Atopic dermatitis or eczema is closely associated with a malfunction of the body’s immune system.  Doctors have recently discovered that among individuals that suffer from atopic dermatitis/eczema there is commonly found an increased amount of a certain cytokine (protein) that is essential to the normal function of the immune system and an increased amount of cytokines that induce allergic reactions.  Essentially, the immune system is fooled into attacking the skin and causing inflammation even when an infection is not present.   

At one point physicians believed that eczema was an emotional disorder.  Now doctors are more informed and realize that although the exact cause, other than genetic heredity, is unknown, eczema or atopic dermatitis is a medical disorder.  Changes in a person’s life that cause stress such as changes in employment, divorce, loss of a loved one, moving, sudden unrelated illness, etc., can definitely exacerbate the condition but are not the cause of the disorder.

How is eczema diagnosed?                                                                   

Diagnosis is mainly visual and may take several visits to your physician to determine if atopic dermatitis/eczema is actually the problem.  Typically the patient will exhibit extremely dry, itchy skin with inflamed patches usually behind the knees, on the inner fold of the elbow, or on the face.  The more the patient scratches the area in response to itching, the worse the appearance of the affected area will be - especially if affected by secondary infections.  Your primary care physician may refer you to a dermatologist (skin specialist) or an allergist for further observation and testing.  Most eczema patients are affected from infancy, but it may seem to improve by 18 months. 

Typical Progression of Atopic Dermatitis/Eczema                            

Some patients may develop eczema later in life between their 30s and 60s but most cases start in early childhood.

 What factors may make my atopic dermatitis/eczema worse?          

Since atopic dermatitis is believed to be an immune disorder closely linked to other allergies, patients should themselves take close note of what affects them adversely and avoid those things.  There are two groups of substances that patients need to take note of when determining what causes their skin condition to flare: irritants and allergens.

Irritants are substances that come in direct contact with the skin for a long enough period of time to cause inflammation.  Items such as wool, synthetic fabrics, or poorly fitting clothing can cause rubbing and thus lead to inflammation.  Also included in this list are items such as detergents, soaps that may cause drying, lotions with high amounts of water or alcohol, cosmetics, perfumes, solvents, dust, sand or cigarette smoke.  Since there is such a wide variety of irritants and each person reacts differently to each one, each person is best suited to determine which items cause the disease to flare.

Allergens are substances from organic sources such as food, plants, animals or the air which cause the immune system to overreact to their presence.  Inflammation can occur even if exposure is for a limited time and in small amounts.  The air can carry such allergens as animal dander, pollens, dust mites, mold.  It is undetermined whether inhalation of these items incites the inflammation or if only direct contact and penetration to the skin causes the problems. 

Even food allergies can trigger or worsen a flare of atopic dermatitis. The most common allergy-causing foods are milk, soy, wheat, peanuts, fish and eggs.  A food allergy can manifest itself in a number of ways such as skin inflammation, nausea and vomiting, abdominal pain, diarrhea, difficulty breathing, congestion or sneezing.  It is best to consult with a physician before going on a strict diet, especially for young children since there are also nutritional factors that affect their growth and development that need to be considered.

Unfortunately, there is no eczema cure as this is an immune related chronic disease.  There are many treatments available for atopic dermatitis/eczema that can help keep the disease in remission, but scientists are still trying to find what genetic path is being passed on that causes the disease.

What are the available eczema treatments?                                       

There are many sources of information available on the internet and from your physician about eczema treatment and we encourage you to do your research.  Here we are providing just a sampling of the eczema treatments that offer you less risk as a patient.  Please consult your dermatologist and/or allergist to find a treatment regimen that is right for you.