Homeopathy in paediatric atopic diseases: long-term results in children with atopic dermatitis

Aim

To study the socio-demographic features, the prescribed remedies and the outcome of atopic diseases in children treated with homeopathy at the Homeopathic Clinic of Lucca (Italy), and the long-term outcome of children suffering from atopic dermatitis (AD) after an approximate 8-year period (range 5–10 years).

Methods

Our data derive from an observational longitudinal study carried out on 213 children (38.6%) with atopic diseases out of 551 children consecutively examined from September 1998 to December 2008. We used the Glasgow Homeopathic Hospital Outcome Score to evaluate the results that were classified on the basis of a Likert scale.

Results

Eighty-three (39%) children were affected by asthma, 51 (24%) by allergic rhinoconjunctivitis, 76 (36%) by AD and 3 (1%) by food intolerance. Follow-up patients were 104 (48.8%), and 65 (62.5%) of them reported a major improvement or resolution. The parents of paediatric patients suffering from AD, who had started homeopathic treatment at <4.9 years of age were invited to follow-up assessment 8 years later and 40 children (mean age 12.9) were examined; 28/40 (70%) had a complete disappearance of AD, 12/40 children (30.0%) were still affected by AD; 8/40 (20%) had asthma and 8/40 patients had, or developed, allergic rhinitis.

Conclusion

These preliminary results seem to confirm a positive therapeutic effect of homeopathy in atopic children. Furthermore, according to the data from the literature paediatric patients treated with homeopathy seem to show a reduced tendency to maintain AD and develop asthma (and allergic rhinitis) in adult age.

Introduction

The term ‘atopy’, coined in 1923 by Coca and Cooke, comes from the privative prefix α and the Greek word άτoπíα which means – among others – ‘different’, ‘unusual’, ‘out of place’.¹ Atopy originally involved only asthma and allergic rhinitis, but in 1933 atopic dermatitis (AD) was also included in the group of atopic disorders, in recognition of the close link of this form of eczema with asthma and allergic rhinitis. AD is often the first manifestation of atopic diseases.² Allergies generally start with AD, and develop towards food allergies in the form of gastro-intestinal, followed by respiratory conditions (rhinitis and asthma).

AD is a chronic, itchy and inflammatory skin disease caused by the interaction between susceptibility genes, environment, pharmacological abnormalities, skin barrier defects, and immunological factors.³ Recently there has been a constant increase in the number of cases of allergy, particularly in developed countries, to such an extent that expressions like “disease of the third millennium” and “allergic epidemic” have been used to describe the phenomenon.⁴ It is a serious and widespread health problem, with a prevalence in children between 10–20%⁵ and 18–25%.6, 7 AD often represents the first step of what we can call the ‘allergic march’ and is one of the main risk factors for allergic rhinitis development (up to 77% of cases) and asthma (from 20% to 68% of cases).⁸ According to Sporik et al. the lifetime prevalence of eczema, wheeze, and hay fever in babies at risk of developing atopic disorders followed-up prospectively for 11 years, were 46%, 63%, and 56% respectively.⁹

There has been an increase in the use of ‘complementary’ or ‘alternative’ medicine in patients affected by skin disease, in particular those with chronic or inflammatory dermatosis. The prevalent use of complementary and alternative medicine (CAM) in children has been estimated to be higher than 40% in the USA¹⁰ and it has been reported recently that in the Tuscany Region of Italy more than 25% of children use CAM, and 23.4% of these consume homeopathic products.¹¹ The data on consecutive patient visits (N = 1117) to 27 doctors of medicine and of osteopathy using homeopathy showed that AD (2.6%) was in the top ten most common diagnoses.¹² In a prospective multicentre cohort study with 103 primary care practices with additional specialisation in homeopathy in Germany and Switzerland on 3981 patients (1130 children), the most common diagnosis in children of both genders was AD (20%).¹³

However, there are still only a few studies to document the efficacy of homeopathy in long-term treatment of AD and to confirm whether such treatments can influence progression towards rhinitis and asthma.