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Eczema Treatment that Comes Up to Scratch

Friday, 7 March 2008

A herbal cream helped to soothe one mother and daughter’s painful itch

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”.

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.

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.

Aloe vera

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.

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.

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.


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

Author: Lucy Freeman

© Copyright 2008 Times Newspapers Ltd.

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