Today’s subject is… itchy.

Eczema is a disease that touches more and more people, and makes their life a daily misery.

So where does it comes from, and why does it happen? Let’s scratch the surface of eczema.

Atopic dermatitis, or atopic eczema, is a condition where skin gets inflamed. The symptoms are itching, small raised bumps, sensitive skin, dry skin, red patches and cracked skin.

Who gets eczema?

More people than ever! Eczema is rising across the world, and today almost 20% of kids and 5% of adults have eczema. Is it more common in cities and in high-income countries. It means that the environment plays a role.

Where do you get eczema?

It depends of your age. Babies can have eczema anywhere on their body. Kids will have it more in the crease of the arms and knees, and adults more around the hands and feet.

Where does eczema come from?

It’s a multifactorial disease, which means that you have loads of different factors teaming up to create the perfect storm.

    • There’s a genetic component, some people have a little defect in the way they produce filaggrin, an important building block of the skin. Their skin barrier is more fragile and hence more prone to eczema. The pH of the skin is higher than usual, leading to even more barrier problems.
    • An overactive immune system. One little player, IgE, is the alarm of the immune system and in the cases of people with eczema has a tendency to get trigger happy.
    • External aggressors. Over washing, products with the wrong pH, especially soaps, seasonal changes, heat, sweat, stress, food allergies… The list is long. All these factors will either trigger eczema or make it worse.
    • A bacterial infection: One bacterium, Staphylococcus aureus (S. aureus for its friends, but it doesn’t have any) is always there when there’s a flare up of eczema. Can destroying this bacteria solve eczema? (suspense music)
    • A microbiome problem. There’s a theory called the hygiene hypothesis. Because of our modern lifestyle (our tendency to wash away our microbes and our overuse of antibiotics) our microbiome is losing diversity and this leads to a rise of autoimmune problems. So, you get inflamed all the time. This theory is popular for skin problems (eczema, psoriasis, acne) but also for asthma, allergies, IBS and all these new diseases coming out of nowhere. A weak microbiome also leaves room for bad bacteria to invade, which brings us to the next point.

How to treat eczema?

There are products targeting each cause of eczema. They’ve been around for a long time and they are not always very nice.

    • Lower the immune response to lower inflammation. You can do that with drugs called immunosuppressants, or with corticoids creams or tablets. It’s very efficient but the side effects are annoying, such as discolouration of the skin. They only work for as long as you take them, and there can be a rebound effect when you stop.
    • Rebuild the skin barrier artificially. This is where all the anti-eczema creams come in: by having a thick cream with a nice film-forming effect, you prevent water escaping, and bad bacteria going in. The problem? These creams are sticky, greasy and kids hate them. It also only helps with the symptoms, and not the cause.
    • Destroy the S. aureus responsible for the infection. You can do that with antibiotics, bleach baths (yes, really. Diluted bleach though) and other antibacterial creams. It works for a time, but antibiotics and bleach destroy all bacteria, not just the bad ones, leaving the skin fragile and prone to more infections.
    • Lower the pH of the skin, make it more acidic. It will help rebuild the skin barrier and help the good bacteria to fight the bad S. aureus. How do you do that? By using pH5 products for washing the skin and for anything you apply after. A cup of vinegar in the bath can help too!
    • Manage stress. Easier said than done, but studies show that meditation, yoga and regular exercise really helps with eczema symptoms.
    • And last but not least: Use the power of the microbiome! Learn more about it here.

Marie Drago