Eczema is linked to a hypersensitive autoimmune response to certain allergens and triggers in the skin.
- Eczema is not contagious
- Eczema is typically evidenced in the family, a genetically predisposed condition, although environmental triggers are thought to be required as well
- Allergens include exposure to certain chemicals and substances, plants, and certain types of food
- Dry and hot (arid) climates tend to aggravate the condition
- Infections and illness can trigger or exacerbate the condition
- Wearing or coming into contact with abrasive fabric or material can cause irritation
- Psychological stress can worsen the condition
Research into the human genome, as with psoriasis and vitiligo, has revealed certain regions which may contribute to a predisposition to eczema, although none have been identified as definitively indicating eczema. A family history of atopy, including asthma, rhinoconjunctivitus, and eczema is noted as increasing a person's likelihood for suffering from similar illnesses, that is, these conditions run in families.
Interestingly, the skin barrier function in eczema sufferers seems to be compromised, especially during active eczematous lesions. Measurements of transepidermal water loss (TEWL) in non-eczema and eczema patients show a definite decrease in skin hydration, "dry skin". "Thin skin" has often been associated with eczema, although through repeated irritation a thickening of the skin may occur (lichenification). Decreased skin hydration levels are associated with decreases in certain skin lipids, especially ceramides. Studies have shown deficiencies in these lipids (ceramides) were related to compromised skin barrier function. Compromised skin barrier function has been correlated to an increased likelihood of skin irritation when exposed to various irritants. Compromised skin barrier function can increase the likelihood of bacterial, fungal, and viral infections.
Once the immune response to an allergen in an eczema sufferer has begun, it forms a cycle that begins to perpetuate itself. Additionally, as skin barrier function is compromised, the cycle is more likely to be further spurred by additional external irritation. Treatments often seek to interrupt or dampen the immune cycle in the skin, hydrate the skin and form a barrier to external irritants, and keep the treatment site clean and free from external stimulus.
Additional eczema risk factors to consider:
- Exposing skin to harsh conditions
- Other sources of psychological stress
- Personal or family history of allergies to plants, chemicals, or food
Stress can make eczema worse. Irritants that can make eczema worse include:
- Wool or synthetic fibers
- Certain soaps and detergents as well as perfumes and some cosmetics
- Dust or sand
- Cigarette smoke
Coping with the physical and emotional aspects of eczema can significantly impact the Quality of Life (QoL) of affected individuals and their families. Effective treatment management, avoiding triggering factors, and practicing routine skin care are critical to limiting the severity of symptoms and reducing the frequency of flare-ups.