Lucy Freeman
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When 38-year-old Jacquie Terry’s daughter, Hope, was 1, a photographer offering portraits in a local supermarket refused to take her photograph. “Unless you put some make-up on her the baby will look so awful you won’t buy the photograph,” he said. Hope’s eczema, having initially been in small patches, had suddenly spread to her face and was inflamed, as it became infected when she scratched.
Terry had expected Hope to contract eczema as Hope’s father has eczema and it tends to run in families. Terry also has psoriasis on her scalp and leg, an inherited skin condition that began during her finals at university. Hope’s eczema was worst on the back of her knees, neck and joints. As well as scratching when she felt anxious, itching would keep her awake at night, and sometimes she would scratch so badly that she drew blood. The eczema would then become infected and a course of antibiotics would be needed, as well as treatment for the condition. This progressed from heavy-duty moisturisers to hydrocortisone and stronger steroid creams, as each one proved ineffective.
Steroid creams are prescribed during eczema flare-ups as they act by reducing inflammation quickly. The strength of steroid cream that a doctor prescribes depends on the age of the patient, the severity of the condition, and the size of the area to be treated.
Hope is now 6 and for the past five years, against her better judgment, Terry has been treating her with steroid creams. Both her GP and her friends had warned against long-term use of the creams.
There seemed no alternative. Even a referral to the local hospital dermatology department for Hope yielded only a thick, unpleasant and ineffective moisturiser. “The GP kept telling me that it wasn’t a good idea to use steroid creams long term, but didn’t give me any alternatives. I clung to it as I just wanted to do anything to relieve Hope’s discomfort,” Terry says.
Potent steroid use for long periods can produce side-effects such as skin-thinning and premature ageing. Many young eczema sufferers are prescribed hydrocortisone or other steroids. They clear up the complaint while they are in use, but they are not designed for long-term use and once someone stops using the preparation the eczema returns.
The last straw came when Hope said she didn’t want to wear shorts for PE because of the skin on her legs. When a friend suggested cardiospermum gel, Terry did some research.
Cardiospermum is one of the commonest herbs used for skin problems in Sri Lanka. Its botanical term is Cardiospermum halicacabum, but is locally known as balloon vine. This wiry climber’s main antiinflammatory powers are said to lie mostly in its leaves and seeds, which have been used for hundreds of years in Sri Lanka for skin dryness and eczema, as the seeds contain triterpenoids, which have an antiinflammatory effect and antibacterial qualities.
Terry and Hope embarked on a course of treatment two months ago, using the hypoallergenic cardiospermum gel that she found online.
“I was dubious at first,” says Terry, “as I had relied on the steroid for so long I didn’t think anything else would work on Hope. Also, the gel smells a bit like compost, but it feels cooling and seemed to absorb really quickly, and the smell doesn’t linger.
“Hope’s skin is really good at the moment. We used the gel twice a day and it soothed the itching almost immediately. She absolutely hates having creams put on, probably because her skin has been so sensitive before, so the fact that the cardiospermum is in a gel, and is not messy or irritating or greasy, has made the whole process much easier.”
Terry is also using the gel for the psoriasis patches on her legs and claims “it is definitely breaking down the rough patches and making them smoother”.
For more information, the National Eczema Society, eczema.org, 0870 2413604. Cardiospermum cream costs £14.99 for 100ml and is available from skinshop.co.uk or phone 0871 8719975
Is natural best?
We look at the evidence for other natural creams. If you plan to use these with steroid creams it may be worth having a chat with your GP to check that they won’t interact.
Evening primrose oil cream
Claims Reduces itchiness and redness.
Any evidence? A review of 26 trials of evening primrose oil for eczema has shown it to be an effective treatment, though it appears to do less well when combined with steroids.
Stockists Gammaderm Cream, £4.99 for 50g, 01981 250124
Manuka honey
Claims Stops infection and reduces inflammation. Best to use in cream form, unless you want to get really sticky.
Any evidence? Manuka honey has been shown to have antibacterial, wound-healing and some antiinflammatory properties. Stockists £13 for 125g, manukahoney.co.uk
Aloe vera (below) Claims Cools down angry skin — reduces redness and swelling. Available in a gel, cream or lotion. Any evidence? Laboratory experiments suggest it has antibacterial and antiinflammatory properties.
Stockists Lotion, £2.99 for 200ml, hollandandbarrett.com
Vitamin E cream
Claims This vitamin helps to repair dry and cracked skin.
Any evidence? Vitamin E has been used for a variety of skin conditions and is generally acknowledged to be an effective treatment.
Stockists £1.12 for 113g, hollandandbarrett.com
Oat milk Claims Creates a moisturising bath. Fill the foot of a cut-off pair of tights with porridge oats and tie it under the tap while running a bath. Or use Aveeno, an oat-based moisturiser.
Any evidence? No.
Stockists £6.66 for 100ml, aveeno.co.uk, 0845 6012261
WHAT’S THE EVIDENCE? DR TOBY MURCOTT
Can cardiospermum cream soothe eczema? There is no evidence from good-quality clinical trials but considerable anecdotal evidence. Cardiospermum extracts have been shown in animal studies to reduce inflammation and it has also shown to have a similar effect on human cells in the test tube. Eczema is, in part, an inflammatory response so it is logical that an antiinflammatory cream may ease it.
But it’s a natural product Natural means neither better nor safe, and everything is made of chemicals.
Could the cream help in any other way? Eczema is also closely linked to stress and anxiety. The description of the cream as being cooling and easily absorbed suggests that using it was a pleasant experience, which might have reduced stress.
Dr Toby Murcott is a former BBC science correspondent
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I have after much experimentation found some herbal ointments and creams extremely effective. In particular Dr Spiezia's Calendula Ointment (although not cheap) completely got rid of the eczema round my eyes. I have also found Aesop's Calendula cream extremely soothing on my eczema. Other sufferers have recommended SK cream to me, although I have not tried this. Taking oil of evening primrose oil, dandelion tea, avoiding a high intake of acidic fruit, reducing dairy, alcohol and caffeine, at least some time in the sun/open air every day, and showering in slightly cooler water I find help significantly.
Claire, London,
I suffer psoriasis on my face and scalp and have to resort to coal tar and hydrocortisone when I have bad flare ups. However, once its under control, I've found that the only cleanser which doesn't aggravate it is Jurlique Foaming Facial Wash. It contains tea tree and lavender amongst other things. Jurlique isn't cheap but it does last for ages - a bottle normally lasts me about 6 months. You can get it by mail order as well as through Selfridges and a few other natural products places in London.
Aziraphale, London,
Having suffered from eczema as a child and treated with steroid creams, I had a clear period from 7yrs old until I started exams in my teenage years. Again a clear period until at University when I was hospitalised for intensive (steroid) treatment. All clear, especially after having 2 children, then in my late forties (start of menopause) I developed psoriasis on my hands and feet ~ very sore. As usual you try allsorts, but the only thing that has really helped is having a 20min bath every morning with Oilatum and Seavite, which is a seaweed extract (available from seavite.ie). This is a daily maintenence after which I apply Vaseline Dermacare. When the inevitable flare ups occur, I soak in a dried seaweed powder solution ( Dolphin SeaVegetables, or GreenAngel ). I also use Seavite shampoo for a dry scalp, although my husband commented yesterday that my hair smelled nice !
Patricia, Helensburgh, Argyll & Bute
dermex cardiospermum range is wonderful it has cut out 80% of my eruptions on my hands
ruth , birmingham, england
Im an aromatherapist and have treated eczema successfully with the following recipe:
10ml jojoba liquid wax to which is added one drop each of essential oil of rose absolute, helichrysum chamomile, lavender and geranium.
Out of these essential oils I find that helichrysum is the most effective one and a drop or two can be used on its own directly on the affected part.
For scalp psoriasis again I would use jojoba and essential oil of lavender.
Can't harm to try
Hanja, Rome, Italy
Was Hope ever tested for food allergies? Our daughter, now two, had severe eczema, but now it is almost completely under control as long as she avoids any kind of milk product. She also takes an anti-histamine most nights, although we are weaning her off that as well.
Sarah, Scotch Plains, New Jersey
I too suffer from psoriasis and eczema and have not found any conventional treatments to be that effective. I did try one herbal remedy which cleared it, but it came back with a vengeance when I stopped, which made me wonder if it contained natural sterols. I wish that herbal remedies had to state whether they contained plant-derived sterols, as I have decided to avoid using pharmaceutical ones because of the skin-thinning sideeffects described. People should be aware that steroids are naturally-occurring and herbal preparations MAY owe their success to them. And if anyone ever finds a successful and pleasantly scented treatment for psoriasis for the scalp I would be delighted!
Lucy Orves, Perth, Scotland
We also had the same problem with our daughter. Tried everything and then we started to use a Syrian soap that was pure called Alepo ( can find on tyhe internet).
vivien, Westport, usa,
After going through every single cream that the pharmacist or dermatologist could recommend for my infant daughter's eczema and finding them all ineffective, the only thing that has consistently worked at clearing it up (besides the hydrocortisone) is linseed oil. I was told that a spoonful a day would do wonders for her, but I hesitated at giving an infant any product orally that had not been cleared by the pediatrician. I decided to simply apply it like a lotion. It works like a charm, the only downside being that it stains her clothes if there is any extra oil on the skin.
Nicole, Paris, France