Knowledge is power - By understanding what’s happening in your skin, tackling your eczema will finally make sense.
Eczema / Atopic Dermatitis
July 5, 2023
Step 1 - Knowledge is power - By understanding what’s happening in your skin, tackling your eczema will finally make sense.
When people talk about eczema, they usually mean atopic dermatitis (AD), a chronic skin condition where the skin has a compromised barrier function and an overactive immune system.
Eczema is the descriptive term for inflammation in the skin but it isn’t specific to a particular cause. It is important to separate out the causes in order to understand how to prevent inflammation and flares.
So what is atopic dermatitis?
Atopic means when an individual has a genetic predisposition to developing allergic conditions so people with AD often also suffer from other allergic illnesses including hay fever, asthma and food allergies. Atopic dermatitis is inflammation in the skin through a genetic and allergic process.
So what’s actually happening in the skin?
The core features of atopic dermatitis:
1. Skin barrier dysfunction
Meaning the skin's ability to act as a barrier is compromised due to genetic/inbuilt weaknesses. This is mainly caused by a predisposition of the skin to lose water. Water plays an important role in the skin, helping to prevent bacteria and irritants from entering the body.
2. Allergic hypersensitivity
Due to the genetic predisposition of AD sufferers to developing allergies, the skin can become sensitive to normally harmless substances leading to hypersensitivity and inflammation.
3. Loss of regulation of normal inflammation
Inflammation is part of the body's normal protective response to harm and leads to immune cells gathering in damaged tissues. In AD the immune response is excessively strong and long-lasting leading to the chronic nature of the condition.
Together these three core features create a vicious cycle of inflammation and barrier dysfunction.
So how do I stop this?
Given that we can’t currently modify our DNA to repair these genetic problems the goal of the treatment is to counteract these three core features
1. Rehydrate the skin and stopping water loss - emollients
2. Avoid allergens - identify triggers
3. Suppress inflammation - flare control creams (topical steroids and topical calcineurin inhibitors)
