Eczema: It's a Stinker

Eczema is a stinker. If you or someone you know has struggled with this red, itchy business, go ahead and raise your hand to testify.

The tricky thing about eczema is that its root causes and "flare-up" triggers are not cut-and-dry. One thing I know for sure after digging into some eczema research is that it has got to be one of the most monetized skin conditions out there. If you find yourself looking for a little eczema info on the internet, you're only a click or two away from a cream or cook book for sale (you heard me) making some dramatic claims about its ability to heal you.

In this post, I'm attempting to weed through the sales pitches to find some good, solid research to offer in your quest for eczema relief.

Here's what we know:

Types of Eczema

According to the National Eczema Association there are SEVEN types of eczema. If you would like the nitty gritty on each type, click that hyperlink. Grab a snack- it's a lot of info.

Here are the 7 types with my highlights:

* Wait * Before you read my descriptions of each type of eczema, you have to PROMISE me that you will not use my list to diagnose yourself (child, spouse, co-worker, momma, boyfriend's step-aunt, et. al). "Skin stuff" is really complex. It is often the body's way of communicating that there is an underlying issue needing to be addressed. If any of these resonate with you, please go see your doctor and get a diagnosis if you don't have one already.

1. Atopic dermatitis- Most common form of eczema; appears as dry, itchy skin patches; triggered when skin barrier is weakened

2. Contact dermatitis- Touching something that elicits a skin reaction; causes redness, swelling, blisters- think poison ivy

3. Dyshidrotic eczema- Appears as small, itchy blisters on hands and feet; triggered by stress, exposure to some metals, seasonal allergies, or the body's improper immune response to sweat on the hands and feet

4. Neurodermatitis- Itchy skin that itches more when it is scratched (like mosquito bites do- IYKYK) which leads to the never ending cycle of itching and scratching, causing thick patches of skin; triggered by stress

5. Nummular eczema- Circular spots of angry, itchy skin; appears similar to ringworm and often misdiagnosed as such

6. Seborrheic dermatitis- Red, oily, inflamed skin covered with white scales; dandruff on adults, "cradle cap" on infants; triggered by stress, cold weather, hygiene, or hormones

7. Stasis dermatitis- Swelling, redness, and itching; often due to chronic venous insufficiency/ poor circulation in the lower legs; typical in older adults with existing vein concerns

Since the most common form of eczema is atopic dermatitis, I'll speak more to causes and treatment of dry, itchy skin triggered by a weakened skin barrier

Eczema: The Itch Is Real. photo from clevelandclinic.org

How Does it Work?

Atopic dermatitis (AD) is best friends with asthma, allergic rhinitis, and food allergies. The little posse is actually called the Atopic March. Having one means you are very likely marching your way to one of the other three.

The principle is that if someone is affected with eczema and their skin barrier is disrupted, it leads to inflammation on other skin-like body surfaces such as the lower respiratory tract, upper respiratory tract, and GI tract, causing asthma, hay fever, and food allergies. In the same way, eating a food you have a sensitivity to can cause an eczema flare up.

Why does it do that?

Contrary to initial theories, eczema is not an autoimmune disease. An overactive or dysregulated immune system can certainly contribute to the presence of atopic dermatitis and its marching buddies, but it is not a condition in which the body attacks its own tissues.

Filaggrin- or lack thereof- could be another culprit. In addition to being fun to say, filaggrin is a protein in charge of building up the top, protective layer of skin. If the FLG gene is mutated and there is a shortage of filaggrin, the skin loses moisture and gains bacteria and viruses, leaving it more susceptible to infection. It has been noted that 20-30 percent of those who suffer with atopic dermatitis have a FLG gene mutation. If you'd like to do a deep dive into some medical research on filaggrin and the FLG gene, this PubMed article should scratch that itch for you. (See what I did there?)

To summarize, the culprit for eczema flare ups are:

• Genetics

• Stress

• Environmental irritants

• Any combination of the above

What Can Help?

If we trace the problem backwards, we've got inflammation caused by allergen sensitization triggered by a disruption in the skin. Right? If we address each link in the eczema chain, the action points become more manageable. Let's do it:

• Decrease controllable causes of inflammation- There is no magic eczema diet, but it's helpful to avoid foods that you know cause inflammation.

  • Leave out smoking, processed foods, fast food, packaged snacks, and sugary consumables.

  • Add in adequate sleep (do your best) and plenty of fruits and veggies.

• Moisturize- This is key to building up a healthy barrier on your skin. Find a quality, viscous moisturizer with no fragrance or dyes and stick with it! Always apply moisturizer within two minutes after you get out of the shower.

• Gently cleanse- Avoid using harsh, abrasive cleansers on your skin. Look for gentle, fragrance-free cleansers.

• Identify and avoid triggers- Irritants or allergens that trigger eczema flare-ups vary from person to person. Here are some common culprits to challenge:

  • Stress

  • Abrasive skincare

  • Fragrance on the skin

  • Sweat

  • Irritating/scratchy clothing

  • Metals like nickel and copper

  • Pollen/mold/dust mites

Remember, the goal isn't to follow all the "healthy skin" rules. You are the only one with your skin, your genetics, and your environmental stressors. (Ref. Psalm 139) After you check in with your doctor, try making a few modifications and see what offers some relief. You got this! I'm cheering you on.