Eczema, a.k.a., dermatitis, is a complex skin condition that affects millions of people globally. Just in the United States alone, eczema is estimated to affect over 30 million people making it, unfortunately, a quite common skin disorder. Because its impact on people’s daily lives can be significant, understanding the intricacies of this disorder is necessary for its effective treatment, management, and trigger avoidance.

Living with eczema goes well beyond just its physical discomfort as it also takes a toll on an individual’s quality of life. The constant itching, rashes, and potential sleep disturbance can cause stress and anxiety making the symptoms that much worse and more profound. Effectively managing this condition is important from a physical, mental, and emotional perspective.

In this blog we will delve into questions like “Can adults get eczema later in life?”, “Does pollen cause eczema?”, “Can an allergist treat eczema?”, and “What is the difference between dry skin and eczema?”

What exactly is eczema? [1]

Eczema is a chronic skin disorder characterised by inflammation, irritation, and itchiness. It manifests in various forms each with its own unique symptoms and triggers. At its core, and because the devil is always in the details, eczema is directly related to an impaired/compromised skin barrier preventing it from functioning properly, coupled with immune system dysfunction.

Imagine, if you will, that your skin is like a heavy winter coat that you would wear to go hiking. The skin’s outermost layer, the skin barrier, is similar to this heavy winter coat whose job it is to protect your body from the cold. Underneath the skin barrier (heavy winter coat) is an intricate immune system (a nice woolly sweater in your backpack) that is ready to be pulled out and worn under your coat should your body experience uncomfortable sensations of cold. When weaknesses/disturbances are detected in the skin (cold sensations experienced), the body’s immune system springs into action (woolly sweater gets put on). The problem becomes when the combination of the heavy coat plus woolly sweater triggers the body to overheat and sweat similar to the causes/triggers of eczema.

Are there multiple types of eczema?

Yes. While there are several different “types” of eczema, the two most common include atopic dermatitis and contact dermatitis:

• Atopic dermatitis typically has a genetic component to it and oftentimes first appears during childhood. 
• Contact dermatitis, on the other hand, is typically triggered by exposure to certain allergens or irritants. 

Other types of eczema include dyshidrotic eczema (little blisters on palms/fingers/soles of feet), nummular eczema (coin-shaped rashes/sores on arms/legs), and seborrheic eczema (scaly patches/red skin on the scalp). 

What causes eczema? [1]

While the precise cause of eczema is not fully understood, the following represent some of the factors that are believed to play a role in eczema:

1. Genetics: Eczema often runs in families which suggests that certain people have a genetic predisposition to developing this skin disorder. Certain genes associated with skin barrier function and immune response can increase the likelihood of a person developing eczema.
2. Skin Barrier Dysfunction: As a reminder, skin serves as the body’s protective barrier against external/environmental allergens, irritants, and pathogens (bacteria, viruses, pollutants, etc.). For those individuals suffering from eczema, their skin barrier is oftentimes found to be compromised/damaged. As a result, the skin barrier is less effective at retaining moisture (resulting in dry, flaky skin), and more vulnerable to the above-mentioned external/environmental “baddies” like allergens and irritants which can then more easily penetrate the skin.
3. Immune System Dysregulation: Eczema is directly related to an overactive immune system response within the skin. An aggressive response by the body’s immune system, triggered by an environmental factor, or even just a perceived threat, leads to inflammation and itching/scratching, i.e., the tell-tale symptoms of eczema.
4. Environmental Factors: Specific types of environmental factors can trigger and/or exacerbate the symptoms associated with eczema. For example, exposure to certain types of allergens like pollen or pet dander, irritants found in harsh soaps and cleaning products, and extreme weather conditions involving heat, cold, and humidity.
5. Dietary Influences: While not as common, certain people may experience an eczema triggering event caused by specific foods and/or food allergens. The ability to first identify and then avoid these dietary triggers is essentially important when it comes to effective eczema management.

Can pollen cause eczema? [2]

The short answer is no, but with a caveat. While pollen itself cannot “cause” eczema, it can contribute to its symptoms, especially in those individuals who have a predisposition to allergies.

As we all know, pollen is a very common allergen that can trigger allergic reactions in people. For those who also happen to suffer from eczema, exposure to pollen can cause their immune system to react leading to itching, inflammation, and skin irritation, all common symptoms of eczema.

The most common form of eczema, atopic dermatitis, has an allergic component. For those who suffer from atopic dermatitis, they are much more likely to suffer from other allergic conditions like hay fever and asthma. Exposure to pollen can be a trigger for these types of allergic reactions causing them to flare up and/or get worse.

Pollen has also been found to sensitize the skin leaving it more reactive to other irritants and allergens. As you can imagine, this increased sensitivity can in turn lead to eczema flare ups and worsen existing eczema symptoms.

Can adults get eczema later in life? [3]

Unfortunately, adults can get eczema later in life. As mentioned above, while eczema typically first presents itself during childhood, adults who have never experienced this skin disorder can develop this condition later in life. This is referred to as “adult-onset eczema”.

Adult-onset eczema can be triggered by numerous factors including changes in the environment (heat, cold, humidity), exposure to irritants/allergens, stress, and of course, genetic predisposition. Although attempting to identify a specific trigger is not easy, it is essential for effective management of the condition.

One important point to note is that while children typically develop eczema on their face and scalp, adults may experience eczema symptoms on other parts of their body like their hands, feet, knees, and elbows. The symptoms, however, are similar, i.e., itching, dryness, redness, and rashes/lesions.

Is there a difference between dry skin and eczema? [4]

While these two skin conditions share similar symptoms, the underlying causes of each are different. For example, dry skin is generally characterized by a lack of moisture in the skin which can be triggered by various factors including environmental (heat/cold/humidity), excessive washing with harsh cleansers, aging, and certain medical conditions. Dry skin’s primary symptoms include flakiness, roughness, and overall feeling of discomfort, but does not involve inflammation and the development of rashes/lesions.

Eczema/atopic dermatitis, on the other hand, is a chronic disorder characterized by inflammation, redness, itching, and rashes/lesions. It often times has a genetic component related to the immune system and an impaired/compromised skin barrier. Unlike dry skin, because eczema involves inflammation and a compromised skin barrier, the effects of eczema are usually much worse because they can cause infection caused by excessive scratching, blisters, and plaques.

In short, while dry skin and eczema definitely share similarities in terms of their respective symptoms, because the devil is always in the details, there is a significant difference between dry skin and eczema in terms of their causes.

Can an allergist treat eczema? [5]

An allergist can certainly play a role in the treatment of eczema by utilizing their expertise in identifying allergens that may be exacerbating/triggering the condition to help manage its symptoms. An allergist will perform the testing/screening to zero in on the specific allergens associated with the condition so that once identified they can be avoided and/or effectively managed. 

An allergist can recommend immunotherapy such as allergy shots to try and desensitize a person’s immune system to the problematic allergens identified during testing. They can also prescribe allergy medications (antihistamines) to help manage the symptoms. Lastly, they typically collaborate with a dermatologist on the overall management of the condition when it comes to recommending certain skincare routines and topical treatment to be used in combination with the treatment recommended by the allergist. It should be noted, however, that if a person’s particular eczema situation is not driven by allergies, looking to an allergist for treatment recommendations may be of limited value. 

What are some tips for effectively managing the symptoms of eczema?

1. Moisturize regularly: Daily use of a moisturizer, especially right after bathing, will help to lock moisture in your skin and keep your skin barrier functioning properly. Moisturizers like the award winning, National Eczema Association-approved BIA® HYDRATING SKIN SUPERFOOD with its patented BiaComplex® skin hydrating and replenishing technology rehydrates your skin and locks in the moisture. Yet another National Eczema Association-approved product is the  BIA® NOURISHING FACIAL OIL which can be used on its own to lock in much needed moisture in the skin or, better yet, can be used in combination with the BIA® HYDRATING SKIN SUPERFOOD for unparalleled sealed-in hydration that your dry, itchy, sensitive skin will love you for!
2. Use gentle cleansers: Opt for mild, non-soap, fragrance-free cleansers for washing your face and body, avoiding the use of hot water as it can be quite drying. Cleansers like BIA® GENTLE CLEANSING OIL is an excellent nourishing, non-soap cleanser that locks in moisture, eliminates dry/flaky skin, and helps soothe the itch associated with eczema. When it comes to the rest of the body BIA® UNSCENTED SOAP, a cold-processed soap packed with soothing, hydrating shea butter is perfect for those wanting to gently cleanse their body without irritation. And oh, by the way, it’s the only soap currently certified as “microbiome-friendly” meaning it will remove dirt from your body while leaving your skin microbiome healthy and happy.
3. Avoid triggers: It’s important to try to identify and avoid potential triggers that can make your eczema worse like specific allergens, foods, detergents, and fragranced products. If an allergy is suspected, consult an allergist for testing and guidance on how best to avoid these triggers.
4. Stress reduction: Practice stress reduction/management techniques like mindfulness, meditation, and deep breathing exercises since stress can trigger eczema flare-ups. By calming your mind you will also be calming your skin, thereby reducing the chances of triggering an eczema flare-up. 
5. Fortify your skin barrier: The havoc wreaked by eczema flare-ups on the skin barrier can be quite aggressive and without a strong, properly functioning skin barrier, effective management of eczema can be challenging, if not impossible. For those suffering from eczema, an option for strengthening the skin barrier from the inside out is ANTU® SKIN BARRIER SUPPORT SUPPLEMENT which, in addition to having potent plant-based antioxidants for supporting and maintaining the skin barrier (critically important for those suffering from dry skin conditions) also contains the amino acid L-histidine which supports skin barrier strength, moisture retention and has been clinically shown to provide effective eczema management and relief. [6] 
6. Soak your skin: Add emollients and other skin nourishing ingredients to your bath water to soothe and moisturize your skin during bathing. For example, Codex Labs SOOTHING SEA SALT SOAK, with itch-fighting oatmeal, skin conditioning serrated wrack, soothing tapioca, and relaxing Epsom + sea salts is precisely the bath tonic most needed by those suffering from eczema.
7. Prescription medications: In the event over-the-counter treatments are insufficient at providing relief, consult a dermatologist for medications like topical steroids, calcineurin inhibitors, and PDE4 inhibitors.
8. In general: Use sunscreen daily; avoid scratching; apply cool compresses to relieve itching and inflammation; get plenty of sleep; stay well hydrated; and stay up to date on eczema management strategies and research developments. [7] new treatments [8] complimentary

Conclusion.

Eczema management is a lifelong journey that requires dedication and ongoing education. Some key takeaways to keep in mind are: allergens like pollen can cause an eczema flare up; an allergist can help to treat eczema; there is a difference between dry skin and eczema when it comes to causation; and unfortunately, adults can get eczema later in life. Understanding its causes, symptoms, and treatment options empowers eczema sufferers to lead happier, more comfortable lives. Being diligent when it comes to what goes on your skin (gentle, hydrating, soothing, microbiome-friendly products) and in your body (water, non-allergenic foods) is critically important for taming this dastardly skin condition.

References:

1. https://nationaleczema.org/eczema/
2. https://acaai.org/allergies/allergic-conditions/skin-allergy/eczema/
3. https://www.aad.org/public/diseases/eczema/adult/can-get#:~:text=Adults%20can%20get%20any%20type,you%20never%20had%20AD%20before.
4. https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-vs-dry-skin
5. https://acaai.org/resource/why-should-i-see-an-allergist-for-my-eczema/
6. https://pubmed.ncbi.nlm.nih.gov/33000160/
7. https://www.ajmc.com/view/dr-peter-a-lio-explosion-of-new-treatments-for-atopic-dermatitis
8. https://pubmed.ncbi.nlm.nih.gov/27388911/