Eczema is a common skin condition characterized by an itchy, red rash. Many skin diseases cause somewhat similar rashes, so it is important to have the disease properly diagnosed before it can be treated.

Dietary changes that may be helpful: Eczema can be triggered by allergies.^{1 2} Most children with eczema have food allergies, according to data from double-blind research.³ A doctor should be consulted to determine if allergies are a factor. Once the trigger for the allergy has been identified, avoidance of the allergen can lead to significant improvement.⁴

It has been reported that when heavy coffee drinkers with eczema avoided coffee, eczema symptoms improved.⁵ In this study, the reaction was to coffee—not caffeine, indicating that some people with eczema may be allergic to coffee. People with eczema who are using a hypoallergenic diet to investigate food allergies should avoid coffee as part of this trial.

Borage oil has also been employed for eczema in open clinical trials, which showed reductions in skin inflammation, dryness, scaliness, and itch.¹⁴ However, a controlled study using 360 mg of GLA daily from borage in patients with eczema was unable to reproduce these results.¹⁵

Older reports using large amounts of vegetable oil (containing precursors to GLA) claimed some success,^{16 17} but these studies were not controlled and do not meet modern standards of research. As a result, it makes more sense to use GLA-containing oils (particularly EPO), rather than vegetable oil.

Although vitamin E at 400 IU per day has been reported in anecdotal accounts to alleviate eczema,²³ research has not supported this effect.²⁴ Moreover, rare cases of topical vitamin E potentially causing eczema have appeared.²⁵ People with eczema should not expect vitamin E to be helpful with their condition.

In 1989, Medical World News reported that researchers from the University of Texas found that vitamin C, at 50–75 mg per 2.2 pounds of body weight, reduced symptoms of eczema in a double-blind trial.²⁶ In theory, vitamin C might be beneficial in treating eczema by affecting the immune system, but further research has yet to investigate any role for this vitamin in people with eczema.

Herbs that may be helpful: Licorice root, used either internally or topically, may help alleviate symptoms of eczema. A traditional Chinese herbal preparation, which includes licorice, has been successful in treating childhood and adult eczema in double-blind studies.^{27 28} The product, known as Zemaphyte, is currently under investigation in England. One or two packets of the combination is mixed in hot water and taken once per day. Topically, glycyrrhetinic acid, a constituent of licorice root, reduces the inflammation and itching associated with eczema.²⁹ Some doctors suggest applying creams or ointments containing glycyrrhetinic acid three or four times per day. Licorice root may also be taken as a tincture in the amount of 2–5 ml three times daily.

Numerous other herbal preparations are used topically to relieve the redness and itching of eczema. A cream prepared with witch hazel and phosphatidylcholine has been reported to be as effective as 1% hydrocortisone in the topical management of eczema, according to one double-blind study.³⁰

Topical applications of chamomile have been shown to be moderately effective in the treatment of eczema.^{31 32} One study found it to be about 60% as effective as 0.25% hydrocortisone cream.³³

Other topical herbal preparations to consider based on traditional herbal medicine are calendula and chickweed creams. Calendula has anti-inflammatory properties, while chickweed is historically used to reduce itching.

Although burdock root is listed in traditional herbal books for the treatment of eczema, there is little evidence to support its use for this condition. It was used historically on the theory that supporting healthy liver function could help the body to remove potentially skin-damaging compounds from circulation.

Sarsaparilla may be beneficial as an anti-inflammatory based on historical accounts. Capsules or tablets should provide at least 9 grams of the dried root per day, usually taken in divided doses. Tincture is used in the amount of 3 ml three times per day.

In traditional herbal medicine, red clover is considered beneficial for all manner of chronic conditions, particularly those afflicting the skin. However, the mechanism of action and responsible constituents for red clover’s purported benefit in skin conditions is unknown. Wild oats has historically been used to treat a variety of skin conditions, including eczema, but it, too, is without scientific investigation.

Tannins, the main therapeutic component of oak bark, bind liquids, absorb toxins, and soothe inflamed tissues. For eczema characterized by oozing or weeping, oak is applied topically by first boiling 1–2 U.S. tablespoons (15–30 grams) of the bark for 15 minutes in 500 ml (2 cups) of water. After cooling, a cloth is dipped into the liquid and applied directly to the rash several times a day. The liquid prepared this way in the morning can be used throughout the day; unused portions should be discarded after that. This approach has been helpful in clinical practice³⁴ but has yet to be scrutinized scientifically.