An Integrative Approach to Improving Eczema
FeaturingSheila Kilbane, MD
David Stouder: Welcome to the Humanized podcast. It’s all about personalizing your health. I’m your host, Dave Stouder. Now today we’ll be discussing An Integrative Approach to Improving Eczema, with Dr. Sheila Kilbane. And before I introduce Dr. Kilbane, I do want to remind you that you can subscribe and get all of the variety of casts – we’ve got videos, audios, transcriptions – at HumanizedHealth.com. I would like to thank our lead sponsor, Village Green Apothecary, and you can visit Village Green Apothecary at MyVillageGreen.com.
Now a little bit about, Dr. Kilbane. She’s a board certified pediatrician, specializes in integrative medicine. Boy, I wish there were more of you around, Dr. Kilbane. She uses the best of traditional integrative medicine to find the root cause of illness. Using her 7-step process along with natural and nutritional therapies, Dr. Kilbane helps families significantly improve or resolve altogether illnesses such as colic, reflux, eczema, recurrent ear and sinus infections, asthma, allergies, and stomach and GI issues such as constipation and abdominal pain. She also conducts online classes in addition to seeing individual patients in Charlotte, North Carolina. She’s written a wonderful book, which you’re seeing up on the screen [Healthy Kids, Happy Moms] and there’s her website there [SheilaKilbane.com/eczema/], but we’ll make sure we announce it at the end of the podcast.
Now Dr. Kilbane, we had you on before, and this is such an important topic because, you know, I’m a parent and it’s one thing when you’re dealing with adults with health issues, they can talk to you, they can tell you how bad it is. And it’s so frustrating sometimes with your children, and we want to give them help, and we run to the doctor and they’re just not necessarily, you know, doing things. So, why don’t you just get in and sort of give us a background of eczema and the triggers and some of the key things we can do about it.
Sheila Kilbane: Yeah, absolutely. Thank you so much, David. And thank you to the Apothecary for hosting this.
So, I wanted to talk about eczema because it’s such a huge issue. 30 million Americans have eczema, and it’s very common. We get lots and lots of calls, lots of patients with it. And I’m going to go through, I’m calling this a jumpstart because the full approach is very comprehensive, integrative medicine is always comprehensive. And so I’m just going to break it down and I’m going to give you some snippets today, some very actionable things to do if you or your child has eczema. And I also don’t want you to worry about taking notes because I have this in a beautiful PDF that you can go to my website and download. So don’t worry about madly taking notes. It’s just at SheilaKilbane.com-backslash-eczema.
And before we jump into eczema, I am going to go through, I’m just going to give a brief recap of our first podcast with you. And we talked about the common thread of the top eight pediatric illnesses. So it’s reflux, eczema, recurrent ear and sinus infections, chronic runny nose, allergies, asthma, abdominal pain, constipation and loose stools. And in integrative medicine, we trained to look at the common inflammation among symptoms. And so we’re going to dig deep into eczema today.
And before we get into it, though: inflammation. So, we talked previously. Inflammation. When we have chronic excess inflammation, that’s when we have symptoms. So when we have that cup that’s all full of inflammation, that’s when we have a flare of eczema or runny nose, maybe we’re mouth breathing, maybe wheezing. And when we take each different aspect of our environment, our food – and I’m going to go through that – and we decrease that inflammation, and then symptoms decrease. So it’s rarely about one magic bullet. It’s usually the whole picture.
And this is an image [on the screen] – and this image is from my book – and I list out all the things. When you have that really big cup of inflammation, right, you can have sleep disturbances, trouble focusing, emotional distress, meltdowns, nasal congestion. I’m not going to read through all of these, but they all are tied together. And then when we decrease that systemic inflammation, it doesn’t mean absolutely everything’s going to go away, but it generally means we’re going to have a decrease in symptoms.
And when we’re talking about triggers, that inflammation is illness, now we go through the triggers of inflammation. So we always have our genetics, and I always break down the five triggers of inflammation. So it’s the way that our genetics interact with our food, environmental allergies, environmental toxins, infectious diseases, and stress – and stress can be physical and emotional – and all of these weigh equally into inflammation.
And when it comes to eczema, today we’re going to mainly focus on the food triggers. We’re going to talk about the gut microbiome. And then the skin microbiome is another very big topic when it comes to eczema – we’ll talk about that on the next podcast.
Is all this making sense so far, David?
David Stouder: Absolutely. I think this is what parents want to hear because even we can rub cortisone cream on something on the skin and get a little relief from a symptom, but it’s WHY my baby or a child, or why I have eczema. And so this is what people need to hear, is getting at changing the pattern, the inflammatory pattern so you don’t have this problem.
Sheila Kilbane: Exactly, exactly. And with eczema, we will often in integrative and functional medicine, talk about healing the skin from the inside out, and it’s actually a two-way street. So if we don’t address the skin as well, that can continue to trigger a leaky gut. So that’s where the whole skin microbiome is a really important part of this, typically when it’s more severe eczema. When it’s mild to moderate, usually the strategies that I’m going to share with you today should really help to make a pretty significant difference if food is one of the triggers.
So, this is a case of one of my patients. This was early on, out of residency. I was a new doctor, didn’t have any idea that there was a connection with our health and food, which speaks to the way that we… we don’t get much nutrition training, or any, really, in medical school when I trained. So now it’s starting to change, which is good. So Johnny was, I’d been seeing him since he was born, and he started, 3, 4 months of age, started getting eczema, was getting recurrent ear infections, we were having to do rounds of antibiotics. And around when he was about 9 months old, mom came in for his well visit and said, you know, Dr. Kilbane, I took dairy out of my diet – she was breastfeeding him – and his eczema improved. Now it didn’t fully go away. And he had had enough ear infections that I had to refer him to get ear tubes. So, a couple of months go by, there’s an insurance glitch, she doesn’t go in to get the ear tubes – and mom was hesitant to get the ear tubes anyway, she just didn’t want to have to put him on general anesthesia. So it gets to be his year visit and he still hasn’t had the ear tube surgery. So the day before his 1-year well-check, mom had a big omelet, which has a lot of egg – and she still had dairy out of his diet, so it was just a big egg omelet. He had a huge eczema flare. So we knew dairy was a culprit, as well as egg. And what the research shows us is that about a third of eczema can be triggered by food allergies or food sensitivities and dairy and eggs are the two big culprits.
So I was seeing these things in real time. And then after the fact I was going in and reading about it and understanding, okay, we do have research on this. So we kept dairy and eggs out of his diet. And the interesting part is when we took eggs out of his diet, the fluid in his ears cleared up and he never had to get ear tube surgery. And there’s a lot of variables there, right? He was getting older, the eustachian tubes when we’re born, they’re more horizontal and then they get more vertical so they drain better, but he still was just over a year of age. So I do think it was the systemic decrease of inflammation that helped him.
David Stouder: Makes sense.
Sheila Kilbane: Makes sense, right? So, I have this big list of all these foods and I just list these out, so these 11 foods cause 90% of our food allergies and food sensitivities. [Dairy, wheat, eggs, corn, soy, peanuts, tree nuts, fish, shellfish, citric acid, sesame.] So it doesn’t mean that all of these foods are unhealthy or that you have to go off of all of them. I list these out because for some kids and adults, it might be dairy and eggs that are the trigger. For some people, it might be wheat or corn or soy. So I just like you to be aware and you can start really paying attention to when you eat something and what’s happening with the skin or with the bowels or with your sleep. So it helps to know this.
And with Johnny, if we relate it back to that cup of inflammation, so his main things… so he had a little bit of stress, right? Because his body, if you’re sick and you’ve got inflammation, you’ve got some stress. And infectious diseases – he was getting recurrent ear infections. But his biggest part of his inflammation was the food. So taking out the dairy and eggs, we decreased his cup of inflammation and he did much better after that. And so for moms who are breastfeeding, they would take it out of their diet. And then as the babies start to eat more food, you keep it out of the child’s diet.
And eczema, it’s just on the rise. Significantly. So in 1946, we had 5% of the population had eczema; 1958, 7%; 1970s, 12%. And in some areas of the U.S., it’s up to 30% and it’s a really big issue. We learn in medical school how to use steroids. So we use topical steroids to decrease the inflammation. And what we do in integrative medicine is we use both – we use steroids if we need to, but we also decrease that inflammation on the inside so that we can get that long lasting, so that we pull the steroids, we don’t continue to have the eczema. And we spent a lot of money on it, 3.8 billion dollars.
David Stouder: Wow.
Sheila Kilbane: Right? So that’s the food portion of it. And I’m going to talk about the microbiome. This was a patient who came to see me, 18 months old, and they came for the eczema, but they also came for his meltdowns. This little boy had such severe meltdowns. This family had never been out to eat because he would scream, he would throw himself on the floor. And they had already made a lot of nutrition changes. And so we didn’t have to, he was already off of dairy. He had been off of gluten, they’d added it back in. But dairy was definitely one of his triggers. But between these two pictures [of the little boy’s eczema], the only thing different was the addition of a probiotic. And that just speaks volumes to how we want to get the gut microbiome… So we have more bacteria in the gut than we have cells in the body and they play a significant role in our overall health, our inflammation and the way we digest and absorb nutrients. So these parents always, they give me these photos because they know I do a lot of talks and they want other families to understand that.
So, what I want to do is give you… This is the way that I proceed with parents and families in my practice. So we gradually remove dairy and I like to only make one food change at a time. So I usually will just take dairy out. We do it over 3 weeks because dairy, it’s so inflaming and it actually has, it’s called an opiate-like effect. So kids can go through what looks like a withdrawal. Have you seen that or read about that?
David Stouder: Briefly, I had a woman who worked in a jail and she had a gentleman who got terrible, terrible stomach pains and only milk would soothe his pains – but she realized the milk was causing it. It was soothing it immediately, but causing it. And it took her a long time, but once she got him to stop using milk, his pains went away.
Sheila Kilbane: Yes. That is it exactly. Exactly. And I learned this the hard way. You know, I would have families, when I first started doing this I would have them go off dairy cold turkey. Moms would call me back a few days later and they’d say, you know, Dr. Kilbane, Johnny is going berserk. I’d say, I’m sorry, we’re on the right track. Keep it out. So at first we do it out of breakfast for the first week, lunch at the second week, dinner and snacks the third week, and then you leave it out for at least 3 to 4 weeks to see if you notice the difference.
Typically once it’s fully out, you’ll notice the improvement within a week or two. And while we’re removing the dairy, we’re going to add in our probiotic for that first week, and then our digestive enzymes for the second week. And then after you do that, if the skin is still flared, then you can remove eggs. But I like to do these two things first.
And then when it comes to the gut microbiome, I use more supplements than this in my practice for kids with eczema, but I wanted to keep it really simple for the purposes here. And these two are the powerhouses of the supplements I use in my practice.
So this probiotic, you do it at the start of breakfast and the start of dinner and the same thing with the digestive enzyme. It’s a plant-based digestive enzyme at the start of breakfast, at the start of dinner. And once you get on these and the kids are off of dairy and they’re doing well, we want to do this for 3 to 6 months before adding the dairy back in, because we want to give… Think about healing the gut like we’re healing a sprained ankle. It can take a good 3 to 6 months for that ankle joint to feel like your own joint again. So we want to give the gut a really good amount of time to heal. Does that make sense? You know, because that inflammation, like red, inflamed, pain, mucus, just think about that along the GI tract.
David Stouder: Well, it makes all the sense in the world, Dr. Kilbane. I think sometimes people, like when we have a symptom and we’re used to sometimes medication, you know, we rub the steroid cream on and it goes away. But I like your analogy of a sprained ankle because it often takes us awhile to get to a problem. And I think what’s good is, as long as we see we’re moving in the right direction, then we should feel good, and if we stay on the right path, then we get to a complete healing.
Sheila Kilbane: Exactly, exactly. And for some people, if it’s a really big improvement off of the dairy or the eggs, it may need to be a lifestyle, right? You may not be able to add that food back in, or you might be able to do it at special occasions. And that’s always my goal in my practice. I don’t like to restrict kids, what they eat. I like to keep a wide variety of food, if at all possible. So if we need to, though, sometimes we have to make it a lifestyle shift.
And so here again, in the download, I’ve got what to remove and replace with. And in my book, I comb through all of the, how we’re going to make sure that the kids have healthy bones if we need to keep dairy out for any length of time, so that we’re still getting calcium. So I cover all of that.
And so just in summary, food triggers with eczema, the two big culprits, about a third of eczema, dairy and eggs can be the two big culprits. But it can be other foods, as well. And then with the gut microbiome, we’re going to do a probiotic and a digestive enzyme.
And then at the next one, we will talk about the skin microbiome, and I just showed a before and after picture of one of my little patients. He definitely needed our topical. He had a bacteria on his skin that needed to be treated with, we used an antibiotic, a topical antibiotic, and then an emollient. [Inaudible segment.] They decided to create a summit. And that summit is coming up at the end of August – this [her PowerPoint presentation] is saying the encore weekend, but it’s the last week of August of 2021. And, and if you go to SheilaKilbane.com-backslash-eczema, you can get my jumpstart guide and then we’ll have the link there for you to sign up if you want to join the summit. It should be really good. And they’re doing it as a masterclass, so it’s going to be very “how to” versus having a lot of different experts speak on different topics. It’s going to be very focused and it’ll be really great.
David Stouder: Well, this sounds good. Let me encourage everybody, if you’re watching this podcast, maybe eczema is your issue or your child’s issue, but if you know someone who needs this information, please refer them to the podcast. And I want to thank Dr. Kilbane for being with us today. And I’ll remind you to go subscribe and get access to all the Humanized videos, podcasts, and we have transcription, so you can just read it, if you want, at HumanizedHealth.com. Dr. Kilbane, thanks so much and remind everyone, you’re looking at the book there, Healthy Kids, Happy Moms. And please go to SheilaKilbane.com; you can go slash eczema to get the jumpstart and to sign up for the seminar or the course where you learn that. Dr. Kilbane, thanks for being with us today.
Sheila Kilbane: Absolutely, David. Thank you so much.