BOSTON, July 29 Despite having access to some of the best health care in the world, many Americans with the most common form of eczema, known as atopic dermatitis, have sought relief from "alternative medicines." However, dermatologists caution that patients seeking alternative treatments to alleviate symptoms of this common, chronic, inflammatory skin disease marked by red, itchy rashes, risk developing more severe symptoms by delaying treatment.
At the American Academy of Dermatology's Summer Academy Meeting 2009 in Boston, dermatologist Peter A. Lio, M.D., FAAD, assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine in Chicago, discussed why eczema patients try alternative therapies and how certain therapies used in conjunction with clinically tested medical treatments could hold promise in further improving the condition.
"Part of the difficulty in understanding why people seek alternative medicine lies in defining this term," said Dr. Lio. "Broadly speaking, it encompasses treatments such as acupuncture, homeopathy and holistic medicine outside of the form of medicine taught in most U.S. medical schools. But people use the term for anything from chicken soup to any lotion or potion sold on the Internet to a new dietary supplement. Unfortunately, a great deal of snake oil can hide under the umbrella of alternative medicine."
Dr. Lio believes there are two main reasons that patients try alternative therapies for eczema. The first reason is that since the cause of eczema is not fully understood nor why it occurs in some people and not others, treatments are based on controlling the symptoms rather than fixing the root cause. Secondly, an increasing number of patients are looking for natural non-medical therapies that do not pose the known side effects of some of the traditional medications.
However, many non-medical therapies, especially herbal treatments, marketed for treating eczema are not governed by the U.S. Food and Drug Administration (FDA) or any agency, and contaminants could cause health problems or drug interactions could occur when used with other medications.
"The biggest risk posed by alternative medicines is worsening symptoms due to delayed treatment. In my practice, most of my patients have used some form of alternative therapy, but largely with little or no measurable improvement," said Dr. Lio. "In fact, one large-scale study found more than half of the eczema patients participating reported using one or more forms of alternative medicine for their disease. The study concluded that the majority of patients reported no improvement or even worsening of their condition after using these alternative treatments."
While topical corticosteroids (the mainstay in the treatment of eczema), antibacterial agents, topical calcineurin inhibitors and moisturizers are among the most effective medical treatments dermatologists prescribe to treat eczema, Dr. Lio suggested certain alternative therapies may be beneficial for some patients, perhaps by reducing stress.
For example, studies show that physical or emotional stress can worsen atopic dermatitis, and one study concluded that stress directly slows the healing of the skin barrier - or its protective outer layer. In another study, psychosocial stress and sleep deprivation were found to disrupt skin barrier function in healthy patients.
"It is possible that some forms of alternative medicine, such as hypnosis and acupuncture, may help eczema patients by reducing stress," said Dr. Lio. "The areas of stress reduction and behavior modification are promising and deserve further exploration as a means to complement traditional medical therapies."
In his practice, some of Dr. Lio's patients report improvement in their condition with acupuncture, but there are no scientific studies examining this potential benefit. Currently, Dr. Lio is trying to initiate a study on the effects of acupuncture on eczema patients at his institution to examine why acupuncture reportedly benefits some patients but not others.
"I think it is important for patients to inform their dermatologist if they are using alternative therapies, as some could cause dangerous drug interactions with traditional medicine," said Dr. Lio. "I always tell my patients that the fact that there are thousands of alternative treatments for eczema suggests that not one of them works really well. But if patients are committed to trying alternative medications, they should consult their dermatologist and not forgo their recommended medical regimen."
For more information on atopic dermatitis, go to the EczemaNet section of www.skincarephysicians.com, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.
Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 16,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or www.aad.org.
SOURCE American Academy of Dermatology