At its best, eczema is an uncomfortable annoyance. At its worst? A nightmare.
From mildly itchy patches to red, inflamed, painful skin, eczema can cause some serious discomfort and affect physical and mental health. Thankfully, there are many effective products, resources, and recommendations to help those living with eczema to enjoy clear, calm skin.
Let’s learn more about eczema and how using the appropriate skincare can help you.
What is Eczema?
Eczema is a common skin condition, affecting up to 30 million people in the United States at any given time. It is known for causing irritated, dry, itchy, and sensitive skin patches on various parts of the body. Eczema looks like dry, flakey, thick, red, or even blistery skin. Eczema can appear in several forms such as:
- Atopic Dermatitis: A form of eczema that is allergic in nature.
- Hand Eczema: Eczema specifically occurring on the hands (up to 10% of cases).
- Winter Eczema: Eczema that either shows up or worsens in cold weather or during the winter. Sometimes this has been called “winter itch.”
Eczema and the Stratum Corneum
The stratum corneum is the top layer of skin and plays a role in any skin condition in which there is itching, flaking, or dryness. The structure of the stratum corneum has been compared to a “brick wall.”
- Corneocytes: These flattened cells (“the bricks”) contain large amounts of keratin, the same material found in fingernails. They form some of the toughest part of the skin barrier.
- Desmosomes: Desmosomes are cellular bridges joining the corneocytes, holding the stratum corneum together.
- Intercellular lipids: These contain three main types of molecules (the “mortar”) including ceramides, free fatty acids, and cholesterol.
Transepidermal water loss (TEWL) is the normal loss of water through the skin. It occurs in all individuals but can accelerate when the skin barrier is impaired, leading to excessive water loss and dehydration. This occurs in eczema. Dehydrated skin then has an even more impaired skin barrier, even further increasing abnormal water loss.
Eczema and Inflammation
Very simply, eczema is a condition of inflammation. In response to a sensitizing agent or stress, the body’s immune cells release messengers called inflammatory cytokines. These increase the inflammatory response, causing the skin’s cells to react. The result is red, irritated, itchy skin that sets off a further inflammatory response and initiates the itch-scratch cycle (described below), making the condition even worse.
Eczema and the Itch-Scratch Cycle
Eczema, like many skin conditions, causes a vicious cycle known as the itch-scratch cycle. When we have itchy skin, we are tempted to scratch. When we do, we are relieved for a moment, but inflammatory chemicals like histamines are released by the scratching. This makes the itch worse and leads to even more scratching and the cycle continues.
Who Gets Eczema?
Anyone can get eczema, but it tends to occur more often in those who have fair skin or are prone to allergies. This is because they have a more delicate skin barrier and are more susceptible to irritation. Eczema is also common in babies and children, especially during winter months or in dry climates.
|What Triggers Eczema?For those who have eczema-prone skin, there may be several triggers that vary from person to person. In many cases, however, those with eczema are particularly sensitive to dryness, cold weather, topical products, and even stress. Here are a few of the external agents involved with the development of eczema:|
Irritants: Soaps, detergents, disinfectants, exposure to food juices, fumes, harsh chemicals
Allergens: House dust mites, pets (especially cats), pollen, mold, certain foods
Microbes: It is possible for bacteria, fungi, or viruses to cause infected eczema once the skin barrier is compromised.
Other: Extremes in temperature, heat, cold, humidity, sweating, stress, hormones
Treatment Options for Eczema
There are a variety of treatment options for eczema, but the best results come from a long-term strategy aimed at healing the skin from within and avoiding aggravating factors. Here are a few of the most popular ways to treat eczema and its side effects:
Antihistamines do little to help improve eczematic skin but can help temporarily reduce itching and inflammation. Unfortunately, long-term use of antihistamines can increase dryness of the skin and mucous membranes — leading to more water loss, a weaker stratum corneum, and worsening eczema.
Topical steroids can be used on eczematoid skin to help reduce itching and inflammation, but they are only recommended for short-term use. When used too long, steroids lead to more fragile skin, which can worsen eczema in the long run.
Cosmeceutical ingredients are often a good choice when it comes to managing eczema long-term. They lack the negative side-effects of antihistamines or steroids and are safe to use for most people. They can also help to heal the skin, support the skin barrier, and prevent eczema in the future, rather than simply quieting the irritation temporarily. Some eczematoid persons, however, may be sensitive to specific ingredients or topical products.
Stress management can be an important part of a management regimen for this condition, as stress increases the symptoms of eczema.
Cosmeceutical Answers for Eczema
Aloe is a humectant, meaning that it binds water in the skin to reduce dryness and counteract abnormal TEWL. It is also soothing.
Centella Asiatica, also known as Asiatic pennywort or gotu kola, helps to encourage collagen synthesis, healing, and can help repair the skin cells damaged by eczema.
4-Hydroxyproline is a bioidentical ingredient found in our own skin to signal for collagen synthesis. It may be obtained from marine plants. 4-hydroxyproline helps to encourage collagen synthesis and repair cells.
Tripeptide-1, a safe and natural ingredient normally found in skin, is one of the body’s “emergency response molecules” for healing. It is useful in a wide range of damaged skin conditions, including eczema.
Glycerol is necessary for normal skin barrier integrity and helps desmosomes release their hold at the proper time so normal skin desquamation and rejuvenation can occur.
Urea can be helpful to moisturize skin at moderate levels. High levels can cause irritation.
Alpha Hydroxy Acids (AHAs) help to exfoliate the stratum corneum, allowing fresh new skin cells to surface. These also improve hydration by increasing skin ceramides and other barrier lipids. Only gentle exfoliants are recommended in eczema, since too much resurfacing may be sensitizing.
Beta Hydroxy Acids (BHAs) reduce inflammation and clear debris from pores. They work well in combination with AHAs but, like AHAs, can also increase sensitivity if used to excess or if formulated improperly for this condition.
Enzymes like papain from papaya and bromelain from pineapple help to dissolve old desmosomes and encourage exfoliation. Too much exfoliation can also be sensitizing in eczema.
Sunflower Seed Oil contains bioidentical lipids required for a normal skin barrier or for regeneration of a damaged barrier.
Niacinamide is an anti-inflammatory compound that helps increase skin ceramides. Although uncommon, a few individuals with eczema may develop a “niacin flush” with niacinamide and so should avoid it.
Linoleic acid is an essential fatty acid that the body is unable to make on its own. It must be provided orally or topically and helps increase skin ceramides, assist the skin barrier, and moisturize the skin.
Magnesium and Calcium can help to improve the function of the skin’s barrier and prevent dryness when taken as supplements or used topically.
Vitamin C is anti-inflammatory and helps to increase skin ceramides.
Botanical extracts have helpful antioxidant and anti-inflammatory benefits for the skin as well as healing benefits.
Lifestyle Tips to Improve and Prevent Eczema
Once eczema has been managed by in-office treatments and cosmeceuticals, there are several steps that can be taken at home to prevent eczema from returning or worsening
|Avoid sensitivitiesAvoid anything that causes dry skinAvoid excess exposure to water (swimming pools, ocean) as this can dry the skin out, alter the skin’s normal microbiome, and deplete the skin’s natural moisturizing oilsEat a diet rich in omega-3 fatty acids (include foods like salmon, herring, mackerel, sardines, nuts, avocados)Use helpful topical products such as those containing ceramides like sunflower seed oil||Cover skin in winter to avoid exposure to cold and windProtect skin in the sun and wear sunscreen to prevent dryness, sun damage, and inflammationUse non-clogging moisturizers generously to keep skin nourishedStay hydrated by drinking adequate amounts of waterCleanse skin with mild, moisturizing cleansers as neededAvoid using excessively hot water when washing the skinAvoid excessive use of fans and heaters in winterManage stress|
Find Relief with Cosmeceutical Skin Care
Eczema can be a troubling, irritating condition, but it does not have to take over your life. Thankfully, some simple lifestyle tips and high-quality cosmeceuticals can help you not only relieve the itch and calm the redness of eczema but help your skin heal. See Where to Buy to learn more about using cosmeceuticals to improve your eczema.