Eczema refers to a wide range of skin inflammatory conditions and is probably one of the most common skin disorder treated. It is also known as “dermatitis” and both terms are used interchangeably in the scientific literature. It is characterized by skin barrier disruption where the epidermal surface undergoes severe disorganization. This can be induced by a wide range of endogenous or exogenous factors. Endogenous stimuli can be due to alternation in our metabolic system while exogenous might be irritants or allergens.
The epidermal skin barrier may get disrupted by the use of chemicals, cleaning formulations, and application of certain topical cosmetics. They can remove or dissolve intercellular lipid content inducing significant damage to the epidermal structure. Dishwashing cleaners are one of the highlighted irritants. Such formulations comprise anionic surfactants, preservatives, and perfume constituents. Anionic surfactants have high irritation potential and have been described to induce “contact dermatitis”. Preservatives & perfume components are also highlighted as potential skin irritants. The repeated exposure to these chemicals over a prolonged time can cause exfoliation of stratum corneum. Physical abrasion can also induce skin damage. The severity of skin damage depends upon the chemical, physical nature of irritants, and surface quality of the substrate skin.
In some cases, the barrier may be defective because of insufficient sebum production which may lead to lower lipid levels. The result is the induction of the inflammatory cascade accompanied by erythema, desquamation, itching, stinging, burning, and possibly pain.
So, what does a patient need?
The immediate goal is to stop the inflammation and offering the patient relief through the use of topical, oral, or injectable actives. In dermatology, topical corticosteroids are most frequently employed to provide relief. The use of antibiotics and other chemical agents are also extensively used. However, consumers are eagerly looking for more natural and green solutions. Here, in this article, we review various strategies and natural options to treat the eczema problem.
Occlusive ingredients have a characteristic feature of forming a protective layer. The ingredients are hydrophobic having long-chain hydrocarbons. Therefore, they inhibit transepidermal water loss as water is essentially required to facilitate wound healing. They also inhibit the growth of microbes preventing any further dermatological complication. These ingredients could either be petroleum-based (petrolatum & mineral oil) or plant-sourced essential oils and butter.
Various plants bear long-chain saturated fatty materials called "butter". Popular examples are Cocoa butter, Shea butter & mango butter, etc. These materials have characteristic aesthetic properties, carbon composition, and are an excellent source of antioxidants, vitamins, and minerals. Their unique composition makes them an ideal candidate for dermatological & skincare applications. The topical application of these butters provides a water-resistant coating accelerating the healing process for damaged and inflamed skin. They nourish skin with vital minerals and improve skin lipid content. That’s why various studies have reported their performance in improving the quality of skin surface, soothing impact, and impeding any microbial contamination.
Cocoa butter is a traditional recipe for skincare. It can be applied topically or blended with other oils to make an occlusive ointment. Shea is another popular butter known for its emollience and moisturizing features. Besides their skin benefits, their composition enhances the sensorial properties of the finished formulation.
Waxes have been in use for cosmetics & dermatological products for centuries. There are two sources of these waxes, natural (plant or animal) and petroleum. Petroleum wax is known as Paraffin wax which is long-chain alkyl compounds having a relatively high melting point. Examples for plant-sourced waxes are carnauba & candelilla while Beeswax is obtained from the honey bee. Waxes are highly resistant to moisture, microbial contamination, and oxidation. This delivers a much-needed aspect for wound healing & recovery in eczema.
These actives are applied directly (depending upon the melting point) or generally formulated as an emulsion blended with other actives.
Humectants are substances that attract water. They work as a sponge to hold or release water as necessary. Their activity greatly depends upon the humidity. Under high humidity conditions, they absorb water molecules from the environment and deliver to skin epidermis. Whereas, under lower humidity conditions, humectants pull water from the deep epidermis to rehydrate the stratum corneum. Amazingly, humectants also make skin smoother by filling holes in the stratum corneum. Examples of humectants include glycerin, sodium lactate, sorbitol, hyaluronic acid, vitamins, and some protein.
Glycerin is a small non-toxic dihydric alcohol which can hold water molecules (40mg of water per 100mg of glycerin). Scientific studies involving glycerin found it an excellent remedy for eczema (contact dermatitis) induced by surfactants. It also improves and accelerates the desquamation of epidermis. Furthermore, it also influences the protective function of the skin against irritation and penetration of substances through the stratum corneum. Glycerin also reduces tissue scattering, stabilizes skin collagen, and accelerates the healing processes.
Plant extracted oils & butter are excellent emollients & lubricants due to their long-chain fatty acid profile. Moreover, they comprise antioxidants, essential vitamins, and free radical scavengers. They prevent moisture loss from skin and also make skin surface soft & smooth. Some examples are popular for their dermatological efficacy for their role in addressing the eczema problem. Among them are
Almond is a well-known and centuries-old remedy for skincare. It is rich in mono-saturated linoleic acid which is responsible for its non-greasy and non-tacky aesthetic application. Extensive scientific studies have reported almond oil for its superior emollience and skin-nourishing properties. It is a good lubricant, sebum restitutive, and reepithelialization agent which boosts lipid level at stratum corneum. It is highly recommended for dry skins and to alleviate itching caused by dermatitis and eczema.
Aloe is another natural remedy for a wide range of skin disorders. It is known for its pain-relieving and characteristic skin-soothing properties. Aloe gel is the most common recipe used which comprises a combination of polysaccharides and lipids along with essential minerals and vitamins. It is mainly applied for skin moisturization for dry & irritated skin. It effectively reduces the magnitude of inflammation activity for eczematous conditions.
A herbal solution to skin inflammation with antiseptic application in the treatment of skin diseases. Its roots contain polysaccharides (glucose & sucrose) while the main bioactive is glycyrrhizin. Licorice brings a cortisol-like action which is essential against contact dermatitis, eczema, and psoriasis. Plant extracts have also a preventive effect against burn infections and are used in cosmetics as antioxidants, refreshing agents, and soothe irritations.
A tree native to the South Asia region has significant medicinal properties. Its leave extract & oil from fruits contains Azadirachtin as the main active ingredient with great antiseptic activity. The seeds oil containing azadirachtinand a mixture of limonoids are known as nimbidin. It also contains proteins, carbohydrates, and polyphenols. The oil is often used in dermatologic & cosmetics products for acne, eczema & contact dermatitis, and other skin infections.
Eczema requires particular attention to fight this skin inflammation. Various synthetic & natural actives are recommended which are either applied directly or formulated in a specific delivery system for topical application. Natural ingredients are gaining popularity as consumers are looking for more green & safe for skincare problems. Petrolatum & silicone oils are effective as they prevent microbial growth and water loss. Essential plant oils & extracts also provide relief and anti-inflammatory properties accelerating the recovery time.