Eczema

Atopic dermatitis, commonly known as eczema, is a complex condition with causes rooted in immune dysregulation, gut health, nutrient deficiencies, and environmental triggers. Rather than being solely a surface-level skin issue, it is frequently a manifestation of deeper systemic imbalances. We work upstream to get to the root, while you see your mainstream providers for temporizing measures.

The primary underlying causes and contributing factors include:

1. Gut Dysbiosis and Intestinal Permeability (Leaky Gut) There is a strong connection between the gut and the skin, often referred to as the gut-skin axis.

• Leaky Gut: When the intestinal barrier becomes compromised, circulating endotoxins derived from gut microbes can escape into the bloodstream, manifesting as skin eruptions and systemic inflammation.
• Bacterial and Fungal Overgrowth: Conditions like Small Intestinal Bacterial Overgrowth (SIBO) and Small Intestinal Fungal Overgrowth (SIFO) or Candida infections have been associated with the development of eczema and skin rashes.
• Early Life Microbiome: Infants who are not breastfed or are born to mothers with poor gut flora may be at higher risk of developing unhealthy gut bacteria, which predicts the development of eczema and other health problems later in life.

2. Food Allergies and Sensitivities Adverse immune responses to specific foods are triggers for atopic dermatitis.

• IgE and IgG Reactions: Eczematous rashes are associated with IgE-responsive and IgG4-responsive food allergies.
• Common Trigger Foods: The most frequent dietary culprits that exacerbate the condition include eggs, peanuts, milk/dairy, fish, soy, wheat, and gluten. High intake of sugar and processed foods can also fuel the underlying inflammation. We suggest starting with gut health, and reducing inflammatory foods.
• Gut health is tested first as it often plays a role in immune function, and is a driver of food sensitivities.
• Cortisol is also tested as it affects gut and immune health.

3. Nutrient Deficiencies The skin requires specific micronutrients and macronutrients to maintain its protective barrier and modulate inflammation. Deficiencies that drive atopic dermatitis include:

• Essential Fatty Acids (EFAs): An imbalance or lack of EFAs alters the plasma phospholipids in the skin, contributing to dryness and scaling.
• Key Vitamins and Minerals: Inadequate levels of zinc, vitamin A, vitamin D, and vitamin E compromise the activity of elongase and desaturase enzymes and disrupt immune balance, paving the way for eczematous rashes. Replacement is based on lab values. More is not better, optimization is better!

4. Genetic and Metabolic Vulnerabilities Certain genetic polymorphisms (SNPs) can hinder the body’s ability to process toxins and inflammatory mediators:

• Unsupported DAO Gene (Histamine Intolerance): A poorly functioning DAO enzyme limits the body’s ability to break down histamine in the gut. This histamine overload can overexcite the immune system and lead directly to eczema, hives, and pruritus (itching).
• Unsupported GST/GPX Genes: These genes regulate glutathione production and detoxification. When impaired, the body struggles to clear chemicals and oxidative stress, which has been associated with the development of eczema and other autoimmune conditions.

5. Environmental and Lifestyle Triggers External stressors can either initiate or exacerbate an atopic dermatitis flare-up.

• Topical Irritants and Environment: Over-washing, exposure to harsh hygiene or makeup components, low humidity, and chemical drying strip the skin’s natural barrier.
• Heavy Metal Toxicity: Accumulation of toxic metals, particularly cadmium and arsenic, has been shown to cause or severely worsen debilitating eczema.
• Secondary Infections: Damaged, eczematous skin is highly susceptible to secondary infections from fungi (like Trichophyton) or bacteria (like Staphylococcus), which perpetuate the inflammatory cycle.
• Emotional Stress: Chronic psychological stress alters gut flora and drives systemic inflammation, making it a well-documented trigger for eczema flares.
• Sleep! Sleep is an important factor in immune function. We recommend trying CBT and sleep hygiene. Integrative therapies like reflexology can also be an excellent adjunct.

Finally, functional stool testing in patients with atopic dermatitis often reveals elevated levels of Eosinophil Protein X (EPX), a biomarker indicating an immune-mediated hypersensitivity and active inflammation in the gastrointestinal tract. Addressing the root causes—particularly by healing the gut, identifying food triggers, and restoring nutrient levels—is our approach for long-term resolution of the condition.

We work in conjunction with your mainstream (PCP or dermatology) providers. We are well versed in working with your current treatment plans, and working upstream for long-term resolution, as you use mainstream interventions as temporizing measures. Our Nurse, Nurse Practitioners, coaches, and herbalist work together to provide comprehensive consultations and plans.

We offer tele-health and see functional medicine patients in Rhode Island, and Massachusetts (more states coming soon).

Disclaimer: This information is provided for educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your primary care provider or specialist before making any changes to your health care plan. The content presented here is intended to complement, not replace, the guidance of your qualified health care professionals.