While the exact cause of eczema hasn’t really been determined – scientists are working to find the exact cause of the skin disorder - eczema is pretty clearly linked to an overactive immune response.
When the immune system - which exists primarily in the gut – is not in balance, it can lead to chronic inflammation, as the immune system goes into overdrive, targeting virtually everything including healthy tissue as an enemy.

Acute inflammation, a necessary response to an injury or infection, is welcome and necessary as specific white blood cells called leukocytes receive messages from the brain that there are injured or infected tissues, and are sent there through the blood vessels to take action that helps restore the body to good health.

When the immune system is functioning properly, these leukocytes along with other members of the body’s first response team help the injury or infection heal.

When overstimulated, however, the immune system, which is in place to fight off foreign invaders, can’t effectively battle whatever is triggering eczema, especially since there are many triggers that can lead to a flare-up.

Signs of acute inflammation include heat, pain and swelling, and it means that the body is doing its job.
Chronic inflammation, while it may have similar symptoms, is completely different.

When the immune system is in overdrive, leukocytes depart and other, more unfriendly blood cells take over, taxing the immune system so it is unable to protect against disorders such as eczema, and mistakenly attacks healthy tissue, instead.

The sensitive immune system associated with eczema means the skin can react to even the smallest trigger or irritant, which leads to inflammation deep beneath the skin. Here, eczema lies in wait, ready to react to those triggers with a flare-up of the skin disorder.

When rashes are on the surface of the skin, they are simply visible signs of an inflammatory disease deep beneath the skin’s surface.

That initial itch is a sign of inflammation sending signals to the skin’s surface. When that itch is scratched, it causes damage to the skin’s surface, opening the door to the entrance of allergens that increase the inflammatory response. That means the itching and redness worsen, leading to more extreme symptoms of the skin disorder.

Because inflammation can easily go unchecked, even when skin prone to eczema appears clear, the skin disorder can return unless chronic inflammation is better managed.

Eczema, also known as atopic dermatitis, tends to show up in specific places on the body, and is most common inside the elbows or the back of the knees, on the face, especially the cheeks or eyelids – where it can be particularly distressing - behind the ears, on hands and feet, and sometimes, on the buttocks, chest, and neck.

Symptoms include:

• Dry skin.
• Severe itching.
• Discoloured patches of skin.
• Thick, cracked or scaly skin, sometimes accompanied by small, red bumps that can leak fluid.

Eczema is also called “the itch that rashes,” because it is not until the initial itching is scratched that the redness and rash actually occurs. Controlling scratching – which can be done by using creams or other products that can keep that itch in check – can help reduce the worst of the symptoms.

Complicating the condition even more, while a weakened immune system caused by disease or illness is the most likely trigger of bouts of eczema. It is not always an immune response that causes the skin disorder.

Eczema can be accompanied by other health problems such as hay fever or asthma, it can be the result of dry sky or other skin problems such as psoriasis, it can be triggered by insect bites or weakened blood vessels, or environmental factors may play a role. It can even be the result of stress, allergies to certain substances, or damp hands and feet.

Other potential causes can be dust mites, exposure to itchy, irritating clothing, animal dander, or a poor diet that is either missing vital nutrients or contains certain substances more significantly than once thought to the disorder. According to the Mayo Clinic, the bacteria Staphylococcus aureus is also a possible eczema trigger.

While some causes can be easily treated – wearing gloves when doing the dishes, for example, can keep hands dry, which can reduce eczema symptoms – others are simply out of your control without making life changes.

The skin problem can be painful, embarrassing and extremely frustrating, especially when some remedies only treat or mask symptoms, and don’t offer a long-term solution to the condition.

The wrong skin care products can trigger or exacerbate eczema, so making smart choices when purchasing skin care products can help ease or prevent outbreaks.

For the best results, choose those products that contain as few ingredients as possible, and watch out for these enemy ingredients, which aren’t good for any skin:

• Phthalates
• Parabens
• Sulfates
• Artificial fragrances and colour
• Petroleum

Each of these unnatural ingredients can cause sensitive skin to become inflamed, triggering outbreaks of eczema. Check the labels, and instead, seek out products containing natural ingredients – in some cases specific essential oils - that more gentle on the skin and can help irritated, inflamed tissues heal.

A host of problems can lead to dry skin, including weather – skin is always drier in winter, when indoor heat zaps skin of moisture, and sun exposure in the summer can also contribute – genetics, hormonal changes, aging, certain medications and hot water.

Dry skin is more vulnerable, and more likely to develop eczema, which requires a moist, healthy environment in which to heal.

To help alleviate dry skin:

• Use gentle cleansers that won’t strip away those protective natural oils in your skin’s surface layer, and find a hydrating moisturiser that can penetrate the skin’s surface, reaching the dermis layer where new, healthy skin cells are formed.
• Skip long, hot baths, which while relaxing and stress-relieving, can lift away skin’s moisture. If you do require a good soak, moisturise liberally when skin is still damp with a lightweight moisturiser or a carrier oil that includes eczema-fighting essential oils.
• As tempting as it might be to try to exfoliate away eczema, don’t do it as it will only exacerbate the problem, not only by stripping away natural oils, but also by helping the itchy, red patches to spread.
• Before you moisturise, check the ingredient list. Certain chemicals such as parabens, sodium lauryl sulfate, fragrances, dyes and alcohols can help make dry, sensitive skin even drier, despite label claims.

Sensitive skin that is prone to bouts of eczema can respond to some foods negatively, so removing some specific foods from your diet could determine if food sensitivities could be contributing to your eczema:

Foods to avoid:

• Gluten. Gluten is the protein in wheat, barley and rye, and for those with sensitivities or a gluten allergy, it can do real damage to the intestinal tract, which is where much of the body’s immune system exists. A weakened immune system can lead to symptoms of eczema. Erasing gluten from your diet may ease symptoms, and with so many gluten-free products on the market, you may not feel so deprived.
• Sugar. Sugar is a serious trigger for eczema. When we consume sugar, it boosts blood sugar levels, signalling the body to send out cytokines, the messengers that trigger an inflammatory response.
• White flour. White flour and foods that contain it break down into sugar quickly, triggering the same unwelcome inflammatory response.
• Trans-fats. Found in fast food and processed foods, trans-fats can trigger inflammation, which researchers determined by comparing the pro-inflammatory effects in those who ate a diet high in trans-fats compared to those who didn’t.
• Dairy. Dairy contains certain proteins such as casein as well as lactose, saturated fat and added hormones that can exacerbate skin sensitivities, especially eczema. Switching to dairy alternatives could restore skin health.
• Processed foods. Foods that are not in their natural state contain a wide range of ingredients including preservatives and artificial flavourings and colouring that can trigger skin problems. Keeping your diet as clean as possible can help prevent problems.
• Saturated fats. Eating too many saturated fats can reduce the body’s ability to control inflammation effectively.
• Members of the nightshade family. Members of the nightshade family, including tomatoes, eggplant, tomatillos, goji berries, peppers, and pimentos, contain natural pesticides that can trigger eczema outbreaks.
• Foods that can cause allergies. Some eczema outbreaks, especially in children, are allergic responses caused by allergies to certain foods such as eggs, peanuts, tree nuts, soy, fish and shellfish.

Making dietary changes can reduce eczema outbreaks by managing inflammation and allergic responses.

Foods that are considered friendly to eczema include those that are anti-inflammatory, such as:

• Fatty fish. While some fish can create an environment more prone to eczema outbreaks, fatty fish packed with omega-3 fatty acids can ease inflammation. Some options are salmon and herring, but an omega-3 supplement is a good option if you can’t fit enough of these anti-inflammatory fish options into your diet.
• Foods with quercetin. Quercetin – a plant-based flavonoid which gives many fruits and veggies their dynamic colours – also acts as an antihistamine and anti-inflammatory. Some delicious options include apples, blueberries, cherries, broccoli, spinach, and kale.
• Foods with probiotics. Probiotics are especially important if you are using an antibiotic to control eczema, because probiotics help replace the active cultures in the gut that are responsible for a stronger immune system. Some probiotic-rich foods include yogurt – check the label to make sure it offers live cultures – soft cheeses, and fermented foods including sourdough bread, sauerkraut, kefir, tempeh, miso soup, and kimchi.
• Turmeric. Turmeric, considered one of the world’s most powerful antioxidants, which fight oxidative stress and free radicals that can damage skin, can also help ease eczema. Turmeric contains anti-inflammatory properties that can help to reduce the itchiness and decrease the symptoms of eczema. Coriander and fenugreek are also two excellent spice options to help ease eczema by fighting inflammation.
• Evening primrose oil. In addition to providing topical relief, researchers in Sweden found that using evening primrose oil as a supplement, which boosts levels of gamma linolenic acid from the inside out, helped relieve symptoms of eczema. The 1991 study that appeared in the American Oil Chemist’s Society journal, found that the condition of the skin’s epidermis improved considerably when fatty acid levels including those of GLA were normalised, improving the nutrient makeup of the skin’s surface layer.

Eczema may respond positively to essential oils, which can provide the best nutrients the earth has to offer. The active compounds in essential oils can combat stress that can trigger eczema, they can offer relief from pain, and can improve the appearance of eczema outbreaks, in some cases addressing rare causes of the skin disorder.

Essential oils are also packed with nutrients that can help ease chronic inflammation. They can provide long-lasting moisture and can support the skin’s natural ability to repair itself.

Because eczema has been linked to a lack of key nutrients, essential oils may provide what you skin needs for not only easing topical symptoms, but going beneath the skin’s surface to provide long-lasting relief.

Some essential oils that may provide relief include:

Lavender - Lavender is a favourite for good reason. It not only relieves stress, but it also acts as a natural pain reliever and anti-inflammatory, making it an excellent essential oil to help ease eczema symptoms.

Lavender is high in linalool, a moisturising compound that can offer welcome hydration to dry, flaking skin, creating an environment for healing.

A 2003 study from Iranian researchers that was published in the Journal of Ethnopharmacology determined that lavender contained both anti-inflammatory and analgesic (pain-relieving) properties. Lavender is gentle enough to be applied to skin, and in this study, when used topically, it helped reduce the redness associated with inflammation.

Chamomile - Chamomile essential oil, both the Roman and German varieties, contains two important anti-inflammatory compounds, alpha-bisabolol and chamazulene, which make it an especially beneficial essential oil for treating symptoms of eczema. Chamomile is gentle enough for children’s skin, and it also offers moisturising properties that are, according to researchers, as effective as a hydrocortisone cream at easing the itching and accompanying redness of eczema.

One clinical trial from 2000 conducted by German researchers and published in the European Journal of Medical Research found that a chamomile-based cream was more effective at easing eczema symptoms than a hydrocortisone cream as well as a placebo.

Frankincense - Frankincense essential oil has been shown to help ease inflammation associated with skin conditions such as eczema. A 2017 study from Utah-based researchers that appeared in the journal Biochimie Open, a French journal, found that frankincense helped control the dermal fibroblasts associated with inflammation, perhaps due to the oil’s high levels of boswellic acid.

Essential oil blends. A 2000 study from researchers at the School of Applied Science at London’s South Bank University tested a blend of essential oils including frankincense, lavender and chamomile as a treatment option to help address eczema outbreaks in children. Parents massaged the oil on their children’s skin daily as part of the study, although the control group used massage only. The study was small, and both groups showed marked improvement. While the essential oils likely were beneficial, the stress reduction caused by the daily massage may have also played a role in reducing eczema symptoms in the children who were part of the control group. The study appeared in the journal Phytotherapy Research.

Sadly, there’s no cure for eczema, but symptoms can be effectively managed with the right treatments. These may include a combination of lifestyle changes and therapeutic interventions. In some cases, eczema can cause additional health complications.

Skin infections, like impetigo are brought on by constant itching. When scratching breaks the skin, bacteria and viruses can enter.

Vigorous exercise can be difficult for people with eczema because sweating can bring on a bout of itching. Dress in layers so you can cool down while exercising. You may also want to avoid intense physical activity during an eczema flare-up.

Many people with eczema report feeling embarrassed and self-conscious about their skin. Receiving proper treatment and getting stress under control can help calm symptoms. Support groups can also help people cope.

In summary, eczema cannot be cured but can be effectively managed using a number of diet, lifestyle, natural and medical interventions.