Healing Crisis – can your eczema get worse before it gets better?

For centuries, the Healing Crisis has been widely documented as the body’s normal response to purging toxins.

There is a similar medical condition called a “Herxheimer Reaction” which is often triggered by antibiotic use. The Herxheimer reaction was named after one of the German physicians who identified the “healing crisis” phenomenon from a sudden die-off of harmful bacteria in the body. For example, when antibiotics are taken internally they cause large amounts of bacteria to die-off in a short period of time, which is why your skin symptoms can worsen again after antibiotic use. It is the release of endotoxins from the destroyed cell walls of the bacteria which can be responsible for the unpleasant side-effects. 

Similarly, when you embark on a health program, the increased release of chemicals that the body has previously stored in your tissues (to safely keep the toxins out of the blood), are now dumped into the bloodstream for processing in the liver. 

The severity of your symptoms largely depends on the amount of toxins stored in your body. 

Healing crisis symptoms can include:

Worsening of your current skin disorder
Lethargy and sluggishness
Itchy skin (or increased itch)
Fever or flu-like symptoms
Diarrhoea or constipation
Skin eruptions (pimples or oozing)
Joint/muscle pains
Swollen glands
Body aches
Sweating or chills


You are unlikely to experience all of the detox symptoms at once but it’s helpful to know that the symptoms will subside.

I have also noted the Hering's Law of Cure when treating patients with eczema.


Hering's Law of Cure:
"All cure starts from within out
and from the head down
and in reverse order as the symptoms have appeared."
Hering’s Law of Cure is an often quoted healing crisis phenomenon first observed by Dr. Constantine Hering in the 1800s. He explained that when healing processes move in the right direction, a patient’s symptoms begin to improve from ‘the top-down, the inside-out and in reverse time’. He observed that a patient’s mental symptoms will often improve before the physical disorder and their internal organs – the liver and kidneys – will heal before an improvement is observed in the outer organ, namely the skin. A patient can also see an old symptom from years ago temporarily return in the form of a Healing Crisis, before it disappears once again.


My personal experience treating patients with eczema:

What I have observed in my own clinic is the first signs of improvement are adult patients who report "feeling better and more energetic” and if facial eczema was a problem it clears up first. Patients often ask why the eczema on their feet have not healed as quickly as the rest of the body – this can be explained by Hering’s Law “healing from the head down”.

Patients with Topical Steroid Withdrawal Syndrome have reported overall smoother skin which occurs within the first few weeks, and if hair loss had occurred, the eyebrows and hair show significant signs of new growth within a month. Their skin is also less itchy and less red in the early days. 

I have also observed in people who have hand eczema, their hand eczema clears up first but in a few cases new eczema appeared on another part of the body. This is a part of the healing crisis and within 4-6 weeks it disappeared.


"How long does a healing crisis usually last?"

It depends on the amount of toxins you have and the severity of your eczema. The length of time can be anywhere from 7-30 days but for topical steroid withdrawal it can be longer (usually nutritional deficiencies are involved and TSW sufferers do much better with supplementation). If you are using supplementation to help your liver successfully detoxify chemicals this process is usually shorter.


"Is it normal to experience a healing crisis?" 

It’s helpful to know that it is a normal process that some people encounter when changing their diet. It occurs when cells in your tissues release toxins into your bloodstream, and your eliminatory organs (i.e. your liver and skin) can’t keep up with the increased toxic load. When your body is not able to eliminate the chemicals quickly enough (via your 6 eliminatory processes) it can make you feel sluggish or unwell for a period of time.

Detox reactions can be uncomfortable and this is often when people with eczema take an anti-histamine to reduce their itch. However, antihistamines work by blocking the Phase 1 detoxification process in the liver so they can slow down the symptoms but they also block the healing process which may prevent your eczema from completely clearing up.

Many people confuse detox symptoms with a sensitivity reaction within the first three days. If you are concerned you can check if you have ingested anything you are allergic or sensitive to. If you haven’t, then it could be a healing crisis.


Chemical elimination pathways – how they help eczema 

Every day you are exposed to toxins, chemicals, heavy metals and irritants from your foods and the environment. While these exposures are largely unavoidable, your body has ways to successfully eliminate these toxins so they don’t adversely affect your health.

Top 6 pathways of elimination:
Lymph and blood
Lungs (via respiration)


How efficiently each eliminatory systems works can determine the severity of your skin symptoms. For example, people with eczema tend to have under-functioning liver detoxification processes (specifically excess Phase 1 and under-functioning Phase 2) as shown by Functional Liver profile testing done by a pathology lab.

Excess Phase 1 liver detoxification processes make a toxin more toxic, and it is Phase 2 where a substance is deactivated for safe removal from the body. So it’s Phase 2 we want to boost when treating eczema. Again, this can lead to a temporary healing crisis before the eczema clears up.

Substances that trigger excessively high Phase 1 Liver Detoxification:

Alcohol, nicotine/smoking, caffeine, stress, steroids, HRT, high protein diets, pesticides, exhaust or paint fumes, dioxin and barbiturates all trigger high Phase 1 reactions in the liver and as a result they can worsen eczema symptoms (ref. source: Healthscope Pathology).


“Can I experience a healing crisis on The Eczema Diet and by taking the Skin Friend supplements?”

Yes absolutely. Not everyone will have a healing crisis/detox reaction, especially if you have been following a cleansing or healthy diet for a long time and have detoxed gradually. For most, it will be a process of gradual improvement of the skin and you will feel more energetic and have general improved wellbeing along the way. However, do not feel that you have failed because it is not smooth-sailing for you, when it was for another as everyone is different and a healing crisis is normal. Then the itch should reduce and subside. For those who experience a healing crisis, this is a good sign and symptoms will improve so hang in there and read the tips, below.


"Can Skin Friend AM cause an increase in energy?"

Skin Friend AM is a powerful detoxification supplement as well as being multi-vitamin to help prevent and reverse common nutritional deficiencies that can cause eczema. It is specifically designed to enhance liver detoxification of salicylates, amines and glutamates which are chemicals that irritate eczema. This is why Skin Friend AM can cause a detox reaction/healing crisis in some people taking it. I have seen this supplement help hundreds of patients (including my own daughter) and the detoxification reactions do subside as the skin improves, so it's worth the wait. 

A few people with young children have reported Skin Friend AM makes their kids more alert and hyper. Adults taking the supplement love the new-found energy the supplement gives them, however for children we need to channel this energy in positive ways. My daughter did not become hyperactive while taking Skin Friend but I've noticed my 8-year old son is more hyper while taking the AM product. The increased energy is likely from the B vitamins even though the amounts are very low Australian Government RDIs (Recommended Daily Intakes).

It is important to persist through this temporary phase because eczema can be caused by B vitamin deficiencies (namely biotin, vitamins B1, B2, B3 and B6), so the supplement is important for nutritional support. In fact, don't do an elimination diet without Skin Friend AM as the natural beta-carotene, zinc, magnesium, chromium and vitamin C are also important for children with eczema.

Most children's supplements contain colours, fruit flavours and hidden sugars (and more) so these products are more likely to cause hyperactivity. Skin Friend AM is the purest children's multi available and the detox symptoms will pass.

In the meantime, to minimise the reactions you can reduce the dose and give the supplement to your child after breakfast when he or she has a full stomach. Ensure they are drinking plenty of filtered water and most importantly take them outside to exercise. If they run around for an hour each day they will use up their extra energy, feel tired and sleep well - it works without fail!

Calcium Matrix PM
Calcium Matrix PM will not cause a detox reaction or hyperactivity. It is used to eliminate salicylates via alkalisation, and it’s also useful for nutritional support for people following a dairy-free diet. And it's great for improving sleep. 


"How long can a healing crisis last?"

Healing crisis symptoms while using Skin Friend AM and/or The Eczema Diet can be anywhere from three days to one month in duration (average time is two weeks). During this time there are activities you can do to make this time of healing as non-disruptive as possible (see next).

If you’re experiencing topical steroid withdrawal syndrome (TSW, or red skin syndrome), you may find you have new flare-ups where you previously applied topical steroids on a frequent basis. This is a normal response and it will improve over time, especially with nutritional support from the Skin Friend supplements.


Can a healing crisis be avoided?

Don’t be discouraged if you are experiencing a healing crisis when treating your eczema with diet. Having eczema is a sign your eliminatory organs need a bit of help to eliminate toxins in your body, so encourage this process as it is a good sign. There are things that you can do to speed up the healing process, such as the following:


How to minimise a healing crisis

Rest – You may feel excessively lethargic during this time so listen to your body and rest. Your body is working hard to remove chemicals and repair the skin from the inside out. Don’t worry, positive changes are taking place. It takes about 28 days for the new skin cells to reach the surface of your skin so rest as much as you need to during this time. It’s best to go to bed before 9pm, if possible, and stay away from electronic devides a couple of hours before bed to help improve sleep. Calcium Matrix PM can also help with improving sleep quality.

Drink lots of filtered water – Filtered water, spring water and low-salicylate juices (home-made with peeled pear, celery and beetroot), are your best choices. These low-salicylate liquids will assist with flushing out toxins. Salicylates are food chemicals which can irritate the stomach lining and burden an over-burdened liver, so for a period of about 12-weeks they shouldbe limited (join our newsletter to download the Complete Salicylate Food Charts).

During this time, avoid drinking coffee and all teas, even herbal teas as they can over-stimulate Phase 1 liver detoxification reactions, and they are rich sources of salicylates. If you are one of the 60-70% of eczema sufferers who are sensitive to salicylates then teas will make you itchier. Eczema sufferers are often sensitive to grasses and flowers so herbal teas should be avoided if you want the healing crisis to subside quickly.

Strictly follow The Eczema Diet – Eating a low-salicylate diet can help immensely. Some people with eczema think they are experiencing a healing crisis when in fact they are reacting to the high salicylates in the foods they are eating (such as green detox products, wheatgrass, herbal teas and supplements, tomato, citrus fruits and more).

For the best results the Eczema Diet should be followed correctly and without the use of herbal supplements which negate the low-salicylate program (as herbs are high in salicylates and you can’t test for salicylate sensitivity while taking them - I'm not saying herbs are bad - they're not - but if you have salicylate sensitivity you should begin on a low salicylate program to speed up your results). Remember the Eczema Diet is a temporary diet and you can expand your foods within 12-weeks if you follow it correctly. See our problem-solving page if you need tips on how to follow it correctly >>

Avoid ingesting toxins – Avoid alcohol; caffeine, dairy products; smoking/passive smoking; chemical cleaning products; perfumes; and skin care with chemicals (if possible) as they are absorbed through the skin. People who are experiencing topical steroid withdrawal often find it necessary to stop using all skin care products/moisturisers as they have become sensitive to them. This is not necessary for everyone (and not right for everyone), but if you find all skin care products worsen your skin, you can avoid them to aid the detoxification process.

Boost dietary fibre intake – It’s important to consume good quality wholegrain carbohydrates during this time to enhance removal of toxins through your bowel. Constipation is your skin’s worst enemy as it means an increased load of toxins are removed via your sweat glands in your skin (which can sting). If you need to you can add psyllium husks to your breakfast to improve bowel movements.

Other high fibre foods include rolled/wholegrain oats, lentils, chick peas, beans (avoid broad beans as they are high in salicylates), and oatbran.

Epsom/salt baths with bicarb soda – To temporarily reduce the itch and support detoxification: 1/4 cup of each. Don't soak for too long as this can dry out your skin.

Bentonite clay – I love this clay used as a face mask. It can helps to temporarily smooth the skin and draw out toxins. Leave it on for 5 minutes. 

Breathing exercises – Your lungs are a toxin elimination organ so breathe deeply and detox. If you need to reduce feelings of stress or anxiety, daily deep breathing exercises can help. If you have trouble falling asleep, try this breathing routine: breathe in for 4 counts, hold for 7 and breathe out for 8. Do this for at least 5 rounds – it really works.

If you need extra help while on The Eczema Diet, join our online Eczema Diet Membership. There are no appointments necessary to speak to Karen and her team of nutritionists on the support forum. There are more tips and resources on our FAQ page here >>