Dryness, itchiness, rashes, lesions… there’s no doubt that that eczema, also known as atopic dermatitis, can do a number on the skin. But it’s more than just a little dry skin and sensitivity — eczema is a complex condition that experts are still trying to figure out. So, throwing on some extra-strength moisturizer may not be the solve you’re looking for (as eczema sufferers can surely tell you).
Here’s what you need to know if you’ve been diagnosed with eczema or think you may have it:
Doctors haven’t figured out what causes it
The inflammatory disease remains a bit of a mystery, explains dermatologist Dendy Engelman, M.D. “Like acne, psoriasis, and rosacea, doctors aren’t quite sure what causes it.” The good news? “We know that there are triggers,” Dr. Engelman says. “For example, when high histamine foods are consumed, people with less than efficient histamine tolerance may experience an increase in the severity of their eczema.” (High histamine foods include smoked meat, shellfish, nuts, vinegar, chocolate, and canned foods.)
There’s an autoimmune link
In 2014, researchers got closer to understanding the condition, proving that eczema is an autoimmune disease. “Previous studies had shown that immune-suppressant drugs have improved eczema patients’ symptoms,” Dr. Engelman explains. This study described in detail the molecular mechanisms involved and found a drug treatment, Dupilumab, that blocks the activity of two immune proteins. The proteins increase the body’s ability to fight off viruses and bacteria — usually a good thing, but these proteins can mistakenly target the body’s own tissues, causing an autoimmune reaction, explains Dr. Engelman.
The treatment is FDA approved, but Dr. Engelman cautions that there’s no word yet on availability and that cost may be a barrier. And keep in mind that Regeneron Pharmaceuticals, the makers of Dupilumab, was one of the study partners. If you’re looking for a place to start treating your eczema, start with your skincare routine and avoidable triggers.
There’s no cure — but there are treatments
There isn’t a cure for eczema yet, but that doesn’t mean you’re doomed to suffer from the symptoms. “Treating eczema and similar conditions has always been a trial approach,” says Dr. Engelman. “My priority is management — knowing the triggers and trying to stay one step ahead of it with corticosteroids and anti-histamines.” Other than certain foods, common triggers include chemicals in cleaning products, hot water, fragranced laundry detergents, allergies, and stress.
What you put on your skin also — not surprisingly — matters. “Look for products specifically formulated for eczema-prone skin, and if it’s received a seal from the National Eczema Association, that’s a huge plus,” says Dr. Engelman. Products should be fragrance-free and contain ceramides (which replenish lost lipids and keep skin pump and moisturized), Dr. Engelman says — she recommends Cetaphil’s RestoraDerm Eczema Calming Body Moisturizer and RestoraDerm Eczema Calming Body Wash.
And if you wear makeup, you’ve probably already noticed that some products irritate your skin. Don’t worry — you can still contour with the best of them. Just look for dermatologist-created, clinically tested brands that won’t aggravate sensitive skin (Dr. Engelman likes Cover FX).