Eczema affects millions of people worldwide. It features itchy and inflamed skin, often accompanied by rashes, dryness, and flakiness. It can appear red on lighter skin tones. On darker skin, it may be harder to see but can be a darker tone, purple, or gray.
While the exact cause of eczema is unknown, many experts believe it may be related to genetic and environmental factors. In recent years, much debate has been around this question, “Is eczema an autoimmune disease?”. We look at what research says.
What is eczema?
Eczema is a chronic condition that causes inflammation, itching, and skin flaking. It can occur on any body part but is most common on the face, neck, hands, and feet. It affects about 30% of people in the United States.
The exact cause of eczema is unclear, but it may stem from a combination of genetic and environmental factors. There is also some evidence that autoimmunity may play a role in eczema.
People with eczema often have a weakened skin barrier, which makes it easier for irritants, allergens, and other environmental factors to penetrate the skin and trigger an immune response.
Autoimmune diseases, on the other hand, occur when the immune system can’t distinguish between a person’s healthy cells and foreign invaders, leading to inflammation and tissue damage.
The immune system naturally safeguards the body from foreign invaders such as bacteria, viruses, and other pathogens.
There are many types of autoimmune diseases, including:
- Psoriatic disease: This can cause skin symptoms known as psoriasis. The symptoms can resemble eczema, but it is a different condition. The body attacks healthy tissues and causes skin cells to reproduce too quickly. It can also cause psoriatic arthritis, which mainly affects the joints.
- Rheumatoid arthritis (RA): RA is when the immune system attacks the joints, leading to inflammation and joint damage.
- Lupus: Lupus occurs when the immune system attacks the body’s own organs and tissues — including the skin, joints, kidneys, and heart — and causes inflammation and damage. Systemic lupus erythematosus (SLE) is the most common type.
- Multiple sclerosis (MS): In MS, the immune system attacks the myelin sheath that protects the nerve fibers, leading to muscle weakness, numbness, coordination problems, and other symptoms.
Eczema and the immune system
The immune system is the body’s defense against foreign invaders, including bacteria, viruses, and other pathogens. When the immune system detects a threat, it sends out cells and chemicals to attack and destroy the invader.
People with eczema tend to have an overactive immune system, causing inflammation and other symptoms. The exact cause of this immune dysfunction is not fully understood, but it’s thought to be related to a combination of genetic and environmental factors.
Here are some ways in which eczema links with the immune system:
Immune response
Eczema involves an overactive immune response, which can cause inflammation and damage to the skin. The skin acts as a barrier that protects the body from the outside world, including allergens, irritants, and other environmental factors.
People with eczema have a weakened skin barrier, which makes it easier for irritants and allergens to penetrate the skin and trigger an immune response. This immune dysfunction is a key factor in the development and progression of eczema.
Another factor in eczema is the role of T-cells, a type of white blood cell that plays a key role in the immune response. In people with eczema, T-cells are overactive, leading to inflammation and other symptoms.
Hypersensitivity
People with eczema may be hypersensitive to certain substances, leading to an exaggerated immune response. This immune response can cause inflammation, redness, itching, and other symptoms on exposure to certain allergens.
Exposure to nickel, for example, in earrings and watch straps, can cause a reaction.
Treatments for eczema
Some common treatments for eczema include:
- Topical creams and ointments: You can apply these to the affected area to reduce inflammation and itching and improve the skin barrier. Some topical medications contain steroids, while others are nonsteroidal, like calcineurin inhibitors. Nonsteroidal preparations include ruxolitinib (Opzelura) and tacrolimus (Protopic).
- Immunosuppressants: These work by suppressing the immune system, which may reduce inflammation and other symptoms of eczema. Immunosuppressants can treat severe cases of eczema that don’t respond to other treatments. Examples include cyclosporine (Sandimmune) and methotrexate (Jylamvo).
- Light therapy: Also known as phototherapy, is a treatment that involves exposing the skin to ultraviolet (UV) light. UV light can reduce inflammation and itching and improve the skin barrier. Light therapy can treat moderate to severe cases of eczema.
- Moisturizers: Regular moisturizer use can help improve the skin barrier, reduce itching, and prevent flare-ups. It’s important to choose a moisturizer that’s free from fragrances and other irritants.
- Medication: A doctor may recommend weekly injections with dupilumab (dupixent) for people with moderate to severe eczema. It is the first medication of its kind to treat eczema and is FDA-approved.
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