© Charlotte Fischer

The rash travels with age

In most cases, the course of atopic dermatitis is time limited with various levels of symptoms. An atopic dermatitis rash can occur soon after birth, mostly starting from the cradle cap on the infant’s head. Soon the whole of the face and neck are affected, followed by the back of the hands and wrists, often with a weeping  rash. In children between the ages of three and seven it moves mainly to the extensor side of the extremities. In older children and young people (aged between 7 and 21) the eczema occurs to a greater extent in the elbow and knee joint. Now the rash tends to be dry, the skin is thickened and itches. The itching can be so strong that it disrupts sleep, something that can affect the whole of way the child or young person feels. We can generalise and say that eczema in the  knee joints indicates metabolic problems, perhaps a digestive disorder, whereas eczema on the elbow tends to be a sign of “excess innervation” of the skin.

Western civilisation makes us ill

Atopic dermatitis is a disease of the western-style highly industrialised countries. It occurs in Europe today at six times the frequency with which it occurred directly after the Second World War. It is also prevalent in Japan. These facts indicate that the free market economy with the optimisation of production processes, competitive pressures, lack of time and hectic activity is one of the contributing factors which promote this nervous skin disease. The development of Germany after the Second World War is often described as the “economic miracle”. “High-tech stress” has been added to that in recent times, such as the constant ringing of mobile phones and excessive time spent working at the computer. The environment into which a child is born today has changed enormously from what it was a hundred years ago: alongside the stress of pollution (physical adverse effects), there is often an absence of rhythm in everyday life and of vital foods (adverse effects at the level of life). Then there is the overload with sensory stimuli (mental adverse effects). Spiritual homelessness and the absence of any religious orientation can sap strength at a spiritual level.

It can often be observed in small children today that they display a great openness towards their physical environment soon after birth. They are attracted by electrical and technical objects and finely differentiated things. These children bring with them an inclination for their soul to be drawn too deeply into their physical environment.

An anthroposophical lifestyle is preventive

What can parents do? What methods have shown themselves to be effective for prevention or relief if there is, for example, a predisposition to suffer from the disease? Interesting results in this respect were shown by a 1999 study from Sweden which compared children from a Waldorf school with state school pupils and discovered that children from families living an “anthroposophical” lifestyle (fewer antibiotics, fewer antipyretic drugs, fewer vaccinations, more organic food) developed significantly less atopic dermatitis, hay fever and asthma than the pupils in the comparison group.

Today we know that the skin problems associated with atopic dermatitis come to expression “inwardly” in a weakness of the digestion. Food intolerance can manifest in the bowel as constipation, diarrhoea, flatulence, abdominal fullness or stomach pains. A weak digestion is based on a shift of the activity of the soul from the metabolism to the human nervous and sensory system. As a result, the senses become hypervigilant (raised soul activity upwards and outwards) and the ability of the intestine to break down food fully is weakened (reduced soul activity downwards and inwards). Possible intolerances are best determined by avoiding a food for two to four weeks and then trying it again to determine any variations. There are also various suggestions with regard to the psycho-social and educational fields: it is clear that children suffering from atopic dermatitis rashes have lost their healthy skin as a “protective cover” (at least for a time). The inflamed and itching skin makes the child mentally sore and vulnerable. That is why it is important to replace this protective cover to the greatest possible extent: that means above all else accepting the child unconditionally along with its eczema and sensitivity. In other respects regular rhythms have proved themselves to be effective for restoring such a cover: saying grace at table and evening prayers, bedtime songs and fairy tales nourish the child’s soul and spirit. The child can also feel himself or herself to be deeply inwardly and unconsciously supported by the rhythm of the yearly festivals in their recurring sequence.

Ointments help

In acute cases the first requirement is to relieve the symptoms: fundamentally we recommend fatty ointments for the dry skin – but sometimes they will not be tolerated on the skin in which case a more permeable moisturising cream should be tried. Red, itching or weeping eczema spots can be soothed by applications of zinc oxide-containing preparations each evening. The anti-inflammatory action of fatty-moist wraps (a cream combined with compresses of black tea) can help in acute episodes of eczema with extensive reddening and a tendency to weep. Oil dispersion baths have also proved their worth: an oil dispersion instrument suitable for home use can distribute a medicinal oil (olive oil with herbal additives) so finely in the water that it gets into the deeper layers of the skin and thus stimulates the warmth organism and strengthens the self-regulating forces.

Anthroposophic medicine uses specific medicines to counter the excessive action of the catabolic forces of the nervous and sensory system with building up substance in the whole organism and specially in the skin. Minerals such as potentised silver (Argen­tum) or quartz as well as bitters such as for example yellow gentian (Gentiana lutea) are used for this purpose. Seed oils (evening primrose oil) with certain unsaturated fatty acids (above all gamma-linolenic acid) can usefully be deployed to support the skin barrier and reduce hypersensitivity at the body’s boundaries. Inflammatory states of the skin with severe itching which do not react quickly enough to mildly acting medicines can be quickly and reliably calmed by the application for a limited period of a cream containing cortisone. The inflammation recedes and time is gained for the medicines of anthroposophic medicine to develop their effect. There are no side-effects from the external application of cortisone when embedded in such a comprehensive treatment concept.

Beyond that, the extended therapeutic spectrum of anthroposophic medicine has a beneficial effect: there are, for example, eurythmy therapy exercises which balance a tendency for the sensory organs to be over sensitive so that after regular and prolonged practice a “thicker skin” is formed. The artistic therapies can also help the child with atopic dermatitis: thus perception and feeling, which often diverge in the person suffering from atopic dermatitis, are brought together again. What the therapeutic mix might look like in each individual case should be discussed with the dermatologist – and can be very specific depending on the constitution of the child and nature of the atopic dermatitis.

About the author: Dr. med. Lüder Jachens is a dermatologist in Riga/Latvia.