Nutritional therapist, Tamla Anderson, explains how a holistic approach to wellbeing can mitigate symptoms of chronic skin conditions like eczema.
Our skin is often an outward reflection of our internal health, predominantly the health of our gut. While conventional treatments for chronic skin conditions like eczema can encompass topical creams and steroids, these can often only mitigate or mask symptoms temporarily, as opposed to treating the root cause. One strand of medicine that adopts a holistic approach to wellbeing to better ascertain why certain chronic skin conditions occur is nutritional therapy. Tamla Anderson is a nutritional therapist based in the UK who specialises in eczema healing, more specifically, the ways in which our diet and environmental factors can influence the health of our skin.
It is estimated that one in 10 adults will experience eczema during their lifetime, a skin condition that typically manifests as red, itchy, inflamed, dry or oozy skin in different areas of the body. Inevitably, the condition can dramatically impact a person’s day-to-day life, often disturbing sleep, and affecting mental wellbeing. Optimising our gut health through the foods we consume and identifying potential triggers that can offset the healthy balance of essential bacteria in the gut, can greatly support the balance and function of other organs, reduce inflammation, and promote better immunity. Health Europa’s editor Lorna Rothery spoke to Tamla Anderson to find out more about the benefits of nutritional therapy in managing eczema.
How do you define nutritional therapy and why did you decide to train in this area?
Nutritional therapy is the evidenced based application of personalised nutrition and lifestyle medicine, intended to support clients back to better health. Nutritional therapy focuses on the underlying causes of ill health, rather than the alleviation of symptoms.
I studied nutritional therapy out of personal interest. Having sought the help of a nutritional therapist in the past, I was curious and wanted to understand it better. In my final year of training, we ran nutrition clinics for members of the public and I absolutely loved doing client consultations, devising personalised plans and then watching their health change and transform over a number of weeks. I was hooked.
Can you explain the connection between our gut health and chronic skin conditions like eczema?
The health of our skin is, on the whole, an outward reflection of what is happening in the gut. We call it the gut-skin axis. This is easier to comprehend when we understand that approximately 70-90% of the immune system is synthesised and lives in the gut. It is a crucial part of our microbiome and communicates with every system and organ in our bodies, including our skin.
We have trillions of bacterial, fungal, and viral cells living in our guts. In fact, we possess more bacterial cells than human cells in our entire body. That is a big deal. Many of these cells are beneficial cells and are essential to our overall wellbeing. Others are also helpful in moderation but become less helpful and even destructive when they proliferate.
Keeping it very simple, when we have a perfect balance of all of the life giving, protective bacteria in our bodies, we can live in complete vibrant health, including skin health. However, when the less helpful or pathogenic bacteria begin to flourish, or if we lack the ‘good bacteria’ we stop functioning so well. This in time will have a negative impact on our health causing a multitude of common illnesses that we see today like, IBS, fatigue, autoimmune conditions, asthma, allergies, skin conditions… and so many more.
Aside from nutrition, what other lifestyle factors play a part in our overall skin health?
Good nutrition is hugely important in skincare. Aside from nutrition, hydration is also essential. We should all be drinking a minimum of 1.5-2 litres of filtered water each day, including herbal teas. And of course, alcohol and too many caffeinated drinks can be dehydrating.
Sleep is also extremely important. Sleep is the time when our cells are renewed and regenerated. When our bodies are in rest and repair mode, cortisol is at its lowest. Cortisol is an inflammatory stress hormone and a driver in eczema. True healing and repair happen when cortisol levels are very low. Likewise, exercise, walking in nature, saunas and massage are activities that help to lower cortisol levels and also boost circulation, which brings oxygen and nutrients to our skin.
With eczema, I suggest that a skin care routine is kept very simple, avoiding products that may affect the pH of the skin and largely keeping clear of lanolin and nut-based products.
What would you say are some of the challenges in treating eczema through the conventional medicine model and what are the key benefits of your approach?
The conventional medicine approach to eczema is the suppression of symptoms with the use of topical and oral steroids of varying strengths in combination with emollients to keep the skin soft.
By suppressing the immune system, steroids can provide a huge relief to those with acute eczema but they do not address the underlying issue, so that the eczema eventually returns and the cycle continues.
My approach involves taking a client through a medical and health history questionnaire. This is a very detailed process and allows me to identify a client’s particular triggers, mediators, environmental stressors, and dietary factors that may be contributing to or even driving the eczema in the first place.
Nobody is the same and some common eczema drivers are as follows:
- Unbalanced or overly keen immune system response resulting in allergies and intolerances;
- Unmanaged stress levels;
- Liver detoxification issues;
- Poor sleep;
- A pet allergy;
- Sensitivity to chemicals in the home and in cosmetic products;
- Contact with mould, damp, or humidity;
- Dysbiosis or an unhealthy/ inflammatory microbiome;
- Poor Omega 3:6 ratio;
- Excess or fluctuating oestrogen levels;
- Candida overload;
- Leaky gut;
- Nutritional deficiencies;
- Excessive histamine or problems metabolising histamine; and
- Mutations in the DNA of proteins that form filaggrin, resulting in impaired skin barrier and susceptibility to Staphylococcus Aureus.
There are many more underlying factors behind an eczema infection and most clients will more than likely have more than one going on.
I will then put together a plan with a list of foods to eliminate for a specified duration and a helpful list of suitable foods, breakfasts, snacks, lunches, and dinners to add to their diet and where required some supplements to support their overall nutrient status. There are also many environmental changes we can also make like using non-allergenic bedding, non-biological laundry powder and using air purifiers in the home.
I guess my approach to the immune system is about balancing and calming the immune response, rather than suppressing it. I do however, when necessary, encourage clients to take a two-pronged approach involving a dietary plan and topical steroids to provide comfort when they need it. In time, they will need to use the steroid creams less and less frequently. That is a personal preference though.
What are some simple ways in which people can support their gut microbiome? Would you say probiotics or particular supplements can be beneficial for eczema patients?
The best way for most people to support the gut microbiome is to eat a diet rich in wholegrains, vegetables, soluble fibres and fermented foods and fruits like berries and un-ripened bananas, while removing processed foods, fried foods, and sugar. This can be daunting to many people but with guidance is totally achievable.
When we eat a diet rich in fruits, vegetables, soluble fibres and fermented foods, these foods make their way through our digestive tract into the large intestines where they are broken down into short-chain-fatty-acids. These SCFAs nourish our beneficial bacteria improving gut integrity, they regulate metabolism, boost the immune system, and reduce inflammation.
On the other hand, when we eat fried, processed, and sugary foods, they are broken down into compounds and metabolites like lipopolysaccharides which are highly inflammatory and set off a cascade of damaging processes throughout the body. I always recommend anti-inflammatory vitamin D and a good quality Omega 3 supplement with an appropriate EPA:DHA ratio for clients presenting with eczema. Other supplements will depend on a client’s individual circumstances. Perhaps magnesium to improve sleep quality, stress levels and motility or zinc if they are zinc deficient, to support skin health, optimal digestion, and the immune system.
I may use certain probiotics to suppress a candida overload or perhaps a good quality general probiotic after a bout of antibiotics. It all very much depends on a client’s needs and how receptive they are to supplementation, but nothing beats a varied diet, rich in the foods mentioned above.
DipNT mANP BANT CNHC, Nutritional Therapist