In contrast to conventional medicine which are prescribed to inhibit or suppress a patient’s symptoms, homeopathic medicines are prescribed to mimic and augment the patient’s immune response and natural defences. As such, homeopathic treatments for hay fever aim to minimise or eliminate symptoms, optimise quality of life, and reduce the risk of developing a coexistent disease. Hay fever is a frequent reason to see a homeopath in the UK, especially when available conventional treatments aiming to reduce the intensity of symptoms do not always achieve clinically relevant reductions.

Although hay fever is prevalent throughout the world, it is predominantly found in socioeconomically developed countries, where the condition may affect as much as 25% of the population. People of all ages may be affected, but the onset of symptoms often begins during adolescence. Its prevalence has increased during the past twenty years despite falling pollen counts.

Hay fever during the summer months causes considerable discomfort and detrimentally affects quality of life- and that too at a time when one wants to be outdoors enjoying the weather. It often interferes with work productivity, sleeping habits, and general day-to-day and recreational activities. Hay fever has also been found to significantly affect psychological wellbeing and cognitive functioning. Other allergic problems such as asthma and eczema frequently coexist, adding to the impact of the condition.

The main cause of hay fever in Britain is grass pollen, particularly perennial rye and timothy grass. Typically, symptoms become worse during the relevant pollen season, and especially if one’s exposure to pollen is increased by spending time outdoors.

Hay fever symptoms peak during June and July. Symptoms in spring are commonly caused by tree pollen, whereas symptoms in late summer and autumn may be due to weed pollen and mould spores. Rape seed may also provoke symptoms of hay fever, although usually through the irritant rather than allergic mechanisms. It has been suggested that emissions of nitrogen dioxide and ozone from vehicle exhausts have also been causing an increase in sensitivities to airborne allergens.

Hay fever exhibits a cluster of symptoms that may affect multiple organs and systems. Symptoms typically consist of seasonal sneezing, nasal itching, nasal blockage, and watery nasal discharge. Eye symptoms including redness and itchiness are also common. Further, more serious symptoms may include seasonal coughing, wheezing and shortness of breath, in addition to systemic symptoms such as tiredness, fever, a pressure sensation in the head, and general itchiness.

Oral or topical antihistamines are the first line of treatment for hay fever in conventional medicine. However, for chronic cases which do not respond effectively to antihistamines, systemic corticosteroids can be prescribed. These treatments have mostly been used to manage the condition in the short term, as the symptoms usually return not long after they are discontinued.

Lately, a large number of hay fever patients are turning to complementary medical treatments, particularly homeopathy in the quest for a natural, gentle and permanent solution. From the homeopathic perspective, one of the great misunderstandings about allergies is the assumption that the allergen (e.g. the cat dander, pollen, or house dust mite) is “the problem”. In fact, the allergen is the trigger and the allergic person’s immune system is deficient. Rather than suppressing the person’s symptoms or avoiding allergen as a mean of staying healthy, a homeopath would seek to find the homeopathic remedy that would strengthen the individual’s defence system.

Each case of hay fever is unique, and a diligent homeopath would prescribe a remedy after careful consideration of the symptoms and causative factors. There is a range of homeopathic remedies that can be prescribed for hay fever, with the most common ones being discussed here.

Allium Cepa. The eyes burn, sting, swell and are sensitive to light. Tears are profuse but do not irritate the skin around the eyes. An important characteristic is that the nose and eyes stream with large amounts of watery discharge. The person sneezes frequently. Acrid nasal discharge burns, making the nose and upper lip sore. Post-nasal drainage makes the throat raw. The person is unusually thirsty. A headache often accompanies the allergies and may be felt in the back of the head or in the forehead at the sinus area. A cough associated with hay fever may get worse when cool air is inhaled.

Natrum Mur. A common symptom of this type of hay fever is excessive, watery nasal discharge (similar to the raw white of an egg). This thin discharge often lasts from one to three days, and then the nose may become stuffy, making breathing difficult. Sneezing is also common. The tongue has a frothy, bubbly coating, especially around the edges. Sometimes canker sores develop on the lips and the corners of the mouth. The mouth is dry, and frequent drinks of water are required. The patient often loses some sense of smell and taste. Sometimes, a hammering headache accompanies the symptoms, which are often worse in the morning from 9:00 to 11:00 AM. Symptoms improve after bathing in cool water. Perspiration also seems to relieve the symptoms.

Gelsemium. There is heavy sneezing and nasal discharge. The face is hot and the nose tingles and often has a burning discharge, especially in the morning. The mucus membranes are dry but the patient does not feel thirsty. The eyelids become heavy and can make it difficult for the patient to keep open. Common symptoms also include a dull headache and slight fever. The legs may ache, and a chill may run up and down the spine. Allergies are often worse in humid, foggy weather and can be aggravated by sudden emotions, bad news, and surprises. Hay fever symptoms tend to be worse in the summer and in the morning around 10:00 AM.

Arsenicum Alb. Asthma is often associated with this type of allergy. Mental agitation, anxiety, and restlessness occur. The eyes burn, and tears are hot and acrid, stinging the face and cheeks. Sneezing can be extreme. There may be tickle in one spot inside the nose that is not relieved by sneezing. Heavy mucus drainage from nose alternates with blockage of the nose. Nasal discharge is thin, watery and burning. The upper lip is irritated and raw from the discharge. There is thirst for warm drinks, which are sipped rather than gulped. Often, breathing is laboured. The person feels chilly and is intolerant of light. Warm applications to the face and nose, elevating the head, and wrapping the body seem to help the symptoms. Sitting up is often the best position. Wet weather, weather changes, and being by the ocean aggravate the symptoms.

Euphrasia. The eyes water constantly, causing itching and burning. Sometimes a sticky mucus on eyes can be removed by wiping them. Eye discharge is acrid, burning, and often thick. Nasal discharge is profuse and watery but does not irritate the nose or upper lip. A frontal headache may accompany nasal discharge. Frequent sneezing that gets worse at night is common. However, if a cough is present, it is actually better at night and worse during the day. Allergies are worse in the sunlight and the wind. Staying in a dark room is helpful.

Sabadilla. The most common symptom of this type of allergy is excessive sneezing with a runny nose. Severe frontal sinus pain is a common symptom. The eyes have a watery discharge, and there is intense itching in the nose. The roof of the mouth itches and is relieved by rubbing the tongue on it. The eyelids are hot, red, and burning- however, tears do not redden the skin around the eyes. Sometimes the person has difficulty hearing due to eustachian tube blockage. The mouth is dry, yet the person is not thirsty. There is general body chilliness and a sensitivity to cold air. Symptoms are worse from the odour of strong foods such garlic and onion. Allergies are relieved with warm food and drinks.

Nux Vomica. Prolonged sneezing spells occur, especially when first waking in the morning. Nasal discharge is runny during the day, but the nose is stuffy at night and outdoors, with each nostril being alternately affected. There is itching all the way from the throat to the larynx and trachea. Itching is also felt in eustachian tubes. The person is chilly and irritable and often stays up late at night due to the discomfort. The allergies can get worse after eating a meal, in the cool and open air, during a breeze or wind. The patient feels better when the nose begins to run. Symptoms are relieved during rest and napping, taking warm drinks, and exposure to moist air.

Bio: 
Haroon Ashraf is a homeopath based in London, where he offers in-person and online consultations. Haroon specialises in treating skin and gut conditions and allergies. Please visit his homeopathy practice at https://holistichomeopathy.co.uk/ for enquiries and appointments.

Topical Steroid Withdrawal

Eczema Infantile

Topical Steroid Withdrawal

Topical Steroid Withdrawal

Eczema

I have observed in practice that often patients making inquiries at the behest of their family or acquaintances, are initially sceptical as to the efficacy of homeopathic remedies in the treatment of this chronic condition. But once their treatments begins, they are left pleasantly surprised to see a steady and progressive improvement of their condition. As the weeks progress, they not only find some level of relief from the distressing symptoms of discoid eczema but also feel a general sense of wellbeing.

Discoid eczema is an idiopathic condition and its manifestations typically include sharply defined, oval, or coin – shaped eczematous plaques. The plaques exhibit small vesicles in the early stages, and towards the later stage these become more scaly, dry and thickened. The eczematous patches are numerous but symmetrically distributed and their size ranges from  1 – 10 cm in diameter. Mild to intense itching usually accompanies the affected areas.

Although the pathophysiology of discoid eczema is not completely understood, the known causative factors include contact allergy, environmental allergens, use of irritating and drying soap, frequent bathing with hot water, skin trauma and exposure to rougher fabrics such as wool. it is frequently associated with skin dryness which may lead to a breach of the epidermal barrier and a permeation of allergens. This form of eczema is known to exacerbate in low humidity and during winter time. Discoid eczema can sometimes be mistaken for ringworm or psoriasis.

Discoid eczema is a chronic relapsing and remitting inflammatory skin condition that can have a significant impact on one’s quality of life. Its management centres on nurturing the natural skin barriers and avoiding behaviours that can cause skin to become dry and irritated. Patients are encouraged to take short baths with lukewarm water using gentle and more natural bathing accessories. Frequently moisturising the skin using thick emollients such as petroleum jelly is usually beneficial, especially if applied immediately after having a bath whilst the skin is still wet. Patients are instructed to use loose clothing and avoid irritating fabrics.

The most common site of discoid eczema is usually the legs, but it can also appear on the torso, hands and feet. The diagnosis is usually clinically based- i.e. on sight of the characteristic round to oval plaques and dry skin. Men are prone to getting this type of eczema later in their life, while women more commonly develop it at a younger age. As with most inflammatory conditions, post inflammatory scarring of skin tissue can result from discoid eczema.

The management of discoid eczema by conventional medicine focuses on relieving symptoms and lengthening the time between flare ups. And for this, medium to high potency corticosteroids are the typical course of action, which usually leads to temporary symptomatic relief. But often it is the case that relapses are experienced not long after the steroids are stopped. However, it is a vicious circle in that the recurrent use of topical corticosteroids predisposes the patient to the risk of skin atrophy. This has lately led to an increasing number of patients of discoid eczema trying homeopathic treatment in search of a more natural and lasting relief, free from side effects.

Discoid eczema now happens to be one of the more frequently reported dermatological disorders for homeopathy patients. There is abundant clinical testimony to show the efficacy of homeopathy in treating discoid eczema and other skin conditions, making this form of alternative medicine as the “go-to” approach for a number of sufferers of this condition.

Homeopathic Remedies for Discoid Eczema

Anacardium. Intense, itchy discoid eczema with mental irritability can be treated with Anacardium. This type of eczema sometimes forms small blisters filled with a clear fluid. The skin feels worse with the application of hot water and through scratching the affected area. The patient is sensitive to cold air and is prone to feeling cold quickly.

Antimonium Crudum. This is useful for treating discoid eczema with dry, itchy skin that cracks easily and forms thick, horny calluses. The symptoms are made worse through overheating at night and also from cold bathing. The eczema forms thick, hard, honey-coloured scabs and is often associated with stomach issues. The patient is very irritable and can be offended easily. Cracking in the nostrils and the corners of mouth would doubly indicate this remedy.

Graphites. The skin tends to be dry, rough and may secrete a thin, sticky, substance. The eczematous plaques may develop cracks and bleed easily when scratched. The skin is generally unhealthy, and even a minor injury tends to ulcerate. The patient seldom perspires and is predisposed to constipation. On the constitutional level, the patient is sad and despondent and quite inclined towards crying easily.

Mezereum. Discoid eczema characterised by intolerable itching, chilliness, and sensitivity to cold air may be helped by Mezereum. Itching with this type of eczema is worse at night during bedtime. Round/oval patches of discoid eczema may become raw, which are then covered with a thick crust, and pus collects under this crust. Burning and itching vesicles may show up around the edges of plaques.

Rhus Tox. This is useful for acute outbreaks of discoid eczema. The eczema has small, fluid filled eruptions. All symptoms are worse at night, in cold, damp weather, and in winter. Scratching causes an even greater need to scratch. The eczema patch tends to burn and can form a thick crust that oozes an offensive substance. The patient is restless, especially at night.

Sulphur. A very important remedy for the type of discoid eczema that feels extremely good whilst scratching. After scratching, however, the skin becomes sore and there is burning. The eczematous plaque tends to ooze if scratched too much; otherwise, the skin tends to be dry, red, and rough-looking. Contact with water aggravates the eczema symptoms and causes further burning. The patient is often sensitive to heat and is prone to skin issues.

Bio
Haroon Ashraf is a homeopath based in London, where he offers consultations in person and online. Haroon specialises in treating skin and gut conditions. Please visit his homeopathy practice at https://holistichomeopathy.co.uk/ for enquiries and appointments.

There are no agreed protocols in modern medicine for treatment of Topical Steroid Withdrawal , as it is not recognised as a distinct clinical entity. Patients seeking help for Topical Steroid Withdrawal are usually prescribed with more topical corticosteroids, which more often than not proves counterproductive. Patients, on the other hand have become more aware, and a recent study found a six fold increase of the hashtag #topicalsteriodwithdrawal on social media platforms such as Instagram between 2018 and 2022.

Topical corticosteroids (TCSs) have been in use since 1950 and they have since been the mainstay for the treatment of multifarious skin conditions. An estimated 10.5 million tubes of TCSs were prescribed in England during 2020-21.

The Medicines and Healthcare Products Regulatory Agency recently issued a warning on the long term use of TCSs. It recommended that if after ceasing the use of TCSs, patients experienced skin burning and redness due to Topical Steroid Withdrawal (TSW), to consult their GP. It is possible that a growing number of patients experiencing such symptoms has contributed to the Agency issuing this caution.

In view of the limited choices available for the treatment of TSW, homeopathy can be explored as a potential avenue for treatment. Homeopathic remedies are gentle and free from any side effects, and generally have a good track record of treating skin conditions. As such, it is not uncommon for homeopaths to receive a growing number of inquiries related to the treatment of TSW. Indeed my experience regarding such inquiries is no different.

Kate (not real name) contacted me two months ago to seek homeopathic treatment when she was six months into TSW. She had used topical steroids for just under a year to treat stubborn eczema on her neck, but after ceasing the use of steroids, TSW symptoms appeared rapidly. Attempts to control and cope with the flare up was not only physically distressing but also took a toll on her emotionally.

As a result of TSW, Kate’s torso and thighs also became affected, as her skin became extremely dry and cracked and presented with crust-like symptoms. Her arms, neck and face were worst affected, having “reptiles like scales” which released fluid and were generally covered with red, inflamed and bumpy patches.

Kate’s TSW symptoms were accompanied by an intense itch, the scratching of which resulted in bleeding on various parts of her body. She felt a burning and stinging pain as a result of the raw skin, and found it difficult at times to tolerate the touch of clothing on her skin.

Although Kate used moisturiser liberally, her dry and flaky skin would absorb the moisture rapidly, resulting in her feeling the need to apply more within a matter of minutes. She experienced distress during the day and was unable to sleep well at night, leading to a deterioration in her physical and emotional well-being.

While recounting her ordeal during the initial consultation, she could not help “not scratch” her already raw and sensitive skin on neck and face, thus perpetuating the vicious circle only to make it even worse –as is the dilemma of TSW.

As I made further inquiries during the course of her consultation, it became clear that the TSW symptoms were a manifestation of the body’s attempt to offload the toxins which had built up over time as a result of long-term TCS use. The major organs responsible for eliminating the toxins from the body were under stress.

Kate had sluggish bowels movements which occurred once in 3-4 days and a tendency towards constipation. I prescribed her a bowel nosode remedy aimed at  stimulating the gut. I often see in my practice that a healthy gut has a direct positive effect on skin health.

The long term use of steroids had placed Kate’s liver under stress, and required detoxification. The homeopathic remedy of Berberis aquifolium is an effective liver stimulant and also has an elective affinity for dry and scaly skin. As such, this remedy also formed part of my prescription.

Constitutional remedies are powerful tools that classical homeopaths employ to deal with deep-seated physical and mental/emotional imbalances. I have seen the effectiveness of these remedies time and time again in the course of my practice. In Kate’s case, the homeopathic remedy Lycopodium was prescribed as a constitutional remedy. Lycopodium has a large sphere of action, and has a strong influence on both skin and Liver.

Four weeks after using the remedies, Kate reported a marked improvement in her skin – her arms and hands were substantially healed (as shown in the illustration above). Her legs and torso were experiencing much less dry skin and flakes, with moisturiser needing to be applied a few times a day. Her face and neck, which earlier would bleed from excessive scratching, had healed noticeably. The redness (often also referred to as Red Skin Syndrome) was also significantly better. The overall progress that she made in four weeks was extremely positive.

Kate further reported that the itch has decreased considerably, as well as the general soreness. She was able to get a good night’s sleep, and wear the clothes she preferred without worrying about the effect on her skin. Overall, she was feeling far more comfortable than she had been a month earlier.

One noteworthy is that the homeopathic remedies helped to improve her quality of life significantly. TSW also has a psychosocial dimension, and my treatment protocol was directed to specifically address this aspect. Kate reported that she felt calmer and more focused.

Although her treatment remains ongoing, the giant leap taken in the short space of four weeks is illustrative of the efficacy of homeopathy in treating TSW, especially when there are not many alternative options. And this comes with the added bonus of holistic improvement.

Some more “before & after” images showing cases of topical steroid withdrawal treated at Holistic Homeopathy

Bio: 
Haroon Ashraf is a homeopath based in London, where he offers in-person and online consultations. Haroon specialises in treating skin and gut conditions and allergies. Please visit his homeopathy practice at https://holistichomeopathy.co.uk/ for enquiries and appointments.

In the course of practice, it is not uncommon for homeopaths to receive inquiries in relation to homeopathy treatments for pets, since clients’ desire to seek a natural, gentle and non-invasive treatment for their pets stems from their own positive experience of homeopathic care. It is not very well known that homeopathy is in fact one of the few available natural treatment choices that can be equally beneficial for dogs and other pets, as it is for their owners.

There has in recent times been a surge in demand for natural health care options that are safe and free from side effects. Complementary and alternative medicine in the form of herbal medicine, acupuncture, traditional Chinese medicine and counselling all provide sufficient natural treatment choices for humans but unfortunately for our four-legged friends these natural forms of treatments are either not readily available or are unsuitable.

Dogs are arguably the most popular pet in the UK and are ranked number one in household ownership of pets. So it is no surprise that our furry friends make an occasional appearance for a homeopathic consultation. Their owners, sometimes prompted by their family or friends, reluctantly book a consultation with a homeopath, uncertain as to the treatment’s efficacy. But more often than not they are left pleasantly surprised to see the effect of homeopathic remedies on the health and well-being of their dogs.

Homeopathy – a Preferred Choice of Alternative Treatment for Dogs 

Homeopathic remedies may take some time, usually 4-6 weeks in showing their beneficial effects on human beings. But with dogs it is a little different – sometimes only 2-3 days are enough to display a marked improvement in symptoms. There is a reason that dogs respond so well to homeopathic treatment. Animals are usually free from lifestyle-related contaminations that humans are predisposed to, such as smoking, drinking, consuming fruit and vegetables sprayed with insecticides, eating processed food and using cosmetics loaded with harmful chemicals. All these things can contaminate our bodies, which can in turn impede the action of homeopathic remedies.

Homeopathic remedies are highly diluted and therefore subtle in action, making them equally safe for dogs and puppies. They work by way of stimulating the healing capacity of the body, and in the process restore health and wellbeing. And if the pathways they follow are clear and unblocked- as is usually the case with dogs – the results can be achieved quickly.

Considerations for Treatment of Chronic Conditions

In cases of chronic conditions, the success of homeopathic treatment is dependent on finding a suitable remedy in relation to the symptoms being manifested by a patient. It is of utmost importance for homeopaths to take note of minute details that make an individual unique, including behaviours, habits and constitution. By way of example, there are more than seventy remedies for the common condition of asthma, and a homeopath having taken note of the individual’s triggers, time of aggravation, factors that provide relief and other such relevant details, will carefully collate all the symptoms before deciding on the remedy. The correct treatment will be the one which most closely deals with the individual’s unique set of symptoms, personality and disposition. And so it remains the case that any successful homeopathic treatment is highly dependent on the close diligence and information-gathering by the homeopath.

In a similar way, dogs with longstanding chronic conditions will need to be investigated thoroughly to select a remedy unique to their set of symptoms, behaviour and emotions. The disposition of a dog such as whether he/she is playful or shy, anxious or calm, angry or joyful and so on, will have a bearing in deciding the homeopathic treatment protocol. To further elaborate this point – a dog suffering from asthma that worsens during damp weather might need the homeopathic remedy called Natrum Sulph in preference of Ipecac which is usually the first port of call when dealing with asthma. Similarly, a low-spirited, easily vexed and frightened dog might need the homeopathic remedy called Phosphorus for chronic diarrhea in preference to other more typical remedies. A dog’s disposition remains vital in deciding on the correct treatment.

Homeopathy is equally useful to deal with sudden, short-term conditions in dogs such as fever, abscesses and fatigue. In this case, pet owners can make use of homeopathic remedies without the need to consult a homeopath, because in such cases only pathological symptoms being displayed by a dog are enough to decide on the remedy. It is not uncommon to hear of success stories from clients whereby their pets have recovered from minor short-term ailments quickly after reaching such treatment.

Administering the Remedy and Dosage

Administering a homeopathic remedy to dogs is fairly simple: lift the corner of the mouth where both lips meet and place 3-4 pellets of the homeopathic remedy inside. Precaution must be taken not to touch the remedy with one’s fingers as this may affect its potency, and so the lid of the remedy container should be used to administer the medicine to the dog. The remedy will dissolve quickly in the dog’s mouth and set the curative process in motion. The dog will probably enjoy the sweet taste of the remedy and might even look forward to the next dose. It is advisable to dispense the remedy 20-25 minutes before or after food since homeopathic remedies act best on an empty stomach. It is a good idea to incorporate homeopathic remedies for common complaints into any first aid/health care kit you may have prepared for your dog. Homeopathic remedies are available in a whole range of doses but for common acute conditions the 200C potency should be used – this can be ordered from any online homeopathic pharmacy. A remedy can be dispensed 3-5 times a day depending on the severity of the dog’s symptoms, and for as long as the symptoms persist.

Homeopathic Remedies for Common Ailments of Dogs

Aconite for Ailments that come on suddenly

Aconite helps to restore balance after a sudden drastic disruption – an example can include a dog putting its head out of the window during a chilly day and catching cold from there. The therapeutic range of this remedy is wide, but any instance of your dog being affected by a sudden external event (like a head out of a window as per the above example), would warrant this remedy. Fear, anxiety, acute inflammatory conditions and shock all benefit from this remedy.

Arnica for Traumatic Conditions

Arnica is the remedy of choice for any case involving injury, shock and/or surgery. It can even be used to relieve persistent pain that may occur years after the trauma, as well as fatigue that may occur after over-use of the muscles. This remedy can deal with sepsis of wounds, whether surgical or accidental, and can also safely be used in lotion and ointments.

Arsenicum for Diarrhea

Diarrhea caused by ingesting an offending article (such as eating stale food) would benefit from Arsenicum. A dog may vomit whilst also showing signs of anxiety and restlessness, and they will probably display an aversion to any kind of food. Arsenicum has shown to not only relieve diarrhoea but also reinvigorate the dog’s appetite.

Bryonia for Arthritis

Bryonia is an excellent rheumatic and arthritis remedy. Typical symptoms include feeling worse after movement, whilst rest provides a more comfortable state. Thus the dog may prefer to be still even when encouraged to move. In particular this remedy is effective for the dog that lies on the affected part so as to place pressure and bring comfort to itself. This remedy has also been used with beneficial effect in mastitis.

Calendula for Wounds

Calendula is an excellent healing remedy, and helps to speed up the recovery from abrasions, cuts and scratches. It acts as a healing stimulus and is strongly antiseptic in its action. The remedy has been mainly used topically in the form of lotion or cream.  However, homeopathic remedy made from Calendula can be also be administered orally to aid the healing of abrasive wounds.

Glonoine for Heat Stroke

This remedy has a good reputation in relation to the treatment of heat stroke. Dogs exposed to excessive heat respond well to it, for example having spent a large amount of time in a conservatory or vehicle on a hot day, without adequate air circulation. Dogs requiring Glonoine will show agitation and irritation after being exposed to the sun for an excessive period of time.
With the UK increasingly experiencing heatwaves during the summer months, Glonoine would be a valuable addition to the first aid kit.

Hepar Sulphur for Suppuration

Hepar Sulphur is a remedy to consider for suppurative conditions. It is useful either as preventive or curative treatment, for septic injury. All purulent or septic conditions should benefit from this remedy, including infected wounds, whether surgical or traumatic. It has been nick-named the “homeopathic antibiotic”.

Nux Vomica for Constipation

Nux Vomica is helpful for digestive disturbances, especially for a dog that experiences constipation. Their bowel movement may be sluggish and they may not have opened their bowels for 3-4 days, or even longer. Although they feel an urge to poop, the dog may be unable to pass it. This occurs primarily due to a lack of peristalsis – a series of wave like muscle contractions that move food through the digestive tract. In such cases Nux Vomica provides gradual support to the bowels in achieving their natural rhythm and helping to resolve constipation.

Written by: Haroon Ashraf

Bio
Haroon Ashraf is a graduate in homeopathy from Middlesex University and his practice is based in London. Haroon can be reached at https://holistichomeopathy.co.uk/ Alternatively, you may contact him at haroonashrafhomeopathy@gmail.com for more information.

Formulated 200 hundred years ago by the German physician Samuel Hahnemann, homeopathy is a safe, gentle and natural system of medicine which stimulates the human body’s natural tendencies to heal itself. Today, over 500 million people worldwide use homeopathic treatments on a regular basis. 

Although homeopathy has an impressive track record in treating a wide range of ailments, I have seen excellent results achieved in the treatment of a range of skin conditions, in the course of my practice. Often the patients who come to me have received conventional medical treatment for their skin conditions, but with varying levels of success. In search of a safer and less invasive cure, and often at the behest of a friend or family member, they decide to (often as a last resort and without much expectation!) give homeopathic treatment a chance. For the vast majority of these patients, my treatment proves to be effective and some are left pleasantly surprised.

A lovely little fellow aged eight years old was brought in by his mother complaining of a large stubborn patch of eczema on his hand. Thus far his mother had been using a topical ointment prescribed by their GP which would successfully alleviate the eczema, only for the complaint to return more viciously after a few months. This cycle had repeated a couple of times. The little boy’s symptoms included an incessant itch which he found difficult to resist scratching, often leading to bleeding at the site of the eczema.

As I investigated the case, two things became quite evident. The patient’s usual bowel activity was sluggish and meant he opened his bowels every 2-3 days. This routine would sometimes go off-track with occasional bouts of constipation, where 4-5 days would pass without activity. Homeopathic theory suggests a vital link between the bowels’ efficacy in eliminating toxins from the body and the consequent effects on the skin when such toxins are not efficiently removed. This combined with the boy’s continued use of the topical ointment resulted, in my view, in driving the eczema deeper.

As the skin is a highly reactive organ, ascertaining the cause-and-effect relationship is vital in helping to build up a picture of what is going on inside. It is not uncommon for me to see a patient suffering from eczema but who also suffers from say, constipation or an over reactive immune system or dysbiosis (disturbed ecology of gut microbiome). Similarly, hormonal imbalances in adolescents hitting puberty, and/or during the premenstrual stage in females, can cause a breakout of acne. Stress and anxiety can be seen time and time again causing inflamed, reddened and itchy skin in some patients. And there are many other skin conditions which are rooted in some sort of internal imbalance.

So, in tandem with the homeopathic doctrine of holistic healing, I proceeded to prescribe the homeopathic remedy Nux Vomica to my young patient, with the aim of providing safe and gradual support to the bowels in achieving their natural rhythm. This remedy encourages peristalsis-a series of wave like muscle contractions that move food through the digestive tract. Although it remains true that Nux Vomica is highly effective in treating sluggish bowels and has not disappointed me in the course of providing treatment to patients, it also remains the case that such treatment cannot be used indiscriminately, since each patient’s specific individual symptoms will determine the eventual choice of remedy.

I further prescribed another homeopathic remedy- Graphites, to my young patient. This remedy is particularly beneficial for eczema located on the hand with a crust-like presentation, and which is sometimes accompanied by clear fluid. My case notes ticked off most of these symptoms. The time and diligence taken to match individual symptoms with those of the remedy is pivotal in prescribing homeopathic treatment.

Providing lifestyle and dietary advice to my clients is central to my practice. Often, adjusting dietary preferences in conjunction with homeopathic protocols produce excellent results. For my patient, I advised less junk food and less refined carbohydrates for the period of the treatment. I recommended that his diet be adjusted to include more soluble and insoluble fibre in the form of fruit, vegetables, beans, potatoes and cereals.

Homeopathic treatment can sometimes cause an initial flare-up of symptoms. For a first-time patient this may be disheartening but in fact such flare-ups are a positive sign as they show that the suppression of symptoms is abating, toxins are being off-loaded and the body is on course to healing itself naturally. My little patient also experienced a mild flare up of symptoms followed by a steady improvement.

Three weeks after my patient began homeopathic treatment, the results were highly satisfying- the eczema patch had cleared by around 90%, there was no longer any itching, and the little boy was opening his bowels on a regular basis. His appetite and quality of sleep had also significantly improved. His mother was impressed with the results, particularly of the fact that she had initially contacted me for her child’s eczema but had as an added bonus seen a general improvement in his health and well-being.

This is how homeopathy works; its approach is holistic, and one that offers sustained cures in a safe and effective manner. As homeopaths are often inclined to say “homeopathy treats the person, not the disease”.

First published in Wellbeing magazine on 27 June 2022

Bio

Haroon Ashraf is a homeopath based in London, where he offers consultations in person and online. Haroon specialises in treating skin and gut conditions. Please visit his homeopathy practice at https://holistichomeopathy.co.uk/ for more information.

Topical Steroid Withdrawal and Red Skin Syndrome generally describe the set of overlapping symptoms experienced after the prolonged use of topical steroids. Although these symptoms may be physically discomforting and emotionally offsetting, but there are no agreed protocols in conventional medicine to treat them. On the other hand homeopathy and other Complementary and Alternative Medicines have been used with considerable success in treating these conditions.

What is Topical Steroid Withdrawal?

The terms Topical Steroid Withdrawal (TSW) and Red Skin Syndrome (RSS) are used interchangeably to describe the set of symptoms experienced after prolonged and indiscriminate use of Topical Corticosteroids (TCS). The length of prolonged use of TCS may vary from several months to a year or even beyond that.

Topical Steroid Withdrawal is also sometimes known as Topical Steroid Addiction (TSA) primarily due to the patient’s physical dependence on corticosteroids, with skin symptoms that worsen after the withdrawal of TCS.

TSW is believed to be a potential adverse effect resulting from TCS overuse, especially where such use has included the face and provided benefit that gradually declines over time. The rebound symptoms, sometimes described as TSW eczema, may be more severe or manifest differently from the initial skin condition.

There is little information in medical literature about what happens when chronic topical steroid therapy is stopped, but more cases of its incidence are being reported in recent times. In a recent study examining patients who ceased long term use of TCS and subsequently developed TSW symptoms, 20% (14 out of 69) of patients were children.

What is the Controversy about Topical Steroid Withdrawal?

It is not widely accepted amongst the medical community that there may be withdrawal symptoms associated with TCS discontinuation after long term use. This may be because traditionally TCS have been recommended intermittently to help skin flare-ups and their long term frequent use has not been studied. In practice however, there have been instances of patients resorting to long term steroid therapy for their skin conditions.

Similarly, a diagnosis of TSW is not easy, because there is no accepted diagnostic criteria for it. The dismissive notion of the medical community to accept TSW as a rationale outcome of steroid overuse can also be a barrier in better understanding this condition.

TSW is frequently discussed on social media platforms, and patients with a history of longterm steroid use are self diagnosing this condition. The difference in opinion between medical practitioners and patients who believe in TSW is a limiting factor in formulating an effective treatment strategy. Failure to acknowledge the concerns of TSW patients adds a psychosocial dimension to this issue.

The National Eczema Association conducted a systemic review in 2015 involving 1085 patients who exhibited TSW symptoms. The authors of this review concluded that TSW is a distinct medical condition, having a unique set of symptoms. This review was updated in 2020 with almost consistent findings.

The non existence of agreed treatment protocols has pushed TSW patients to seek help from online communities, where some people have shared their positive experience of using Complementary and Alternative Medicines such as Homeopathy and Traditional Chinese Medicine.

Are there any side effects of topical corticosteroids?

There is a growing concern amongst patients about TCS side effects, with increasing discussion of TSW particularly on social media platforms.

TCS have a range of know side effects, and patients using them on their face or genitals are more susceptible because of the higher risk of increased permeability on these areas.

Topical steroids work by way of constricting the blood vessels and after their cessation, the symptoms of Red Skin Syndrome may be secondary to vasodilation. Patients at times report Red Skin Syndrome as a stubborn eczema which does not respond to steroids, when this is in fact a consequence of the long term use of steroids. And it is not uncommon in my practice to see patients presenting similarly.
Some other side effects attributed to the use of TCS are the reduction in epidermal thickness, erythema due to vasodilation, hypopigmentation due to reduced activity of melanocytes and purple colour spots and rash. However, the severity of the side effects depends on the length of time and potency of the steroid used. Cautious and discriminate use of steroids is generally considered safe inducing only minimal side effects, which diminish with the passage of time.

Topical Steroid Withdrawal Symptoms

There has been a discussion to suggest that symptoms resulting from TCS discontinuation may be an exacerbation of the underlying skin condition. But there are some features which are typically reported in TSW and those are completely unrelated to the initial skin condition.

Patients coming off steroids after long term use typically report widespread red skin associated with itchiness. This diffusely red skin may develop within days to weeks of ceasing TCS and is generally referred to as TSW eczema.

There are myriad of other symptoms that I see in TSW patients in my practice namely oedema, skin sensitivity, burning pain and excessive skin exfoliation.

Red sleeve sign and elephant wrinkles as commonly observed in TSW get their name from their presentations. Red sleeve sign refers to diffusely red patch ending abruptly at the wrist or ankles, while sparing the palms and toes. Elephant wrinkles is a term that describes thickened skin with reduced elasticity especially on extensors.

Topical Steroid Withdrawal Timeline

There is no agreed timeline to suggest the resolution of TSW, especially when patients are left to deal with this condition themselves due to an absence of approved treatment protocol.

Complete resolution has occurred between weeks to years depending on the severity of symptoms. A study review conducted to asses the improvement of TSW in 24 patients of atopic dermatitis reported improving symptoms in 2 years.

Another study which reviewed the blogs of TSW patients reported that 7 of 13 subjects continued to have active TSW symptoms such as shedding, oozing, pain and itching even 20 months after stopping the use of TCS.

A survey of 3840 participants with self diagnosed TSW found that 26% of those who had stopped using steroids for more than five years reported continuance of some symptoms.

Topical Steroid Withdrawal Treatment

Conventional medicine recommends either the tapering or complete cessation of TCS as a way to manage TSW symptoms. Reported responses to these therapies are inconsistent, with little, if at all any benefit.

Emollients, over the counter antihistamines to control itchiness, ice packs and cold compresses have been used for temporary and partial symptomatic relief. But there is not enough data to asses the efficacy of these measures with any degree of certainty. However, colloidal oatmeal baths have been successfully used to sooth some TSW symptoms.

Homeopathy for Topical Steroid Withdrawal

I have observed in my practice, time and again, homeopathic treatment helping patients with skin issues and in some cases as a last resort, when patients had exhausted other therapeutic choices. And my experience in treating Topical Steroid Withdrawal and Red Skin Syndrome is no different.

Homeopathy visualises skin as one of the organs responsible for eliminating harmful toxins from the body, other such organs being the liver, kidneys and guts. And therefore eczema or other similar skin conditions are treated by supporting the skin and stimulating other organs of elimination.

For example, I have so often come across cases in my practice, where constipation in a patient would reflect on their skin in the form of acne, eczema or erythema. And in such cases the “resetting” of the bowels by use of bowel nosodes or Nux vomica as well as prescribing a suitable remedy for treating skin symptoms, helped my patients enormously. Cures achieved in this manner are not only gentle but also sustainable, because the underlying causes responsible for a pathology are addressed concurrently.

Similarly, at times, a sluggish liver can manifest topical symptoms such as pustule, papule and skin patches accompanied by incessant itching. In such cases my patients have done considerably well on Chelidonium for stimulating the liver alongside the pertinent skin remedy. Organ remedies remain one of the cornerstones of my practice and I have seen them work brilliantly, time and again for my patients.

Now let us decipher as to why Topical Steroid Withdrawal or Red Skin Syndrome may be a consequence of long term use of topical steroids. From the homeopathic standpoint, the use of topical steroids for treating a skin condition is akin to suppressing the symptom. And this is in fact tantamount to driving the toxin deeper in the body, which then returns with greater severity after cessation of TCS. This also explains why the severity of TSW symptoms is proportionate to the potency and longer use of TCS.

TSW is treated in homeopathy, in a similar way as any other skin condition. The arsenal of homeopathic remedies is quite rich and capable of dealing with all different symptoms that are commonly observed in TSW. I have seen a good number of patients, who trusted homeopathy for treating TSW, and they were certainly not disappointed.

At the same time, I also caution my patients about having unrealistic expectations from homeopathy. Homeopathic remedies are subtle in their action and may take some time to take effect. Usually two to three weeks into homeopathic treatment would be a reasonable period to asses its efficacy.

The homeopathic approach in dealing with skin conditions is usually centrifugal, which means driving the symptoms inside out. And in case of TSW, sometimes the suppression of symptoms due to overuse of TCS is so deep, that a patient may experience a flare up of symptoms at the commencement of their homeopathic treatment. But then there are ways to keep the flare under control. One thing remains pretty certain- that the flare up is almost always followed by TSW symptoms diminishing.

Cures achieved in this way are lasting and the chance of their recurrence is often minimal.

Summary

The underlying causes of TSW are not well known, and a better understanding in the future may help explain the persistence of its symptoms for a prolonged period of time. Further research into TSW is required to develop a consensus on diagnostic criteria and treatment protocols.

Existing treatment choices for TSW are limited, and largely patients have to endure the tormenting symptoms of this condition for a long period of time. Although there may not be enough scientific backing for these treatments, people seeking help from Complementary and Alternative Medicine have reported beneficial effects.

TCS are useful for many patients who suffer from inflammatory skin diseases. But one always needs to use these under the guidance of a doctor/dermatologist who can better decide on the potency and length of time a topical steroid should be used.

Some “before and after” images showing cases of topical steroid withdrawal treated at Holistic Homeopathy

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Acne is not an easy condition to manage, especially if it persists beyond adolescence. Apart from causing physical discomfort, acne can have some psychosocial consequences causing low self-esteem, social isolation and depression. Sometimes using home remedies for acne and properly identifying those foods that affect acne is all that is needed to deal with this distressing condition.

Acne is a chronic inflammatory disorder of skin follicles and is characterised by inflamed spots on the face, neck, back and chest. Increased sebum (natural oil lubricant) together with clogged pores is directly related to the severity of this condition.

Acne is one of the most common skin problems in the world, affecting up to 80% of individuals between 12 and 25 years of age. Studies have shown a high incidence of acne in girls aged 14 – 17 and in boys aged 16 – 19 years.

Genetics, youth, male sex, stress, smoking and use of cosmetics with pore-clogging ingredients are some of the factors that contribute to the onset of acne. A treatment regime aimed at reducing inflammation, and controlling sebum production and unclogging the pores has been found to be effective in getting rid of spots.

Mostly, acne resolves by itself by the time someone reaches their early twenties, however the chronic cases may persist into adulthood- this pattern tends to be more common in females. Cysts and scarring are the characteristic features of long standing and severe cases.

Home Remedies for Acne

The main goal of acne treatment is to control and treat acne lesions, prevent permanent scarring and limit the duration of the condition. Some home remedies discussed int this section have been used with benefit in reducing acne inflammation and controlling breakouts.

Apple cider vinegar

Apple cider vinegar has been used with considerable benefit for restoring the normal pH of skin, acting against bacteria and regulating sebum (oil) production. Some studies have shown considerable effectiveness of apple cider vinegar in controlling inflammation and consequent breakouts of acne. Alpha hydroxyl acids in apple cider vinegar are believed to eliminate dead cells and unclog the pores, which helps in acne clearing.

How to use

1/4 cup of apple cider vinegar mixed with 1/8 cup of water may be applied directly on the skin with a cotton swab. Alternatively a mask made by 1/2 avocado and 1/4 cup of apple cider vinegar mashed to the consistency of a paste, may be used.

Raw papaya

Raw papaya fruit has been used as a natural treatment for acne. Papaya contains an enzyme papain, which is believed to control inflammation and pus formation. It also removes dead cells leaving the skin smooth and supple whilst clearing the dirt from skin pores.

How to use

Scrubbing the fleshy side of the skin of a half-ripened papaya can be used in controlling the outbreak of acne. Alternatively, mash up the flesh of a ripe papaya to a consistency that can be applied directly. Leave on the skin for 10-15 minutes before rinsing with warm water.

Cinnamon and honey

Although the old home remedy of cinnamon and honey has been used with considerable benefit for clearing spots and reducing inflammation, more research is needed to ascertain its scientific authenticity. Cinnamon has been found to have anti-bacterial effects against acne according to a report published in 2017. But this report called for more trials and studies in order for results to be conclusive. Separately, in other studies honey has been reported to limit acne owing to its antibacterial properties.

How to use

A teaspoon of cinnamon mixed in a tablespoon of honey to the consistency of a paste may be used as a mask. This can be applied to the the skin for 10-15 minutes and before rinsing with lukewarm water and patting dry.

Lemon juice

helps to dry up excess oil and flush the pores. Its disinfectant and exfoliant properties have been beneficial in clearing acne and toning scars. Lemon juice is also believed to stimulate the blood circulation which helps with the supply of required nutrients to skin.

How to use

two freshly squeezed lemon juice diluted with 1/2 cup of water may be applied topically. Lemon contains citric acid which can be an irritant for skin, therefore it must be used in moderation.
A trial with a small amount of diluted lemon juice to test the affected area before applying fully, is a good precaution to take.

Tomatoes

Tomatoes are rich in antioxidants and are good source of vitamin A, vitamin C and lycopene. All these have a beneficial effect on healing inflamed spots. Lycopene is a powerful antioxidant, which is found in high end facial cleansers. Tomatoes have also been generally credited with getting rid of spots.

How to use

Blend two medium sized tomato in a blender and apply directly to the face. Leave on for 10-15 minutes and then wash off and gently dab face with a smooth towel. Alternatively, cut a tomato in two halves and place flesh-side up on the affected area for up to 15 minutes before washing.

Tea tree oil

helps to control infection and speeds up healing of blemishes. Research has found that 5 per cent tea tree oil is as effective against acne as a 5 per cent benzoyl peroxide solution, but with fewer side effects. Another study conducted on a sample size of 18 individuals concluded that use of tea tree oil significantly improved mild to moderate acne and that it was well tolerated.

How to use

A drop of tea tree oil can be applied directly three times a day to the affected area.

A clinical study showed that a combination of tea tree 3%, aloe vera 10% and propolis 20% has potent antibacterial and anti-inflammatory properties. And these products used combined are more efficacious than being used as single product even at higher concentration. This formulation can be prepared at home by mixing these ingredients in desired proportions in petroleum jelly.

Baking soda

Baking soda is another effective treatment for acne. It has been used with considerable success in clearing acne. It has also been found to be effective in clearing red marks from the skin, leaving it smooth. Bicarbonate in baking soda helps to fight fungus and bacteria and dry up excess oil. Baking soda may be at times a mild irritant for skin causing excessive dryness and may leave a burning sensation.

How to use

Mix two tablespoons of baking soda in 100 ml water and apply the resultant paste on the affected area in slow circular motions. After 6-8 minutes of gentle massaging, wash the face thoroughly with lukewarm water.

Echinacea

Echinacea is a natural treatment for acne and for other skin lesions including wounds, and its safety and efficacy has been reported in a laboratory study. Echinacea is known for its antiviral, anti-inflammatory and antibacterial properties and has been traditionally used with noticeable success for treating acne. A study positively reported the efficacy of Echinacea herbal extract against a strain of bacteria in the laboratory. Its topical and oral use combined may assist in nurturing healthy skin.

How to use

Echinacea tea can be used to make a daily face wash by adding two teaspoons/tea bags of Echinacea tea in 250 – 300 ml water. This can be brought to a boil and then left to become lukewarm before dabbing it on the affected area with cotton wool. Alternatively, drinking Echinacea tea has been found to be helpful in clearing spots and acne due its immune boosting attributes.

Chasteberry tea

Chasteberry helps to tame the flare up of acne and spots that appear before a mensural period. Some studies show that this herb helps to regulate female hormones.

How to use

Drinking 1 to 2 cups of chasteberry tea for two to three months has been associated with beneficial effects for premenstrual acne.

Zinc

Zinc is a promising alternative to other acne treatments due its influence on acne. In one study, subjects with the most advanced acne in the group had lower mean serum zinc than other subjects in the study.

Some studies have found that zinc supplements can reduce acne. And in one study subjects’ treatment with zinc reported a significant improvement in mean inflammatory papule count compared to those who were not treated with zinc.

How to use

Oral intake of zinc supplements must be kept to moderate level, as too much zinc can cause copper deficiency. One study reported the effectiveness of zinc with moderate doses of 30mg of zinc per day.

Rose water

Rose water has been traditionally used for many skin problems including acne, making it a remedy of choice for healthy skin. It serves equally well when used as a cleanser or facial wash. Its regular use for two to three months has helped in achieving a clear complexion.

Some anti-microbial properties has been attributed to it, but the scientific backing to this claim is limited. Even so, one study reported its anti oxidant and anti-inflammatory activity helping to control acne.

How to use

Virgin extract of rose may be purchased from a health and beauty store and used 2-3 times liberally on the face for two months.

Diet and Acne

There is no silver bullet when it comes to optimal foods to cure acne. Diet alone may not be sufficient to treat acne, but will be part of an overall regime to treat acne. Thus the right foods can make a significant difference. Furthermore a correlation between diet and acne has been highlighted in recent studies.

As for any other conditions, a healthy and balanced diet would beneficially affect acne treatment. Therefore, the use of vegetables, whole meal food, legumes and cultured/probiotic food may be incorporated into the diet plan to augment the benefits of home remedies.

On the other hand some foods are known to cause acne. Scientific research and anecdotal use has helped to identify the food items which can cause acne flares.

In this section a correlation of foods that help or cause acne has been discussed with a focus on their use as part of acne treatment.

Foods to Help Acne

Dietary Fibre

A 2016 survey study conducted to explore the connection between diet and acne reported that acne patients consuming foods with higher dietary fibre generally observed an improvement in their condition.

Dietary fibre is prebiotic, which beneficially modulates gut micro biome, which in turn helps to inhibit inflammation. It is also a constituent of complex carbohydrates having a low glycemic index. Beans, lentils, broccoli, avocado, corn on cob, berries and apple are a few examples of foods having high dietary fibre.

Vitamin A

Vitamin A is an antioxidant, which helps to keep inflammation under control. It has helped acne patients in clearing spots and blemishes. A survey study reported highest proportion of respondents extolling its benefits for acne treatment.

Although vitamin A supplements can be purchased from health stores, their use should not be exceeded beyond the recommended daily dose of 5000 IU. On the other hand sweet potatoes, carrots and dark green vegetables are good sources of vitamin A, which may be incorporated in the overall diet plan.

Carotenoids

Foods containing carotenoids have been generally linked with good skin health and reduction in pimples. Additionally, eating these colourful foods, high in carotenoids such as carrots, tomatoes and peppers give a healthy glow to skin. For those seeking healthy skin, a diet supported by food rich in carotenoid pigments have also been shown to induce brightness.

Protein

Foods that are rich in protein are a source of amino acids, which are used to make collagen; collagen is an essential constituent of healthy skin cells, providing strength, firmness and elasticity to the skin matrix. A lack of collagen may result in saggy and wrinkled skin thereby affecting overall skin health. Poultry, fish, cottage cheese, soy and egg whites are healthy sources of protein, which may be included in the diet to boost collage production.

Omega-3 fatty acid

Omega 3 fatty acid is anti-inflammatory and has been used with some benefit in treating acne. One study found that adolescents who consumed large amounts of fish and seafood, which are rich in omega-3 fatty acids, appeared to be less prone to manifest acne. It also suggested that omega-3 fatty acid is helpful in controlling inflammatory papule and improving global aspect of wellbeing. Salmon, mackerel, flaxseed, chia seeds and walnuts are natural sources that are rich in omega-3 fatty acid.

Foods that Cause Acne

High glycemic index food

There is some research evidence that supports a link between high glycemic index diet and acne. Foods with high glycemic index, such as sugar and refined carbohydrate are rapidly absorbed, leading to higher blood glucose levels, which results in a metabolic reaction resulting in elevated levels of insulin.

Increased levels of serum insulin have been shown to augment sebum production, which play a role in causing acne. An insulin rush has also been associated with the pro–inflammatory state of the body.

This theory has been tested in several trials and in one, a 10-week low glycemic diet resulted in the improvement of acne, with skin showing decreased inflammation and reduced sebaceous secretion.

Sugar, soda drinks and even innocuous foods, such as white bread, pasta, white rice and other refined carbohydrates, when part of an overall high glycemic index diet, may exacerbate ace.

The role of Western diet has also been researched as a potential cause of acne. Researchers have noted that the Western diet typically corresponds to the high glycemic diet, which makes it a probable trigger for acne.

It is interesting to note that chocolate as a dietary factor triggering acne is a long-held belief. But at this point there is no evidence to suggest that a factor specific to chocolate can trigger acne. Rather, research points to its sugar content and contribution to high glycemic index diet as a probable cause.

Milk and dairy

Acne patients who keep a track of their diet have found that milk is one of the most common food implicated in acne flare-ups. A more recent report also supporting the association between milk consumption and acne revealed that intake of milk during adolescence was associated with a history of teenage acne.

The association of skimmed milk and acne is more marked than for other forms of milk suggesting that the fat content of milk was not a trigger for acne. Instead, some researchers hypothesised that skimmed milk tiggers acne because the responsible hormones are less diluted in it due to lack of fat contents. And acne, particularly in teenagers are correlated with hormonal activity.

Scientific backing for other dairy products such as cheese being a probable cause of acne is not as strong. But if you are acne prone, it would be a good idea to switch to soy, almond or rice milk and avoid dairy products.

Fried and greasy food

Acne patients have a usual perception that increased intake of greasy and fried food would lead to an outbreak of acne. A survey conducted in 2018 to explore beliefs concerning the relationship between diet and acne, reported that out of 104 acne patients that were surveyed, 73 chose a category that patients have historically described as an acne trigger food: that of fried and greasy food.

But some large studies have been unable to consistently prove that these common food culprits cause acne. That said, it is plausible on individual basis, that certain foods do trigger acne in certain patients. For example, if you notice that every time you eat fried chips, you break out with pimples, then fried chips may be the culprit. And certainly, it is a better idea to avoid these oxidative foods altogether.

Coffee

Although there is no conclusive scientific evidence to suggest the relationship between coffee and acne, we can make certain assumptions based on the known effects that coffee and caffeine have on our body.

Coffee is a stimulant of the nervous system, and it can also sometimes exacerbate sebum production, which is a known acne trigger. Correspondingly some survey studies have suggested a decrease in acne in those subjects who excluded coffee from their diet. But this may in part be due to milk and sugar that is added in the coffee. So, the exclusive effect of coffee on our skin in not too well understood as yet.

However, there is sufficient anecdotal evidence to consider coffee as a probable cause of acne, so excluding this from diet may be worth trying.

Alcohol

When it comes to the appearance and health of our skin, alcohol is almost always detrimental. In the short term it dehydrates the skin, giving it a sallow and puffy appearance, and the sugar that saturates most cocktails also aggravates acne and may even hasten wrinkles.

Alcohol’s main breakdown product, acetaldehyde, inflames the skin, releasing histamine that dilates blood vessel and causes characteristic facial flushing.

So, it may be safe to conclude that alcohol has a detrimental effect on the general health of skin, and it may set off acne.

Homeopathy for Acne

Homeopathy is the second most common form of Alternative and Complementary Medicine used by outpatient dermatology patients, with acne comprising the most common disorder for which it is used. There is some data to suggest that homeopathy may improve acne and acne scars, providing a rationale for using this approach to treat patients. Patients also increasingly demand therapies that they feel may offer them relief with minimal side effects, both of which homeopathy is reputed for. In this section, I will discuss some homeopathic remedies that have been used with considerable success in treating acne.

Sulphur

This is one of the most important remedies for acne, especially if the acne is chronic and recurrent. The area around the spots burns and itches. The skin of the face is rough, dry and hard. The acne may be associated with large comedones and boils. Any kind of water touching the skin is aggravating. The person tends to suffer from constipation and looks dry and disheveled.

Pulsatilla

A woman who has acne, especially around the time of a menstrual period, may respond well to Pulsatilla. It is particularly suitable to the person of an emotional disposition, and to those who are sensitive to cold. Such persons usually desire comfort and consolation.

Nux vomica

Nux vomica May help relieve acne for people who drink too much alcohol, smoke heavily, and generally abuse or overwork themselves. People affected with this type of acne often have stomach problems, such as increased acid or constipation.

Silica

Silica is useful for very cystic acne to help drain whiteheads. When given in high potency, this remedy helps stop the formation of boils. Silica is a very important remedy for healing the area after the boil has drained, and it helps form stronger and healthier tissue. This remedy also helps prevent scars after a large, cystic acne has formed.

Graphites

Graphites is useful for treating pimples that tend to ooze a sticky, thin discharge. Cracks may form around the acne, and eczema on the face may generalise in one area. The person is generally constipated and acne is worse around the time of menstrual period.

Summary

Chronic acne is a distressing condition having a bearing on the physical and emotional wellbeing of patients. A holistic treatment strategy based on the individual needs of the patients may significantly help in relieving this condition. Home remedies for acne when used in combination with the dietary precautions and healthy lifestyle choices have shown to have a beneficial effect in treating acne.

Besides this, there are some other aggravating factors for acne such as stress and anxiety, exposure to sunlight, heat during summer, and excessive sweating. These factors need to be identified on a personal level to take remedial measures against them.

Self awareness and a knowledge of available treatment strategies is vital in determining a bespoke acne treatment protocol.

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Eczema is a debilitating skin condition, having implications for the patients’ quality of life such as physical sufferings, issues of mental and social wellbeing, and sleep deprivation. A treatment strategy incorporating use of natural eczema remedies, and  precautions and preventions can help alleviate its distressing symptoms.

Eczema, also known as atopic dermatitis, is the most common form of skin inflammation. Genetic as well as environmental factors are thought to play a part in the development of this condition. Those with eczema usually have dry, scaly and itchy skin that is prone to infection.  In some chronic cases, excessive scratching may induce the thickening and scarring of skin.

Intense itching is the predominant symptom of eczema, which can be quite discomforting and distressing. Repeated scratching triggers a self-perpetuating itch-scratch cycle, which can have a significant impact on the patient’s quality of life.

Atopic eczema is caused due to a compromised barrier function of the outer most layer of skin, making it susceptible to the penetration of irritants and microbes.

The lifetime prevalence of eczema is about 12% in children and 7% in adults. About 60% of cases develop within the first year of life. The personal and family history of allergies such as asthma, hay fever and rhinitis is closely related to eczema.

How to Prevent Eczema

Skin hygiene is at the core of eczema management. Therefore, bathing and showering are encouraged to keep the skin clean. However, it is advised to keep baths and showers to under 10 minutes because prolonged exposure to water may wash away the protective oils that keep our skin moist.

The use of lukewarm water as opposed to hot water is recommended for bathing. A study found that the temperature of hot water in bathing/showering should be set at about 38–40 °C because the itching response is induced at a skin temperature of 42 °C or higher.

Soap substitute that is free of sodium laurel sulphate (SLS) is recommended for bathing. This chemical is a skin irritant and may act as a trigger for eczema patients. SLS free formulations of aqueous cream or emulsifying ointment are good substitutes of soap that can be purchased from the pharmacy.

After bathing, use heavy cream-based moisturiser to guard the skin against dryness. Petroleum jelly works well as an after-bath moisturiser. Avoid water based lotions, scented lotions and even baby lotions, which have a high water content, and other chemicals.

Common physical irritants that can exacerbate eczema include carpets, harsh fabrics, woollen cloths, dust mites, and chemicals found in detergents, antiseptics, chlorine and some plants and grass. Even water can be a mild irritant for sensitive skin. Avoidance of these will help to keep the eczema in

remission.

Disturbances in perspiration and excess sweat retained on the body may worsen eczema symptoms. To protect the skin surface from having excessive sweat, undergarments made of breathable and low hygroscopic fabric should be worn and warm temperatures and humidity should be avoided.

Food intolerance is another factor that can cause a relapse of eczema; hence it is important to be aware of whether any such intolerances exist. There is no formal test to assess food intolerance and so patients will need to ascertain whether they have any through trial and error. Foods that can trigger eczema include cow’s milk, tomatoes, strawberries, citrus fruits, eggs, peanuts and artificial colours, flavours and preservatives.

Any stimulation of the immune system can temporarily induce an eczema flare-up. This can be caused by a viral infection, a hidden bacterial infection (eg urinary tract infection) or emotional stress. Antihistamine therapy may be helpful in patients with a suspected stimulation of the immune system.

Sometimes intolerable itching is the most distressing symptom of eczema, and it is not an easy symptom to manage.  People may scratch their skin in their sleep and wake up with skin lesions induced by scratching. In such cases thin cotton gloves can be used at night. Keeping the nails of infants short would also be good practice.

How to Treat Eczema

The treatment of eczema is aimed at maintaining a state of remission without the need for active drug therapy.  The main management of eczema includes hydration and topical anti-inflammatory medications for flare-ups. The priority in treatment is focusing on a daily skin moisturising regimen with a fragrance-free ointment that has minimal preservatives.

The use of ointments improves the moisture content in the outer most layer of skin and leads to the prevention of allergen invasion and relapses, as well as suppression of itching by recovering and maintaining skin barrier functions. Hydrophilic ointments with moisture retaining properties have been used with significant benefits in managing eczema.

Studies have shown that the use of full body emollient therapy in newborns at a high risk of developing eczema, once per day starting from 3 weeks of age, had relative risk reduction of 50% as compared to those where such emollients were not used.

Several cohort studies have reported that increased Omega-3 long-chain polyunsaturated fatty acids intake during pregnancy may reduce the risk of atopic eczema and asthma. The use of omega-3 in the form of fish oil during pregnancy and the early life of newborns has been proposed as a prevention for various allergies. Omega-3 influences the cell membrane, and potentially modulates inflammatory responses.

Low levels of vitamin D have been reported in children and adults with eczema. Vitamin D regulates immune functions, and as such its deficiency exacerbates bacterial infections in the skin leading to eczema. Vitamin D has been found to improve eczema in a subset of patients who had recurrent bacterial infections.

Similarly, a double-blind randomised control trial showed a significant improvement in the active group being administered vitamin D, regardless of the initial severity of their atopic eczema. Supplementation of vitamin D is a safe health service endorsed route to prevent the deficiency of this vital vitamin for the rest of the body, particularly during the winter months.

Some studies have reported the protective effect of breastfeeding against the development of atopic eczema. Breastmilk supports diverse colonisation of microbiome besides nurturing the immune system of the newborn. There is some scientific evidence to suggest that exclusive breastfeeding until the age of four months reduces the risk of developing eczema at four years of age regardless of presence of family history of allergies and asthma.

For high-risk infants unable to be completely breastfed, hydrolysed formula milk may be used in preference of cow’s milk for reduced infant and childhood allergies. The general consensus amongst reviews is that hydrolysed milk formula in at-risk infants offers some protection against allergic diseases, in particular, eczema.

Several studies examining the role of prebiotics and probiotics in allergies have shown that alteration in gut microbiota composition can precede the occurrence of atopic eczema. The use of prebiotics for the prevention of allergy in infants reported some reduction in atopic eczema. Similarly, some specific strains of probiotics modulate gut bacteria, which influence skin inflammation and protect against developing eczema.

Kefir, tempeh and sauerkraut are probiotics packed with good bacteria. These and several other probiotics can be cultured at home using easy to follow recipes with the added benefit of cutting the cost. On the other hand specific strains of probiotics such as Lactobacillus and Bifidobacterium can be purchased from health stores. Fruits, vegetables and legumes are good sources of prebiotics due to their high fibre content.

Colloidal oatmeal has hydrating and anti-inflammatory properties that substantiate its benefit in treating eczema symptoms. Colloidal oatmeal is water attracting and helps the skin retain water. Similarly, symptoms associated with eczema dry skin, such as itching, skin irritation and increased skin sensitivity can be managed well with colloidal oatmeal.

Oatmeal containing body cream has shown to significantly improve skin hydration and reduce skin desquamation. Therefore, oatmeal cream is a valuable alternative to prescription creams with promising treatment benefits of eczema.

Colloidal oatmeal is also beneficial for eczema patients as a bath additive. Anecdotally, patients with wounds and sensitive lesions prefer oatmeal baths over bleach baths because of their tolerability and lack of irritation to the skin.

Herbs for Eczema

Herbs offer a range of actions that directly impact the skin and can be applied directly. Chickweed (Stellaria Media), for example is an extremely effective remedy for relieving the itching of eczema. It is most effective in a non-greasy form, such as poultice, lotion or cream. Alternatively, treating the bath water with a tablespoon of Chickweed oil is effective in helping sooth the skin that is itching from eczema.

The herb Gotu Kola (Centella asiatica) has been traditionally used for inflammatory skin conditions such as eczema and the research has been supportive for these claims. More prominent relieving of eczema symptoms has been observed with the gel product. Alternatively, poultice soaked in the tea made from 1 to 2 teaspoons of dried herb in a cup of very hot water has been used with benefit.

Aloe Vera is anti-inflammatory, and it is applied externally in the form of gel for wound healing and soothing inflamed skin. Because of its moisturising effect, the skin becomes softer, and wounds heal rapidly. Many eczema patients reported a decrease of eczema symptoms such as skin dryness and scaling and improved skin quality, after using aloe vera gel topically.

Chamomile cream has been used with considerable benefit in inflammatory skin conditions. Chamomile helps in skin cell regeneration and works as an antioxidant, fighting free radical damage on the skin. It is also believed to be hypoallergenic with the ability to neutralise skin irritants.

Calendula officinalis is credited with reducing inflammation and preventing infection due to eczema. The prevention of infection is associated with the antimicrobial properties of this herb which has a healing effect on skin lesions, abrasions and minor wounds caused by excessive itching.  Its beneficial effects have been experienced by using it in the form of ointment which can be purchased from health stores.

Evening Primrose oil has shown promising results to ease eczema symptoms, when taken orally as a supplement. It supplies gamma-linolenic acid (GLA), an essential fatty acid that people with eczema sometimes lack. 1000 mg capsule three times a day may be taken for three to four months, for noticeable benefit.

Homeopathy for Eczema

Homeopathy has an impressive track record of successfully treating skin conditions. It is the second most common form of complementary and alternative medicine used by outpatient dermatology patients. A recent case series has shown promising results of homeopathic intervention for eczema patients and reported a sustained relieving of eczema symptoms.

Homeopathic remedies are safe and gentle in stimulating the body’s internal healing capacity, which make them equally beneficial for children and adults. Some common homeopathic remedies that have been used in treating the following types of eczema are as follows: –

Sulphur is a very important remedy for treating eczema that feels extremely good whilst scratching. After scratching, however, the skin will become sore and there is more burning. The eczema tends to ooze if scratched too much, otherwise the skin tends to be dry, red, and rough looking. Contact with water aggravates the eczema and causes great burning.

Graphites have been used with success for eczema, where skin tends to be dry and rough and secretes a very thin, sticky, gluey substance. Cracks that bleed easily may be seen. This remedy is particularly helpful for eczema on the eyelids, behind ears, around the mouth and chin, in the bends of elbow, and behind knees. This eczema oozes a fluid that is usually watery, transparent, and sticky.

Arsenicum album is useful for dry, scaly eczema that resembles fish scales. The affected area itches excessively and burns. The burning is relieved with the application of hot water or warm cloth. Varying levels of mental restlessness is often seen in patients.

Rhus tox is useful for acute outbreaks of eczema, especially if the entire body is affected. The eczema has small, fluid filled eruptions. All symptoms are worse at night, in cold, damp weather, and during winter. Scratching causes an even greater need for scratching. The eczema tends to burn and can form a thick crust that oozes an offensive substance.

Mezereum is useful for eczema that is characterised by intolerable itching, great chilliness, and sensitivity to cold air. Itching with this type of eczema is made worse at night by the warmth of the bed. This remedy is also useful for treating eczema that occurs at the site of vaccination. It has been used with encouraging results for cradle cap of children.

Summary

Eczema is a complex condition requiring a multifactorial treatment strategy to manage it. The management of eczema rash and associated itching is fundamental in improving the quality of life for the eczema patient. A combination of precautions, elimination of certain dietary items, and healthy lifestyle form the basis to treat eczema. Similarly, skin hygiene and moisturising with a suitable ointment, emollient or cream help to tame eczema symptoms. Identification of food intolerances and other triggers such as environmental allergens may be helpful in determining a precaution regime. Therefore, general awareness and knowledge of the condition by the patient, including foods to avoid with eczema, assume equal significance. Likewise, alternative and complementary health approaches and the use of some micronutrients in the form of supplements may be used with beneficial effect. In case of chronic eczema, which may well be a lifelong condition, achieving a lengthy period of remission is the core treatment strategy.

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