As the negative impacts and harmful side effects of conventional treatments of eczema with steroids and calcineurin inhibitors are realized, why not turn to the many natural options for highly effective and safe support for eczema?

Eczema, a skin disorder that is chronic, systemic and inflammation-based, is also known as atopic dermatitis (AD). It is easily identified by red, dry, itchy and scaly skin.^[i] Long term use of the two most common AD treatments -- steroids and calcineurin inhibitors -- can lead to a host of negative outcomes including elevated cholesterol levels, damage to the heart, kidneys or liver, infertility^[ii] and increased risk for infections, burning or pain.^[iii]

Luckily, many safer natural alternatives are available without the side effects, from probiotics, fermented foods, prebiotics, vitamin supplementation and ginseng to natural plant oils.

1. Probiotics

Treatment using different probiotics is one of the most highly researched areas for eczema remedies. In a study of the effects of probiotics on the clinical symptoms, immune responses and gut microbiota in 109 AD patients, participants were offered oligosaccharides, Bifidobacterium bifidum, Lactobacillus plantarun (LP) or a placebo.

The LP group had the best SCORAD index (a way to measure AD symptoms), increased serum interleukin (IL)-10 levels -- a signal of a strong immune response -- and improved gut microbiota.^[iv]

Significantly decreased symptoms of AD, including the area of affected skin, intensity of AD and patient symptoms, were found in an eight-week study of 66 children from 4 months to 4 years old who were given the probiotic Lactobacillus rhamnosus, compared to a placebo.^[v]

Two probiotics combined effectively reduced the incidence of infant eczema in children under 3 years old in a meta-analysis of 12 studies with 2,093 infants.^[vi] Another study of 90 children from 1 to 3years old showed that three probiotics combined -- Lactobacillus acidophilus, bifidobacterium lactis and fructo-oligosaccharide -- decreased SCORAD by 33.7% and led to significant clinical AD improvements versus the placebo.^[vii]

2. Fermented Foods

"Fermented foods" refer to any foods or drinks that have undergone the process of fermentation -- the chemical breakdown of sugar by yeast and bacteria. Common fermented foods -- kefir, tempeh, natto, kombucha, miso, kimchi, sauerkraut and probiotic yogurt -- can boost the number of beneficial bacteria, or probiotics, in your gut, which improves digestion and strengthens your immunity.^[viii]

Research to successfully treat eczema has included fermented blueberries, black rice, orange juice, whey protein,^[ix] kimchi,^[x] natto,^[xi] barley,^[xii] rice bran^[xiii] and other fermented foods.

In countries such as Korea where there are many types of fermented foods and beverages in the typical diet, those who consumed high levels -- more than three times a day  -- of fermented foods such as doenjang (soybean paste), chungkookjang (Korean soybean like natto), kimchi (fermented cabbage), fermented seafood, makgeolli (rice wine) and beerhad a lower prevalence of AD.^[xiv]

Two antioxidants -- blueberry and black rice -- were fermented with LP for in vitro and in vivo studies of AD-induced mice and led to significantly improved skin inflammation as marked by lower IL-1β, IL-6 and IL-8 levels and less scratching.^[xv]

Similarly, 50 adults with mild to moderate AD drank LP fermented orange juice daily for eight weeks, which alleviated AD symptoms and enhanced quality of life due to its immunomodulatory effects.^[xvi]

3. Prebiotics

Prebiotic foods include onions, garlic, Jerusalem artichokes, bananas, apples and chickory root. They are high in fiber that is not easily digested and serve as great food for your gut bacteria to flourish.^[xvii] Prebiotics may help with allergy prevention and symptoms of eczema by impacting the systems involved in allergic disease development such as inflammation, immunity and gut health.^[xviii]

In a meta-analysis of 22 studies, prebiotic supplementation in infants lowered the risk of developing eczema, wheezing, asthma and food allergies compared to the placebo.^[xix] Another meta-analysis of four clinical trials including 1,218 infants found that prebiotic supplemented formula may prevent AD in infants up to 2 years of age.^[xx]

4. Vitamins

Vitamins can also be a restorative treatment for eczema and allergic disorders, particularly vitamins B12, D and E. Researchers studied 21 children with eczema from ages 6 months to 18 years. All patients who were treated with topical vitamin B12 had significant improvements to their skin compared to the placebo treatment.^[xxi]

For eight weeks, 49 AD patients applied topical vitamin B12 cream twice to one side of the body and the placebo preparation on the other side. Results showed significant superiority of vitamin B12 cream in comparison with placebo to reduce the extent and severity of AD.^[xxii]

A total of 483 cases and 483 controls were reviewed and a vitamin D deficiency was found to be higher among children with asthma, allergic rhinitis, eczema, acute urticaria and food allergies compared to controls.^[xxiii]

A meta-analysis of 11 studies of AD patients versus healthy controls showed that the AD population, especially the pediatric group, may be at higher risk for lower vitamin D levels. Supplementation with around 1,600 IU of vitamin D daily resulted in a clinically meaningful AD severity reduction of 11 points.^[xxiv]

In a study of 61 healthy subjects and 506 patients with various skin disorders, blood glutathione-peroxidase levels -- a measure of oxidative stress -- were low in patients with psoriasis, eczema, vasculitis, mycosis fungoides and dermatitis herpetiformis. Those patients treated with tablets containing 0.2 milligram (mg) of selenium and 10 mg of vitamin E found their skin disorders improved within six to eight weeks, as did the marker for oxidative stress.^[xxv]

Forty-two AD patients were divided into those given 400 IU of vitamin E or a placebo for four months. Vitamin E significantly improved itching, extent of the lesion and overall quality of life with no side effects in comparison to the placebo group.^[xxvi]

5. Ginseng

Korean red ginseng extract (RGE) in a 500 mg tablet taken daily for eight weeks was shown to improve AD severity, skin barrier function, itching and sleep disturbances in 41 AD patients.^[xxvii]

In two AD-induced mice models using in-vitro and in-vivo studies, RGE regulated the expression of proinflammatory cytokines and chemokines via the mitogen-activated protein kinases (MAPKs) and the nuclear factor kappa B (NF-κB) pathway in allergic inflammation.^{[xxviii],[xxix]}

RGE exerts therapeutic effects against AD by inhibiting the T helper (Th) 2 mediated inflammation as well as by diminishing the itching sensation in a mouse model.^[xxx]

6. Black Currant Seed Oil

Three hundred and thirteen pregnant mothers were randomly assigned to receive black currant seed oil (BCSO) or olive oil as a placebo until breastfeeding ended and then the infants were supplemented until they turned 2 years old. BCSO reduced the prevalence of AD in children.^[xxxi]

In their animal studies of a polysaccharide extracted from black currant, researchers have shown a positive effect on immunomodulation and significant improvements in AD symptoms.^[xxxii]

7. Sea Buckthorn Oil

Sea buckthorn contains flavonoids, carotenoids, polyunsaturated fatty acids, minerals, vitamins and important omega oils, which give it antibacterial, anti-sebum, antifungal, antipsoriasis, anti-AD and wound healing activities.^[xxxiii]

Staphylococcus aureus (SA) causes a wide range of skin diseases such as bacterial keratitis, follicles, psoriasis, cellulitis and AD. Sea buckthorn oil (SBO) extract reversed the effects of SA in an in vitro study.^[xxxiv]

Topical application of SBO in an AD-induced mice study significantly improved AD-like lesions, exerted an anti-inflammatory effect and repaired the skin barrier by regulating Th1 to Th2 balance.^[xxxv]

8. Evening Primrose Oil

In a reanalysis of 26 clinical studies with 1,207 AD patients, evening primrose oil was shown to have beneficial effects on itching, crusting, edema (excess buildup of water) and redness between four and eight weeks after treatment was initiated. However, the magnitude of this effect was reduced in association with increasing frequency of potent steroid use.^[xxxvi]

Natural Alternatives for Eczema

Eczema, or AD, remedies using natural foods, plants or supplements are highly effective and provide an alternative to potentially harmful steroids or other common drug treatments. For more in-depth evidence, see GreenMedInfo.com's research on eczema, atopic dermatitis and skin diseases.

References

[i] Mayo Clinic. Atopic dermatitis (eczema) - Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273

[ii] Healthline.com. Are Steroids Bad for You? Uses, Side Effects, and Dangers. https://www.healthline.com/nutrition/are-steroids-bad

[iii] SingleCare. Eczema Treatments & Medications. https://www.singlecare.com/conditions/eczema-treatment-and-medications

[iv] Zhifeng Fang, Wenwei Lu, Jianxian Zhao, Hao Zhang, Long Qian, Qun Wang, Wei Chen. Probiotics modulate the gut microbiota composition and immune responses in patients with atopic dermatitis: a pilot study. Eur J Nutr. 2019 Jul 24. Epub 2019 Jul 24. PMID: 31342226

[v] Yi-Jie Wu, Wei-Fong Wu, Chia-Wei Hung, Ming-Shiu Ku, Pei-Fen Liao, Hai-Lun Sun, Ko-Hsiu Lu, Ji-Nan Sheu, Ko-Huang Lue. Evaluation of efficacy and safety of Lactobacillus rhamnosus in children aged 4-48 months with atopic dermatitis: An 8-week, double-blind, randomized, placebo-controlled study. J Microbiol Immunol Infect. 2017 Oct ;50(5):684-692. Epub 2015 Nov 27. PMID: 26733351

[vi] Minghui Sun, Jing Luo, Hanmei Liu, Yue Xi, Qian Lin. Can Mixed Strains of Lactobacillus rhamnosus GG and Bifidobacterium Longum Reduce Eczema in Infants under Three Years of Age? A Meta-Analysis. Nutrients. 2021 Apr 25 ;13(5). Epub 2021 Apr 25. PMID: 33923096

[vii] Sergei V Gerasimov, Volodymyr V Vasjuta, Oksana O Myhovych, Lyudmyla I Bondarchuk. Probiotic supplement reduces atopic dermatitis in preschool children: a randomized, double-blind, placebo-controlled, clinical trial. Am J Clin Dermatol. 2010;11(5):351-61. PMID: 20642296

[viii] Heathline.com. 8 Fermented Foods: Kefir, Kimchi, Miso, and More. https://www.healthline.com/nutrition/8-fermented-foods#Frequently-asked-questions

[ix] Josée Beaulieu, Claude Dupont, Pierre Lemieux. Anti-inflammatory potential of a malleable matrix composed of fermented whey proteins and lactic acid bacteria in an atopic dermatitis model. J Inflamm (Lond). 2007;4:6. Epub 2007 Mar 21. PMID: 17376223

[x] Chun Wook Park, Myoungsub Youn, Young-Mi Jung, Hongik Kim, Yoonhwa Jeong, Han-Ki Lee, Hye One Kim, Insun Lee, Soo Won Lee, Kook Hee Kang, Yong-Ha Park. New functional probiotic Lactobacillus sakei probio 65 alleviates atopic symptoms in the mouse. J Med Food. 2008 Sep;11(3):405-12. PMID: 18800885

[xi] Yong Hwan Choi, Hyun Lim, Moon Young Heo, Dae Young Kwon, Hyun Pyo Kim. Anti-inflammatory activity of the ethanol extract of Chungkukjang, Korean fermented bean: 5-lipoxygenase inhibition. J Med Food. 2008 Sep;11(3):539-43. PMID: 18800904

[xii] Takafumi Iguchi, Ayumi Kawata, Toshiro Watanabe, Tapan Kumar Mazumder, Soichi Tanabe. Fermented barley extract suppresses the development of atopic dermatitis-like skin lesions in NC/Nga mice, probably by inhibiting inflammatory cytokines. Biosci Biotechnol Biochem. 2009 Mar 23 ;73(3):489-93. Epub 2009 Mar 7. PMID: 19270394

[xiii] Saba Evelyn, Chun Hee Lee, Jeong Da Hye, Lee Kija, Kim Tae-Hwan, Roh Seong-Soo, Kim Seung-Hyung, Rhee Man Hee. Fermented rice bran prevents atopic dermatitis in DNCB-treated NC/Nga mice. J Biomed Res. 2016 May 20 ;30(4). Epub 2016 May 20. PMID: 27323667

[xiv] Sunmin Park, Ji-Hyun Bae. Fermented food intake is associated with a reduced likelihood of atopic dermatitis in an adult population (Korean National Health and Nutrition Examination Survey 2012-2013). Nutr Res. 2016 Feb ;36(2):125-33. Epub 2015 Nov 19. PMID: 26826428

[xv] Seong Min Hong, Min Cheol Kang, Mirim Jin, Taek Hwan Lee, Beong Ou Lim, Sun Yeou Kim. Fermented blueberry and black rice containing Lactobacillus plantarum MG4221: a novel functional food for particulate matter (PM)/dinitrochlorobenzene (DNCB)-induced atopic dermatitis. Food Funct. 2021 Apr 21 ;12(8):3611-3623. Epub 2021 Mar 31. PMID: 33900308

[xvi] Naomi Harima-Mizusawa, Keiko Kamachi, Mitsuyoshi Kano, Daisuke Nozaki, Tatsuo Uetake, Yuji Yokomizo, Takayuki Nagino, Akira Tanaka, Kouji Miyazaki, Shinichiro Nakamura. Beneficial effects of citrus juice fermented with Lactobacillus plantarum YIT 0132 on atopic dermatitis: results of daily intake by adult patients in two open trials. Biosci Microbiota Food Health. 2016 ;35(1):29-39. Epub 2015 Oct 27. PMID: 26858928

[xvii] WebMd.com. 8 Foods High in Prebiotics and Why You Need Them https://www.webmd.com/diet/foods-high-in-prebiotic#2-3

[xviii] WebMd.com. 8 Foods High in Prebiotics and Why You Need Them. https://www.webmd.com/diet/foods-high-in-prebiotic#1

[xix] Cuello-Garcia, C, Fiocchi, A, Pawankar, R, et al. Prebiotics for the prevention of allergies: A systematic review and meta-analysis of randomized controlled trials. Clin Exp Allergy. 2017; 47: 1468-1477. https://doi.org/10.1111/cea.13042

[xx] Osborn DA, Sinn JK. Prebiotics in infants for prevention of allergy. Cochrane Database of Systematic Reviews. 2013(3). https://doi.org/10.1002/14651858.CD006474.pub3

[xxi] Ronald Januchowski. Evaluation of topical vitamin B(12) for the treatment of childhood eczema. J Altern Complement Med. 2009 Apr;15(4):387-9. PMID: 19368512

[xxii] M Stücker, C Pieck, C Stoerb, R Niedner, J Hartung, P Altmeyer. Topical vitamin B12--a new therapeutic approach in atopic dermatitis-evaluation of efficacy and tolerability in a randomized placebo-controlled multicentre clinical trial. Br J Dermatol. 2004 May;150(5):977-83. PMID: 15149512

[xxiii] M S Ehlayel, A Bener, A Sabbah. Is high prevalence of vitamin D deficiency evidence for asthma and allergy risks? Eur Ann Allergy Clin Immunol. 2011 Jun ;43(3):81-8. PMID: 21789969

[xxiv] Sonal R Hattangdi-Haridas, Susan A Lanham-New, Wilfred Hing Sang Wong, Marco Hok Kung Ho, Andrea L Darling. Vitamin D Deficiency and Effects of Vitamin D Supplementation on Disease Severity in Patients with Atopic Dermatitis: A Systematic Review and Meta-Analysis in Adults and Children. Nutrients. 2019 Aug 9 ;11(8). Epub 2019 Aug 9. PMID: 31405041

[xxv] L Juhlin, L E Edqvist, L G Ekman, K Ljunghall, M Olsson. Blood glutathione-peroxidase levels in skin diseases: effect of selenium and vitamin E treatment. Acta Derm Venereol. 1982 ;62(3):211-4. PMID: 6179360

[xxvi] Fariba Jaffary, Gita Faghihi, Arghavan Mokhtarian, Sayed Mohsen Hosseini. Effects of oral vitamin E on treatment of atopic dermatitis: A randomized controlled trial. J Res Med Sci. 2015 Nov ;20(11):1053-7. PMID: 26941808

[xxvii] Kim, H.; Park, C.W.; Cho, S.H. The Beneficial Effect of Korean Red Ginseng Extract on Atopic Dermatitis Patients: An 8 Weeks Open, Noncomparative Clinical Study. Ann. Dermatol. 2018, 30, 304-308. https://synapse.koreamed.org/articles/1104553

[xxviii] Ji-Ye Kee, Yong-Deok Jeon, Dae-Seung Kim, Yo-Han Han, Jinbong Park, Dong-Hyun Youn, Su-Jin Kim, Kwang Seok Ahn, Jae-Young Um, Seung-Heon Hong. Korean Red Ginseng improves atopic dermatitis-like skin lesions by suppressing expression of proinflammatory cytokines and chemokines in vivo and in vitro. J Ginseng Res. 2017 Apr ;41(2):134-143. Epub 2016 Feb 19. PMID: 28413317

[xxix] Ju-Hyoung Park, Eun-Kyung Ahn, Hye-Jin Ko, Jae Yeon Lee, Seung-Mi Hwang, SeonMi Ko, Joa Sub Oh. Korean red ginseng water extract alleviates atopic dermatitis-like inflammatory responses by negative regulation of mitogen-activated protein kinase signaling pathway in vivo. Biomed Pharmacother. 2019 Jun 18 ;117:109066. Epub 2019 Jun 18. PMID: 31226639

[xxx] Hyun Joo Lee, Sang Hyun Cho. Therapeutic Effects of Korean Red Ginseng Extract in a Murine Model of Atopic Dermatitis: Anti-pruritic and Anti-inflammatory Mechanism. J Korean Med Sci. 2017 Apr ;32(4):679-687. PMID: 28244297

[xxxi] P Linnamaa, J Savolainen, L Koulu, S Tuomasjukka, H Kallio, B Yang, T Vahlberg, R Tahvonen. Blackcurrant seed oil for prevention of atopic dermatitis in newborns: a randomized, double-blind, placebo-controlled trial. Clin Exp Allergy. 2010 Aug;40(8):1247-55. Epub 2010 Jun 9. PMID: 20545710

[xxxii] XHiroshi Ashigai, Yuta Komano, Guanying Wang, Yasuji Kawachi, Kazuko Sunaga, Reiko Yamamoto, Ryoji Takata, Mika Miyake, Takaaki Yanai. Effect of administrating polysaccharide from black currant (Ribes nigrum L.) on atopic dermatitis in NC/Nga mice. Biosci Microbiota Food Health. 2018 ;37(1):19-24. Epub 2017 Nov 16. PMID: 29387518

[xxxiii] Swati Pundir, Prakrati Garg, Ananya Dviwedi, Aaliya Ali, V K Kapoor, Deepak Kapoor, Saurabh Kulshrestha, Uma Ranjan Lal, Poonam Negi. Ethnomedicinal uses, phytochemistry and dermatological effects of Hippophae rhamnoides L.: A review. J Ethnopharmacol. 2020 Oct 2:113434. Epub 2020 Oct 2. PMID: 33017636

[xxxiv] Humaira Shah, Hafiz Abdullah Shakir, Sher Zaman Safi, Abid Ali. Hippophae rhamnoides mediate gene expression profiles against keratinocytes infection of Staphylococcus aureus. Mol Biol Rep. 2021 Feb ;48(2):1409-1422. Epub 2021 Feb 19. PMID: 33608810

[xxxv] Yajing Gu, Xinxin Wang, Fang Liu, Jin Zhang, Xiufang Zhang, Jiping Liu, Sijia Li, Decheng Wang, Hongquan Guan, Diandong Hou. Total flavonoids of sea buckthorn (Hippophae rhamnoides L.) improve MC903-induced atopic dermatitis-like lesions. J Ethnopharmacol. 2022 Mar 16 ;292:115195. Epub 2022 Mar 16. PMID: 35306042

[xxxvi] N L Morse, P M Clough. A meta-analysis of randomized, placebo-controlled clinical trials of Efamol evening primrose oil in atopic eczema. Where do we go from here in light of more recent discoveries? Curr Pharm Biotechnol. 2006 Dec;7(6):503-24. PMID: 17168667