Understanding Eczema Part 2: Causes


In the last post, we began our discussion about eczema by coming to agreement on exactly what we mean by eczema.  To recap, the term “eczema” is often used throughout the medical community to describe multiple types of dermatitis (inflammatory skin conditions).  For our purposes in this series of posts, we will only consider the form of eczema known as “atopic eczema”, also known as “atopic dermatitis”.   We will cover other forms of dermatitis in future posts.  Alrighty then – let’s look at what causes eczema.

Well, the truth is that the etiology (original cause of onset) of eczema is not clearly understood from the western/scientific perspective.   (Fortunately, Traditional Chinese Medicine has a much more useful understanding of the underlying conditions that predispose one to developing eczema and we will uncover these in the next post).  In most cases eczema appears in infancy.  Though there has been no proof yet that eczema is inherited, studies show that babies are more than 80% likely to develop it if both parents have it.  Developing eczema (atopic dermatitis) after the age of 20 is relatively uncommon.

According to the National Eczema Association, it is estimated that over 30 million Americans suffer from this form of eczema.  Though the exact cause is unknown, approximately 85% of people with eczema are found to have elevated serum IgE levels.  IgE antibodies in the blood indicate that eczema seems to be the result of  a Type I hypersensitivity response.  Type I hypersensitivity is a type of immediate allergic response.  For reasons that are poorly understood, some people are predisposed to having allergic reactions (respiratory, eye, digestive or skin symptoms) to substances that do not cause a reaction in other people.  So people who develop eczema also tend to have asthma and/or allergic rhinitis (seasonal or year-round allergies).

In many cases of eczema (especially in children), the itchy rash gets worse with exposure to certain foods such as milk, eggs, soybeans, fish and wheat.  Inhalants, like dust mites or pollen, that cause other allergy symptoms (like sneezing, runny/stuffy nose, itchy eyes, sore throat), can also cause eczema to flare.  Another factor that may be involved with the cause or exacerbation of eczema is Staphylococcus aureus bacteria.  “Staph” bacteria are present on our skin in normal concentrations all the time.  In acute flare-ups of eczema there is often a much higher number of staph bacteria present on the skin.  These bacteria secrete toxins that seem to act as “super-antigens” (substances that cause the body to produce antibodies in response to their presence) and result in an immune response that produces inflammation and makes the eczema worse.

What else makes eczema worse?  It’s a long list, so hang on:  skin dehydration (like from frequent bathing, over-washing of hands, dry climates), hormonal changes (like pregnancy, menstruation, thyroid problems), infections (staph, streptococcus, herpes simplex, candida), dry or cold weather, wool clothing or blankets, and emotional stress.

Let’s put it all together now:  Eczema generally develops in infants who have factors that predispose them to having allergies and/or asthma.  These factors are more likely to exist in the child if both the parents had eczema, allergies or asthma.  Perhaps the original allergy that triggers eczema is due to a response to certain foods or airborne allergens. It is possible that these hypersensitive immune reactions directly cause the eczema or perhaps they cause an inappropriate change in the regulation of normal bacteria on the skin, thus allowing an increase in the population of staph bacteria which then cause the eczema.


Even though the original cause of eczema isn’t fully understood, we do know that the following things often make eczema worse:

  • Milk
  • Eggs
  • Peanuts
  • Soybeans
  • Fish
  • Wheat
  • Dust mite allergies
  • Pollen allergies
  • Over-washing hands
  • Frequent bathing
  • Pregnancy
  • Menstruation
  • Thyroid imbalances
  • Infections (staph or strep or herpes simplex)
  • Dry, cold weather
  • Wool clothing or blankets
  • Emotional stress

In our next post, we will start looking at eczema from the perspective of Traditional Chinese Medicine.  Then we can discuss what helps to improve eczema.

Tags: allergic reaction, atopic dermatitis, atopic eczema, beeswax allergy, dermatitis, dermatology, eczema, natural skin care, rashes, skin care, skin rash

Topics: Allergies, Eczema, Rashes

Publish Date: October 5, 2010     *Articles may include updates since original publishing.

About the Author ()

Diana Hermann is a licensed acupuncturist and board certified in Chinese Herbal Medicine. She received her Master Degree in Acupuncture and Oriental Medicine from the Oregon College of Oriental Medicine in Portland, OR and trained in China at the Nanjing University of Traditional Chinese Medicine. Diana treats patients in her Fort Collins, Colorado clinic and hand crafts herbal skin care products for her company Zi Zai Dermatology. In 2015, she completed the Diploma In Chinese Medicine Dermatology program from Avicenna in London, UK. She completed the program for a second time in 2019 in Chicago.

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