Eczema: it’s a word that might make you scratch just thinking about it. If you’re one of the people grappling with this persistent skin condition, you should know you’re not alone. Eczema affects up to 10% of the UK population, turning everyday activities into uncomfortable challenges and peaceful nights into itchy ordeals.
But what exactly is it, and why does it seem to have a mind of its own? Whether you’re dealing with occasional flare-ups or constant irritation, understanding this complex condition is the first step towards finding relief. Dr Dalia, a dermatologist with many years of experience, can help you manage your condition and reclaim comfort.
Eczema, also known as atopic dermatitis, is more than just a skin condition—it’s a complex interplay of genetic, environmental, and immunological factors. But what does this mean for you and your skin?
At its core, it is an inflammatory skin condition characterised by itchy, red, and sometimes weepy patches of skin. It’s like your skin’s alarm system is constantly going off, even when there’s no real threat. This oversensitivity leads to the hallmark symptoms that many of you are all too familiar with.
But did you know that it isn’t just one condition? There are actually several types, each with its own quirks:
Each type of eczema can present differently, but they all share common symptoms. You might experience:
One of the most frustrating aspects of this condition is its chronic nature. It tends to flare up and then subside, often without any apparent reason. This unpredictability can be emotionally taxing, affecting not just your skin but your overall quality of life.
The exact cause of eczema remains a bit of a medical mystery. However, research has uncovered several factors that contribute to its development and persistence. Here are some of these factors:
Genetic Factors
If you have this condition, you can partly blame your genes. Studies have shown that if one or both parents have it, their children are more likely to develop it too. Specifically, mutations in the gene responsible for creating filaggrin—a protein that helps maintain a healthy skin barrier—have been linked to some types of eczema.
But here’s an interesting twist: having the gene doesn’t guarantee you’ll develop it, and not having it doesn’t mean you’re immune. This is where other factors come into play.
Environmental Triggers
Your environment plays a role in eczema flare-ups. Common triggers include:
These environmental factors can irritate your skin or trigger an allergic response, leading to those familiar eczema symptoms.
Immune System Dysfunction
Eczema is considered an autoimmune condition, meaning your immune system is overreacting to minor irritants or allergens. This overreaction leads to inflammation in the skin, causing the redness, swelling, and itching characteristic of eczema.
People with eczema often have higher levels of a type of antibody called IgE. This antibody is typically involved in fighting parasitic infections, but in eczema, it seems to be misdirected, causing inflammation in response to harmless substances.
Skin Barrier Defects
Your skin acts as a barrier, protecting your body from irritants, allergens, and moisture loss. In people with eczema, this barrier doesn’t work as well as it should. This can be due to genetic factors (remember that filaggrin protein we mentioned?) or can develop over time due to environmental damage.
A compromised skin barrier allows irritants and allergens to penetrate more easily, triggering inflammation. It also allows more moisture to escape, leading to dry, easily irritated skin.
Lesser-Known Causes
While the above factors are well-established, researchers are continually uncovering new potential causes of eczema:
It’s also important to understand the factors that can trigger flare-ups or make existing symptoms worse. You can considerably reduce the frequency and severity of your eczema outbreaks by identifying these triggers:
Allergens and Irritants
Your skin comes into contact with countless substances every day, and for those with eczema, many of these can spell trouble. Common irritants include:
Stress and Emotional Factors
Have you ever noticed your eczema worsening during periods of high stress? You’re not alone. Stress can have a significant impact on the symptoms, creating a frustrating cycle: stress exacerbates it, which in turn causes more stress.
This stress-eczema connection is thought to be due to the effect of stress hormones on the immune system and inflammation. Additionally, stress can lead to behaviours that worsen the condition, such as reduced sleep or increased scratching.
Climate and Weather Conditions
Your skin’s nemesis might be lurking in the forecast. Many people with eczema find that their symptoms are influenced by weather conditions:
Some people find that their eczema improves in sunny weather. This could be due to the beneficial effects of UV light on the immune system, or the increase in vitamin D production.
Hormonal Changes
For many women, eczema symptoms can fluctuate with hormonal changes. You might notice flare-ups:
These hormonal fluctuations can affect skin hydration, oil production, and even the way your immune system responds to irritants.
Diet and Nutrition
While the link between diet and eczema isn’t fully understood, what you eat can potentially influence your symptoms. Some studies suggest that a diet high in fruits, vegetables, and omega-3 fatty acids may help reduce inflammation and improve eczema symptoms.
On the flip side, some foods might exacerbate eczema in certain people:
Diagnosing eczema might seem straightforward – after all, it’s visible on your skin, right? However, because eczema can mimic other skin conditions, a proper diagnosis from a dermatologist like Dr Dalia is essential for effective treatment.
When you visit Dr Dalia for eczema concerns, here’s what you can expect:
But when should you book that appointment? Here are some signs that it’s time to seek professional help for eczema:
Here are some treatment options for eczema:
Topical Treatments
Systemic Treatments
For more severe or widespread eczema, systemic treatments might be necessary.
Natural and Alternative Remedies
While scientific evidence varies, some people find relief with:
Here are some recommendations:
In the Shower
Clothing Choices and Fabrics
Home Environment Changes
Diet and Nutrition Tips
While there’s currently no permanent cure for eczema, many people experience long periods of remission where symptoms are minimal or absent. With proper management and treatment, it’s possible to control symptoms effectively and significantly improve quality of life. Research is ongoing, and new treatments are continually being developed that may offer better long-term solutions in the future.
No, eczema is not contagious. You cannot catch it from someone else or spread it to others through physical contact. However, if it becomes infected (a condition called eczema impetiginisation), the infection itself may be contagious. This is why it’s important to keep the affected skin clean and seek treatment if you suspect an infection.
Some studies suggest that certain vitamins and supplements may help manage the symptoms. Vitamin D, vitamin E, and zinc have shown potential benefits in some research. Evening primrose oil and fish oil supplements are also sometimes recommended.
Eczema can affect people of all skin tones, but it may look different and be diagnosed differently in people with darker skin. In lighter skin, it typically appears red or pink. In darker skin, it might look darker brown, purple, or grey, and can be more difficult to detect visually. This can sometimes lead to delayed diagnosis or misdiagnosis. Additionally, people with darker skin may be more prone to skin discolouration (hyperpigmentation or hypopigmentation) after flares.
Yes, it is associated with several other health conditions. People with this condition are more likely to develop asthma and hay fever, a triad known as the “atopic march”. There’s also an increased risk of certain skin infections due to the compromised skin barrier. Some studies have found links between this condition and mental health conditions like anxiety and depression. More recently, research has suggested potential associations with cardiovascular disease and certain autoimmune disorders, although more studies are needed to fully understand these relationships.