"The itching was so bad, I wanted to cut off my arm..."
That's how a coworker recently described a flare-up of her chronic skin condition, eczema. She isn't alone in her agony, either. The skin condition made news last week when reports out of Hong Kong cited it as the reason a young woman killed her parents and herself.
Eczema takes on several forms, but the most common is atopic dermatitis. It involves problems with the immune system that cause flare-ups of the skin. Your skin might feel inflamed, turn red or have red spots, and become extremely itchy. Other forms also involve the formation of blisters or greasy, weeping spots.
Many folks report itching that's so intense, it wakes them up from sleep. It may flare up rarely or exist in a near-constant state of irritation.
Eczema is more common as a childhood disease, with about 13% of kids under 18 developing the condition. Most outgrow it.
But some never do... more than 18 million adults also have it, including people who end up with adult-onset eczema.
And that number keeps climbing. Each year, more and more people need treatment for this uncomfortable and at times, agonizing condition.
We don't know exactly what causes eczema. Doctors currently believe it's a multifactorial disease. Mutations on a few genes only account for a few cases, but eczema tends to run in families. Often immune diseases like rhinitis and asthma increase your risk for eczema, but the connection isn't clear yet.
What we do know is that eczema results from an immune system in overdrive. The lesions seen in the outbreaks come from ramped up immune signals. That means rushes of inflammatory responses.
In fact, a 2014 study from the Icahn School of Medicine at Mount Sinai, New York found that certain autoimmune drugs stopped eczema attacks. They found the mechanism responsible... Eczema, it turns out, is a type of autoimmune disorder. That means our immune system actively attacks our skin.
As you might remember, we wrote about another autoimmune disorder, rheumatoid arthritis. In that case, your immune system attacks the barrier around your joints. It causes swelling and pain, and breaks down bones.
Autoimmune disorders also include type 1 diabetes, lupus, Hashimoto's disease, Crohn's disease, irritable bowel syndrome, and multiple sclerosis, just to name a few. There's even some evidence that Alzheimer's may result from autoimmune complications.
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Autoimmune disorders don't have a known cause. But one related condition is one we've written about many times before... chronic inflammation. Inflammation is the response of your immune system to an irritant. So, an autoimmune reaction involves an overabundance of inflammation without an outside irritant.
We're concerned about eczema because it often appears along with or ahead of other autoimmune disorders. For instance, folks with rheumatoid arthritis have twice the likelihood of developing skin conditions like eczema.
What's more, about one in 20 men and one in 12 women will develop an autoimmune disease. More troubling, that number keeps increasing and doctors don't know why.
Although we don't have the answer for stopping autoimmune diseases yet, our advice will help keep inflammation lower and provide some relief. That includes: Get out and get moving (especially for rheumatoid arthritis), stop eating processed foods, and get plenty of antioxidants.
As for eczema, the best course of action if you're plagued by these outbreaks of itchy, blistering, or bumpy skin, is to get a diagnosis. And because it's an immune flare-up, figure out the source. That could require allergy testing. You also want to protect your skin barrier, which means softer soaps and lotions like CeraVe or Aveeno.
Since eczema and a number of other conditions worsen with allergies, take good care of your airways, too. I recommend a neti pot for clearing out the sinus cavity. Checking your local air quality for high pollen counts also helps you avoid too much exposure.
And don't forget, diet helps. Getting plenty of antioxidants in foods like fruits, vegetables, and olive oil keeps inflammation at bay. But some fruits and vegetables can trigger allergies. So, if you're allergic to say, weed pollen, you might have a reaction to foods like bananas, melons, and cucumbers.
Finally, avoid overly processed foods. That's because highly processed foods like our "white killers" (white bread, white sugar, and white rice) contribute to massive inflammation. Similarly, artificial sugar causes its share of inflammation as well. I've told people for years to limit white killers, so be sure to cut these out of your diet as soon as possible.
- The American Academy of Dermatology on adult eczema.
- Something different: Blue milk, sure, but blue sand?
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
June 26, 2018