Eczema

Eczema is not caused by a single factor but by a combination of genetics, skin barrier dysfunction, immune system changes, and environmental triggers.

• Genetics: Many people with eczema are born with variations in genes that control the formation of the skin barrier. A key gene, filaggrin, is often involved. When this gene doesn’t work properly, the skin has a harder time holding in moisture and keeping out irritants.
• Skin barrier problems: Healthy skin acts like a protective wall, sealing in water and blocking out bacteria, allergens, and chemicals. In people with eczema, this barrier is weakened, making the skin dry and sensitive.
• Immune system response: The immune system of someone with eczema tends to overreact. Even everyday substances that are harmless to most people—like soaps, pollen, or dust—can trigger inflammation, redness, and itching.
• Environmental triggers: Many factors outside the body can trigger or worsen eczema. Common triggers include weather changes, hot showers, harsh soaps, detergents, fragrances, pet dander, pollen, wool clothing, stress, and sometimes certain foods.
• Bacteria and microbes: The skin of people with eczema is often more likely to harbor bacteria such as Staphylococcus aureus, which can worsen symptoms and sometimes cause infections.

One common thread among most types of eczema is that it develops when a person is genetically prone to a weaker skin barrier, making it harder to retain moisture and easier for irritants to penetrate. The immune system can overreact, triggering inflammation that causes itching and redness. Genetics plays a role, and having a family history of eczema, asthma, or allergies increases the risk. Every day exposures then trigger the condition, leading to flare-ups.

• Atopic dermatitis: The most common form often begins in childhood. It usually appears in the folds of the elbows, behind the knees, or on the hands and face.
• Contact dermatitis: Caused by the skin touching an irritant or allergen, such as soaps, detergents, fragrances, metals, or plants.
• Dyshidrotic eczema: Produces small, itchy blisters on the hands and feet. Triggers can include stress, sweating, or certain substances.
• Nummular eczema: Creates round, coin-shaped patches of irritated skin, often linked to dryness or minor skin injury.
• Stasis dermatitis: Develops on the lower legs in people with circulation problems, leading to red, irritated, or discolored skin.
• Seborrheic dermatitis: Affects oil-rich areas such as the scalp, eyebrows, and the sides of the nose, often causing redness and flaking.
• Neurodermatitis: Appears as thickened, very itchy patches of skin that develop from repeated scratching or rubbing.

Eczema can affect anyone, from young children to adults. Many cases of atopic dermatitis appear before age six, and while some children outgrow it, others continue to have symptoms later in life. Adults can also develop eczema for the first time. Both men and women are affected, and symptoms can range from mild itching to more severe, widespread rashes. Because eczema can look different depending on skin tone, it may be harder to recognize in darker skin tones, which can delay treatment.

Eczema is more than just dry or itchy skin. It can affect how well you sleep, how comfortable you feel at work or school, and your confidence in social situations. Severe cases can lead to open sores or infections that require medical attention. While there is no single cure, the good news is that eczema can be managed successfully. With proper care, many people find relief and enjoy long stretches of healthy, comfortable skin.