Overcoming Medical Dogma–Eczema

July 28, 2012 in Categories: , by

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The recurring series “Overcoming Medical Dogma” is a collaborative effort between The Paleo Mom Sarah Ballantyne, PhD, scientist turned stay-at-home-mom, and Paleolithic MD Dr. Ernie Garcia, MD, Internal Medicine and Sleep Medicine specialistThe goal of these co-written posts is to go beyond the typical physician-patient interaction where the patient describes symptoms, the physician diagnoses and prescribes medication and/or dispenses diet and lifestyle advice. In each post, we will discuss a common medical condition, the typical treatments that your doctor may recommend, and what you should know about these conditions that your doctor may not tell you. We will reference relevant research and present our recommendations for addressing this condition.  Lastly, we will address the benefits of pharmaceuticals (prescription and OTC) as well as home/natural remedies which may help.

What is Eczema?  Eczema is a general term used to describe a collection of skin conditions (the most common being atopic dermatitis) in which the skin is inflamed and irritated.  The inflammation in these skin conditions is in the epidermis, or outer layer of the skin, and this is the main distinction between eczema and other skin conditions.  The presentation varies and can include any of the following symptoms:  redness, skin edema (swelling), itching, dryness, crusting, flaking, blistering, cracking, oozing, or bleeding.  It can affect any area of the body and areas can range in size from quite small to very large.  Eczema affects about 10% to 20% of infants and about 3% of adults and children in the U.S. 

It was once thought that eczema was a primary immune system disorder, where an overactive immune system, led by a type of white blood cell called T-Cells, responded to environmental factors by initiating an inflammatory response.  This idea made sense because not only would inflammation produce the red, irritated skin characteristic of eczema, but this dysfunctional immune response also provided an explanation for the observed incidence of atopic dermatitis in conjunction with asthma, hay fever, and other allergies.  However, the most up-to-date research does not support this explanation. 

The most current research points to a different origin of eczema.  It is now thought that eczema results from structural defects in the epidermis resulting in “impaired barrier function”.  Essentially, abnormalities in the skin make it more permeable to toxins and antigens, which then causes an exaggerated immune response 1.  You could think of this as “leaky skin”, where the skin no longer is able to fulfil its primary role as the first line of defence between the body and the outside world.  Once the barrier function of the skin is disrupted, various substances (like toxins, allergens, antigens; basically anything that the immune system views as a foreign invader) can “leak” in from the outside and this is what activates the immune response.  This model is supported by recent isolation of specific mutations in the gene for filaggrin, a structural protein in the epithelial cells of the skin.  This defective gene (and perhaps other similar gene mutations) may lead to a dysfunctional epidermal barrier and is likely the primary cause of eczema. 

What is your doctor likely to tell you about it?  Your doctor will likely tell you that the exact cause of eczema is unknown, but it’s thought to be linked to an overactive response by the body’s immune system to an irritant.  He or she may not be aware of the newest research on eczema, but that will not affect decisions on treatment.  It’s fairly common and not life threatening.

What is your doctor likely to prescribe?  Treatment of any skin condition should always start with proper care of your skin.  In the case of eczema, you should avoid triggers such as heat, perspiration, and low humidity, and keep the skin well hydrated at all times. The standard pharmaceutical treatment is the application of topical corticosteroid creams, which can be purchased in your local pharmacy or prescribed in stronger strengths by your doctor.  If allergies are suspected, a daily antihistamine such as loratidine (Claritin) may be suggested.  In severe cases, your doctor may prescribe an oral corticosteroid, such as prednisone. 

Now if you have your thinking hats on (and we’re sure you do), you are asking “If eczema is no longer considered a primary immune disorder, why is the standard of treatment aimed at stopping inflammation and controlling the immune response?”  The answer is that the symptoms of eczema are indeed caused by an immune response, but it is a response from environmental triggers entering the body through “leaky” skin as opposed to an immune system run wild and attacking itself. 

What should you know that your doctor may not tell you?As discussed above, the most current belief is that those with eczema carry a genetic predisposition to “disrupted epidermal barrier function” 1.  This could be thought of as “leaky skin” and is a very analogous to a “leaky gut”.  In fact, because of the similar roles of the skin and the gut to act as a barrier, it is no surprise that eczema is also associated with increased intestinal permeability 2, i.e., a leaky gut.  It is still unknown whether a leaky gut contributes to the development of eczema, however.   

Eczema is also often seen in conjunction with a multitude of autoimmune diseases.  For example, eczema occurs about three times more frequently in celiac disease patients and about two times more frequently in relatives of celiac patients, potentially indicating a genetic link between the two conditions.  For this reason, gluten sensitivity is suspected as a possible root cause for eczema, but that is still unconfirmed.  Anecdotally, many people find that their eczema goes away when they adopt a gluten-free diet.  Other people find elimination of additional foods, such as eggs, are required to see improvement.  There also appears to be a strong link between eczema and immune hypersensitivity 3.  For example, more than 50% of children with atopic dermatitis go on to develop asthma and allergies.  This may be related to the association with increased intestinal permeability or may reflect an as yet unknown common causal mechanism (such as a gene mutation or environmental factors).   

Although progress had been made toward understanding this complex condition and how it relates to other health issues, the cause of eczema remains unknown.  We are certain the coming years will bring more information and we will try to update everyone as it is available.

A Comprehensive Approach to Treatment:  We believe that a paleo diet is an excellent initial approach to dealing with eczema.  This is because a paleo diet reduces inflammation and heals the gut.  Including glycine-rich foods like homemade bone broth and organ meat can help speed the healing of both the gut and the skin (glycine is an essential component of connective tissue and the extracellular matrix that acts as a scaffold for cells).  Sun exposure and eating vitamin D-rich foods such as fish and organ meat can be very helpful in speeding healing (you might also consider a Vitamin D3 supplement, but check with your doctor first).  Consuming plenty of oily cold-water fish (at least three times per week) as well as eating grass-fed and pastured meat will also help because the high omega-3 content of these foods (and low omega-6 content) could help resolve inflammation.   

Anecdotally, most people report alleviation of their symptoms with adoption of a paleo diet.  In extreme cases, or in individuals who do not see alleviation of their symptoms with out-of-the-box paleo, it may be worth trying a more restricted implementation of the paleo diet, such as the Autoimmune Protocol, a paleo version of the GAPS diet, or even something as simple as completing the Whole 30 Challenge from Whole 9 Life.   

Over the counter topical corticosteroid creams may still provide some alleviation of symptoms (most notably the itching) and might be required initially.  Other moisturizers which may help heal the skin faster and relieve itching include extra virgin coconut oil and lotions containing calamine, aloe vera, arnica montana, Vitamin D and/or Vitamin E.  Diane Sanfilippo provides herbal supplement recommendations in her new book Practical Paleo (herbal supplement recommendations are generally beyond both of our backgrounds and we recommend that you consult with someone with specific training in these supplements such as a Naturopathic Physician).  If your attempts to control symptoms with diet and supplements alone do not produce adequate relief, we suggest visiting your doctor for advice on more specific pharmaceutical intervention in the form of stronger topical steroids or short courses of oral steroids in extreme cases.

1 Elias PM and Steinhoff M  “Outside-to-Inside” (and Now Back to “Outside”) Pathogenic Mechanisms in Atopic Dermatitis. J Invest Dermatol. 2008 May; 128(5): 1067–1070.

2 Pike MG et. al. Increased intestinal permeability in atopic eczema. J Invest Dermatol. 1986 Feb;86(2):101-4.

3 Boguniewicz M.  Atopic dermatitis: beyond the itch that rashes. Immunol Allergy Clin North Am. 2005 May;25(2):333-51.

Comments

My son had really bad eczema that progressively got worse and worse. We finally opted to get the inline shower filters and it got a little bit better. When we bought our new home, we bought a whole house filtration system and soft water system. Within two baths his skin had drastically smoothed. He is eczema free now.

My 3 yr old has eczema really bad. We also use a filter system on our shower that seems to keep it from getting really bad. I have noticed if he goes swimming in his little pool, the unfiltered well water dries the skin out and it gets really bad again. I am going to try to give him a shower as soon as he comes in from playing in the pool to see if that helps… I don’t want to tell him he can’t swim. :-( Now that you say that about the whole house filtration system, I am going to look into it. If it would help it would be worth it!

My son came down with eczema when he was 6 months old. It flared up every winter and receded in the spring. (We live in SW Florida, so our weather was not really cold, but it was less humid.) It was the worst two years ago — his poor little hands were cracked and bleeding from it, and I thought it would never go away. However, no eczema this past winter, much to my surprise! Almost three years ago when he was 10, he started losing his hair, and within a few months, he had lost every bit of hair on his body and was diagnosed with alopecia universalis. We did do a gluten free diet for a short while toward the end of the first year (very difficult with teenagers in the house), and he did take some specific nutritional supplements for a while. His hair started growing back the second year, but fell out again after a severe case of impetigo. Do you have any thoughts on whether the Paleo diet or your autoimmune protocol would benefit him? Or any other advice for me? Thank you!

Yes, I think the autoimmune protocol would be an excellent thing to try for your son (alopecia is an autoimmune disease). It will be a challenge to get him to stick with it, just because of his age, but maybe if he starts to feel better and see his hair growing back, it will help? Also, he probably has a very healthy appetite, so you might want to stock up on grass-fed lunch meats, jerky, fruits and veggies to make sure there are convenient easy snacks around for him to eat (grasslandbeef.com has lots of great products, just read the ingredients lists for nightshade spices). Good luck!

I went grain and sugar free almost two years ago because of a diagnosis of eczema. Apparently I had it for a long time but only noticed it when it started to spread to the crease along my nose/cheek. I has home with my infant and eating lots more carbs/sugar and was sleep deprived so it thrived. Anyway, gave us grains/sugar for that reason only and then found out about primal/paleo. I’d hlike had eczema for years and didn’t realize what it was. Seriously, within 36 hours the irritation on my eyes and behind/in my ears was gone. It only flares up again if I eat too much sugar. I’ve hardly had any flare ups for the past two years but have been eating choco now for a couple of weeks and I have it again – flakey eyebrows, and skin behind ears, and itchy ear canals. If I eat sugar at night, my ear canals itch the next day. Crazy! But if I go 24 hours w/o eating sugar (I don’t eat any grains so that is not the cause) it all goes away. Amazing!

Hi there, I’ve been reading your blog with interest. I’m not paleo yet, but I’m very interested and looking into it. I’ve made major changes to our family’s diet since reading a book called Sweet Poison by David Gillespie, which is gaining popularity here in Australia. It’s all about fructose, similar stuff I think to what Dr Robert Lustig talks about in the US. Anyway, we’ve gotten rid of all sugar, honey etc. The kids have some whole fruit, but that’s it. And my kids are dairy intolerant so we’re all off dairy. I’ve just bought the book you recommended by the Whole30 people (forget the title). So I’m hoping to be able to make the changes we need to get a bit more healthy.

One question I do have though – and it was this post that reminded me – is, what about tinea (I think you might call it Athlete’s foot?). I know this is kind of gross, but for the past couple of years I’ve had it on my hands! (I think it started when I was pregnant with my daughter 3 years ago and would rub creams on my poor sore pregnant feet). I never even knew I had it on my feet, but over the past few years my hands have become more and more dry and sore, no matter what I do and recently a doctor said that I have ‘dry scale tinea’ on them. I’m wondering if you know much about this, whether it’s something a paleo diet would help?

David Gillespie is doing some great work. Have you seen his latest book? It has more of a focus on omega-6 fats. Any yeast growth in or on the body should be helped by a lower-carb paleo approach (like the Whole30 approach). Skin conditions are often symptoms of a leaky gut, so making sure to add lots of bone broth, organ meat, and fermented foods (like raw sauerkraut or kombucha tea) should help speed healing too. Good luck!

I know this reply cmes a bit late but maybe someone else browsing these pages will find it helpful.. I used to have fungal infections of the skin and got only temporary relief from topical antifungal creams. Going strict paleo helped but did not rid me of it completely. I decided to take things further and went very low carb and supplemented with Pau D’Arco. I’m now completely free of fungal infections as well as eczema and many other symptoms I used to have lika depression, joint pain etc.

Same here. Had athlete’s foot frequently. Eczema on my scalp, in my ear, eyebrows.
I had Raynouds disease (were your fingers all go white, due to lack of blood circulation), acne. And it’s all gone due to elimination of Dairy and grains. I cann’t have gluten free food as there are still grains in there which makes the eczema come back and I get kind of blisters underneath my foot when I eat gluten free stuff.

So informative! Thanks for the tips and as always, you’ve included something that I didn’t know before! Love it. My son had eczema for about a year till grains and dairy came out of his diet. I JUST noticed, like yesterday, that he has teeny patch on his skin for the first time in 3 months. I’m worried he eats too many eggs, or as you said, maybe there’s just a genetic predisposition to it. Sigh, the battle keeps going!

There seems to be a link between eczema and food sensitivities, although exactly how it works is still now known. Egg allergy/sensitivity is common with eczema, which is tough because it’s really hard to cut out, especially with kids!

Hey I just want to say that I LOVE your blog and I have been waiting for something scientific like this to come out on the Internet for years. I myself am in the scientific field and have been suffering from Lichens planus for 26 years (my lifetime or as long as I can remember) . I have been following the autoimmune protocol for about a month now and can’t ever remember feeling happier. My mood is always elevated, I have energy all the time, and my sores are controlled. They did initially get better however one night of drinking brought them back with a vengeance.

On to my question, I have been drinking a superfood juice for the past week that contains spirulina, wheat grass and barley grass. Is this the same as wheat and barley and can they be consumed on the AIP?

Once again thank you for allowing me to see there are others out there like myself searching for a natural cure and fed up with steroids.

I have heard that chlorella is not good for you because the membrane has lipopolysaccharide in it (the same protein as in E. coli that causes inflammation and food poisoning). I’m not sure if spirulina has LPS as well, but I avoid it for this reason (and I tend to get tons of DHA from fish and grass-fed meat and tons of minerals from green veggies in my diet). Generally, grasses are fine as long as they are a few days old before harvesting (if harvested too early, they can still have quite a high anti-nutrient content). So, if you feel like it’s okay, then I would keep it in your diet for now (you can always revisit later). If you are suspicious that this is slowing down healing, then try leaving it out for a week or two and see if you notice a difference. :)

We could start a club for scientists with lichen planus who follow the paleo AIP. :)

Thank you so much for your thoughtful and nicely cited blog posts. As a long time locavore and sustainable food enthusiast, Paleo has been on my radar for years – but it had always seemed to me that people were following the rules due to a fairy tale of the noble savage. It didn’t seem harmful, but neither did it seem rational or compelling Your trained critical mind, ability to research and to write clearly have me convinced.

I am an MD in residency, under enormous work stress with a totally deranged sleep schedule and too little sunlight. Over the past year since starting this phase of my training, my nearly inconsequential eczema has turned into a constant peeling mess and broken out in new places (a horrible thing when handling ill people, so I’m using daily topical steroids) and recently my gut has become unpredictable. My coffee habit has increased to a pot each day and my diet has turned to one of convenience in the hospital cafeteria (formerly included lots of local pastured meats and tons of veg from the fantastic CSA). I find myself often insomniac, too wound up with caffeine and sugar – admittedly also with excitement as I love what I am learning and doing, I just wish it wasn’t wrecking my body!

Today, as I start an elective month with a slightly less terrible schedule, I embark on a month of strict Paleo. I will rely heavily on your recipes and posts for inspiration and courage. My husband is supportive and aiming for 50% Paleo and our two young kids are enthusiastic eaters, so at least my support system is on my side.

Thank you again, and please keep up the excellent work.

I recently had began developing a rash and itchiness on my wrists and hands, so I attempted treatment with vitamin e oil with little results. It really surprised me that it didn’t go away, so I talked to my wife about it, she said she and our daughters had the same thing just not as bad as mine(I must wash my hands more:-)) She finally tracked it down to the hand soap we just purchased, it was big commercial brand and contained a plethora of ingredients. One specifically seemed to create a trail, sodium lauryl(harsh)/laureth(less harsh) sulfate. So I did a little research on this ingredient and found this http://articles.mercola.com/sites/articles/archive/2010/07/13/sodium-lauryl-sulfate.aspx You have to read this article, it says that it’s used as a skin irritant when skin medical treatment need something to be tested on. I also says that it can lead to organ toxicity among other things. Well, why am I washing my hands with this stuff…long story short, we had to throw out all our recent soap purchases approx. $130 shampoo/body soap too! And now we have natural soap, made with mostly natural oils. Doesn’t feel like it’s ripping my skin off anymore, because the old soap probably was.

I’m really glad this post keeps the option of using topical steroid cream in the beginning to relieve symptoms. My infant son had terrible, weeping, bleeding eczema blisters and cracked skin almost from day one, and I resisted using steroid creams for a long time. We tried every natural remedy we could find, and I eliminated every possible allergen from my diet (I was breastfeeding) and still we only had marginal results. I finally consented to the steroid cream and, sure enough, once he got out in front of it he was able to heal from the eczema. He just needed a little support. I felt terrible for not giving him the relief from what must have been very painful symptoms sooner. The good news is that once we got it under control, we have been able to manage it through a healthful primarily paleo diet. Also, it was easy to slowly re introduce foods to figure out the intolerance: eggs. Thanks for your useful blog!

I am a perinatal nurse that has worked with hundreds of families..my observation is that when babies are formula fed..they get eczema more often..one woman had 4 kids with horrid eczema..the breastfed her 5 th..beautiful skin! I share that story with all my second time moms who are dealing with a first born with eczema…BREASTFEED!!!

I had eczema for years on my arms and legs and it was getting worse…started to appear on my face above my eye. I tried taking out various foods from my diet. I tried dairy, sugar, eggs…and finally wheat. Within 2 days of eliminating wheat it started to fade and it has not come back since. That was 14 years ago. At the time I had been baking bread with extra wheat bran and wheat germ, thinking it was healthy. I was so relieved that I was able to figure it out.

My daughter is 6mo old and has just been diagnosed with bad eczema. The doc said to use Eucerin and 1% cortosone cream. I am breastfeeding and I am not too hot about giving my BABY topical steroidal cream. I have been using natural cream from Target, called BabyGanics. The cream has helped a lot, and the redness is completely gone, and it seems to be helping a lot. But it is not fully gone, and I am just wondering what I need to be doing, like do I need to change my diet, or consume more vit D and E? I have also been using coconut oil but have not been using it consistently, so not sure if it has made any difference. I hear so many different stories and so many different treatments, I feel like I have no idea what to do next if it does not go away. The doctor did not say anything about cause, just told me to use those creams. ugh…..

Eczema is very very correlated with food sensitivities. If your daughter is exclusively breast fed, then yes, looking at your diet is a good idea (I don’t generally recommend supplementation, just eating a really nutrient dense diet full of vegetables, fruits, quality meats and fish). If your baby is getting a mix of solids (did the eczema start with solids?), then have a look at what she is getting (and maybe do both). Coconut oil, olive oil, and tallow (especially grass-fed tallow) are all good moisturizers for helping to restore barrier function to the skin (check out Primal Life Organics and Vintage Tradition for ready-made creams).

Hi – I write a blog about managing eczema, allergies, and asthma naturally. I’m looking for someone to write about their experiences with Paleo eliminating their eczema. Please email me if you know of someone that may be interested in writing a guest post. Thanks! jennifer (at) eczemacompany (dot) com

Jennifer

Hi Everyone,

I want to share with you all that we found a cream that (believe it or not!) that actually made my daughters eczema go away! We struggled hard with a very itchy baby, tried everything and a didn’t believe this day would come. It’s called magicream123. You can only get it online from the UK. The website is magicream123.com. Its all natural. A combination of Chinese herbs and Vaseline. We heard about it from my Chiropractor whose son also had bad eczema. We still can’t believe our daughter isn’t itching constantly. She plays unbothered and I cry whenever I put her to bed because my baby falls asleep easily and without being all wrapped up tight. We have told everyone we know it hopes it can help another family too.

Emily

65 years old. Been Paleo 1-1/2 years and never in my life–a healthy one–have I had rashes until earlier in the year when I got a spray of itchy rash on my left calf, a couple of spots on both my upper feet around where my sandals hit the skin and now a dime size spot on my hand that is now kind of nasty looking and getting oozy. I am pretty good about staying away from gluten, eat mostly clean as I can, good oils, just a little dairy (but lots of Kerrygold butter, some grassfed meatetc. I take about 5,000 to 7,000 D3 per day, fermented cod liver oil, magnesium are my main supplements. I don’t know what I weigh but wear a size 8 and thin boned. I leaned out some when went Paleo. I have found I have little body hair now. Skin is very thin and sun spotted as I have fair northern European skin. The calf rash has gone to not bothering me and another small spot on my ankle bone is improved but this hand spot is bad. Got any ideas? It looks like eczema. it now occurs to me I have been eating more 86% dark chocolate in the last few months while this has been happening. Yeah, much more chocolate for sure. Maybe I should eliminate that first.

Chocolate is a fairly common allergy and there is definitely an allergy or food sensitivity link to eczema. But, many skin conditions look very similar, so I would recommend seeing a dermatologist to get a diagnosis. It will be easier for you to figure out what to do about it after that. And I recommend Liz Wolfe’s skintervention guide as a resource: http://skinterventionguide.com/?hop=sbpaleomom

Hi, Thank-you for your wonderful article, shedding some light on the horrendous skin irritation. I’ve had eczema my whole life and have only had it under control for the past three years (i’m now 21).

As a child, I would visit my GP every few months with a new ailment somewhere on my body. At one stage, my doctor suggested that I may have aliens living on my skin as I would always present a new boggling mystery for him to solve! When I hit puberty (12 years old) my skin just went crazy, my mum named it the “Volcanic Eruption”. I developed a vast amount of pimples and black heads around my T-Zone and eczema everywhere on my body. The crease between my forearm and upper arm was the worst. The whole area was just covered with flakey, dry, bleeding, sore skin. It got to the point where I could no longer bend my arm on some days as it was so painful. As soon as my mum caught onto what was happening, she rushed me off to the best dermatologist she could find.

At my first appointment, I was given 4 prescription cremes and ointments, antibiotics and strict instructions to follow in the following months. To alleviate my arms, I had to apply vast amounts of a non-alergenic moisturiser and wrap in plastic film for 30 minutes twice a day. I was so humiliated the first time my mum wrapped me up, I balled my eyes out. But it worked and within a few weeks the eczema from my arms had drastically subsided. I now only have a few scars to show it was ever there.

It has been difficult finding make-up which does not kill my skin. Although many advertise as being “irritant free” etc, it’s taken vast trial and error to concoct the perfect mix. I can only use eye shadow sparingly as it aggravates the eczema on my eyelids. If I attend a fancy event and wear a lot of make-up, for the next few days i’ll be lapping on the moisturiser and topical cremes.

Recently, I’ve also been diagnosed with “clinically severe eczema” which I quite proud of. I have a big box of prescription cremes and ointments which comes with me wherever I go. I have also began using compound ointments which can only be made at special pharmacies, on site.

I’ve been researching alot about the Paleo diet and how people have seen stifling results in their health. Reading this article about eczema has given me the push that I needed to begin believing in the lifestyle change.

Whenever I com pain to girlfriend about a bad blemish or red spot, they lean in close, squint and say “but your skin is flawless”! If only they knew the whole story..

Thanks for writing an amazing blog!! I have some psoriasis and arthritis and I have read to eliminate nightshade vegetables which include peppers… does this include all peppers including bell peppers, jalapeno peppers, chilli thai peppers, habenero peppers? I really enjoy spicy food so was just wondering if i can still cook with the spicy peppers! Thanks so much!!

Great article thank you for your research. I am a breastfeeding mum of an 8mo who has had eczema since 6mo. I have cut out egg, dairy and nuts from my diet to no avail. I am thinking Paleo for me could help him (his diet is already only veg fruit and meat but he is still breastfed for most of his nourishment) do you have any thoughts? I have got rid of detergents in the home and am taking probotics and flacseed oil.
Thanks again and keep up the great work.

I have a friend who has been dealing with the same thing. Nightshades were a huge trigger food (in her diet, passed on through breastmilk) as were eggs, nuts, and seeds (she was already paleo). I don’t recommend flaxseed oil. If you want an omega-3 supplement, fish oil is much better (and it’s way way better to just eat lots of fish).

My husband has awful eczema on his feet. It is so bad it keeps him up at night and often causes him to limp. His feet look like they have been severely burned right now. I want to help him so bad. He’s very resistant to trying dietary changes, but I read him this article and I think he might be a little more open to it now. He said first he wanted to try taking fish oil, putting a water filer on the shower, stopping using soap on his feet, and replacing his lotions with coconut oil.

I never had skin issues (I’m 38) but have been experimenting with Paleo diet the past few years. I found that on standard paleo, I felt terrible! Was exhausted all the time and could not think straight, and these symptoms would start about 3 weeks to a month into the diet. I thought maybe it was just not for me, but I wanted so badly to believe in the miracle of paleo that everyone was raving about. Then, about 6 months ago, I developed guttate psoriasis–all over my torso and legs and it was hideous! Started doing some research and then started the Autoimmune Paleo diet. My psoriasis is nearly gone! But if I cheat, it will flare up. I can notice a huge difference in just a week of eating AIP. I guess the moral of the story is, I think regular paleo made me worse with all the eggs, nuts and nightshades. Hopefully I will someday be able to eat these again in moderation. But I’m definitely glad I found something that works, because medical treatment most certainly did not. I feel like I should go back to my dermatologist and give an inservice on this diet, but I guess that wouldn’t be good for business ;)

For someone who believes that it’s excessive dry skin which is the culprit in their eczema I’d like to offer up a very simple solution: cocoa and shea butter. NOT coconut oil, topically at least. Coconut oil DRIES the skin after a while. Cocoa and shea butter do the opposite, they heal and are recognized by the skin as a substance which can and should be absorbed because it is desperately needed. I have had rashes around my ankles in the winter because of the cotton of socks drying my skin out. They got so bad I had to use a topical steroid but you know what kept it from coming back again and again like what happens with topical steroids? Using cocoa butter on it twice a day and leaving it uncovered. It’s a fissure in the skin which gets infected and the immune system goes nuts trying to fix it, hence the rashes. If you heal the fissures then you’re good. If you keep the skin from cracking then you’re even better. Now every day after my shower I apply either cocoa or shea butter on the areas of my body which are most succeptable to eczema rashes and it’s the perfect preventative measure. Easy, too. I’ve fought with this sense I was seven years old and all the Rx moisturizing creams didn’t do a thing. But simple cocoa and shea butter works like magic.

My keratosis pilaris cleared up with paleo but I got eczema for the first time in my life (I’m 29). It appeared only on my right elbow. I am very discouraged. I believe it is due to the increase of eggs in my diet. Is it possible to treat this so I can enjoy eggs again? Should I eliminate nuts as well? Thank you.

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