Client background
A 7-year-old girl presents with chronic eczema, primarily affecting the backs of her knees, elbows and the sides of her neck. Her symptoms include itching, redness, dry patches and occasional weeping lesions. The eczema flares cyclically, worsening during colder months and after periods of stress or illness. Her mother reports that the child has struggled with eczema since infancy, but symptoms have intensified over the last 12 months, coinciding with increased school demands and a recent move to a new home.
The child frequently scratches at night, disturbing her sleep and causing fatigue and irritability during the day. She reports feeling ‘itchy all the time’ and avoids wearing certain fabrics or participating in physical activities that make her hot or sweaty. While she’s socially engaged and enjoys time with friends, she has become increasingly self-conscious about her skin, especially when symptoms flare.
Her parents have tried various over-the-counter creams and short courses of topical steroids with only temporary relief. They are seeking a more holistic, long-term approach to managing her eczema.
Dietary history
- Diet includes fruits, vegetables, lean meats, grains and some processed snack foods.
- Regular consumer of dairy (milk, yogurt, cheese) and wheat-based products.
- Eats a standard breakfast, lunch, and dinner, but prefers carbohydrate-heavy meals.
- Cravings for sweet foods, particularly in the afternoon.
- Drinks mostly water with occasional juice. Rarely consumes soda or caffeine.
- No known food allergies, but parents suspect possible food sensitivities, particularly to dairy and/or gluten.
- History of mild constipation and occasional bloating.
Dietary considerations:
Her diet suggests adequate calorie intake, but potential inflammatory triggers such as dairy and gluten may be contributing to her skin symptoms. Her preference for sugary and processed foods could be impacting her gut integrity and immune balance, while her fibre intake may be insufficient to support optimal detoxification and bowel health.
Naturopathic considerations
Inflammatory skin response & atopic terrain:
Eczema is a chronic, inflammatory skin condition often associated with immune dysregulation and atopic predisposition. Her history of eczema since infancy, family history of allergies and recurring flares suggest a constitutional pattern of heightened immune reactivity, possibly exacerbated by environmental and dietary triggers.
Gut-skin axis:
Her digestive history of constipation and bloating, combined with skin inflammation, indicates a dysregulated gut-skin connection. Gut dysbiosis or poor microbial diversity may be contributing to systemic inflammation and skin barrier dysfunction. Improving gut health through diet and probiotics may reduce systemic inflammatory load.
Histamine sensitivity & immune modulation:
Persistent itching and redness links to histamine imbalance with chronic scratching and inflammation further depleting histamine-degrading enzymes. Supporting the body's ability to process histamine may reduce symptom intensity.
Sleep disruption and nervous system imbalance:
Nighttime itching is significantly impairing her sleep quality, which in turn may be impairing healing and immune function. Nervous system support is essential to promote better sleep and reduce cortisol-mediated inflammation.
Environmental triggers:
Cold weather, sweating and certain fabrics appear to exacerbate her symptoms, pointing to potential barrier dysfunction and sensitivity to physical irritants. Emotional stress from school and environmental change (moving house) may also be contributing to immune dysregulation.
Herbal support
- Chamomile (Matricaria chamomilla): Anti-inflammatory, antihistamine and calming. Reduces itching and supports skin healing.
- Nettle (Urtica dioica): Antihistamine and nutrient-dense; supports liver detoxification and reduces histamine-related flare-ups.
- Oats (Avena sativa): Nervine tonic and anti-inflammatory; supports both skin and nervous system.
Herbal formula:
- Chamomile (Matricaria chamomilla): 40 mL
- Nettle (Urtica dioica): 35 mL
- Oats (Avena sativa): 25 mL
Total: 100 mL
Dosage: 0.9mL twice daily
Additional recommendations
Dietary modifications
- Trial a 4-week dairy and gluten-light diet to observe potential reduction in flare frequency.
- Increase omega-3 intake through flaxseed oil, chia seeds and oily fish to reduce systemic inflammation.
- Support liver detox pathways with broccoli, cauliflower, beetroot, and leafy greens.
- Reduce refined sugars and processed snacks that may aggravate inflammation.
- Increase fibre intake with vegetables, flaxseeds, and whole grains to improve bowel regularity.
Supplement support
- Children’s multivitamin with zinc, vitamin A and essential fatty acids.
- Fish oil (high in EPA/DHA) to reduce skin inflammation.
- Probiotic: Broad-spectrum with strains such as Lactobacillus rhamnosus and Bifidobacterium lactis.
- Quercetin with bromelain: To help stabilise mast cells and reduce histamine-mediated inflammation (child-appropriate dose).
- Vitamin D3: Daily, especially during winter months to support immune balance.
Lifestyle recommendations
- Use natural, fragrance-free moisturisers and soaps to avoid skin irritation.
- Bathe with colloidal oatmeal or chamomile infusion, followed by emollient application to seal in moisture.
- Implement a consistent bedtime routine with calming activities (e.g. story time, soft music, gentle stretching).
- Maintain short, clean fingernails to reduce skin damage from scratching.
- Encourage gentle physical activity to reduce stress and support lymphatic movement.
- Dress in breathable, natural fabrics to reduce skin irritation and overheating.
Follow-up
After 4 weeks, the child’s itching has decreased completely, particularly at night, allowing for improved sleep. Skin lesions are less inflamed and decreased in number with no new weeping patches. Constipation has improved with increased fibre and hydration and her mother reports fewer complaints. The family noted a slight improvement in mood and emotional resilience.
Next steps
- Reassess and extend dairy and gluten-light approach for another 2 weeks with potential reintroduction testing.
- Adjust herbal formula to include Burdock root (Arctium lappa) to support liver clearance and skin health.
- Consider topical herbal applications, such as calendula cream for acute flare-up support.