In the study, which compared 295 children from two Rudolf Steiner schools near Stockholm, Sweden with 380 children from ordinary schools in the same area, the children who followed an anthroposophic lifestyle associated with Rudolf Steiner had less than half the atopic disease (allergic type skin and breathing disorders) of the children in ordinary schools.

Only 13 per cent of the Steiner children had atopic disease, compared with 25 per cent of children at the control schools. In many industrialised countries, atopic disease afflicts an estimated one in three children.

In the Swedish study, the difference between the two groups was most pronounced for current atopic dermatitis and bronchial asthmas. Only 3.1 per cent of children in the Steiner schools had reported wheeze in the six months prior to the study, compared with 7.6 per cent of the control children. Asthma cases reported by a doctor among the Steiner children (2.7 per cent) were less than one third of the percentage of cases among the control children (9.5 per cent).

In a variety of allergy tests, the Steiner children also recorded far lower rates of allergic reactions, with an overall allergic response of 24 per cent, compared with 34 per cent among the children at ordinary schools.

After comparing many lifestyle factors, the researchers concluded that the reason for the lower incidence of allergy among the Steiner children had mostly to do with a tendency among their families to use fewer conventional drugs and to eat more foods with live lactobacilli, which may enhance intestinal microflora.

Of the Steiner children, 52 per cent had had antibiotics, compared with 90 per cent of the ordinary children, and only 18 per cent of the Steiner students were immunised with the measles, mumps and rubella combined vaccine (MMR), compared with 93 per cent in the ordinary schools. Sixty three per cent of the Steiner children consumed fermented vegetables containing live lactobacilli, compared to only 4.5 per cent of the control children (Lancet, 1999, 353: 1485-8).

The team decided to carry out a double blind, placebo controlled study because of the great interest in Chinese herbal therapy as a treatment of the condition.

Forty adult patients with longstanding and widespread atopic dermatitis were randomly selected into two groups to receive two months’ treatment of either a formula of 10 herbs or placebo herbs. The second group were then switched to the active herbs formula after a four week “washout” period.

The active herbs had a beneficial effect, the team revealed. Patients showed a rapid and continued improvement. Of the 31 patients who completed the study and expressed a preference, 20 preferred receiving the Chinese remedy and just four preferred the placebo. No side effects were reported, although many said the concoction was unpalatable.

The research team said that the safety of the herbs still needs to be assured, and that they need to be made more palatable. They strongly recommended that sufferers should receive liver and kidney testing before embarking on a herbal treatment, while all patients with a history of jaundice or alcohol misuse should be excluded.

An Australian oncology department reported five such children born between l985 and l987 developing brain tumours.Although three of the cases were in vitro fertilization, and two through artificial insemination, the common link, says the research team, is clomiphene (Clomid) used to stimulate ovulation.

The letter published in the Lancet urged all doctors keep records of methods of fertilization. That goes for patients, too.

She stopped taking the doxycycline and took EAC drops daily. After one month, she had no allergic skin problems and now, 18 months later, after taking nothing for 10 months, she has no acne either. Another ultrasound showed that her ovarian cysts have disappeared.

It clearly irritates her and I have to stop her scratching. I have tried numerous skin creams, including calendula, graphites and E45, but nothing works. Eventually, by May, her skin is soft and normal again.

Neither my GP nor homoeopath has been able to help. The only thing I can think of is that it has something to do with the light level over the winter. I have thought of giving her a vitamin D supplement as winter approaches, but not without guidance as I know it can be highly toxic in overdose.- GH, Staines

A We consulted our panel member Harald Gaier, an allergy specialist who sees many cases of the kind you describe. Most commonly, these hard bumps occur on the back of the arms, but sometimes they even appear on the cheeks.

Dr Gaier believes it is most likely an allergic reaction to something she is eating or even an airborne allergy like mould, which is more prevalent in the winter. Even food allergies can be seasonal, and low levels of vitamin A or D precipitate them. Given Alice’s special background, it’s likely she was not breastfed and was fed the wrong foods before you adopted her. This makes it likely that she developed sensitivities to certain foods, which may have been given to her too early – before her digestive system could cope. The two most likely culprits are dairy products or soy (since she was probably given either cow’s milk or soy formula), or a grain such as wheat.

As with James (see above), Alice would benefit from a clinical ecologist with experience in allergies. If the problem is a food, simple avoidance should solve the problem. If her allergy is airborne, you may wish to consider a course of homoeopathic desensitisation drops. (For a list of practitioners, call The British Institute for Allergy & Environmental Therapy, tel: 01974 241 376.)

If Alice is prone to vitamin D shortage, you may consider boosting her D levels with cod liver oil (or beta-carotene supplements if you are vegetarian). She might also benefit from children’s vitamins. Our sister publication PROOF! tested a variety of brands, and concluded that the best value for money were BioCare ‘s products. This Birmingham-based company does a series of vitamins in drops, which can be mixed with juice and made palatable for the very young.

A Skin problems are notoriously difficult to treat – whether by conventional or alternative medicine. Prescribed drugs will generally not work .

One alternative may be Chinese herbal medicine. This hit the headlines over a decade ago when Dr David Atherton, of Great Ormond Street Hospital for Children, tested Chinese herbs on 37 children with severe eczema. Most were cured after a few weeks of treatment (Lancet, 1990; 336: 1254). In a similar trial of 31 adults with dermatitis, 20 significantly improved with the herbs, although some found them ‘unpalatable’ (Lancet, 1992; 340: 13-7). The herbal mix is now marketed as Zemaphyte.

An ointment using 10 per cent tea tree oil, marketed as Bogaskin, was tested by researchers at the University of Zurich on dogs suffering from a variety of intractable skin conditions. Bogaskin proved effective in over 80 per cent of the animals. In addition, there were few adverse reactions (Schweiz Arch Tierheilkd, 2002; 144: 223-31).

Another possible treatment is NADH (nicotinamide adenine dinucleotide), the active ingredient in vitamin B3. This has recently proved to be a powerful antioxidant. Dermatologists in Poland recently tested an ointment containing 1 per cent NADH mixed with ordinary Vaseline, and found it ‘very effective’ in the treatment of certain kinds of dermatitis (Clin Exp Dermatol, 2003; 28: 61-3).

It sounds like your gut is also out of sorts and more reactive to foods at the moment. Take essential fatty acids like fish oils or their derivative EPA to calm inflammation and these allergic tendencies. Also, suspect Candida overgrowth from all the antibiotics you took (see WDDTY’s The Candida and ME Handbook), and find a good acidophilus preparation. Avoid all sugar and refined carbohydrates, and the offending foods.

If all else fails, under-the-tongue immunotherapy (where homoeopathic potencies of allergens are given) cures skin problems in three-quarters of cases (Allergol Immunopathol [Madr], 2000; 28: 54-62).

The number of drugs which can cause eczema reads like a stock report at your local pharmacy. According to Drs Ruggero Caputo and Stefano Veraldi, two Italian dermatologists at the University of Milan (Eczema, Ronald Marks, ed., Martin Dunitz Ltd, London) the most common for producing dermatitis include: antibacterial drugs (aminoglycosides, antibiotics like amoxycillin, ampicillin, erythromycin, gentamycin, lincomycin, rifamycin, cephalosporins), antimycotic drugs, anti viral drugs, tromantadine hydrochloride, idoxuridine, acyclovir, antiparasitic drugs, antihistamines, phenothiazines, steroids, non steroidal anti inflammatory drugs, anesthetics, and anticancer drugs.

What has pushed eczema up the ranks to become one of the most common skin disorders of modern life? One short answer is the increasingly toxic environment in which we now live. We unwittingly expose ourselves to hundreds of chemical irritants and allergens – day in, day out. The sources of these toxins are often innocuous and ubiquitous to our current lifestyle – that bottle of washing-up liquid in the kitchen, that tube of toothpaste in your bathroom, that box of laundry detergent.

For atopic eczema sufferers who have an inherited allergic susceptibility, exposure to these chemicals aggravates their symptoms and perpetuates painful flare-ups. For those who weren’t born with particular allergic tendencies, constant contact with toxic substances enables substantial amounts of chemicals to enter your system (the skin can absorb up to 60 per cent of whatever substances with which it comes into contact). These chemicals build up to the point where they push the immune system into toxic overload, triggering an eczema reaction. This type of eczema is called ‘allergic contact eczema’.

Causal substances (or allergens) are not necessarily harsh or irritating, and don’t provoke a reaction in everyone – only in those who have become sensitised to them.

The type of eczema that’s not linked to an allergic reaction is known as ‘irritant contact eczema’. Causal substances (or irritants) are often abrasive, and can cause inflammation in almost everyone if there is long- or strong-enough or frequent-enough contact.

Many eczema triggers have both allergenic and irritant properties. To find these toxic triggers, you need look no further than your own home. So, let’s take a quick tour around your house and finger the usual chemical suspects.

Cleaners
Our first stop is the kitchen. Look under the sink and you’ll find a veritable Pandora’s box of chemicals among the cornucopia of household-cleaning products. Our obsession with removing dirt and making our homes germ-free regularly exposes us to a laundry list of skin irritants. One of these is sodium lauryl sulphate (SLS), frequently found in washing-up powders/liquids. It’s a powerful foaming agent known for its effective degreasing ability – which is why it’s also used in car washes and in garages to degrease car engines.

SLS concentrations as low as 0.5 per cent are already capable of causing irritation; higher concentrations of 10-30 per cent can cause skin corrosion, severe irritation and are even deemed dangerous (J Am Coll Toxicol, 1983; 2: 183-235). The powerful cleansing effect of this chemical dissolves and dries out the natural protective oils of your skin. It can also alter the quality of skin proteins (denaturation), which not only leads to skin irritation, but also makes the protective epidermal layer more permeable, thereby allowing easier access to other toxins to penetrate into the lower, more sensitive layers of the skin as well as to attack the immune system (Acta Dermatol Venereol, 1957; 37: 269-75).

Other common household-cleaner ingredients that are particularly corrosive to the skin and may trigger allergic reactions include:
* bacteria-killing disinfectants such as ammonia, chlorine and pine oil
* grease-cutting petrochemicals such as mineral spirits and phenol (or carbolic acid)
* stain-removing alkalis such as sodium or potassium hydroxide.

Even the water you use to wash your dishes and clothes could be making your eczema worse. UK researchers investigating eczema in schoolchildren found that it was significantly more prevalent in the hardest-water areas (Lancet, 1998; 352: 527-31). It is thought that the high calcium and magnesium content of hard water could either act as a skin irritant in itself, or interact with other chemicals to break down the skin’s defences and allow the invasion of toxins.

And if you’re thinking that a pair of rubber gloves could protect your skin from this chemical onslaught, think again.

Contact with rubber products is commonly associated with eczema. These flare-ups can be seen, with increasing prevalence, in healthcare workers who frequently wear tight-fitting latex gloves for hygienic reasons, as well as in atopic patients who have undergone multiple surgical operations (Rev Prat, 2002; 52: 1420-3). Eczema develops either as an allergic reaction to the natural latex proteins found in the material or as an adverse side-effect to irritant chemicals that have been added to the latex during manufacturing. Skin reactions to latex vary from the relatively mild (itching, slight redness) to the more serious (burning sensations, hives).

If you have to come into contact with chemical cleaners or products, you could substitute rubber gloves with ones made from vinyl or other non-latex materials.

Food
Moving on from the kitchen sink, we can usually find cupboards packed with victuals and provisions to satisfy your family’s appetite – as well as an arsenal of eczema-provoking allergens.

Intolerance to certain types of food has long been recognised to be a major cause of eczema – in particular, the atopic form. Common culprits include dairy, soy, eggs, wheat and shellfish. Avoiding these foods is easy enough once you’ve identified the ones to which you’re allergic.

However, much of what we buy at the supermarket these days, even those claiming to have ‘nutritional value’, are chock-full of artificial flavours, preservatives and colours that worsen eczema. Food-allergy studies noted skin and/or intestinal reactions in people with atopic eczema to tartrazine dye, sodium benzoate and sodium metabisulphite preservatives (Clin Exp Allergy, 2001; 31: 265-73), and the flavour-enhancer monosodium glutamate (MSG) (J Allergy Clin Immunol, 1997; 99: 757-62).

Among these additives, tartrazine – alias E102 – is a particular menace. This synthetic orange-yellow colouring is considered one of the most aggressive allergens of all the azo dyes and, worryingly, it has infiltrated a vast number of food and beverages – such as coloured fizzy drinks, fruit squashes, cake mixes, custard powder, soups, sauces, ice cream, sweets, jam and mustard. It’s also found in cough syrups and in the capsules containing medicines. Simply avoiding orange/yellow foods may not be enough as tartrazine is sometimes mixed with blue to produce various greens to enhance, for example, tinned peas.

Aside from eczema, other known reactions to tartrazine include migraine headaches, blurred vision, hyperactivity in children, and worsening of other atopic conditions often found with eczema such as asthma and a constant runny nose.

It’s not only processed foods you need to watch out for. Whole, natural foods like fruit and vegetables are likely to sport a coat of pesticides that could spell trouble to hypersensitive people. A high prevalence of both allergic and irritant contact eczema has been found in rural populations and among agricultural workers (Sangyo Igaku, 1987; 29: 3-16; Dermatol Monatsschr, 1989; 175: 203-14).

What price beauty?
Onwards now to the bathroom where, scattered around the bathtub, we are likely to find a colourful abundance of bubble bath, shower gels and shampoos, each pledging to leave you squeaky clean and healthy.

Nevertheless, these products contain a cocktail of chemicals that threaten your health. You wouldn’t dream of soaking yourself in a tub of washing-up liquid, but look more closely at your bottle of bubble bath and you’ll find, lurking among the list of ingredients, SLS – that aggressive cleaning agent and common cause of eczema. Other bathroom hiding places of SLS are toothpastes, shampoos, shower gels and just about every personal-cleaning solution.

Most facial washes designed to keep your skin clear of unsightly spots use polyethylene glycol (PEG), a caustic that dissolves grease – whether on your person or in the oven. But it’s also a recognised toxin that can cause an immediate or delayed allergic eczema reaction (Contact Dermatitis, 1978; 4: 135-8).

A relative of PEG, propylene glycol (PG) is a solvent used by manufacturers for its moisture-regulating, antiseptic and preservative effects. Commonly used in cosmetics, haircare products, deodorants and aftershave, it’s also a main ingredient in antifreeze and brake fluid. PG is believed to be more irritant than allergen, and most skin reactions to the chemical tend to be due to its toxicity, rather than an allergic response (Contact Dermatitis, 1975; 1: 112-6; Hautarzt, 1982; 33: 12-4).

An allergen commonly found in cosmetics and toiletries is lanolin. To be more precise, it’s the wool alcohols in refined lanolin that are often responsible for eczematous flare-ups. A natural product derived from fleece, lanolin’s high fat content makes it a good moisturising base for products such as hand creams, skin moisturisers, glossy lipsticks, cream makeup foundation and bath oils. Ironically, it is used in some emollients to treat dry skin conditions such as mild eczema. Lanolin is also ubiquitous in hairsprays, air fresheners, household-cleaning products, laundry detergents, treated fabrics (for a waterproof finish) and clothes dye.

And what’s a bubble bath if it doesn’t exude the soothing aroma of ylang ylang or lavender? Fragrance has become a major selling point for many personal-hygiene products and cosmetics. But the cost of sweet-smelling skin is high, taking into account the more than 5000 chemicals used in fragrance manufacture – many of which are known toxins and allergens.

And if you’ve been using a favourite fragrance for some time now, you may want to consider drastically cutting down on that spritzing. Researchers have found a positive correlation between age and fragrance allergy. It appears that repeated exposure to fragrance and age-related susceptibility factors, such as increased skin permeability, both contribute to the increase in the number of fragrance-allergy sufferers (Br J Dermatol, 2003; 149: 986-9).

Other allergens and toxins that you submit yourself to in the name of beauty include:

* formaldehyde, commonly used as a preservative in cosmetics, as well as in cleaning agents and industrial products (Am J Contact Dermat, 1999; 10: 12-7)

* paraphenylenedeamine (PPDA) and related agents, found in permanent hair dyes and a common cause of occupational eczema among hairdressers (Contact Dermatitis, 2002; 46: 319- 24). Even home hair-dyeing kits, which mostly use semipermanent dyes, penetrate the shaft of the hair, allowing chemicals to enter the skin and cause an allergic reaction. Switch to temporary or vegetable (henna) dyes instead.

Clothes
In the bedroom, let’s head for the wardrobe full of clean, fresh-smelling clothes, courtesy of that tub of biological washing powder. This type of laundry detergent contains quantities of enzymes (proteases and lipases) that digest proteins and fats – for exceptional stain-removing even at low temperatures. But traces of these enzymes stay in the fabric and, when it comes in contact with the skin, can trigger eczematous reactions.

Switching to a non-biological washing powder may help, but those also contain irritants such as preservatives, to protect fabric against the effects of ageing, as well as synthetic fragrances, to give laundry that smell of ‘summer freshness’.

The type of fabric is also important in controlling skin inflammation. Eczema sufferers are often told to steer clear of wool, an irritant even for those with normal skin sensitivity. But synthetic fibres also provoke or aggravate eczema. One study found that three synthetic shirts had a significantly greater capacity to irritate eczema patients, while a cotton shirt was the best tolerated (Z Hautkr, 1990; 65: 907-10).

What about that genuine leather jacket with the matching leather shoes you got for Christmas? They’re made from a natural material and so should get a thumbs-up, right? Wrong – though it’s not the leather that poses the problem, but the chemical used to treat it – namely, chromates, the chromium compounds used for tanning (Contact Dermatitis, 1996; 35: 83-5). Try substituting your leather items for those that have been vegetable-tanned instead. And when you’re buying a new pair of shoes, it may be worth remembering that manufactured rubber shoe soles contain two common eczema allergens, thiuram and mercaptobenzothiazole (Allerg Immunol [Leipz], 1974-75; 20-21: 281-5).

Your jewellery box may also harbour allergens, especially if it contains nickel jewellery. Eczema on the ears is a familiar sight thanks to nickel-containing earrings. The metal is also used for belt buckles, zippers, buttons and snaps. Nickel-related eczema may be worsened by sweat as the moisture allows the metal ions to be better absorbed into the skin.

Less obvious sources of allergy are stainless-steel or chromium-cobalt products. Through chronic exposure from, for example, metallic orthopaedic implants, enough toxic metal can leach into the system and provoke an allergic eczema response (Rev Chir Orthop Reparatr Appar Mot, 1995; 81: 473-84).

This list of allergens and toxins, cleverly concealed in every corner of your home, is far from exhaustive. Our daily exposure to them has fuelled the rising numbers of eczema cases, and only by removing them can we control this epidemic.

Tina Tan

However, there is herbal help in the search for safer, drug-free alternatives.

* Milk thistle (Silybum marianum) is traditionally used as a liver tonic as it contains the powerful liver-protecting ingredient silymarin. It supports the liver’s defences against tissue-damaging free radicals and inhibits the production of histamine, the protein involved in many allergic reactions, including eczema.

* Globe artichoke (Cynara scolymus) is another plant that protects and supports the liver. Like milk thistle – they share similar constituents – artichoke regulates the production of inflammatory substances that contribute to eczema.

* Aloe vera, chamomile and lavender, all known for their soothing properties, can help when applied as a herbal cream.

* Viola tricolor, or wild pansy, is a traditional folk remedy that is supposed to be effective for early childhood itchy-skin conditions such as cradlecap, milkcrust and infantile eczema (British Herbal Pharmacopoeia, Part 2, 1979: 227).

* Burdock (Arctium lappa) is another traditional medicine claimed to have cleansing and purifying qualities that can help relieve skin eruptions and tame inflammation.

* Lupin (Lupinus termis or albus) seeds are traditionally used in some African countries for treating eczema. One double-blind study compared an ointment containing extract of Lupinus termis with corticoid therapy and a placebo. The results showed that the herbal ointment was as effective for treating chronic eczema as was the drug (J Nat Prod, 1981; 44: 179-83).

* Liquorice (Glycyrrhiza glabra) benefits extend to also include helping eczema sufferers. When comparing the effectiveness of topical liquorice gel preparations (containing glycyrrhizinic acid standardised to about 20 per cent) for reducing the symptoms of atopic dermatitis, researchers found that the higher concentration (2 per cent) was more effective than the 1 per cent formulation (Dermatol Treat, 2003; 14: 153-7).