Eczema, also known as atopic dermatitis, is a chronic skin condition that affects millions of people worldwide. While it commonly begins in childhood, many adults either develop it later in life or experience a resurgence of symptoms they had as children. Eczema can vary in severity, from mild itching and redness to severe, painful flare-ups. This article will focus on what causes severe eczema in adults, exploring both internal and external factors.
What is Eczema?
Eczema is a condition that causes the skin to become inflamed, itchy, and red. In more severe cases, the skin can blister, crack, and ooze. Although it can affect any part of the body, common areas include the hands, face, neck, and inner elbows. Eczema tends to flare up periodically, with symptoms worsening for a while before improving again.
Symptoms of Severe Eczema
Severe eczema in adults can lead to a range of uncomfortable and distressing symptoms, including:
- Intense itching, often causing sleepless nights
- Thickened, scaly skin
- Redness and inflammation
- Painful cracks in the skin
- Oozing or weeping of fluid from affected areas
- Skin infections caused by scratching
Severe eczema can greatly affect quality of life, making it important to understand what triggers and worsens the condition.
SEE ALSO: What Triggers Eczema on Feet?
Genetic Factors
One of the leading causes of eczema is a genetic predisposition. If you have a family history of eczema, asthma, or hay fever, your chances of developing eczema are higher. Research has shown that people with eczema often have mutations in a gene called filaggrin. This gene is responsible for producing a protein that helps maintain the skin’s protective barrier. When this barrier is compromised, the skin becomes dry and more prone to irritation and infection, leading to severe eczema flare-ups.
Immune System Dysfunction
Eczema is often associated with an overactive immune system. In people with eczema, the immune system mistakenly reacts to harmless substances as if they were dangerous invaders. This leads to inflammation and itching. In severe cases, the immune system’s response can cause extensive skin damage and discomfort.
Environmental Triggers
The environment plays a crucial role in exacerbating eczema symptoms. Many external factors can trigger severe eczema flare-ups in adults. Some of the most common environmental triggers include:
1. Irritants
Everyday substances such as soaps, detergents, shampoos, and household cleaning products can irritate the skin and worsen eczema. Many people with severe eczema are particularly sensitive to these irritants, which can cause immediate flare-ups upon contact.
2. Allergens
Common allergens like pollen, dust mites, mold, and pet dander can trigger the immune system in people with eczema. When exposed to these allergens, the body releases chemicals that cause itching and inflammation. This can lead to severe eczema, particularly during allergy seasons when these allergens are more prevalent in the air.
3. Weather Changes
Cold, dry air can deplete the skin’s moisture levels, leading to dryness and irritation, which can cause severe eczema flare-ups. On the other hand, hot, humid weather can cause excessive sweating, which can also trigger eczema by clogging the skin’s pores and increasing irritation.
4. Clothing and Fabrics
Certain fabrics can irritate the skin and exacerbate eczema symptoms. For example, wool and synthetic fabrics can cause friction and itching. Wearing loose, soft cotton clothing can help minimize irritation, but for people with severe eczema, even minor irritations from fabrics can lead to significant discomfort.
Stress
Stress is a major factor in severe eczema. While stress does not directly cause eczema, it can trigger flare-ups or make existing symptoms worse. When you are stressed, your body releases a hormone called cortisol, which can suppress the immune system and worsen inflammation. This heightened inflammatory response can lead to more intense itching and more frequent flare-ups.
Adults who lead stressful lives, whether due to work, personal relationships, or other factors, may find that their eczema worsens during times of heightened stress. Additionally, severe eczema can itself be a source of stress, creating a vicious cycle that is difficult to break.
Dietary Factors
Diet can play a role in triggering or worsening severe eczema in some individuals. While food allergies are not a primary cause of eczema, certain foods can trigger flare-ups in people who are sensitive to them. Common food triggers include:
- Dairy products (milk, cheese, yogurt)
- Eggs
- Soy products
- Wheat and gluten
- Nuts and seeds
Some people with severe eczema find that eliminating or reducing their intake of these foods can help alleviate symptoms. However, it is important to consult with a healthcare professional before making significant changes to your diet.
Skin Infections
People with severe eczema are more susceptible to skin infections. Bacteria, viruses, and fungi can easily penetrate the damaged skin barrier, leading to infections that worsen eczema symptoms. The most common infection in people with eczema is caused by Staphylococcus aureus bacteria. This bacteria can cause the skin to become red, swollen, and painful, and in severe cases, it can lead to serious complications.
Scratching the skin, which is common in people with severe eczema due to intense itching, can introduce bacteria and worsen the infection. This creates a cycle where the infection causes more itching, and the itching leads to more infections.
Hormonal Changes
Hormonal fluctuations can also contribute to severe eczema in adults. Many women experience eczema flare-ups during pregnancy, menstruation, or menopause due to changes in hormone levels. Estrogen, in particular, affects the skin’s moisture levels, and when hormone levels drop, the skin can become drier and more prone to irritation.
Lifestyle Factors
Several lifestyle factors can increase the likelihood of developing severe eczema or worsening existing symptoms. These include:
Smoking: Smoking can irritate the skin and reduce the skin’s ability to heal itself. It also increases inflammation throughout the body, worsening eczema symptoms.
Alcohol: Excessive alcohol consumption can dry out the skin and weaken the immune system, leading to more severe eczema flare-ups.
Lack of sleep: Sleep deprivation can weaken the immune system, making the body more prone to inflammation and infection. Many adults with severe eczema experience sleep disturbances due to itching, which can exacerbate their symptoms.
Treatment for Severe Eczema
Managing severe eczema requires a comprehensive approach that addresses both the symptoms and the underlying causes. While there is no cure for eczema, several treatments can help control the condition and reduce flare-ups.
1. Topical Treatments
Topical corticosteroids are commonly prescribed to reduce inflammation and itching in people with severe eczema. These creams and ointments work by suppressing the immune system’s overactive response. In more severe cases, doctors may recommend stronger medications like calcineurin inhibitors, which also reduce inflammation but are less likely to cause skin thinning than corticosteroids.
2. Moisturizers
Keeping the skin well-moisturized is critical for managing severe eczema. Moisturizers help repair the skin’s barrier, reducing dryness and preventing flare-ups. Thick creams or ointments are generally more effective than lotions, as they provide a stronger barrier against moisture loss.
3. Phototherapy
In cases where topical treatments are not enough, phototherapy (light therapy) may be recommended. This involves exposing the skin to controlled amounts of ultraviolet (UV) light, which can help reduce inflammation and itching.
4. Oral Medications
For severe eczema that does not respond to topical treatments, oral medications such as corticosteroids, antihistamines, or immunosuppressants may be prescribed. These medications work by calming the immune system and reducing inflammation throughout the body.
5. Lifestyle Changes
Making certain lifestyle adjustments can also help manage severe eczema. This includes avoiding known triggers, wearing soft fabrics, reducing stress, and maintaining a consistent skincare routine that includes moisturizing daily.
Conclusion
Severe eczema in adults can be triggered by a variety of factors, including genetic predisposition, immune system dysfunction, environmental triggers, stress, and hormonal changes. Understanding the underlying causes of eczema is essential for managing the condition effectively. While there is no cure, proper treatment and lifestyle changes can significantly improve quality of life for those suffering from severe eczema. Always consult with a healthcare professional to determine the best treatment plan for your individual needs.
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