itching of my legs that gradually progressed from the thighs to the feet over a period of 6 months. Even years after the original treatment, the body formed a reaction that moved to the surface in accordance with Hering's Law.
When considering individuals with allergic symptoms at multiple levels and those on chronic suppressive allopathic therapies, a well trained professional homeopath will be a crucial asset to choose the appropriate remedies and dosages that may need to be given over an extended time period to gradually improve the health. I want to specifically emphasize the importance of that last statement.
The following discussion will be directed toward those individuals who have primarily eczema without serious underlying allergic or other pathology, and who have not been on long-term suppressive therapy. Important symptoms I consider when evaluating such individuals include: major stressors related to the onset or worsening of eczema symptoms, particular modalities that affect the symptoms including time of day, heat or cold, particular foods, bathing, etc., concomitant symptoms such as gastrointestinal disturbances, headache, chills, etc. and the actual distribution and symptoms of the rash itself. These symptoms are all taken within the general context of the individual nature of the person in question. Are they generally irritable and fastidious, or mild and yielding? What are their likes and dislikes in general? Hopefully, some cohesive picture of the imbalance that exists within the person (including the eczema) will emerge.
For example, some of the most commonly used remedies for patients with eczema include:
Sulphur is perhaps the most commonly used remedy for these people. They tend to be individuals who take up a lot of space psychically. They have lots of ideas, are generally friendly, and never afraid to let you know their opinion, whether you asked for it or not. Their eczema tends to be very itchy, with scratch marks and bleeding (especially in the bends of joints like elbow or knee). It is worse for the heat of the bed or bathing, worse for itching, and much worse for wool exposure. There may be oozing or even infection in the rash. People who do well with Sulphur may have many symptoms, but frequently will have hot feet, craving for sweets and alcohol, aversion of eggs or the smell of eggs, and easy diarrhea.
Arsenicum Album may be useful for individuals who have strong tendency to be tidy and very exact in their nature. They are frequently restless individuals with a distinct fear of germs, dirty things and the possibility of catching a disease or cancer. Their eczema tends to be very dry, red, burning, and occurs in patches (especially on the hands). The rash is worse for cold air, worse when they are more anxious, and better for warmth. These individuals may also have trembling, easy diarrhea, internal chilliness, and constant thirst for small amounts.
Arsenicum Iodatum Individuals who need this remedy differ from Arsenicum album in many ways. While they may have similar fears with regard to the health and diseases, and the same type of restlessness, they tend to have internal heat rather than chilliness. They may have a tremendous appetite, but seem to gain very little. Their eczema tends to be dry, burning and worse for heat, which is opposite of Arsenicum album.
Graphites is to be considered for individuals whose eczema is very dry, and tight over the skin. The eruption becomes cracked open and oozes a sticky white or yellow discharge that is frequently more apparent on waking in the morning. Typical location of the rash is behind the ears, and in the webs of the fingers and toes.
Rhus Toxicodendron type individuals are generally conscientious individuals who may appear to be reserved with worries about how they should be behaving and acting. They tend to be restless with a feeling that they need to be doing something productive. Their eczema tends to be itching and smarting, with raised areas or even blistering and oozing.
The rash is worse from cold, worse in the morning and better from itching. Sometimes they will want to scald the rash with a very hot shower for temporary relief.
Lycopodium clavatum type individuals are generally chilly, thin, and suffer from a lack of confidence, which may be covered by a façade of bravado. Their eczema will tend to be dry, flaking, dirty appearing, cracked and at times with discharges. There may be thickening of the skin and involvement of the feet.
Natrum Muriaticum is considered for individuals who are somewhat reserved, yet considerably insightful and opinionated. They are very sensitive on both the physical and emotional levels.
These remedies are just a handful of literally hundreds of remedies that have been used to treat people with eczema. In all cases of eczema, one must remember that the individual has the disorder as a result of sensitivity and over-reactivity. In such individuals, the potential for a homeopathic remedy to evoke a response is high. They tend to react or even over-react to many things. Likewise, they may react strongly to either a correct remedy for their nature or even to an incorrect remedy. The reaction is likely to be according to their typical reaction, which is the skin eruption. If the skin reacts and the eczema becomes worse, one can only be sure that the homeopathic remedy is correct if the overall health of the person is improving. Ultimately if the health is improved, the eczema is capable of being helped and will most likely improve with that remedy (even if the rash initially worsens).
Hahnemann suggested that the remedy should be given in a potency that would produce a cure and result in the least disturbance of the ecology of the individual. In other words, the best dose is the one that improves the health of the individual, resolves the symptoms and does not cause a worsening of the symptoms. In my experience, the higher the potency of the correct remedy-the more likely there will be an aggravation of the symptoms. Therefore, it is best to give a trial of a lower potency such as a 6c. To be even safer, placing the remedy into a water solution of 4 oz of purified water and then placing a teaspoon of the solution into a second 4 oz of water will further decrease the strength of the dose. This dilution process can be repeated to further diminish the strength of the remedy. When remedies are used at low potencies, I generally find that they will need to be repeated at some frequency, even up to a daily basis. Eventually, as the remedy acts, dosing should be required at less frequent intervals.
Using homeopathy to raise the health of an individual can be a powerful aid in those with eczema. I cannot overemphasize the importance of remembering that eczema is a system disorder involving sensitivity and over-reaction. Proper selection of remedy and dosing is essential to help those with this disorder improve their health to the point that their symptoms might resolve. In general, these individuals are best treated by a well-trained homeopath, in conjunction with more traditional medical evaluation.
Previously Published: Homeopathy Today
Additional information on Homeopathic Medicine and Optimal Wellness available from Todd A. Hoover, MD, DHt 610 667-2138