www.homoeotimes.

com
Article

Homoeopathic Perspectives of Eczema

Dr. A. Ravindra Babu
Prof.Dr.K.Senthilkumaran
Introduction

Prof.Dr.K.S.Senthil Kumaran, a young

enthusiastic homoeopath serves as Introduction
Professor and Head of the Department of Word Meaning: Greek ‘ekzema’: ‘to erupt’ or ‘to boil out’
Medicine in Government Homoeopathic
Eczema is a type of dermatitis, and these terms are often used
Medical College and Hospital at
synonymously (e.g., atopic eczema or atopic dermatitis [AD]). Eczema
Thirumangalam, Madurai. Here in this
is a reaction pattern that presents with variable clinical findings and the
article he shares his views on Homoeopathic
common histologic finding of spongiosis (intercellular edema of the
perspectives of Eczema
epidermis). Eczema is the final common expression for a number of
disorders.

Clinical Morphology

Acute stage

• Weeping and crusting

• Blistering -usually with vesicles but, in fierce cases, with large
blisters
• Redness, papules and swelling- usually with an ill defined border
and scaling.
Chronic stage

Chronic eczema may show all of the above changes but in general is:

• Less vesicular and exudative

• More scaly, pigmented and thickened
• More likely lichenification & dry

A u t h o r

Prof.Dr.K.Senthilkumaran, MD (Hom)
Professor & HOD, Dept of Medicine

Govt.Homoeopathic Medical College and Hospital

Thirumangalam, Madurai -625706

Email-drkksk@gmail.com

Mob-9443326206
Prof.Dr.K.Senthilkumaran

November 2015 Homoeo Times 5

Article www.homoeotimes.com

where some internal or constitutional factors are thought to be

causative.

Eczema a working classification

Mainly caused by Irritant
exogenous (contact) Allergic
factors Photodermatitis
Other types of eczema Atopic
Seborrhoeic
Discoid (nummular)
Acute vesicular contact eczema
Pompholyx
• Leathery thickened state, with increased skin markings Gravitational (venous, stasis)
• Secondary to repeated scratching or rubbing; and more likely to Asteatotic
fissure. Neurodermatitis
Histopathologic Features Juvenile plantar dermatosis
Napkin (diaper) dermatitis
The histopathologic features are often similar in different types
of eczemas and depend on the stage. In the acute stage, there is 1) Exogenous Eczemas
spongiosis (intercellular oedema in the epidermis), microvesicle A) Allergic contact dermatitis
formation and a mononuclear cell infiltrate around dilated dermal
Allergic contact dermatitis is a disorder of the skin resulting
capillaries. In the chronic stage, the features are acanthosis
from a delayed hypersensitivity reaction mediated by T-lymphocytes
(thickening of stratum malpighii), elongation of rete ridges,
against certain chemicals (contact allergens) causing sensitisation
hyperkeratosis and parakeratosis (nuclei seen in stratum corneum).
on coming in contact with the skin. Most contact allergens are
A combination of these two patterns is seen in the subacute stage.
haptens (incomplete allergens) which become complete allergens
Classification after combining with epidermal carrier proteins.
A simple classification divides eczemas into ‘exogenous’, where Although there are over 2800 known environmental allergens
some external causative factor is identifiable and ‘endogenous’, contact allergy is commonly seen in response to the following
allergens:

Lichenification of the wrists

November 2015 Homoeo Times 6
www.homoeotimes.com
Article
Type Synonyms Frequency/age group Remarks
Atopic dermatitis Neurodermatitis Besnier’s prurigo Very common, mostly occurs in Cause unknown but appears
Infantile eczema infants and the very young to be immunologically
mediated
Seborrhoeic dermatitis Infectious eczematoid dermatitis Very common in all age groups Probably has a microbial
cause, with overgrowth of
normal skin flora being
responsible
Discoid eczema Nummular eczema Uncommon, mainly in middle- Cause unknown
aged individuals
Lichen simplex chronicus Circumscribed neurodermatitis Quite common, mainly in young Initial cause appears to be a
and middle-aged adults localized itch causing an
‘itch–scratch cycle’
Eczema craquelee Asteatotic eczema Uncommon, restricted to the Low humidity and vigorous
elderly washing seem responsible
Venous eczema Stasis dermatitis Gravitational Common in the age group that has Multiple causes, a common
eczema gravitational syndrome variety is allergic contact
dermatitis to medicaments
used
Allergic contact dermatitis Common in all adult age groups Delayed hypersensitivity
except the very old response to a specific agent
Primary irritant contact Occupational dermatitis, Housewives’ Very common in all adult age Both mechanical and
dermatitis eczema groups except very elderly chemical the trauma
responsible
Photosensitivity eczema Not uncommon, mainly in adults Both phototoxic and
photoallergic types occur
1) Scalp: Hair dye (para phenylene diamine), shampoos, hair clips 6) Trunk: Nickel in clothing straps, rubber in elastic garments,
(nickel), hair bands antiperspirants
2) Face: Cosmetics, fragrances, kum-kum, adhesive of bindi, 7) Thighs, legs, feet: Coins, keys and pens kept in pocket, topical
sunscreens, airborne contact allergens (pollens, cement, and medicaments used for stasis dermatitis, leather or rubber in
wood dust), hair dye, and lime (see colour atlas) footwear (see colour atlas)
3) Eyelids: Airborne allergens (e.g. pollens of 8) Hands: Nickel, cobalt, chromium (cement), vegetables, plants,
Partheniumhysterophorus), nail cosmetics (due to inadvertent hairdyes, epoxy resins, acrylic, etc.
contact with eyelids), eyedrops, eyelash curlers B) Irritant contact dermatitis
4) Earlobes: Earrings (nickel), hearing aids, eardrops containing
Irritant contact dermatitis occurs as a result of the skin coming
neomycin (see colour atlas)
in contact with irritants which cause an altered state of sensation
5) Neck: Jewellery (nickel), airborne allergens, elastic garments,
(burning, stinging) and some morphologic changes. Examples of
antiperspirants (see colour atlas)
irrtiants are cleansers, soaps, detergents, organic solvents, alkalies,
November 2015 Homoeo Times 7
Article
vegetables like chillies and citrus fruits, and certain medications like
benzoyl peroxide and retinoic acid. Two common varieties of irritant
contact dermatitis are housewife’s eczema and diaper dermatitis.
Housewife’s eczema is caused by prolonged and repeated
contact with water, soaps, detergents and vegetables. It affects
dorsal aspects and sides of the fingers, fingertips and webs of the
hands.
Diaper dermatitis occurs in infants due to prolonged occlusion
with non-absorbable plastic diapers. Ammonia produced by
decomposition of urea in the urine by certain microorganisms
causes more irritation. Secondary infection with Candida albicans is
common. The dermatitis affects the convexities of the thighs,
buttocks and genitalia while sparing the folds.
C) Infectious eczematoid dermatitis (Infective eczema)
This is due to an allergic reaction to organisms or their products.
The eczema responds to treatment with antibiotics which eradicate
the organisms. It is distinct from infected eczema and occurs
commonly on the legs due to chronic folliculitis.
2) Endogenous Eczemas
A) Atopic dermatitis
The word ‘atopy’, which literally means ‘out of place’, represents
an inherited tendency which predisposes to atopic dermatitis,
bronchial asthma and allergic rhinitis.
November 2015 Homoeo Times
www.homoeotimes.com
Atopic dermatitis is a chronic relapsing pruritic skin disorder of
unknown aetiology, associated with personal and/or family history of
atopy and a typical distribution and morphology. It is characterised by
distressing symptoms due to a low threshold for itching, tendency of
the skin to lichenification and frequently, raised level of serum IgE.
It is estimated that about 3% of all infants and 10% of school
children suffer from atopic dermatitis. These figures are for Europe
but in India, the prevalence and severity are less, though on the
rise.
Immunological abnormalities are: (i) Raised IgE levels in 80%,
(ii) Defects in cell-mediated immunity, (iii) Defects in neutrophil and
monocyte chemotaxis.
Clinical features: The symptom of itch is so central in the
pathogenesis that atopic dermatitis is described as "the itch that
rashes and not the rash that itches". The disorder is characterised
by infantile, childhood and adult phases. The infantile phase starts
between 2-6 months of age, and pruritic papulovesicular, oozing
lesions are distributed on the face, scalp and front of the knees and
legs (see colour atlas). By the age of 18 months, the childhood
phase starts and is characterised by itchy lichenified lesions in the
cubital and popliteal fossae, sides of the neck, wrists and ankles.
The distribution in the adult phase is similar and there is a marked
tendency to lichenification and generalisation. The disorder may
begin and remit in any of these phases.
B) Seborrheic Dermatitis
Seborrheic dermatitis is a common, chronic disorder
characterized by greasy scales overlying erythematous patches or
plaques. Indurationand scale are generally less prominent than in
psoriasis, but clinicaloverlap
exists between these diseases
(“sebopsoriasis”). The most
common location is in the scalp,
where it may be recognized as
severedandruff. On the face,
seborrheic dermatitis affects the
eyebrows, eyelids,glabella, and
8
www.homoeotimes.com
nasolabial folds.Pityrosporumovale, a yeast normally present on
the skin, is increased in the scales of seborrhoeic dermatitis. The
disorder is more common in AIDS where the patients have increased
susceptibility to yeast infections.
C) Discoid eczema or nummular eczema.
Article
E) Asteatotic Eczema.
Eczema craquelée is an uncommon eczematous disorder that
occurs on the extensor aspects of the limbs of elderly subjects and
is characterized by a ‘crazy paving’appearance. The most common
affected sites are the shins, the fronts and sides of the thighs,
extensor aspects of the upper arms and forearms, and the back.
Involved skinis pink, roughened and superficially fissured, giving a
crazed appearance

Homoeopathic Approach and remedies for Eczema

• In Homeopathy, we talk about the 'Law of Cure’. The Law of

Discoid eczema is a quite common eczematous disorder of
unknown cause, distinguished by the appearance of reddened,
scaling, rounded areas on the arms and legs.
Slightly raised, pink-red, scaly discs, varying in diameter from 1
cm to 4 cm, appears on the arms and legs and, less frequently, on
the trunk . The disorder is usually quite itchy and the skin on the
arms and legs is often dry as well.
Cure is that the body heals itself from the inside out; from above
down and from a more important to a lesser important organ.
• The skin is also an organ of elimination. Everything in the body
is connected in energy flow and systems are inter-dependant.
An outward expression of disease is usually a display of an
inner imbalance or disharmony.
• In the same way suppressed skin disease can cause internal
problems e.g. asthma and arthritis. So, with the bigger picture
in mind, we can see that eczema is multifactorial and needs a
multi- factorial approach to cure.
• A whole health approach is needed with what Homeopaths
would call 'Constitutional treatment'. A constitutional remedy
(specific to the individual) is selected by assessing the physical,
mental and emotional states, family history, and the past health

D) Venous eczema or Gravitational Eczema history of the person.

• To treat the person as a whole rather than treating only the
Venous eczema occurs on
disease. Eczema is simply an external presentation of an
the lower legs and is the result
internal disorder due to lowered vitality and immunity. When
of chronic venous
the whole person is treated, the power of immune system is
Hypertension. Itchy, pink,
enhanced thereby causing the disease to disappear.
scaling areas develop on a
• Homeopathy does not believe in treating eczema or any skin
background of the changes of
diseases by simply applying ointment or creams.
chronic venous hypertension.
• The type of eczema, location, aggravating and relieving factors
The affected areas are often
will be taken into consideration, besides many other factors in
around venous ulcers, but the
choosing the remedy.
margins of the eczematous process are poorly defined. Occasionally,
• Eczema is curable with Homeopathy. Person with acute,
the process spreads to the contralateral leg and even to the thighs
chronic and recurring eczema find excellent treatment with
and arms.
Homeopathic remedies.
November 2015 Homoeo Times 9
Article
• Homeopathic treatment not only successfully removes the
eczema, but also eliminates the possibility of development
of other hypersensitivity disorders such as asthma after the
eczema is cured.
The following remedies are most useful in day to day practice
Alumina, Arsenicum Alb., Baryta carb. Belladonna, Bovista
Calc. Carb., Cicuta, Clematis, Croton Tig., Dulcamara, Graphites,
Hepar Sulph., Ignatia, Kali carb., Lachesis, Lycopodium, Merc. Sol.,
Mezereum, Natrum Mur., Nitric Ac., Oleander, Petroleum, Psorinum,
Rhus Tox., Rhus Ven., Sarsaparilla, Sepia, Staphysagria, Sulphur,
Thuja, Tuberculinum, Vinca Minor, Viola Tricolor.
Alumina
Dry, thin subjects and old people with constipated bowels; the
slightest bruise of the skin smarts; brittle nails; much itching with no
relief from scratching; itching aggravated in the evening and from
the heat of the bed, and every other day; and, in the open air.
Arsenicum
Intense itching. Turns to burning when scratches till raw; when
burning stops, itching returns. Skin dry as paper. Flaking. Pussy.
Small vesicles. Eczema worst on uncovered parts or areas. Chilly,
weakness. Sips cold water. Restless. Anxious, worried about health,
death, security, picky, miserly. Worse: after midnight, cold air or
bath, wet; better: hot bathing, warm room.
Baryta carb.
Eczema capitis, with falling out of the hair and swelling of the
adjacent glands; fat, dumpy children; timidity in the presence of
strangers; chronic disposition to swelling of the tonsils or glands of the
neck; takes cold easily; aggravation at night and from scratching.
Bovista
Eczema about the mouth and nostrils; general lassitude,
especially in the joints; perspiration smells like onions, aggravated
from warmth; grocers' itch; moist vesicular eruption with formation
of thick crusts; eruption on the thighs and bends of the knees; on
the back of the hand; swelling of the upper lip; burning, itching; no
relief from scratching, symptoms worse during hot weather; the skin
of the fingers becomes dented by the use of the scissors or other
November 2015 Homoeo Times
www.homoeotimes.com
instruments.
Croton tig.
Any form of eczema uncomplicated with disease of other
organs; watery diarrhoea gushing out forcibly; excessive itching,
but the patient cannot bear to scratch very hard as it hurts; a mere
rub suffices to allay the itching.
Dulcamara
Eczema on the face and extremities preceding the menses,
oozing a watery fluid and bleeding after scratching; after its
disappearance, faceache and violent asthma; desire for cold drink,
eructations, vomiting in the morning; persons who get angry easily;
aggravated in cold weather, after taking cold, from cold, and evening
when at rest; ameliorated while moving in warm air.
Graphites
Red itching pimples; oozing of honey like liquid, which crusts
over. Infects and scars easily, heals slowly. Overweight, sweaty,
constipated. Scalp. Hairline, behind ears, genitals, back of hands,
palms, skin folds. Thickened skin. Deep cracks in fingers, heels,
etc. nails thick. Grooved. Worse: night, menses, heat (though chilly).
Better: cold application.
Hepar
Eczema with glandular enlargements, severe itching and
scratching, oedematous swellings; eczema behind the ears on the
scalp, burns and smarts after scratching, and is very sensitive to the
touch; after the abuse of mercury; sleeplessness after midnight;
aggravated at night, from cold air and from contact; ameliorated
from wrapping up warmly.
Kali carb.
In persons inclined to pulmonary difficulties; take cold easily;
sensitive to cold; sticking pains all over; eruption dry at first, but
when scratched exudes a moisture; comes on in warm weather;
great dryness of the skin; deficient perspiration (Graph., Alum.,
Led.); yellow, scaly, violent itching spots over the body, especially
over abdomen and around the nipples. Aggravated between 2 and
3 a.m, from cold air (Hep.), from becoming cold. Ameliorated in
warm air and on getting warm.
10
www.homoeotimes.com
Mercurius sol.
All forms of eczema, especially of the hairy parts in persons
who perspire easily, but obtain no relief from perspiration; tendency
to inflammation of the lymphatic glands; increase of saliva;
enlargement of the tongue, showing the imprints of the teeth;
scorbutic gums; after scratching, bleeding and smarting,
sleeplessness before midnight; aggravated at night; after getting
warm in bed; after scratching; ameliorated in the morning.
Mezerium
Violent itching; smarting, crawling, but parts feels cold, as if cool
breeze. Acrid oozing, forms hard, thick crusts with pus under them
or white scabs, matting the hair. Intense burning after scratching.
Eczema after vaccines.Scalp, margins of hair, face, lids, eyebrows,
hands and feet, cracked lips. Worse: night, heat of bed or bath,
drafts, damp, touch. Better: open air.
Nat Mur
Small itchy blisters with corrosive fluid; skin becomes red, raw,
inflamed. Margins of hair; bends of joints, behind ears. Dry flaky
crusts form after.Craves salt, thirsty. Greasy, oily hair. Dry skin in
general. Underweight.Eczema from suppressed emotion, inner
grief. Avoids consolation, fuss. Worse: warmth, salt, seashore, And
menses, better: cool weather or bathing.
Petroleum
Red, raw, moist surface: burning and itching: oozing after
scratching. Deep cracks in folds, fingers. Bleed easily, become
infected. Ulcerations. Eruption of the palms, fingerprints, bends of
joints, behind ears, genitals. Itching, scratches until it bleed; the part
becomes cold after scratching. Worse: winter, cold air, moving
vehicles, night. Better: warm air, dryness.
Rhus tox.
Eczema inner side of thighs, particularly after vaccination, with
much itching and thirst; the eruption is generally moist, the surface
raw, and the parts swollen; a red, inflamed, swollen rim from
subcutaneous infiltration surrounds every portion of the eruption
(Ars., black rim around the eruption); white, thick, moist crusts form,
which smell offensively, and itch, especially at night; cheeks, face,
November 2015 Homoeo Times
Article
and scalp affected; falling off of the hair; milk crust on face, humid,
angry looking, with hard, brown crusts; eczema, of the scrotum, with
intolerable itching.
Sepia
Eruptions during pregnancy and nursing; itching of skin,
changing to burning when scratched; soreness of the skin and
humid places in the bend of the joints and behind the ears; pruritus,
with vesicles on a red base over all parts of the body. Dry ringworm,
especially on the face of children; dry offensive eruption on the
vertex and back of head, itching and tingling, with cracks behind the
ears; pruritus, with vesicles on acrid base over all parts of the body,
face, eyelids, hands, feet, armpits, vulva, anus, ears, hairy parts.
Silicea
Eczema capitis, with humid itching eruption in scrofulous
children; pale, cachectic countenance; enlarged cervical glands;
leucorrhoea, backache; menses too profuse; eruption on the back
part of the head, either moist, or dry and scaly; offensive; scabby;
itching during the day and evening, never at night; soreness after
scratching; burns; pustules form and discharge copiously.
Sulphur
Moist, weeping eruptions, foul odor. Intensely itchy; scratches
till it bleeds, causing burning. Skin bleeds easily. Dry, scaly, cracked
areas. Unhealthy skin, pimples, easily infected. Burning hot feet at
night. Hair margins, face, areas of perspiration, feet, bends of
elbows, knee. Intellectual dreamer. Lethargic, unmotivated. Tired
and always hungry. Worse: night, warmth of bed, heat, bathing,
wool. Better: dry, cool bathing.
References
1. Roxburgh’s Common Skin Diseases-17th Edition.
2. Clinical Dermatology-Hunter-3rd Edition.
3. Sauer’s Manual of Skin Diseases-Brian J. Hall, Md-10th
Edition.
4. Hahnemann S. The Chronic Diseases: Their Peculiar Nature
and Their Homeopathic Cure. 12th impression. New Delhi,
India: B. Jain Publishers, Ltd; 2009.
5. Harrison's Principles of Internal Medicine, 19E
6. Davidson’s Principles and practice of medicine, 22ed.
11