Eczema is so varied in the way it manifests, and in the underlying causes, that it should scarcely be considered as a single condition. Consequently, the aromatherapist's approach needs to be very flexible. A number of essential oils are described as being useful for eczema, but by no means all of them will be helpful in every case, and not all of them are suitable for use directly on affected areas of skin.

Stress is involved in almost all cases of eczema, and a very important part of the aromatherapist's task is to try to reduce the level of stress, without which direct treatment of the skin is merely palliative. Oils such as Camomile, Bergamot, Lavender, Melissa and Neroli are very important here, and should be used in massage and in baths that can be used every day at home, or when the person with eczema is feeling particularly fraught. In the case of infantile eczema, a child may often be reacting to the parents' tensions, and it is often helpful to treat one or both parents as well as the child.

Some, though by no means all, eczema, is allergic in origin, and because of what we know about the relationship between stress and allergy, it is again important to do everything possible to lower the level of stress, as well as determining what allergens seem to aggravate the skin and making sure that they are avoided as far as possible. These may be contact irritants, such as soaps, cosmetics, detergents and other household chemicals, dust, plants, etc., or the reaction may involve one or more foodstuffs and help from an allergy clinic or clinical ecologist might be needed to identify them.

Sometimes, eczema can be seen as an attempt by the body to throw off accumulated toxins through the skin, especially where the diet has been very poor, or high in additive-laden foods. In these circumstances, detoxifying essential oils need to be used in massage and baths, and perhaps a short fast or cleansing diet undertaken. When this is done, the eczema may get temporarily worse as the body begins to throw off more toxic waste, and the person with eczema will need to be encouraged and supported through this healing crisis before real improvement is seen. Juniper is perhaps the most important oil to use in detoxifying, and it is significant that it is emotionally detoxifying, too.

For direct treatment of the skin, Camomile has been found to be the most helpful oil in the great majority of cases, though for a small handful of people Melissa turns out to be a better choice. Some therapists like to blend these two oils together, but it may be preferable to use one at a time, so that you know which is actually helping most in each instance. If you use Melissa direct on the skin, dilute it to very low proportions, perhaps 1% or even lower, as it is a very strong oil and can set up a worse irritation than was present already. In these tiny amounts, though, it can have an almost magical effect on even stubborn eczema.

Mix the essential oils in a non-perfumed lotion or a light aqueous cream, as many people with eczema find that carrier oils and fatty ointments make the condition worse. Another way of applying the oils is in cold compresses, and this can be extremely soothing when the eczema is very itchy. It is also the most effective way, other than bathing, of treating the skin if a large area is affected.

Bergamot, Geranium and Lavender are other oils that can be used to help, but in each case a little trial-and-error may be necessary, since this is such an individual and unpredictable condition. In every case, use the oil in a very low dilution initially.

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