Eczema affects more than 31 million Americans between childhood and adulthood, ranging from mild to severe. Though there’s no known cause of eczema, several aspects of our lives–internal and external–can exacerbate symptoms, some of which we have no control over.

What is eczema?

Eczema is a non-contagious skin condition that can cause us to experience symptoms, including blisters, dry skin, itchiness, scaly patches, skin infections, and rashes. However, itchy skin tends to be the most common symptom. There are seven different types of eczema one can experience, including atopic dermatitis (which is the most common form), contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. 

No one cause of eczema or singular factor contributes to the condition, though both genetic and environmental factors likely cause it. For example, atopic dermatitis is caused by an overactive immune system which makes our skin barrier dry and itchy. Other factors that can affect or cause eczema include an irritant or allergen “switching on” our immune system, which can cause a flare-up. In addition, when our skin rubs against itself, this friction can also increase irritation. There is even a genetic component to the condition involving the protein filaggrin, which helps our body maintain moisture in the skin. If we are deficient in protein, it can make our skin drier and itchier.

What are common irritants?

Dry skin, weather, diets, exercise, and stress are common irritants and triggers for eczema flare-ups. While symptoms of stress and anxiety are not the root cause of eczema, they can cause various symptoms of the condition. When we’re stressed, our body releases cortisol. However, if too much cortisol is released, it can deregulate our immune system, thus causing an inflammatory response in our skin.

Food can also trigger our eczema, including citrus fruit, red meat, shellfish, wheat or gluten, cow’s milk, and other dairy products. Several household items may cause an eczema flare-up, including exposure to dry air, some types of soaps, laundry detergents with chemical additives, certain fabrics (for example, wool), surface cleaners, fragrances, dust mites, as well jewelry and utensils made with certain types of metals (for example, nickel).

Do our hormones affect our eczema?

Everything in our bodies is intrinsically linked. Body systems work together to perform functions but can also influence–or disrupt–other actions. For example, one aspect of our health that can affect and worsen our eczema includes female sex hormones, including estrogen and progesterone, and their effect on the immune system. 

Women’s hormone fluctuation can trigger eczema and the condition’s subsequent flare-ups. This can occur during menstruation, as well as during and after pregnancy, as well as during menopause. Our skin has estrogen receptors and cyclical hormonal fluctuations, which can influence our skin’s ability to produce lipids and affect the skin’s thickness, hydration, and barrier function. Oestrogen plays a role in several skin functions, including regulating collagen, sebum production, fluid retention, improving elasticity, and aiding wound healing.

During the premenstrual period, estrogen drops and leaves effects on our skin, including water loss, an imbalance of our skin’s microbiome, and reduced wound healing. An estimated 47% of women with atopic dermatitis experience worsened symptoms during the premenstrual week, a condition referred to as premenstrual dermatitis or estrogen dermatitis.

How can we treat it?

While there’s no specific cure for eczema, there are several methods of treating the condition to alleviate symptoms. Treatment, like many other health modalities in life, will depend on each person’s preference and be influenced by the severity of their condition and the type of eczema they have. 

A dermatologist will be able to assist in finding the best treatment plan, which tends to consist of creating a skincare routine, over-the-counter products, prescribed topical medications, phototherapy (light therapy), and immunosuppressants; there are also several alternatives and natural treatments that can be used to treat symptoms. Some of these methods include cryotherapy, medical-grade honey, meditation, acupuncture, and anti-inflammatory diets that limit the consumption of dairy, flour, red meat, sugar, and whole grains and promote a more plant-based eating style.