Eczema Overview

Introduction

Atopic dermatitis, the most common form of eczema, is a chronic condition that tends to flare up periodically. It can be severe and long-lasting. 

What is eczema?

Atopic dermatitis, commonly known as eczema, is an inflammatory skin condition that causes dry, cracked, and itchy skin. Though it is more common in children, it can develop in adulthood. This chronic (long-term) condition can improve over time and sometimes clear completely in children as they grow older.1 Eczema has become more frequent globally and affects up to 10% of the adult population.2

Symptoms

Eczema most often affects the scalp, face, hands, and the back of the knees and elbows, although it can affect any part of the body. The main symptoms include inflamed, dry, sore, and cracked skin, which can vary in size from small patches to widespread inflammation. Eczema can appear as grey or purple on dark skin, and darker brown or red on lighter skin. Other symptoms of eczema include leathery and rough patches of skin, hives (raised bumps), and an increased number of skin creases/folds on the affected skin.4 People with eczema generally have cycles where symptoms are sometimes more severe and other times less noticeable.1

Causes

The cause of eczema is believed to be a combination of genetic and environmental factors.3 People with eczema produce inflammation as a response to allergens and topical irritants, which is due to an overactive immune system. There are many causes of eczema, ranging from allergens to stress or even living in damp, cold, hot, or swampy places. Being genetically predisposed to this skin condition means that having dry skin or food allergies can cause a flare-up.  

Some research indicates eczema is a result of a mutation of the gene that produces filaggrin, a protein responsible for the maintenance of a protective and healthy skin barrier. Without it, allergens and bacteria can enter the body, leading to dry, itchy, and inflamed skin.3 

Risk factors

One factor which can increase the risk of eczema is dry skin since the skin can easily become tight and brittle, which may cause the skin to flare up. Therefore, moisturising the skin is important in managing genetically predisposed skin. Both natural products and everyday household items are risk factors for skin inflammation since these products can contain irritants. For example, juice from fresh fruits, laundry detergent, body wash, perfumes, and oils can cause irritation and eczema.  

Many health professionals argue emotional stress can trigger eczema.3 This is because stress releases the hormone cortisol, and an elevated level of cortisol causes increased oil production in the skin, which can trigger an eczema outbreak.5

You can reduce your risk of eczema by making a few changes to your lifestyle

The following lifestyle factors have the greatest impact on your risk of chronic bronchitis. We will also look at what you can do to reduce your risk from today.

Nutrition

It is important for those that suffer from eczema to have a well-balanced diet, specifically incorporating foods with anti-inflammatory properties, such as ginger and turmeric. Though no food or diet will cure eczema, limiting dairy, sugar, and red meat and favouring fish and vegetables has many benefits and reduces the risk of a flare-up. This is because improved nutrition reduces inflammation in the body and leads to pain relief.12

Physical activity

Since there are links between stress and eczema, exercise can be employed to promote a better mood and relieve stress. Though this will benefit the skin,13 exercising causes a loss of fluids which dries out the skin, while the sodium in sweat can irritate and sting, causing flare-ups. There are many ways to lessen sweat during physical activity, which can range from selecting exercises such as strength training or walking where overheating is less likely or wearing breathable clothes. 

Obesity

Obesity is linked with increased eczema occurrence.3 This is due to the body retaining moisture and causing bacterial growth in the skin folds, which triggers skin rashes and itchiness and therefore eczema.9 Research indicates that loss of excess weight will improve eczema, alongside the additional benefits of losing weight, such as stress relief from regular physical activity.10 

Alcohol

Alcohol consumption not only dries out the skin but dilates the blood vessels. This can lead to eczema becoming itchier, heated, and more uncomfortable. Studies show alcohol causes a strong immune system reaction in the body, along with its dehydrating effect, which makes skin conditions like eczema worse.7 Since those with eczema are likely to have a weaker skin barrier function and drier skin, reducing alcohol intake and drinking water to keep skin hydrated is advised.8 

Sleep

Sleep deprivation affects the skin’s ability to produce collagen and hydrate, which leads to dry and dull skin. This, combined with the stress levels caused by sleep deprivation, may trigger inflammatory reactions in the skin, flaring up existing skin conditions such as eczema. Forming healthy sleeping patterns can therefore help manage and reduce eczema.6 

Mental Health

Depression and anxiety are common triggers of eczema. Eczema itself then generates more stress and anxiety, which causes an unhealthy cycle. One theory as to why those with inflammatory skin conditions are more prone to mental health problems suggests that it may be due to the mechanisms of communication between their brains and bodies during an inflammatory response. Recent research has revealed over 30% of people with eczema were also diagnosed with anxiety and/or depression,11 and therefore incorporating self-care and relaxation is advised. There are many options such as meditation, yoga, or breathing exercises. 

Wellness

Keeping your emotional health balanced is necessary for your physical health. Self-care is important for overall good health.

This is because an inflammatory skin condition could be related to other types of inflammation in the body. Taking care of one’s emotional well-being will help improve some of the common symptoms of inflammation. It is advised to speak to a mental health professional or primary care physician, as being proactive about wellness will prevent the severity and frequency of eczema. 

Conclusion

Eczema is a chronic skin condition that can be caused by both environmental and genetic influences. Risk factors and triggers can be controlled by lifestyle changes such as following a healthy sleeping schedule and controlling your diet. Research has shown overall wellness can minimise flare-ups. 

Diagnostic testing

At Klarity we use the latest technology when it comes to diagnostic testing. Our home blood tests give you health insights and personalised recommendations. Find out which test you should take. 

References

  1. Atopic eczema [Internet]. nhs.uk. 2017 [cited 2022 Aug 29]. Available from: https://www.nhs.uk/conditions/atopic-eczema/
  2. Silverwood RJ, Mansfield KE, Mulick A, Wong AYS, Schmidt SAJ, Roberts A, et al. Atopic eczema in adulthood and mortality: UK population–based cohort study, 1998-2016. Journal of Allergy and Clinical Immunology [Internet]. 2021 May 1 [cited 2022 Aug 29];147(5):1753–63. Available from: https://www.sciencedirect.com/science/article/pii/S0091674920317127
  3. Eczema causes and triggers [Internet]. National Eczema Association. [cited 2022 Aug 30]. Available from: https://nationaleczema.org/eczema/causes-and-triggers-of-eczema/
  4. Eczema (Atopic dermatitis): symptoms, treatment, causes, more [Internet]. EverydayHealth.com. [cited 2022 Sep 2]. Available from: https://www.everydayhealth.com/eczema/guide/
  5. Eczema and stress: what’s the link? | pfizer [Internet]. [cited 2022 Sep 2]. Available from: https://www.pfizer.com/news/articles/eczema_and_stress_what_s_the_link
  6. How does lack of sleep affect skin? [Internet]. Sönd. [cited 2022 Sep 2]. Available from: https://www.sondskin.co.uk/blogs/discover/eczema-and-sleep
  7. Does alcohol trigger eczema flare-ups? [Internet]. Balmonds. [cited 2022 Sep 2]. Available from: https://balmonds.co.uk/blogs/blog/does-alcohol-trigger-eczema-flare-ups
  8. Dermatologist-approved tips for exercising when you have eczema [Internet]. National Eczema Association. 2014 [cited 2022 Sep 2]. Available from: https://nationaleczema.org/blog/eczema-exercise/
  9. Skinsight - skin problems related to obesity [Internet]. skinsight. [cited 2022 Sep 2]. Available from: https://www.skinsight.com/disease-groups/skin-problems-related-to-obesity
  10. Jung MJ, Kim HR, Kang SY, Kim HO, Chung BY, Park CW. Effect of weight reduction on treatment outcomes for patients with atopic dermatitis. Ann Dermatol [Internet]. 2020 Aug [cited 2022 Sep 2];32(4):319–26. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7992650/
  11. Eczema and emotional wellness [Internet]. National Eczema Association. [cited 2022 Sep 2]. Available from: https://nationaleczema.org/eczema-emotional-wellness/ 
  12. Have eczema? How your diet may play a role [Internet]. Cleveland Clinic. 2021 [cited 2022 Sep 2]. Available from: https://health.clevelandclinic.org/eczema-diet/
  13. Dermatologist-approved tips for exercising when you have eczema [Internet]. National Eczema Association. 2014 [cited 2022 Sep 2]. Available from: https://nationaleczema.org/blog/eczema-exercise/
  14. Eczema and emotional wellbeing [Internet]. [cited 2022 Sep 2]. Available from: https://www.pihhealth.org/wellness/articles/eczema-and-emotional-wellbeing/

Iqra Khalif

Pharmaceutical Science, University of Hertfordshire

Iqra Khalif is a pharmaceutical scientist with deep roots in research and development. She has a leadership qualification in global health and is interested in strategising for innovation in the life sciences.
She currently works in data analytics and management for a health-tech startup.

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.