Eczema is an umbrella term for various inflammatory skin conditions, or dermatitis. Several types of dermatitis involve an overreaction from the immune system, but it is not an autoimmune condition.
An autoimmune disease is the result of the immune system mistakenly attacking the body’s healthy tissues. Typically, this is different from other types of immune responses, such as an allergic reaction, which happens when the body perceives exposure to a specific substance as a threat.
While the immune system is involved in the development of eczema, doctors classify it as an inflammatory skin condition.
This article discusses how the immune system is involved in different types of eczema.
Eczema refers to a group of conditions that cause itchy, inflamed rashes on the skin. If an individual has a light skin tone, eczema may appear in red patches. The patches may appear brown, purple, or gray on dark skin tones.
According to the National Eczema Association, doctors currently recognize seven types of eczema, which are:
Read about the different types of eczema.
Most types of eczema appear to have some links to the immune system, but the evidence is limited.
This article looks at three types of eczema: atopic, dyshidrotic, and nummular eczema and explores their possible links to autoimmunity.
Learn about autoimmune diseases.
The American Academy of Dermatology Association states that AD is a common form of eczema that does not have a single cause. Researchers think AD develops due to a combination of genetics, a sensitive immune system, and environmental factors that trigger the symptoms.
Dermatologists believe that people with AD have a genetic trait that causes their skin to lose moisture too quickly, causing gaps in the skin barrier. This can lead to dry, less well-protected skin.
Read about eczema and genetics.
This alone is not always enough to cause AD. Other factors that may put people predisposed to the condition at risk of developing it include:
- living somewhere that is cold and dry for at least some of the year
- exposure to pollution and tobacco smoke
- stress
The authors of a 2021 study suggest that AD may start as an allergic response before progressing to an autoimmune response. They argue that this may be what causes chronic inflammation and relapses. However, they also noted that further research into this topic is necessary.
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However, the National Eczema Association highlights that while overactive or dysregulated immune functions are involved in the development of eczema, the immune system is not mistakenly attacking specific cells in the body. It does do this in autoimmune diseases.
Therefore, healthcare professionals currently classify AD and other types of eczema as an inflammatory skin condition. However, research into its cause is ongoing and its classification may change depending on the findings of future studies.
Learn about treatments for atopic dermatitis.
Dyshidrotic eczema, or pompholyx, causes small, itchy blisters on the soles, palms, and edges of the fingers and toes. According to the National Eczema Association, the cause is unknown, but many people living with the condition also have another form of eczema. In addition, doctors have noted that dyshidrotic eczema can run in families.
Some common triggers for flare-ups include:
- metal allergies, especially nickel allergy
- seasonal allergies, such as hay fever
- heat and humidity
- laundry detergents
- stress
Few studies have looked at the immune response in people with dyshidrotic eczema, doctors classify it as an inflammatory skin condition.
Read about other triggers for eczema.
Nummular eczema
According to the National Eczema Association, experts do not know what causes nummular eczema, but they think it has links with:
- having dry or sensitive skin
- having other types of eczema
- metal allergies
- cuts, insect bites, or chemical burns
- low blood flow in the legs if the patches appear there
No research has looked at whether nummular eczema could be an autoimmune disease, so healthcare professionals classify it as an inflammatory skin condition.
Autoimmune conditions can cause eczema and skin rashes, but presenting with either of these conditions would not necessarily lead to a doctor diagnosing an autoimmune disease. Eczema is widespread and can occur on its own.
People can also have eczema and autoimmune conditions together, and one may worsen the other. Conditions that increase the sensitivity of the immune system or cause inflammation may exacerbate eczema.
Additionally, eczema can occur as a secondary complication of an autoimmune disease. For example, inflammatory bowel disease (IBD) can lead to difficulty absorbing nutrients.
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Skin conditions can also be a side effect of treatments for autoimmune diseases. For example, infliximab (Remicade), one of the medications doctors prescribe to treat Crohn’s disease, may cause eczema.
A 2015 study found that 29.6% of study participants experienced scaling eczema and 18.5% developed exacerbated atopic eczema after taking this medication.
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The National Eczema Association notes that the exact cause of eczema is unknown, but factors that can activate the immune system, include:
Things that reduce the skin’s ability to hydrate and protect itself can also cause symptoms. For example, frequent handwashing, use of alcohol hand sanitizer, and hot baths can cause skin dryness. Moisturizing after getting the skin wet or using sanitizers that contain moisturizers can help.
Some of these factors have a more significant influence on certain types of eczema than others. For example, the National Eczema Association notes that a specific kind of yeast, known as Malassezia, probably causes seborrheic dermatitis.
This yeast usually lives on the skin, but it can trigger an immune response if it overgrows. Antifungal creams and shampoos help manage it.
It is crucial that doctors identify the specific type of eczema to understand its causes and prescribe the best treatments. People can have more than one type of eczema in different places on their bodies, which may need different approaches.
Eczema can also look very similar to other conditions, such as psoriasis and actinic keratosis, a precancerous skin rash.
Speaking with a dermatologist is advised if someone has not yet received an eczema diagnosis or if conventional eczema treatments are not working.
Learn about when skin rashes can signify cancer.
Eczema is an umbrella term for seven conditions that cause inflammation and itching. Each is slightly different and can have various triggers.
Doctors classify eczema as an inflammatory skin disease. The immune system is involved in its development, but it is not an autoimmune disease.
Anyone who thinks they may have eczema should speak with a healthcare professional.