What Causes Eczema? | What No One Tells You

What causes eczema? If you are someone who suffers from chronic eczema then this post is for you! Even if you are newly dealing with it as an adult, you will still find this post very helpful. You will learn what the actual cause of eczema is, not just the cause of the flare ups. There is a difference. You will learn about it in this post.

Disclaimer: While I am a registered nurse, I am not a doctor. I cannot diagnose or treat any medical conditions. This article is for informational purposes only.

I, personally have struggled with eczema since childhood. Primary care doctors and dermatologists threw steroid cream after steroid cream at me to keep the eczema at bay. I was instructed to put mild steroid creams on my face and my face was bleached from it. I was never warned of the hazards of long term use of topical steroids. Sure the packaging says to not use it long term. It does not say why. The doctors also never told me why. I DO NOT WANT this to happen to you. So while this is wordy, PLEASE read this whole post. You need to understand this concept before you can get your skin to a healthy state!

In this post, I am first going to define eczema. Then I am going to show you why treating the symptoms of eczema (itching, rashes, flareups) will not be nearly as effective as treating the root cause of why you continue to get flare up after flareup. Therefore, I will also be sharing what I believe to be the root cause of eczema after MUCH independent research. I have been steroid cream free for 3 years now and have not needed to see a doctor for my eczema.

This post is all about what causes eczema.

What Is Eczema?

Eczema is an umbrella term used to identify a group of skin conditions. Often the skin becomes itchy, inflamed, and can have a rash-like appearance. There are seven types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, neurodermatitis, nummular eczema, seborrheic dermatitis, and stasis dermatitis. This information was retrieved from the National Eczema Association.

In this post, I will essentially be talking about atopic dermatitis and contact dermatitis as these are the two types I personally have. Once, I did have one isolated circular patch. It looked similar to ring worm but I found out it was coin-shaped eczema or nummular eczema. I will not be addressing this type of eczema, but know it exists in case you ever see a perfect isolated coin shape. If you have other forms of eczema please use one of the links to the National Eczema Association to learn more about the specific type of eczema you have.

What is Atopic Dermatitis?

Atopic dermatitis Is the most common form of eczema according to the National Eczema Association. It is a chronic condition. That said, some people seem to outgrow it. There is no cure for this condition. It can appear anywhere on the body. The folds such as the elbows and backs of knees are common places. I often see it on the face, eyelids and necks of children and adults alike. It is labeled as the most difficult of the eczemas to treat. In more recent years, it has become known that the skin barrier is damaged.

This post will share my opinion on the skin barrier in relation to atopic dermatitis. That said, beliefs in the medical field on this seem to differ. (More on this later). If you have atopic dermatitis, you may have other forms of eczema as well. For example, I also have contact dermatitis. I have observed that people in general and even doctors use the terms eczema and atopic dermatitis interchangeably.

What is Contact Dermatitis?

The information about this form of eczema was again sourced from the National Eczema Association. Contact dermatitis is pretty much just what it sounds like. It is a reaction that happens when the skin gets irritated from something it came in contact with.

The first type of contact dermatitis is irritant contact dermatitis. This type of reaction is not caused by the immune response but rather from irritants damaging the skins cells. Think detergents, soaps, nickel, wool etc. For me, wool is a trigger or anything itchy. Often, symptoms will occur shortly after the contact making it easy to pinpoint the irritant. (National Eczema Association).

The second type of contact dermatitis is allergic contact dermatitis. “Allergic contact dermatitis is a delayed allergic reaction that appears as a rash a day or two after skin is exposed to an allergen. A common example is poison ivy.” (National Eczema Association). This type of eczema has literally been the death of me!!! Figuring out the allergen can be a bear due to the delayed reaction. This is why I personally find it useful to test a product in a small place on my body and then watch it for days afterwards before using a product. I often have this type of eczema with new product use.

People at high risk of developing contact dermatitis are those who are exposed to many products such as hairdressers, estheticians, mechanics and healthcare workers. Heredity and diet is not a factor with contact dermatitis.

What Causes Eczema or Atopic Dermatitis?

So in 4 words: A damaged skin barrier. That my friends, is it. The skin barrier is the outer most layer of the skin’s epidermis layer. This layer is called the stratum corneum. You can picture it as a brick wall. This wall contains skin cells bound together by lipids(mortar). A nice new brick wall is a solid wall that doesn’t let anything in our out. But picture a brick wall where the mortar is crumbling away. This is the skin barrier in someone with atopic dermatitis.

How To Get Rid Of Eczema | 5 Steps to Repair The Skin Barrier– My post on repairing the skin barrier.

A healthy skin barrier keeps external things like allergens, bacteria, chemicals etc, out. It also keeps good things in, such as water. Hence, with an impaired skin barrier you’re prone to dry and dehydrated skin, which can lead to further skin barrier damage. Also, external things including bacteria and viruses can easily enter the system initiating an immune response leading to flareups and infections in people with atopic dermatitis. I am allergic to dust, so dust would be able to enter my system through the skin also causing an immune response and an eczema flare up for me.

Not everyone is in agreement with why the skin barrier is impaired. Some say that the immune system is over reacting therefore damaging the skin barrier. Others are saying people who suffer with atopic dermatitis have a mutation of the gene Fillagrin. (National Eczema Association). “Filaggrin is a protein that helps our bodies maintain a healthy, protective barrier on the very top layer of the skin.” (National Eczema Association). I agree with the latter. I truly believe from my own experience and trial and error that I was born with an impaired skin barrier. Hence, there is no cure. This would also imply that controlling my eczema is a lifelong process.

“Leaky Gut” and Eczema

There is also reason to believe that when the skin barrier is impaired your diet can effect your flare ups. Why? When your diet is bad your gut health is out of balance and it leads to “leaky gut”. The toxins and bacteria leak through the intestinal walls and into the system. An impaired skin barrier leaves openings for these toxins to then exit through the skin and sit on top of the skin. This causes inflammation and irritation leading to an eczema flare up in people with atopic dermatitis.

This is why people often believe certain foods cause eczema. Certain foods may cause flareups but they are not the cause of the eczema itself. The thing to note is that the damaged skin barrier is the cause of the eczema. If the skin barrier were in a healthy state it would keep those toxins inside the body, therefore preventing any flareups from “leaky gut”.

Contact Dermatitis and The Skin Barrier

So my theory here is pretty simple. The skin barrier is still damaged with this type of eczema, but the damage is from external irritants and allergens. Therefore, you have much more control over preventing this type of eczema. Many people get this type of eczema from mask use and excessive washing of the hands.

In order to repair the skin barrier you need to figure out the allergen or irritant and avoid it. That’s pretty simple. (In next week’s post I will address how to do this). This type of eczema is not a problem unless there is exposure to the allergens and/or irritants that damage the skin barrier. Essentially, you have more control over the breakdown of the skin barrier in this case.

Why Know One Tells Us

I HAVE NO IDEA!!!!! I battled eczema since childhood and no one ever explained to me what on earth was actually going on with my skin. To give the medical field the benefit of the doubt, this skin barrier thing seems to be a newer concept. That said, I still bump into people under provider care for eczema and they have no clue about this. So it is safe to say it was not discussed.

When I got diagnosed with contact dermatitis I was never referred to an allergist for testing. I was pulled out of work a few times because my hands were so raw and inflamed I couldn’t work. I was given oral steroids and topical steroids. When it settled I’d go back to work. NOT ONE doctor ever offered to allergy test me to see if that was some of the cause for the flare ups!

I finally took it upon myself to get allergy tested after battling a facial rash not even a dermatologist could control without me using chronic mild steroid cream on my face (more about this next week). I was found to be allergic to every dust mite I was tested for, gold and hospital grade antibacterial agents. This made a lot of sense as I was a nurse by this time. But, I always had reactions to so many products that I realized I would have to take matters into my own hands to find anything else out.

The Take Aways

The cause of eczema is a damaged skin barrier. Perhaps you were born with a damaged skin barrier aka atopic dermatitis. Or maybe external factors have damaged your skin barrier aka contact dermatitis. You may even be dealing with both situations, as I am.
Doctors often treat symptoms and not the cause of the problem. I often get proof from family members and friends who have high blood pressure and diabetes that this is true. So many times I find that diet and exercise are not discussed as a form of treatment for the conditions. If it is mentioned, the seriousness is not stressed and pills are thrown at people as a first choice. (Yes, I do know sometimes pills are necessary). Diet and exercise can prevent and even REVERSE many health conditions. What does this mean for eczema? Providers are often treating the symptoms of eczema (itching, rash, flareups) rather than the cause of those symptoms (an impaired skin barrier). Yes, steroid cream will clear up those symptoms, for a short period of time. At times they are necessary. But they do not recommend long term use (longer than two weeks) of topical steroids. So how could a product used for two weeks repair the skin barrier of someone with atopic dermatitis when this person was born with an impaired skin barrier? I rest my case. More about his next week.
The only thing that will prevent eczema flareups long term for atopic dermatitis is repairing the skin barrier. Because this is a chronic problem, you need to be constantly rebuilding the skin barrier. To maintain clear skin, maintenance is necessary. Read my post on repairing the skin barrier here… How To Get Rid Of Eczema | 5 Steps to Repair The Skin Barrier

As mentioned before for contact dermatitis, simply identifying the irritant and allergens and avoiding them should protect your skin barrier from break down. If this is unavoidable to do, you must also constantly be rebuilding the skin barrier in the areas of exposure.

Stay Tuned For How I Rebuilt My Skin Barrier

This post is already very lengthy. But it is vital to understand what causes eczema. Now you can learn what to do to repair and maintain your skin barrier. This will prevent eczema flareups and avoid the need for steroid creams. I went from using steroid creams daily to not using them in 3 years! I know that each person’s eczema has different flare up triggers, but repairing the skin barrier will help you to see what a difference it can make for you!

In next week’s post I will share my tips and regimen for repairing and maintaining my skin barrier. It is linked here: How To Get Rid Of Eczema | 5 Steps to Repair The Skin Barrier

Thanks for sticking with me! Yes, I am a skincare nerd if you haven’t gathered that thus far!