Understanding what eczema is and how it works is key to finding the most effective treatment.

Atopic Dermatitis (AD), more commonly referred to as eczema, is a complex disease that affects different people in many different ways. Flareups can be triggered by a wide range of stimuli, with varying degrees of severity, often causing painful, unsightly weeping sores. Not surprisingly, the nature of eczema is frequently misunderstood considering how many different ways it can express itself. Let’s look at four interesting aspects of eczema that may help us better understand it and how to treat it.

Eczema Is an Allergic Condition

Many people view eczema as a stress-related disease since stress seems to be a common trigger

for flare-ups. However, the triggers don’t reflect the source of the disease itself. Eczema is categorized as atopic because it is related to other atopic diseases such as hay fever or allergies. (In fact, about 60 - 75 percent of children with moderate to severe eczema will develop hay fever or asthma as well.) “Atopic” refers to the fact that the allergic reaction can occur on the skin without the skin being in direct contact with the allergen itself. Stress can aggravate eczema, just as it can aggravate asthma, but the skin would not react to stress in this way without the allergy itself.

Eczema Has Many Triggers, Not Just Stress

Eczema flare-ups can be triggered by a wide range of stimuli, many having nothing to do with stress or even a particular allergy. These may include:

Cold, dry conditions

Warm, humid conditions

Chemicals in household cleaners

Certain types of foods

Poor air quality (e.g., cigarette smoke)

Coarse fabrics

Certain shampoos or other hygiene products

The specific triggers may differ from person to person, and sometimes it’s a matter of trial-and-error to identify and avoid those triggers. However, by paying attention and adjusting habits accordingly, one can often reduce the occurrence of flare-ups.

Eczema Is Inherited, not Caught

Eczema flare-ups can be unsightly and scary-looking, especially when they produce weeping sores. However, eczema is not contagious and the related infections can’t be passed through contact. In most instances, eczema can be traced genetically to allergic sensitivities within the family line. In fact, if both parents have eczema, there’s a 60- 80 percent chance their offspring will have it, too.

Biologics Are Showing Promise in the Treatment of Eczema

True to their name, biologics are medications developed from biological organisms and/or their products, and they can be used to target specific biologic pathways in certain patients. While many instances of eczema can be treated by topical steroids, antihistamines and antibiotics, some patients with moderate to severe eczema often don’t see the desired results from these medications. For these patients, a biologic drug called dupilumab (Dupixent) has produced dramatically positive results, frequently resulting in a complete clearing of the skin.

Since eczema affects different people differently, the best pathway to relief involves working with a board-certified allergist in developing a personalized treatment plan, including biologics when necessary.

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