Causes of Eczema: Why Does It Occur and How Can You Prevent It?

Why Does Eczema Occur? The Main Causes Explained¹ ² ³

The causes of atopic eczema, also frequently referred to as atopic dermatitis, are multifaceted; genetics play a significant role by interacting with environmental factors.

Impact of Genetic Mutations on the Skin in Eczema¹ ² ⁴ ⁵

In individuals without eczema, the stratum corneum, the outermost protective layer of the skin, is composed of corneocytes, which are well-organized, flat, and sturdy cells. Natural moisturizing factors (NMF) in these corneocytes retain water, maintaining skin hydration. 
However, filaggrin gene mutations associated with atopic eczema lead to: 

• Disorganization of corneocytes, weakening the structure of the skin barrier. 
• Increased permeability of the skin barrier, resulting in more significant water loss and reduced protection against external aggressions, notably allergens, irritants, and infections (bacteria, viruses, fungi). 
• A reduction in natural moisturizing factors (NMF) exacerbates skin dryness. 
• This alteration in the structure of the skin, disorganized and dehydrated, allows external environmental agents (allergens, irritants, bacteria) to penetrate the epidermis and abnormally stimulate the immune system, triggering an eczema flare-up.

What Role Does Stress Play in Eczema?³ ⁶

Stress is an aggravating factor for atopic dermatitis as it disrupts the immune system and the skin barrier.

Which Environmental Factors Can Trigger Eczema?¹ ² ³

Environmental trigger factors for atopic dermatitis vary from person to person; a particular allergen may trigger eczema symptoms in one person but not another.

How to Prevent Atopic Eczema Flare-Ups?

Reduce Exposure to Trigger Factors⁶

Identifying the trigger factors of atopic dermatitis is fundamental.
Common environmental allergens include dust mites, pollens, pet dander, and some foods. 
Common skin irritants include strong soaps, detergents, harsh cleaning products, and synthetic fabrics or wool. They can cause mechanical or chemical irritation to already sensitive skin. It is recommended to opt for gentle, hypoallergenic products and prefer clothes made from natural fabrics, like cotton, which are less likely to irritate the skin. 
Moreover, climatic variations, such as extreme cold or heat, can also exacerbate eczema symptoms by affecting skin hydration. 
Finally, fine particles in polluted air can penetrate the weakened skin barrier and trigger or exacerbate inflammatory reactions. Similarly, tobacco smoke, whether through direct or passive exposure, can irritate the skin and contribute to the frequency and severity of eczema flare-ups. Therefore, avoiding polluted environments and abstaining from or limiting exposure to tobacco smoke is advisable to help keep the skin in the best possible condition.

Daily Application of Emollients to Strengthen Hydration and the Skin Barrier⁶

Regularly using emollients is central to maintaining skin hydration and restoring its barrier function. These products help trap moisture, reduce dryness and itching, and prevent eczema flare-ups. Applying emollients after bathing or showering when the skin is still slightly damp is recommended to maximize their effectiveness.

Opt for Gentle Skin Care⁶ ⁷ ⁸

Proper skin care based on daily skin hydration with an emollient is essential for eczema. Doctors also recommend avoiding soaps in favor of gentle, fragrance-free products, such as DEXERYL washing oils and creams, taking short, lukewarm showers, and patting the skin dry rather than rubbing. Additionally, wearing clothes made of cotton or linen rather than synthetic fibers or wool can reduce skin irritation.

Minimise Stress and Dietary Risk Factors¹ ⁶ ⁹

Relaxation techniques such as meditation, yoga, or breathing exercises can help reduce stress, a psychological symptom and trigger for eczema. 
Doctors recommend not changing the diet unless a food allergen is identified. An allergist can assist in identifying and eliminating food allergens causing eczema.