What causes eczema, and how do I treat it?

You’re stressing at work, battling allergies, and here comes the kicker — eczema. Is eczema just a regular rash? If so, why does it tend to appear on and off?

Eczema is a condition that causes dry, itchy skin. The itching can be so bad that you scratch compulsively, even while you’re sleeping. With all that scratching, skin can become thick, red, inflamed, and covered in hives. 

Eczema is related to your immune system. People with allergies, hay fever, or asthma are more at risk of developing eczema. This is because of the type 2 immune system response. The type 2 immune system response is generally triggered by allergies. It shortens the lipid molecules in your skin, reducing their ability to retain moisture. 

What causes eczema?

Your skin plays a big role in your overall health. Not only is your skin the largest organ in your body, it’s also a protective barrier between your internal organs and the external world.

Eczema is linked to a genetic mutation that makes it hard for your skin to retain proper moisture. When your skin’s moisture levels go down, that weakens your skin’s protection. 

It’s a combination of factors that causes eczema. There’s your genetics, your innate immune system, and external factors like harsh soaps or emotional stress. Then, there’s the fact that eczema itches like crazy. Some people get into a loop where they scratch their eczema so hard that they damage their skin’s moisture barrier even more, leading to new eczema flare-ups. 

Who gets eczema?

If you get eczema, there’s a strong likelihood that your parents passed it down to you. Mutation of the filaggrin gene is linked to 75% of eczema cases. 

People who have eczema also tend to have allergies. Half of patients with moderate to severe eczema also suffer from asthma, hay fever, and food allergies.  

Eczema tends to show up when patients are children. Even infants can get eczema. Babies and kids tend to get eczema because their immune system hasn’t finished developing. 

Eczema symptoms

Eczema has such telltale signs that doctors often diagnose the condition just by looking at it. Here are some signs that your skin rash might be eczema:

• Dry skin.
• Itching.
• Scratching your skin at nighttime. 
• Red patches of skin, which can evolve to brownish-gray. 
• Small raised bumps, also called hives. If scratched aggressively, hives can burst and form a crust. 
• Thickened skin with pronounced cracks. 
• Raw, sensitive, and swollen skin from prolonged scratching. 
• Darkened skin on eyelids or around the eyes. 
• Skin changes around the mouth, eyes, or ears.

Eczema examples:

11 tips for relieving eczema symptoms

Since eczema tends to flare up periodically, it’s good to know how to find short-term symptom relief. The following tips can help soothe your skin and relieve some itching. They’re not a substitute for seeing a dermatologist or allergist. A doctor can prescribe medication that interacts with your immune system, bringing more profound and long-term symptom relief. 

1. Identify what triggers your eczema. Common triggers include dry heat, low humidity, harsh soaps, wool fabrics, and allergens. 

2. Moisturize twice daily with a gentle, unscented moisturizer. 

3. Use gentle soaps for hand washing and bathing. Look for unscented soaps as fragrance can cause irritation. 

4. Limit your baths and showers to under 15 minutes. Bathing too long can overdry your skin. 

5. Dry skin gently after bathing. Apply moisturizer while your skin is still wet.

6. Take a bleach bath. This sounds extreme, but it’s actually recommended by dermatology associations to reduce skin infections and calm flare-ups. Add ½ a cup of bleach to a 151 litre bathtub. Soak for no more than ten minutes, and don’t dip your head underwater. Bleach baths should be taken no more than twice a week. 

7. Take an allergy medication to calm your allergic immune response. 

8. Wear smooth fabrics like silk or cotton. Avoid coarse fabrics like wool that can irritate and itch. 

9. Practice relaxation and mindfulness techniques. This can help keep flare-ups at bay, and help you deal with the itching and mental distress of a current flare-up. 

10. Take a baking soda or oatmeal bath. For baking soda baths, add ¼ cup of oatmeal to a full bathtub. For oatmeal baths, add a ½ cup of rolled or ground oatmeal to a full bath. Oatmeal and baking soda baths are very soothing for skin redness and can help calm itchiness. 

11. Take vitamin D supplements. Some research shows a link between eczema and vitamin D deficiency.

Medical treatment for eczema

Eczema is frustrating when it comes back again and again. A doctor can provide stronger, longer-term solutions than using gentle soaps or taking oatmeal baths.

The first question is, should you see an allergist, dermatologist, or general practitioner to treat persistent eczema? The answer depends on how complicated your condition is. If your eczema is linked to an auto-immune condition, is severe, or is worsening over time, an allergist is the better choice. You’ll need extensive testing to pinpoint the underlying causes. If your eczema is moderate and doesn’t interfere too much with life, a dermatologist or GP will offer quicker solutions.  

Here’s how doctors offer clinical eczema treatment:

• Medicated creams such as corticosteroids and calcineurin inhibitors.
• Oral or topical antibiotics to fight infection.
• Oral anti-inflammatory medication. 
• Injectable biologic (monoclonal antibody) called dupilumab (Dupixent). This is used to treat people with severe cases of eczema who don’t see improvement with other treatment options. 
• UV light therapy.

Eczema is an uncomfortable condition with all the skin tenderness and itching it causes. There’s also a big psychological component. Since our skin is so visible to everyone around us, skin conditions can make us want to cover up and avoid social situations. It’s frustrating to not live life on your own terms. Luckily, eczema is treatable with the right help. 

An allergist or dermatologist provides treatments that really make a difference. Since eczema can be a lifelong condition, it’s better to get help sooner so you can enjoy more years of short sleeves, long baths, and peaceful sleep.