Seeing Red: Sensitive Skin, Rosacea, and Eczema
Sensitive skin types have high pitta and react to internal or external stimulation with redness, dilated capillaries, and dermatitis. Whether it is simple flushing or an inflamed rash induced by an allergic reaction, the root cause of sensitivity is stimulation of the cardiovascular system. But although all these symptoms indicate sensitive skin, all sensitive skin is not the same and should not be treated in the same way. Rosacea, eczema, and allergic skin are all inflammation-based ailments, but they are very different conditions and must therefore be pacified by very different care. Rosacea is primarily characterized by dilated capillaries (blood vessels) in the skin and is rooted in an overly stimulated circulatory system, whereas eczema can manifest as an itchy rash or simply flaky skin.
Labeling skin “allergic” does not necessarily mean that it is prone to flushing and redness; it means skin is reactive to various or specific stimuli that cause inflammation. The beauty industry considers sensitive skin to be that which flushes and blushes easily. It is a delicate skin type that can be a precursor to rosacea. This is why skin care products made for sensitive skin should be soothing and should not contain stimulating ingredients.
Dermatologists commonly blame genetics for sensitivity and rosacea. I dislike focusing on genetic factors because it leads people to believe that their sensitivity is unavoidable. While you may have a genetic predisposition to a more stimulated cardiovascular system or a rosacea-prone skin color, you can control inflammation by correcting its cause and balancing your body.
If you have this type of system, including a tendency toward high blood pressure, high pitta, poor digestion, and allergies, you tend to have a stronger blood flow and capillary dilation, which cause breakage and redness. This causes blushing, which may be constant or intermittent and acute, depending on the amount of stimulation. It is also another reason why skin hydration is important, since good water content in its blood and tissues keeps the capillaries flexible and prevents damage. It is a form of protection against easily stimulated blood systems and helps prevent breakouts as well as broken blood vessels.
Along with hydration, skin color can provide protection as well as camouflage for sensitivity. Returning to the point about a predisposition for sensitive skin, your genetic makeup dictates the amount of melanin in your skin, which can make sensitivity more or less visible and provide varying levels of defense against sun exposure. But while higher levels of melanin provides darker skin with more protection from the sun, dark skin is actually more reactive because it has a heightened immune response. This causes hyperpigmentation and inflammation, even though the irritation is less noticeable. Fair complexions appear to have a greater tendency to redness, but this has to do with dehydration and skin thinness, as well as the color itself. Lighter skin has less melanin and therefore a lower immune response to stimuli, which results in less inflammation-induced scarring and pigmentation.
But sensitive skin does not only occur because of a genetic tendency; environmental factors also play an important role in depleting the skin’s barrier and making it vulnerable to inflammation. Because sensitivity is accentuated by heat and trauma, external factors such as ultraviolet damage, pollution, wind damage, and temperature fluctuations all contribute to rosacea, eczema, allergic, and sensitive skin.
Sun is probably the most obvious environmental influence on sensitive skin, because sunburn and overexposure to the heat causes direct inflammation and damages cells; it also causes long-term dehydration. In the last chapter, we discussed how sun exposure affects acne-prone skin, and because acne is also a form of inflammation, the same concepts apply here. While the sun’s pitta energy promotes sensitivity, many other environmental elements do the same by depleting the skin’s resilience. Any form of trauma contributes to sensitivity, and both wind and pollution cause skin damage—wind applying pressure and pollution (including exhaust fumes) wreaking havoc on the cellular level. Extreme temperatures and fluctuations also induce inflammation, because as the skin adjusts to different conditions, the blood vessels dilate and the capillaries sometimes break, leading to chronic redness. This is why some skin becomes more sensitive in the winter-time; the frosty weather outside strongly contrasts with heated indoor conditions. The same goes for the height of summertime when hot outdoor temperatures alternate with cold, air-conditioned rooms. To help make such transitions easier on your skin, pat your face for a few minutes when you move indoors or out and experience different extremes in temperature. This helps regulate skin temperature as you adjust to the new environment.
A number of behaviors also affect sensitive skin. While you may be prone to inflammation, it is usually your lifestyle that sets the stage for chronic redness or skin ailments. Diet is hugely important to managing sensitivities. Alcohol, tobacco, caffeine, spicy foods, fried foods, and overcooked and barbequed foods cause dehydration and capillary dilation, which worsen sensitivity. These pitta-increasing foods create internal heat and aggravate sensitivity, whereas a pitta-pacifying diet soothes and calms redness. Eat lighter foods that do not overwork your digestive system, and opt for cooling, raw foods to reduce skin sensitivity and overall heat, inflammation, and acid in your body. A vegetarian diet is ideal for pittas, but if you do consume animal products, lean meats are best because they are less heavy and require less digestive fire to process them.
Pitta lifestyles and characteristics also promote heat and sensitivity within body tissues. People with rosacea and sensitive skin often put a lot of pressure on themselves and are known perfectionists. These characteristics heighten the heart rate and produce internal heat. According to ayurveda, pitta’s tendency to compete, organize, and become agitated also causes stress that stimulates the cardiovascular system. All inflammation is governed by pitta (fire). Pittas put an ample amount of stress on themselves, which overburdens the circulatory system and causes high blood pressure and blood vessel dilation.
Stress also weakens the digestive system. Since the digestive process is governed by pitta, dysfunction in this system can cause excess acid and inflammation. Ayurveda considers undigested food very detrimental to the body, as it is a form of waste. This waste, along with any other factors that tax the body, is the cause of allergic skin. A compromised immune system leads to reactions. Dr. Vasant Lad has said that people who are highly influenced by the weather, have food sensitivities, or suffer from allergic skin reactions demonstrate imbalance; their constitutions cannot cope with any external influence because they are already burdened with toxicity. Emotional distress is just another strain that gives way to inflammation, dehydration, and poor digestion.
Another lifestyle-related influence is a lack of water intake and of adequate hydration in skin care products. Dehydration increases sensitivity because it weakens the skin’s acid mantle (barrier function). Think of the skin as a brick wall: The cells (bricks) and the intracellular lipids (mortar) create a dense barrier. When skin cells dehydrate, they shrink, causing tiny spaces or cracks in the wall. This creates weakness, making it easier for bacteria, germs, and other environmental pollutants to infiltrate and for moisture to escape from the deeper cells. Hydration levels can sometimes be linked to genetics, and research shows that Asian skin tends to experience more transepidermal water loss than Caucasian and African-American skin, making it more sensitive. Hyperpigmentation occurs when dehydration allows skin to be irritated constantly and is also a common occurrence in Asian skin.
The use of natural skin care products is important, because they absorb and penetrate better than synthetic products that simply sit on the skin’s surface. Hydrating serums and creams are imperative for any skin sensitivity; moisture calms the skin (reduces pitta), and only hydrated skin has the capacity to regenerate and heal itself. Poor skin care can lead to self-induced sensitivity, and overuse or misuse of peels and astringents can lead to cellular damage and a stripping of the skin’s natural defenses.
Caring for Sensitive Skin
Proper care is vitally important for sensitive skin. Skin care products should provide protection as well as anti-inflammatory action. When choosing products for sensitive skin, be cautious and avoid any irritating or depleting ingredients that might exacerbate your delicate skin. This may seem obvious, but a lot of sensitivity is self-induced. The use of glycolic peels and a variety of drying agents can weaken the skin and make you photosensitive. If your skin has visible redness, avoid chemical peels and other products with drying agents and opt for a gentle exfoliant, such as a scrub made of soft jojoba beads and a clay spot treatment for actual pustules.
Using natural, gentle skin care products geared toward calming and soothing is another component of daily maintenance for sensitive skin. Petroleum-based products are clogging (comedogenic), which suffocates the skin and prevents it from being healthy and resilient. Petrolatum and propylene glycol are also common irritants; many people think they “react to everything,” when they actually just need to use products without petrochemicals. Synthetic fragrances and dyes can also inflame or deplete the skin; I have seen localized inflammation on eyelids and cheeks where color cosmetics have been applied and near earlobes where perfumes have been dabbed. A pure mineral makeup line is the best alternative when selecting eye shadows and blushes, and natural perfumes made of high-quality essential oils are ideal. The latter is especially important because studies have found that some perfumes increase photosensitivity.
However, you must be careful even when using natural ingredients. Stimulating herbs and additives such as ginseng, vitamin C, and lemon essential oil cause redness in sensitive skin. Try to incorporate as many natural, comforting ingredients as possible. Essential oil of sandalwood, chamomile, helichryse, calendula, melissa, and lavender all lessen inflammation. Nourishing base oils such as jojoba, evening primrose, coconut, and borage bolster the skin’s immunity to damage and offer a lubricating barrier. Vitamin E oil is another excellent ingredient for healing after trauma; it is an antioxidant, which helps strengthen the skin.
From a more scientific standpoint, collagen and elastin in skin care products are fantastic additions for rebuilding skin tissue. Collagen increases the water content of the skin, which also makes it more healthy. But finding and using products with a natural base is still imperative; without this, they will not be able to properly permeate the skin surface.
Rosacea
Rosacea is an extreme form of sensitivity that is actually a cardiovascular disorder, appearing as red skin, sometimes with papules and a thickened texture. It always presents with dilated or broken capillaries, and because the blood nourishes and detoxifies the skin, the dysfunction of blood vessels causes the other rosacea symptoms of skin nodules and deformation (in severe cases). Rosacea leads to couperose, a condition in which dilated blood vessels retain blood cells, giving an appearance of redness; this is caused by poor elasticity of the capillary walls. All rosacea, sensitivity, and broken capillaries include couperose. Rosacea is becoming more common as more people are exposed to extreme weather and lifestyle stress.
Rosacea (known as “acne rosacea”) has four identified degrees of severity. Some rosacea manifests as subtle flushing. This is an early stage, and if you do not care for your skin and pacify your pitta at this point, it will progress to a more intensive form of the ailment. Stage one is referred to as prerosacea, when the skin exhibits signs of sensitivity, with occasional blushing and flushing. You can prevent the condition from worsening at this point if you avoid external triggers, use proper skin care, and mitigate internal inflammation.
Stage two is mild rosacea. The skin becomes highly sensitive and prone to flushing with heated inflammation. Irritation in this stage lasts for several hours but is not permanent.
Stage three, moderate rosacea, is when redness becomes chronic. The skin is easily aggravated, with stinging, burning inflammation. Acnelike bumps that do not come to a head and are full of lymphatic fluid may appear chronically or flare up during times of stress or in extreme weather; broken blood vessels are apparent.
This leads to stage four, severe rosacea. Luckily, only a minority of sufferers progress to this stage, when papules and tissue deformation occur. Bulbous noses are usually found in men, often induced by constant, excessive alcohol consumption (which is an identified rosacea trigger as well as a pitta aggravator).
CAUSES OF ROSACEA
As mentioned earlier, ayurveda believes that rosacea is always related to the cardiovascular system and is the result of a pitta imbalance. This is why both Eastern and Western physicians agree that rosacea sufferers (like those with sensitive skin) should avoid things that stimulate the heart rate. This includes eating spicy and barbecued foods, drinking alcoholic beverages, smoking, doing excessive cardiovascular workouts, exposing themselves to extreme heat or cold (which dilates the capillaries), and subjecting themselves to constant stress. These behaviors not only contribute to the aggravation and advancement of rosacea due to the accumulation of heat in the body, but they can also lead to acute rosacea breakouts.
Poor digestion and elimination also contribute to rosacea, since pitta governs digestion. Ensuring that you are properly digesting your food and purging waste greatly improves this condition. The first time one of my clients broke out in papulopustular rosacea (rosacea with papules), she was so determined to heal her skin that she started a series of colon irrigation treatments and completely eliminated allergens and difficult-to-digest foods from her life. The results were incredible. After approximately one year, I couldn’t even tell she had had rosacea! Though it was a struggle, with patience and natural treatments, she attained beautiful, healthy skin without oral medication or topical prescriptions.
CONVENTIONAL TREATMENTS FOR ROSACEA
While rosacea varies in degree of severity from person to person, dermatologists tend to treat all cases in the same way. Oral antibiotics, like tetracycline, and topical antibiotics, such as metronidazole (found under the brand name Metrogel), are commonly prescribed to relieve symptoms. But these solutions are temporary if not counterproductive. Metronidazole can damage skin and even worsen rosacea. According to ayurveda, antibiotics aggravate pitta, which is the original cause of rosacea. Although they are prescribed for their anti-inflammatory properties, common side effects such as photosensitivity, heartburn, diarrhea, nausea, and liver toxicity (all symptoms of pitta excess) indicate that any reduction in inflammation is short-lived.
When treating the skin tissue itself, lasers and intense pulsed light (IPL) therapy are also popular recommendations, and they can be used to eliminate damaged capillaries. But this is purely cosmetic, and these treatments do not prevent or cure the root cause of the problem. Redness and broken blood vessels simply return if the underlying inflammatory issues are not resolved. Laser and IPL treatments are best practiced in conjunction with a program of internal healing to produce long-term results.
HOLISTIC SOLUTIONS FOR ROSACEA
According to ayurveda, most skin disorders, especially rosacea, are linked to dysfunction of the rakta dhatu (blood, specifically the red blood cells). The blood is governed by pitta, and the reduction of internal heat pacifies this dosha and puts less stress on the blood vessels in the face.
One of the best ways to relieve rosacea is to change the way you eat. Everything you ingest influences the energetic components of your body, so following a pitta-pacifying diet is imperative. Many of my rosacea clients have felt it was nearly impossible to give up coffee, wine, or chocolate, but until these stimulants were eliminated, they saw little improvement in their skin. (See the food chart) Avoiding hot, spicy foods and acidic fruits and vegetables is the first step, but you must also consider how your food is prepared. Because oil enhances heat, reducing pitta also means using oil sparingly when cooking. Many pittas cannot digest fats properly, and too much oil consumption aggravates the liver. Also, avoid adding heat to your food through overcooking, frying, and barbequing. These cooking methods not only increase the presence of the fire dosha in your meal, but they often make the food difficult to digest. When you overwork your digestive system, it requires more digestive fire and creates heat. Al dente or raw vegetables and gently cooked proteins are ideal. You also need to be strict about avoiding any foods to which you have allergies or sensitivities, since the energy required to process them also causes inflammation.
Because rosacea is a cardiovascular disorder, you must address imbalances within this system. The appearance of broken and dilated capillaries shows that your circulatory system is distressed, very likely congested, and in need of detoxification. Blood-cleansing herbs such as turmeric, arjuna, hibiscus, coriander (cilantro), burdock root, neem, and amalaki are excellent. Each of these remedies is known to purify the blood and relieve it of pitta heat. If you have trouble finding them at health food stores or specialty herb shops, try one of the many online retailers that sell ayurvedic staples (see the resources section at the back of this book). The herbs can be taken in capsule or powder form, but they can also be gently introduced into your everyday routine as teas or cold infusions. Tinctures are sometimes an option, but most tinctures have an alcohol base, and alcohol aggravates pitta.
Two of my favorite remedies are hibiscus tea and a coriander cold infusion; both are easy to make and delicious. Hibiscus is relatively easy to find in tea bags, but I buy dry hibiscus flowers from tea specialty stores or herb shops. I simply steep a heaping tablespoonful in boiling water for five to ten minutes, resulting in a slightly tart tea with a lovely, rich red color. I strain it before drinking; I also sometimes chill it to make a wonderful iced tea in summertime. Hibiscus is an excellent anti-inflammatory and also lowers high blood pressure.
A coriander cold infusion is just as straightforward to prepare, but it is more of an acquired taste because of its unique flavor. To make this cooling drink, place approximately two tablespoons of chopped fresh coriander leaves in a glass of water and let it sit overnight. In the morning, remove the leaves, and strain the coriander-laced liquid. According to ayurveda, this pitta-pacifying beverage decreases heat in the blood and purifies the body of heavy metals. It can also be used on a compress for inflamed skin.
Blood cleansing can also by done by bloodletting. This is an excellent treatment for relieving the body of blood laden with heat and can be done by placing suction devices on the surface of the skin or by donating blood. Both ayurveda and traditional Chinese medicine (TCM) use suction for bloodletting; ayurveda employs animal horns or leeches, and TCM uses glass cups. Practitioners commonly place these items on areas of the back, and the areas that become reddest indicate the body parts and organs that store the most heat and toxicity. Not only does this practice release excess pitta in the affected organs, but it also shows where the weakest points of the body are, which can help you choose more specific cleanses or rejuvenating therapies geared toward those organs. When all of the covered areas are very red, it indicates that the blood is saddled with heat that must be alleviated.
One way to do this is through pranayama (breath work). This helps bring more oxygen to the blood and purge heat via exhalation. These breathing exercises are both purifying and cooling, and pranayama is incredibly good for stress reduction, which is another big trigger of rosacea and sensitive skin. Simple exercises can slow down the heart rate and increase oxygen intake. Try inhaling for a count of ten, hold the breath for another count of ten, then exhale slowly to a last count of ten. I used to do this ten times every night before bed when I had acne and found that it helped me sleep better and decreased inflammation.
One client and yogini I know does sheetali pranayama when she is feeling hot-headed or irritable. This is a traditional breathing exercise specifically aimed at ridding the body of excess heat by rolling the sides of the tongue up, making a cooling tunnel through which breath can enter the body. I have done this breathing exercise when I’ve had acid stomach and when I’ve felt irritable. It doesn’t make a lot of noise, so you can do it anywhere. Sit comfortably and roll your tongue to make a tube. This acts like a straw through which you breathe. Inhale through your mouth, allowing the air to travel through your rolled tongue, picking up coolness along the way. Exhale through your nose. Feel the cold breath coming into your body and excess heat leaving it.
Finally, beyond keeping your mind and body cool, you need to address the lymphatic system. While heat may be concentrated in the circulatory system and too much stimulation here is detrimental to rosacea, lymphatic congestion and water retention also contribute to the dilation and breakage of capillaries.
Overweight people sometimes have a lot of inflammation on the cheeks, possibly due to superficial dehydration caused by a lack of circulation. Here, blood is not moving freely through the capillaries, and the lymph is not draining. When people with kapha imbalances (but not necessarily kapha constitutions) who are prone to congestion and puffiness swell with lymphatic fluid, pressure is put on the blood vessels, dilating and breaking them. This is prevalent in the thigh area, creating spider veins, and in other areas where cellulite exists, further inhibiting circulation. When lymphatic congestion cuts off circulation, dehydration and undernourished skin cells result. This exacerbates inflammation and worsens rosacea. When blood vessels break, this too compromises proper circulation in the skin. While blood flow is supposed to nourish skin tissue and transport waste away from it, poor circulation impedes the skin’s ability to self-cleanse and detoxify. This gives way to the formation of nodules and skin bumps; it also further inhibits lymphatic movement.
Lymphatic drainage is important for sustaining a healthy complexion and soothing sensitive skin. Pressure-point massage often drains off lymphatic and glandular congestion almost immediately, bringing down redness. To do this on your own, simply press and release sections of your skin with all four fingertips on both hands. Start at the top of your forehead, forming pressure-point rows with your fingers, and work your way down until you reach the underside of your chin. Pay special attention to the “rows” on the brow bone and under the cheekbones. Avoid going over your eyes, as this area is tender, but spend time on the bones of the eye socket, as this can help relieve puffiness around the eyes.
SKIN CARE FOR ROSACEA
When it comes to rosacea, hydration is the first line of defense, so it is imperative to avoid astringent skin care products. Use a milk cleanser to avoid disturbing the skin’s acid mantle, and only use hydrating, alcohol-free toners. Hydrating serums are also essential; choose one containing soothing ingredients such as aloe vera or chamomile water. Rosewater is particularly beneficial for rosacea, because it helps repair and strengthen capillary walls; make sure it is high quality and completely pure, because some cheaper, low-quality rosewaters are extracted with chemical solvents that can actually be irritating.
The more water you can infuse into your skin, the healthier, more robust, and less easily aggravated it will become. The more dehydrated your skin, the easier it is for blood vessels to break. Use nonstimulating oils (such as coconut and jojoba) and soothing balms to help keep your capillaries supple and barricade moisture in.
Rosacea skin that is severely dehydrated has a tendency to become so sensitive that it cannot tolerate oils and creams. Skin like this usually feels tight and is rough to the touch, and even anti-inflammatory oils cause skin reactions and burning sensations. This occurs because dehydration compromises the skin’s barrier, and the fats in the oils have heating qualities that penetrate deeply. Even oils that are good for pitta can be aggravating, so if you think your skin is dehydrated, test a little oil on one patch of skin before applying it all over your face. If you can’t use oil, opt for a lotion to replenish your skin, and incorporate heavier moisturizers when the rosacea has begun to calm down and your skin has healed.
Sunblock is extremely important for rosacea skin, which is aggravated by UV damage. Limit sun exposure even when you apply sunblock because the thermal heat itself inflames rosacea. Use a natural, mineral-based sunblock; many chemical sunscreen agents are irritating.
Conventional medicine often stresses that people with rosacea must only use noncomedogenic skin care (products that will not clog pores). If you use products made wholly of natural ingredients, this should never be a problem. Rosacea skin is prone to dehydration because excess pitta burns up moisture. This leads to dried sebum in the skin. Again, it is important to remember that it isn’t oil, but a lack of water, that causes congestion. Try increasing the moisture of your skin with water-rich serums, and get regular facial treatments that include carefully performed extractions. Extractions should be followed by a soothing, nurturing mask treatment.
Use a calming mask once or twice a week at home to cool the skin and boost hydration. Gel masks are packed with water and a good option for rosacea; you might also try cream masks that contain pitta-pacifying oils. Cream masks have more body and are ideal during the colder, drier months. If you do not have a cream mask in your skin care collection, yogurt is a great homemade treatment for rosacea and sensitive skin. It reduces pitta whether you eat it or use it topically. Simply apply a tablespoon of plain, organic yogurt to the skin and leave it on for thirty minutes. Rinse with cool to tepid water, and pat dry with gentle pressing motions. Your skin should feel more moist and calmer. This is an excellent mask for rashes and irritated breakouts.
As with generally sensitive skin, the holistic approach for rosacea must encompass a soothing skin care regimen, along with anti-inflammatory lifestyle practices such as stress management, a cooling (pitta-reducing) diet, and avoidance of stimulants (including tobacco, alcohol, and caffeine). Since both rosacea and sensitive skin have multiple causes, this approach appropriately addresses the body, mind, and spirit.
Eczema
Eczema is very common, but it is often undiagnosed because many people mistake it for an allergic reaction. This skin ailment can exhibit different symptoms, depending on the type of eczema you have and what you use on your skin. It can show up as dry, flaky patches of skin; red lesions that are inflamed and accompanied by a burning sensation; or small bumps that look like water blisters and may be itchy. Eczema is often so irritating that it wakes you up during the night. Changes of season can trigger it, as can food allergies and skin care products, but these are not the root causes. Eczema, like other skin ailments, is an expression of doshic imbalance. The solution is not simply to eliminate the symptoms but to discover what is happening inside the body.
ECZEMA TRIGGERS
According to modern dermatology, there is no official cause for eczema. While cortisone creams are usually the prescribed solution for eczema outbreaks, avoiding triggers often proves more effective.
Extreme dehydration has been the trigger for every case of eczema I have observed. When the skin is dried out, it is vulnerable to irritants and bacteria (leading to eczema bumps). When the internal organs are dehydrated, many imbalances result, causing inflammation, a backup of waste, and tissue depletion.
Skin that is prone to eczema flares up when its defenses are compromised, and depending on the type of eczema, aggravated doshas may manifest as dryness, redness, or dampness. This is why air travel, which leads to excess vata and dehydration, often triggers eczema. The combination of experiencing a new climate, the dry airplane environment, and the stress of traveling provide a perfect formula for a flare-up. If you are prone to eczema, lubricate your skin when taking a long flight and spray it frequently with a hydrosol plant water to avoid breakouts. This is even beneficial if you do not have eczema, because constant flying and traveling ages the skin rapidly.
Stress management is important in avoiding dehydration and other eczema triggers. As we discussed earlier, stress weakens the kidneys and leads to internal inflammation that can translate into topical inflammation (in the form of pitta eczema, which is red and irritated). Stress-related eczema often occurs on the insides of the elbows, between the fingers, and on the backs of the knees. Posttraumatic stress disorder has also been cited as an eczema trigger, demonstrating how closely this skin disorder is linked to emotional states.
Eczema breakouts are most likely to occur during a change of season or climate when the body is stressed by the need to reacclimatize. Kapha blisters usually appear during shifts from dry to wet environments. Vata eczema occurs when going from hot to cold, dry weather. But again, climate change is only a trigger, because the external environment causes any doshic imbalance to show up as symptoms. Furthermore, the qualities of these symptoms reflect the qualities of the imbalance.
TYPES OF ECZEMA AND THEIR AYURVEDIC SOLUTIONS
The conventional protocol for managing eczema uses cortisone cream to reduce redness. Unfortunately, this thins the skin without treating the source of the imbalance. Treating the appropriate doshas is more effective than cookie-cutter prescriptions, and because there are different types of eczema (corresponding to vata, pitta, and kapha), understanding them helps you identify the best way to treat whichever form you have.
Skin with vata eczema is dry, flaky, and chapped, but it is also the easiest type to treat. While it can appear on the face, behind the ears, and in other small areas on the body, it often occurs in parts that have been depleted by wind exposure and other elemental damage. Large areas such as the sides of the midriff, the calves, and the lower arms and hands can display this type of eczema. Vata eczema does not itch or burn, but it can become uncomfortable if the skin becomes so dry that it starts to crack.
Apply a rich cream or pure oil for this condition; it helps immensely and feels wonderful. Ensure that you use only pure vegetable oils so your skin can absorb them fully. Sesame, sunflower, and avocado oils are especially effective because of their heavy texture, and moisturizing this type of eczema is like a refreshing drink for the skin.
Internal moisturizing is also important, and I recommend taking omega-3 essential fatty acids. They are fantastic for lubricating the intestines, holding hydration, and aiding digestion. Remember, oil is not water-soluble, so it will help retain water.
Pitta eczema is red and inflamed, and sufferers often experience a burning sensation. It most often appears on the face and hands, but it can also spread to other areas of the body. Although it can be dry and flaky with obvious skin irritation, you must avoid straight oils and rich creams when experiencing a breakout (unlike with vata eczema). Oil accentuates pitta’s heat and creates hivelike lesions. Think of frying food—you use oil to make the pan hotter. Even cooling oils seem to aggravate pitta inflammation. Instead, try a gel moisturizer containing aloe vera and a light lotion. You may need to reapply it throughout the day to keep your skin moist and support its barrier function. Spraying hydrosols of rose and chamomile can also be very effective.
My own desperation in dealing with an eczema outbreak led to the discovery of Pure + simple’s best-selling pitta eczema product. Excess pitta had brought years of acne as well as eczema. In treating eczema outbreaks, I had used emollients that only increased heat and caused hivelike reactions. During one flare-up, I hastily applied Pure + simple Firming Eye Gel—and it was fantastic! Because it is nourishing to combat aging and light in texture so it can be used in the sensitive eye area, it provided protection and moisture without heat-inducing oil. After this product was reintroduced as our Skin Softening Moisture Lotion, it became our most popular moisturizer for sensitive skin.
Skin care products that contain algae are also beneficial for pitta eczema. The algae holds in moisture without the need for a heavy cream or oil. Many serums and moisturizers contain algae for this reason; simply look for it in the ingredients list when shopping for skin care products. The closer it is to the top of the list, the more algae the product contains.
After the appearance of pitta eczema subsides, you can use oils and richer moisturizers again; this is actually advisable because preventing dehydration with oil-based skin care helps prevent the occurrence of pitta eczema breakouts.
Ingesting and cooking with cooling oils, especially organic coconut oil, is ideal for pitta eczema. Take or use one to two tablespoons of oil a day to give your body more moisture and provide anti-inflammatory and antibacterial properties. This type of eczema requires you to pacify pitta, so you need to eat and manage your emotions according to pitta- reducing guidelines. One helpful practice is to avoid alcohol in your skin care products as well as in your diet. Because alcohol adds heat and dehydrates, it is extremely aggravating to this type of eczema.
Kapha eczema looks wet, like light perspiration on the skin, and is at high risk for fungal infection. Usually it acquires what appear to be water blisters and is very itchy. Keep this type of eczema clean and use antibacterial, antifungal, purifying herbs such as tea tree, peppermint, and sage in the form of hydrosols or diluted in oil or lotion. These herbs can also be found in many natural skin care products aimed at purifying the skin.
As with any antikapha skin care regimen, you need to avoid kapha qualities in products. This means avoiding all rich, moist skin care. Never apply heavy creams and oils to this type of eczema, especially when water-filled bumps appear. Dusting turmeric powder on the affected area can help absorb some of the skin’s wetness and also kills localized bacteria. Products containing black mud and dead sea minerals, which contain sulfur, are also excellent for kapha eczema because of their antimicrobial properties. One popular Pure + simple moisturizer contains black mud and can be used on eczema on the face, hands, and back of the ears. Clients have called it “amazing” and “a lifesaver,” but not all dead sea products are created equal. Some companies use a petroleum-derived chemical base, which is counterproductive and results in clogged pores. Remember to avoid any skin care products that contain petrolatum, mineral oil, or the words propyl or paraffinium in the ingredients list.
Consuming flax seed oil is excellent for this type of eczema; it mitigates kapha and lowers cholesterol and fat in the body. Take one or two tablespoons (or the equivalent in capsules) each day to help clear up outbreaks and prevent future ones. Avoid fermented foods such as alcohols, preserves, vinegars, and miso, which aggravate kapha and internal fungus (candida). Kapha eczema is provoked by dampness, fungus, yeast, and mold—all of which you must avoid and eliminate from your body and environment. One of my clients broke out in kapha eczema after moving into a basement apartment that had a mold problem. The dampness of the basement and the presence of mold resulted in a topical reaction expressing excess kapha. When she moved again, her skin cleared up quickly.
Eczema is sometimes difficult to diagnose because it can come and go. Just remember that when you experience a breakout of vata, pitta, or kapha eczema, there is a doshic imbalance at work. Adapting how you care for your skin and body in accordance with which dosha(s) need balance is the only way to truly treat eczema. This approach also helps clear up your skin over the long term and avoid cyclical, recurring eczema.