Causes of Eczema

Our team of Skin Care Research Scientist possess a total of 40 years of collective eczema research led by a Johns Hopkins MD. These scientist specializing in eczema have confirmed that the primary cause or etiology of eczema is an immune system disorder, but there are many other contributing factors as well.

A variety of things can contribute to cause eczema. Most commonly, the main cause of eczema is a general allergy of sensitivity. This results in atopic eczema and is associated with asthma and hay fever. Eczema can also result from skin contact with a substance that irritates the skin. Substances such as laundry detergents, soaps, diesel or engine oils, strong chemicals, cleaners, etc. commonly cause skin inflammation for individuals with eczema. Upon contact, the immune system reacts and will cause the skin to become inflamed, irritated, and very sore. Varicose veins can also cause eczema. This form of eczema affects the lower legs of individuals with poor circulation. Some foods have also been known to cause eczema. This varies from person to person. However, if the individual has an idea what the problem food may be, doctors advise them to remove the food from their diet and watch for any improvement. Emotional factors and stress levels can also aggravate eczema. If an individual is upset, the body and face often become red, itchy, and hot. A high stress level can also cause eczema to flare up. Eczema follows a course with many ups and downs, particularly associated with seasons and stress (Hall 80). It can be possible to control or minimize your eczema by identifying and isolating those triggers that are the cause of your eczema or cause your eczema to worsen during an outbreak.

Symptoms of Eczema

The symptoms of eczema include itching, redness, dry/flaky skin, and even blisters (www.medinfo.co.uk). Usually the first symptom of eczema is intense itching; this itching can be very uncomfortable and individuals may tend to scratch the skin. The itchy feeling is an important symptom in eczema, because scratching and rubbing in response to itching worsen the skin inflammation characteristic of eczema. Scratching should be avoided because it can only make the eczema symptoms worse. The dry skin will become redder in color and may even crack due to scratching. Scratching may also lead to infection. It is a good idea, therefore, to keep fingernails cut short and to keep the hands occupied during the day in order to control the urge to scratch. The urge to scratch symptom becomes a repetitive cycle: the more you scratch, the more it itches.

Eczema runs its course through three distinct phases: acute, subacute, and chronic. The usual symptoms associated with the acute stage of eczema include pain, heat, tenderness, and possible itching (Mackie 77). The affected areas are characterized by extreme redness and drainage at the lesion site (Mackie 77). The subacute phase of eczema includes symptoms associated with skin redness and crusting; however, there is no extreme swelling. People in the subacute phase tend to complain about the symptom of itching more than the pain (Mackie 77). Individuals with lesions developed over three months are referred to as having chronic eczema. Itching is a predominant symptom in this phase as well and scratching causes the lesion to worsen (Mackie 77). Individuals with atopic eczema will find that their symptoms tend to worsen in the winter months due to decreased humidity in the home or office (Hall 79).

Forms of Eczema

The most common form of eczema is atopic eczema. Atopic eczema is marked by dryness, thickening, excoriation, and even scarring (Hall 79). This chronic condition is not contagious; the cause is hereditary and usually begins in infancy as a rash on the scalp, face or upper extremities of the baby. Atopic eczema is most commonly located in areas where the body bends or experiences contact thus creating friction that can cause eczema. Young housewives and househusbands may have their first recurrence of atopic eczema as an adult due to the tasks of dishwashing and raising a child (Hall 79). This type of eczema affects 15 million people and is usually accompanied by asthma and hay fever (Dermatology Times, October 1998). Trigger factors for atopic eczema may include soap, harsh chemicals, heat and humidity, stress, certain foods (the most common offenders include eggs, milk, wheat, soy protein, and peanuts). Many of these ingredients can turn up in unusual places, such as all-natural soaps, makeup, cream or lotions. Inhalant allergens such as house dust mites, pets, pollen and cut grass are also triggers that can cause eczema. Atopic dermatitis is normally associated with a family history of asthma or allergic rhinitis accompanied by chronic or recurrent dry, extremely itchy, inflamed lesions. Neurodermatitis is a chronic eruption of the skin that results from continuous scratching.

Severe atopic dermatitis can also cause eye complications, which may lead to permanent eye damage. When these complications occur, itching in and around the eyelids becomes severe. Signs and symptoms of eye complications also include eye watering and inflammation of the eyelid (blepharitis) and the lining of the eyelid (conjunctivitis). These ocular symptoms can be very similar to ocular rosacea. Because eczema and rosacea can occur together it's important to be able to distinguish whether your facial skin condition is atopic eczema or rosacea.

Seborrheic eczema (also called seborrheic dermatitis, infantile seborrheic eczema, child/infantile eczema) is most commonly associated with flaking and sometimes redness of the skin (www.medinfo.co.uk). Seborrheic dermatitis occurs when there is inflammation of the skin where sebaceous glands are concentrated (Rouse). Seborhheic or baby eczema is genetically determined, and therefore is not contagious. This type of eczema can affect the face, chest, eyebrows and eyelids, nose, ears, chin, forehead, and most commonly affects the scalp. The symptoms can be unpleasant, unattractive, and uncomfortable especially during the winter months when there is less sunlight.

Seborrheic dermatitis begins with dry or greasy scaling of the scalp areas which become red, oily and may possibly cause itching. The itching associated with seborrheic dermatitis is not as bad as the itching associated with psoriasis. Seborrheic dermatitis is often thought of as a severe case of dandruff accompanied at times by an odor, which is caused by the buildup of bacteria on the scalp. Seborrheic dermatitis cannot be cured. However, remissions due to treatment or natural reasons do occur for varying amounts of time (Hall 114).

Infantile seborrheic eczema, also called cradle cap or baby eczema, affects the face, scalp, and upper extremities and is often associated with food consumption (cheese, egg whites, wheat, or nuts are common causes of infantile seborrheic eczema). Other triggers that can cause baby eczema include soaps, laundry detergents, fabric softeners, wool, and polyester or blended fabrics. A natural treatment, feeding the baby breast milk can help to control or limit eczema in infants. The symptoms usually fade away, but can progress in older children to dermatitis of the neck and upper and lower extremities. Child/infantile eczema will fade away or may persist in localized areas of the hands and face. Oozing and crusting are common symptoms. The symptoms may also fade only to return in times of stress. Child/infantile eczema usually clears up by school age but can resurface in adulthood.

Perioral dermatitis affects mostly women. In addition to redness around the mouth, the symptoms of perioral dermatitis may also include small red bumps or even pus bumps and mild peeling. Treatments include using a non-tartar, non-fluoride toothpaste. Lip balms, lipstick, or toothpaste can also cause perioral dermatitis. Peri-oral dermatitis is seen by some as a variant of rosacea and by others as distinct and separate skin condition.

Contact dermatitis is an inflammatory response by the skin to an outside allergen or irritant. Substances that cause contact dermatitis include household items, clothing, cosmetics, and plants. Contact dermatitis can be further defined by the types of substance that cause the symptoms to appear. Irritant contact dermatitis is produced by a substance that has a direct toxic effect or exposure to an irritant and a skin reaction can occur immediately or gradually after repeat exposure. Examples of substances that cause irritant contact dermatitis include acids, certain toilet bowl cleaners or drain cleaners, oven cleaners, detergents, ammonia, lye, cement, turpentine, and paint thinners. Allergic contact dermatitis will trigger an immunologic response that causes inflammation called a skin allergy. Examples of substances that cause allergic contact dermatitis include poison ivy, poison sumac, poison oak, dyes, fragrances, leather, rubber compounds (gloves and shoes) and nickel (jewelry accessories). Itching and burning are common symptoms in both types of contact dermatitis. Typically the symptoms of contact dermatitis include redness, swelling and oozing. If left untreated, contact dermatitis can result in dry, thickened, cracked skin. The webs of the fingers, back of the hands and forearms are common sites of contact. Local contact with an allergen followed by exposure to ultraviolet radiation (sunlight) can cause photoallergic dermatitis.

The symptoms of dyshidrotic eczema include itching of the hands and feet which can cause a sudden onset of blisters. Symptoms including burning pain or itching may be experienced before blisters appear. The cause of dyshidrotic eczema may be a sensitivity to nickel or other metals such as chromium or cobalt, also fragrances, fungal infection (tinea pedis), stress, aspirin, oral contraceptives, smoking, and implanted metals. Dyshidrotic dermatitis is a form of hand eczema which is more common in women and starts on the sides of the fingers as itchy little bumps and then develops into a rash. Dyshidrotic eczema may affect only the feet. Some patients have involvement of both hands and feet. Following treatment, protect hands for at least 4 months after dermatitis has healed. It takes a long time for skin to recover, and unless you're careful, the dermatitis will reoccur. The symptoms of hand eczema include red, itchy, scaly, cracked skin with blisters up to one inch in diameter, usually on the palms of the hands. Dentists are prone to hand eczema. The cause of hand dermatitis is usually a combination of sensitive skin and irritation or an allergic reaction from materials touched. People with hand dermatitis often have dermatitis elsewhere. Prevention and avoidance can be a powerful treatment. The following suggestions will be helpful for anyone with symptoms of hand dermatitis: wear waterproof or cotton-lined gloves, avoid contact with soaps, detergents, scouring powders, and irritating chemicals. Wear waterproof gloves when peeling or squeezing lemons, oranges, or grapefruit, peeling potatoes, or handling tomatoes. Wear heavy-duty gloves while gardening, wash dishes in a dishwasher, do not wash clothes by hand, avoid contact with turpentine, paint, and paint thinner, floor polish, and shoe polish. Wash hands in warm water and a small amount of mild soap, rinse carefully and dry gently. Wearing rings can cause hand dermatitis to become worse.

Pustular psoriasis or pustular dermatitis may cause blister-like lesions of noninfectious pustules (yellow pus spots) and intense scaling usually found on the hands or feet. They tend to become red and scaly and may crack. Individuals with pustular psoriasis can be seriously ill and may require hospitalization during the course of their treatment. Hyperlinearity atopic dermatitis occurs in the palms and results in increased numbers and depth of the lines on the palms of the hands with little redness.

Foot eczema or dermatitis are scaly areas of irritated skin, common in children during wintertime when the air contains less moisture. Foot eczema can cause feet to dry out and crack. The most common cause of foot eczema is dyes used in the manufacture of shoes and sneakers which are made with dyes and/or rubber. These irritants cause rashes and dry or scaly skin. Leather shoes also contain dyes. Also known as dyshidrosia or dyshidrotic eczema, foot eczema has nothing to do with sweating feet. Sweating is an important symptom in that it washes off natural oils which leads to additional dryness. The symptoms of foot eczema are characterized by the sudden onset (1 to 3 days) of deep-seated, clear vesicles, which resemble the pearls in tapioca pudding. In the later stages, scaling, thickening, and painful fissuring may occur. Secondary bacterial infection is very often a complication with dyshidrotic eczema. Successful treatment may include wearing socks that are 60% cotton and changing shoes every day -- alternate 2 to 3 pairs of shoes. Follow recommended treatments for at least 4 months after skin has healed. It takes a long time for skin to recover, and unless you're careful the dermatitis will reoccur. Pompholyx or pedopompholyx eczema is vesicular foot eczema. In early stages it is seen as tiny blisters deep in the skin associated with itching and may cause a burning feeling. In later stages, it shows more peeling, cracking or crusting.

Xerotic eczema, winter itch, or asteatotic eczema occurs in winter and in the elderly on the legs, arms, and hands. It is characterized by dry, cracked, fissured skin and redness. Stasis dermatitis is a rash of the lower legs which is due to poor return of blood to the heart. Usually the inner leg is more involved than the outer lower leg. Sometimes the rash breaks down into a sore resulting in a stasis ulcer. It affects people with varicose veins.

Nummular eczema or nummular dermatitis is a ringworm-like rash of circular, itchy, scaling patches, widespread on the arms and legs but may also be found on the trunk and buttocks. Nummular eczema is most common in older people with very dry skin.

Discoid eczema is found in adults and appears suddenly as a few coin-shaped areas of red skin, normally on the trunk or lower legs. The areas become itchy and may weep fluid. Eczema diabetes is also known as leg ulcers. Venous stasis eczema is a persistent inflammation of the skin of the lower third of the legs associated with erythema and brown hyperpigmentation.