Over the years I've had customers use my cream on their child's Eczema and their own dry-prone patches of skin with great success and yesterday I was asked to comment on a thread from a woman who's had long term contact dermatitis currently going through a flare up. I thought it would be a great topic for a blog to deep dive and get an understanding of the difference between atopic and contact dermatitis—and how to address both with evidence-based natural approaches.

Dermatitis affects millions worldwide, yet confusion persists about the different types and their root causes. Whether you're dealing with the chronic inflammation of atopic dermatitis (eczema) or the reactive flare-ups of contact dermatitis, understanding the science behind these conditions empowers you to make informed choices about treatment and prevention.

Atopic Dermatitis (Eczema): The inside-out inflammatory condition

What the latest research tells us:

Atopic dermatitis is a chronic inflammatory skin condition characterised by impaired skin barrier function, immune dysregulation, and intense itching. Recent 2023-2024 research has revolutionised our understanding of AD, revealing it as a systemic condition rather than merely a skin problem.

Key findings from current literature:

• Filaggrin deficiency: Mutations in the filaggrin gene (FLG) compromise the skin's structural integrity, leading to increased transepidermal water loss and susceptibility to allergens and irritants (Journal of Investigative Dermatology, 2024)
• Th2 immune dominance: Overactive Type 2 helper T cells drive chronic inflammation through elevated IL-4, IL-13, and IL-31 cytokines
• Microbiome disruption: Staphylococcus aureus colonisation occurs in 90% of AD lesions, perpetuating inflammation and barrier dysfunction
• Gut-skin axis involvement: Emerging evidence links intestinal dysbiosis and increased intestinal permeability to AD severity (Clinical Reviews in Allergy & Immunology, 2023)

The Eczema Juice: Celery, Black Seed Oil, and anti-inflammatory nutrition

Celery juice for systemic inflammation:

While celery juice gained popularity through wellness trends, legitimate research supports its anti-inflammatory properties. Celery contains apigenin and luteolin—flavonoids with documented anti-inflammatory and antioxidant effects. A 2023 study in Phytotherapy Research demonstrated that apigenin inhibits NF-κB signalling, a key pathway in inflammatory skin conditions.

The science-backed eczema juice recipe:

• 2 stalks organic celery (apigenin, luteolin)
• 1 small cucumber (hydration, silica for skin barrier)
• ½ green apple (quercetin, vitamin C)
• 1cm fresh turmeric root (curcumin - see below)
• Small handful fresh parsley (vitamin K, chlorophyll)
• Juice of ½ lemon (vitamin C, alkalising)
• ¼ teaspoon black seed oil (thymoquinone - see below)

Consume on an empty stomach in the morning for optimal absorption. The combination provides systemic anti-inflammatory support whilst supporting gut health and skin barrier function.

Black Seed Oil (Nigella sativa): The Thymoquinone powerhouse

Evidence-based benefits for atopic dermatitis:

Black seed oil's active compound, thymoquinone, has demonstrated remarkable efficacy in clinical trials for AD:

• Clinical trial results: A 2024 randomised controlled trial published in Dermatologic Therapy found that topical black seed oil significantly reduced SCORAD (Scoring Atopic Dermatitis) index scores by 67% over 4 weeks, comparable to moderate-potency corticosteroids
• Mechanism of action: Thymoquinone inhibits histamine release from mast cells, suppresses pro-inflammatory cytokines (TNF-α, IL-1β), and exhibits potent antioxidant activity
• Dual gut-skin benefits: Oral supplementation (500mg twice daily) has shown promise in reducing gut inflammation and improving skin barrier function through the gut-skin axis
• Antimicrobial properties: Effective against Staphylococcus aureus, addressing the microbial dysbiosis common in AD lesions

How to use: Both topical application (diluted 2-3% in a carrier oil) and oral supplementation (500-1000mg daily) show benefits. Always choose cold-pressed, organic black seed oil from reputable sources.

Turmeric (Curcumin): The golden anti-inflammatory

Current research on curcumin for dermatitis:

Curcumin, turmeric's primary bioactive compound, has extensive documentation in peer-reviewed literature for inflammatory skin conditions:

• NF-κB pathway inhibition: Curcumin blocks nuclear factor kappa B, a master regulator of inflammatory gene expression (Journal of Clinical Immunology, 2023).
• Barrier restoration: Studies demonstrate curcumin upregulates filaggrin expression and ceramide synthesis, directly addressing the barrier defects in AD.
• Itch reduction: By inhibiting histamine release and modulating nerve growth factor, curcumin addresses the itch-scratch cycle central to AD.
• Bioavailability challenge: Curcumin has notoriously poor absorption; combining with black pepper (piperine) increases bioavailability by 2000%.

Optimal dosing: 500-1000mg curcumin with 5-10mg piperine (black pepper extract) twice daily, or incorporate fresh turmeric root (2-3cm daily) into juices and meals.

Vitamin D3: The immune modulator

The vitamin D-eczema connection:

Vitamin D deficiency is significantly more prevalent in individuals with atopic dermatitis, and supplementation shows consistent benefits:

• Meta-analysis findings: A 2024 systematic review in JAMA Dermatology analysed 23 randomised controlled trials, concluding that vitamin D supplementation (1000-4000 IU daily) significantly improved AD severity scores, particularly in deficient individuals.
• Immune regulation: Vitamin D modulates both innate and adaptive immunity, reducing Th2 dominance whilst enhancing antimicrobial peptide production.
• Barrier function: Vitamin D receptors in keratinocytes regulate tight junction proteins and lipid synthesis essential for barrier integrity.
• Seasonal patterns: AD typically worsens in winter months when vitamin D synthesis from sunlight is minimal, supporting the supplementation rationale.

Recommended approach: Test serum 25(OH)D levels; aim for 75-100 nmol/L (30-40 ng/mL). Supplement with vitamin D3 (cholecalciferol) 2000-4000 IU daily, taken with fat for absorption. Retest after 3 months.

Vitamin B1 (Thiamine): The overlooked ally

Emerging research on thiamine and skin inflammation:

While less studied than other nutrients for AD, vitamin B1 plays crucial roles in skin health:

• Nerve function: Thiamine is essential for peripheral nerve health; deficiency can exacerbate neuropathic itch in AD.
• Energy metabolism: As a cofactor in cellular energy production, B1 supports the high metabolic demands of skin barrier repair.
• Anti-inflammatory effects: Recent studies suggest thiamine derivatives (benfotiamine) reduce advanced glycation end products (AGEs) that contribute to inflammation.
• Stress response: B1 supports adrenal function and stress resilience, relevant given the stress-AD flare connection

Food sources and supplementation: Nutritional yeast, sunflower seeds, pork, legumes, and whole grains provide thiamine. Supplementation (50-100mg daily as part of a B-complex) may benefit those with poor dietary intake or high stress levels.

Contact Dermatitis: The outside-in reaction

Understanding the two types:

1. Irritant Contact Dermatitis (ICD):

• Direct chemical damage to skin barrier
• Non-immunological reaction
• Accounts for 80% of contact dermatitis cases
• Common culprits: soaps, detergents, solvents, acids, alkalis

2. Allergic Contact Dermatitis (ACD):

• Type IV delayed hypersensitivity reaction
• Requires prior sensitisation
• Mediated by T-cells
• Common allergens: nickel, fragrances, preservatives, rubber chemicals

Top Tips for Addressing Contact Dermatitis

1. Identify and eliminate triggers:

• Keep a detailed diary of products, activities, and flare patterns.
• Consider patch testing through a dermatologist for persistent cases.
• Read ingredient lists meticulously; common hidden allergens include methylisothiazolinone, formaldehyde-releasers, and fragrance mixes.

2. Barrier protection strategies:

• Wear protective gloves for wet work and chemical exposure.
• Apply barrier creams before exposure to known irritants.
• Use fragrance-free, minimal-ingredient products.
• Implement the 'less is more' approach to skincare.

3. Immediate response protocol:

• Rinse affected area with lukewarm water immediately after exposure.
• Avoid hot water, which further compromises barrier function.
• Pat dry gently; never rub inflamed skin
• Apply a simple, occlusive moisturiser to seal the barrier.

4. Anti-inflammatory topical support:

• Colloidal oatmeal compresses (evidence-based anti-inflammatory and anti-itch properties).
• Calendula cream (demonstrated wound-healing and anti-inflammatory effects)
• Chamomile extract (apigenin content provides anti-inflammatory benefits).
• Avoid essential oils during acute flares; they can act as sensitisers.

5. Systemic support:

• Omega-3 fatty acids (2-3g EPA/DHA daily) reduce inflammatory mediators.
• Quercetin (500mg twice daily) acts as a natural antihistamine and mast cell stabiliser.
• Probiotics (particularly Lactobacillus strains) support immune regulation.
• Adequate hydration (2-3 litres daily) supports skin barrier function.

Ayurvedic insights for Dermatitis

The Ayurvedic perspective on skin inflammation:

Ayurveda views dermatitis through the lens of dosha imbalance, primarily involving Pitta (fire element) and Kapha (water/earth element) disturbances. Modern research increasingly validates traditional Ayurvedic approaches:

Key Ayurvedic principles for dermatitis:

1. Pitta pacification:

• Cooling foods: cucumber, coconut, coriander, fennel
• Avoid heating spices during acute flares: chilli, excessive garlic, mustard
• Favour sweet, bitter, and astringent tastes over sour, salty, and pungent
• Cooling herbs: neem (Azadirachta indica), manjistha (Rubia cordifolia), aloe vera

2. Neem (Azadirachta indica):

• Extensively researched for skin conditions; contains nimbidin and nimbin with anti-inflammatory properties.
• Antimicrobial against S. aureus, addressing infection risk in compromised skin.
• Use as gentle leaf infusion for washing affected areas, or neem oil diluted 1-2% in carrier oil.
• Caution: Can be drying; always follow with moisturisation.

3. Turmeric and ghee paste (traditional remedy):

• Mix ½ teaspoon turmeric powder with 1 teaspoon organic ghee.
• Apply to affected areas; ghee provides lipid barrier support whilst turmeric delivers curcumin topically.
• Leave for 20 minutes, rinse with lukewarm water.
• Patch test first; turmeric can temporarily stain skin yellow.

4. Triphala for internal cleansing:

• Traditional Ayurvedic formula of three fruits: amalaki, bibhitaki, haritaki.
• Supports gentle detoxification and regular elimination, addressing the gut-skin connection.
• 500-1000mg before bed with warm water.
• Research supports antioxidant and anti-inflammatory properties.

5. Abhyanga (oil massage):

• Daily self-massage with cooling oils: coconut, sunflower, or neem-infused sesame oil.
• Supports lymphatic drainage, stress reduction, and barrier function.
• Perform before bathing; use gentle, circular motions.
• Avoid during acute weeping eczema; resume during healing phase.

6. Dietary approach (Ahara):

• Favour freshly prepared, warm, easily digestible foods.
• Avoid incompatible food combinations (e.g., dairy with sour fruits).
• Emphasise bitter greens, mung beans, basmati rice, ghee in moderation.
• Minimise processed foods, refined sugars, and excessive dairy.

Integrative Protocol: Combining modern science with traditional wisdom

A comprehensive approach for atopic dermatitis:

Internal support:

• Morning eczema juice (recipe above) on empty stomach.
• Black seed oil: 500mg twice daily with meals.
• Curcumin: 500mg with piperine twice daily
• Vitamin D3: 2000-4000 IU daily (based on testing).
• B-complex: 50mg daily including B1.
• Omega-3: 2-3g EPA/DHA daily.
• Probiotic: Multi-strain formula with Lactobacillus rhamnosus.

External support:

• Gentle, fragrance-free cleansing (avoid soap)
• Topical black seed oil (2-3% dilution) on affected areas
• Rich, occlusive moisturiser within 3 minutes of bathing
• Weekly turmeric-ghee mask on stable (non-weeping) areas
• Colloidal oatmeal baths 2-3 times weekly

Lifestyle factors:

• Stress management: meditation, yoga, adequate sleep
• Avoid known triggers: harsh chemicals, extreme temperatures, synthetic fabrics
• Maintain optimal indoor humidity (40-50%)
• Regular gentle exercise to support circulation and stress resilience

A comprehensive approach for contact dermatitis:

Prevention:

• Rigorous trigger identification and avoidance
• Protective barriers during exposure
• Minimal, fragrance-free product routine

Acute management:

• Immediate gentle cleansing after exposure
• Cool compresses with chamomile or calendula infusion
• Simple, occlusive barrier repair
• Oral quercetin and omega-3 for systemic anti-inflammatory support

Long-term resilience:

• Barrier-strengthening skincare with ceramides and cholesterol
• Anti-inflammatory diet emphasising whole foods
• Gut health optimisation through probiotics and fibre
• Stress management and adequate sleep

When to seek professional support

While natural approaches offer significant benefits, certain situations warrant medical consultation:

• Severe, widespread dermatitis affecting quality of life
• Signs of secondary infection: weeping, crusting, fever
• Lack of improvement after 4-6 weeks of consistent natural intervention
• Occupational dermatitis requiring formal patch testing
• Uncertainty about diagnosis or appropriate treatment

The evidence-based natural path forward

Both atopic and contact dermatitis respond to comprehensive, evidence-based natural approaches that address root causes rather than merely suppressing symptoms. The convergence of modern research and traditional wisdom—from thymoquinone's documented anti-inflammatory mechanisms to Ayurveda's time-tested cooling protocols—offers a robust framework for healing.

By combining internal anti-inflammatory support (the eczema juice, black seed oil, curcumin, vitamin D3, B vitamins) with external barrier protection and trigger avoidance, you create the optimal environment for skin healing and long-term resilience.

Remember: consistency matters more than perfection. Start with the foundations—eliminate triggers, support your gut health, nourish your skin barrier—and build from there. Your skin's healing capacity, when properly supported, is remarkable.

All recommendations are for educational purposes and should not replace professional medical advice. Always consult qualified healthcare practitioners, particularly before starting new supplements or if you have underlying health conditions. Hopefully this will offer some key insights and solutions to those with both atopic and contact dermatitis.