Eczema And Hydration

Introduction

Eczema is a condition that causes the skin to become dry, red, and itchy. While it usually develops in childhood, it can also affect adults. Allergies, such as hay fever, and asthma have also been shown to cause eczema.

If eczema causes dry skin, does it then follow that proper hydration is the best way to counteract this? This article will explore the relationship between hydration and the skin.

What is eczema?

The skin is made up of three layers:

• The outer layer, or epidermis - this itself is also made of multiple layers, which are as follows:
  • Corneal/horny layer
  • Spinous/prickle-cell layer
  • Basal layer
• The middle layer, or dermis
• The inner layer, or subcutaneous layer

Eczema causes the corneal layer to become damaged. This is usually due to inflammatory processes that occur within the skin.¹ The area of the body that eczema most commonly appears on are the flexural surfaces - the areas in which joints bend inwards - such as the elbows or knees. 

Symptoms

Some common symptoms of eczema are as follows:

• Dry skin
• Itchy skin 
• Bleeding 
• Inflammation of the skin, leading to redness 
• Scarring from scratching 
• Changes to the colour of the skin
  • Hypopigmentation - lightening of the skin following bouts of eczema
  • Hyperpigmentation - darkening of the skin following bouts of eczema 
• Disturbed sleep due to itching at night
• Difficulty concentrating on tasks due to itching 

Water is essential for proper skin function

It is likely you have heard the phrase ‘humans are 70% water’ at some point in your life, in a multitude of different contexts. However, what does this phrase actually mean on a physiological level? Water is a major component of cells and tissues within the body. As such, it makes up around 70% of our body composition. There are various roles that water plays within the body, including:

• Acting as a solvent for minerals
• Acting as a carrier in the cells
• Being the base environment for all of the other transport systems to function, such as blood and lymphatic systems
• Maintaining body volume
• Heat regulation, such as sweating
• Lubrication 
• Shock absorption
• Acting as a barrier²

Skin elasticity

The elasticity of the skin refers to the skin’s ability to return to normal after it has been stretched. You can test your own skin elasticity very easily. Simply pinch an area of your skin, usually the back of the hand, for 5 seconds and see how long it takes to return to normal. We tend to lose skin elasticity as we age, therefore the time it takes to get back to normal will increase as you get older. Additionally, certain skin conditions can also affect the elasticity of the skin, including eczema. 

Wound healing

People with eczema are more likely to suffer from skin breakages, due to the factors listed above. As such, it is important to understand what constitutes a good environment for the skin to heal itself effectively. 

There are four stages of primary wound healing:

• Haemostasis
  • The formation of a blood clot which is seen on the skin as a scab.
  • A release of chemicals in the blood that causes the blood vessels to constrict, limiting the amount of blood loss.
• Inflammation
  • This occurs as a result of injury to the cells, resulting in the release of chemicals that try and get rid of any potentially harmful substances, such as bacteria.
• Proliferation
  • A release of chemicals following the inflammatory process.
  • These chemicals cause healing to occur in the lower layers of the skin and promote the growth of new blood vessels.
  • Occurs roughly a week after the initial injury.
• Maturation/remodelling
  • Collagen is deposited within the wound to help strengthen the area. 

Once this process is completed, you have a healed area. Sometimes this process of healing will leave a scar. 

Water is essential for wound healing due to the level of hydration needed for each stage of the healing process. If you are dehydrated, there will be a lower blood volume in your system. As a result of this, the time taken for the chemicals to travel in the blood will increase, leading to a longer recovery time. It also means that it will take longer for the recovering cells to receive oxygen and nutrients which are important for the healing process. 

If internal hydration levels are important for wound healing, the external environment is equally so. When we are injured, plasters and wound dressings are helpful for a number of reasons, one of which is that they help prevent water inside the body from escaping through the affected area. However, it is important to keep wounds clean and dry before applying the dressing, so as to minimise the risk of infection. If the wound is too wet, it can slow down healing and may introduce bacteria to the area.³

Hard water is especially bad for eczema

Water is classified as ‘hard water’ if it contains high levels of calcium and magnesium. Links have been found between exposure to hard water and increased skin sensitivity to irritants, alongside damage to the skin barrier. As such, washing skin with hard water could potentially play a part in the development of eczema. It has also been proposed that calcium-containing water might lower the skin’s ability to heal. Given that people suffering from eczema often have more sensitive skin than others, it is likely they are more prone to experiencing the negative effects of hard water. 

Moisturise from both inside and outside

If water is so essential, how can we make sure we are maximising our hydration levels effectively? Drinking water is helpful, but the water consumed orally will be used for a lot of other functions around the body. As such, it’s important to make sure our skin is not being neglected. The best way to do this is by utilising external methods of hydration, such as moisturisers. This gives the skin a little boost in a more targeted manner.

Conclusion

Eczema is a condition that causes the skin to become dry, red and itchy. Water is not only essential for us to function, both internally and externally, but it is also very helpful in reducing the severity of some eczema symptoms. It’s also important to remember that the quality of water will have an impact on your skin. If you are concerned about your skin you should seek medical advice for a tailored consultation and targeted advice.