Complementary and alternative therapies for atopic dermatitis

Santa Rosa Family Medicine Residency Program, San Antonio, TX, USA.
American family physician (Impact Factor: 2.18). 04/2012; 85(8):817-23.
Source: PubMed
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    ABSTRACT: Atopic dermatitis (AD) is a chronic, relapsing, itchy dermatosis of multifactorial origin, which commonly starts in childhood. Defective metabolism of essential fatty acids leading to relative dominance of pro-inflammatory prostaglandins (PGE2 and PGF2) has been reported as an important factor in the pathogenesis of AD. Evening primrose oil (EPO) as a source of gamma-linolenic acid (GLA) has been of interest in the management of AD. To evaluate the efficacy and safety of EPO in atopic dermatitis in our patients. Consecutive new out-patient department (OPD) patients of a referral hospital in Kolkata clinically diagnosed as having AD were randomly allocated to two groups. To the first group, evening primrose oil was supplied as 500-mg oval clear unmarked capsules, while placebo capsules identical in appearance and containing 300 mg of sunflower oil were given to the other group. Treatment continued for a period of 5 months. With pre-designed scoring system (based on four major parameters: extent, intensity, itching, and dryness), clinical evaluation was done at baseline and subsequent monthly visits. Data of the first 25 patients from each group who completed the 5 months of trial were compiled and analyzed. At the end of the fifth month, 24 (96%) patients of EPO group and 8 (32%) patients of placebo group showed improvement. There was significant difference in outcome of treatment between two groups (P<0.00001). No significant adverse effect was reported by any patient/guardian at any point of assessment. Evening primrose oil is a safe and effective medicine in management of AD. However, since not all researchers across the world have found the same good result, further large trials on Indian patients are needed.
    Indian journal of dermatology, venereology and leprology 09/2008; 74(5):447-52. DOI:10.4103/0378-6323.42645 · 1.39 Impact Factor
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    ABSTRACT: To assess, over a period of 12 months, whether homoeopathic treatment could influence eczema signs/symptoms and quality of life (QoL) compared with conventional treatment. Prospective multi-centre cohort study. Children with eczema aged 1-16 years were recruited from primary care practices. Conventional versus homoeopathic treatment. Patients (or parents) assessed eczema symptoms by numerical rating scales as well as disease-specific Atopie Lebensqualitaets-Fragebogen (ALF) and general quality of life (KINDL, KITA) at 0, 6 and 12 months. A total of 118 children were included: 54 from homoeopathic (mean age+/-S.D. was 5.1+/-3.3 years; 56% boys) and 64 from conventional practices (6.2+/-3.8 years; 61% boys). Eczema symptoms (assessed by patients or their parents) improved from 0 to 12 months for both treatment options, but did not differ between the two groups: 3.5-2.5 versus 3.4-2.1; p=0.447 (adjusted). Disease-related quality of life improved in both groups similarly. In the subgroup of children aged 8-16 years the general quality of life showed a better trend for conventional treatment compared with homoeopathic treatment (p=0.030). This observational study is the first long-term prospective investigation to compare homoeopathic and conventional treatment of eczema in children. Over a period of 12 months, both therapy groups improved similarly regarding perception of eczema symptoms (assessed by patients or parents) and disease-related quality of life.
    Complementary Therapies in Medicine 03/2008; 16(1):15-21. DOI:10.1016/j.ctim.2006.10.001 · 1.55 Impact Factor
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    ABSTRACT: There is not enough evidence to recommend using probiotics for the treatment of eczema. Eczema is a skin condition characterised by an itchy red rash, which affects between 5 and 20% of people at some time in their life. People with eczema have different bacteria in their gut to people without eczema, and sometimes they have inflammation in their gut. It may be possible to treat eczema symptoms by changing the mix of gut bacteria or by reducing inflammation in the gut. One type of treatment that might achieve this is probiotics - these are live micro-organisms taken by mouth such as the Lactobacillus bacteria found in unpasteurised milk and yoghurt. This review of twelve trials found that probiotics do not reduce eczema symptoms such as itching, nor do they change the overall severity of eczema judged by patients or their doctors. The results varied between different trials but overall do not suggest that probiotics are an effective treatment for eczema. Further studies of new probiotics are needed, because it is possible that different types of probiotics which haven't yet been studied in eczema treatment could be more effective. Probiotics can rarely cause infections and gut problems.
    Cochrane database of systematic reviews (Online) 02/2008; 4(4):CD006135. DOI:10.1002/14651858.CD006135.pub2 · 6.03 Impact Factor


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