Eczema (Atopic Dermatitis)

Last Updated: August 16, 2022

Eczema (atopic dermatitis) is a common, painful skin condition where the skin is inflamed, itchy, and the skin barrier is disrupted. Treatment generally involves addressing each of these aspects.

Eczema (Atopic Dermatitis) falls under theSkin, Hair, & NailsandAutoimmune Diseasecategories.

What is eczema?

Atopic dermatitis, also called eczema, is a common skin condition. "Atopic" refers to a heightened sensitivity toward allergens, leading to frequent, excessive immune reactions that inflame and irritate the skin (dermatitis). Other atopic diseases include allergic rhinitis and asthma. It is most common during childhood, with a prevalence of up to 25% of children affected, but can persist into adulthood; over a lifetime, 7–10% of people will get eczema at some point.[1]

What are the main signs and symptoms of eczema?

Red, inflamed skin lesions that can occur on many parts of the body. These lesions are dry and often itchy, swollen, oozing, crusting, and with time can become lichenified (thick and leathery). Scratching is common, which leads to a vicious cycle of irritation leading to scratching leading to further irritation. Psychological symptoms such as depression, anxiety, and insomnia are also common.

How is eczema diagnosed?

Diagnosis is generally based on signs/symptoms and medical history. Eczema is chronic, so it can take a while to be sure that the lesions are due to eczema rather than a more acute phenomenon like an infection, an acute or transient allergic reaction, or exposure to harmful chemicals. A history or family history of asthma, hay fever, and dry skin also makes eczema more likely. To determine the severity of atopic dermatitis and track treatment progress, researchers and doctors objectively measure several characteristics of the lesions with scoring systems such as EASI and SCORAD.[2]

What are some of the main medical treatments for eczema?

The use of topical barrier creams and topical corticosteroids, such as hydrocortisone, are typically the first line of treatment. Oral and topical antihistamines are also commonly used early. If this proves insufficient, immunosuppressive (focused on curtailing the excessive immune system activation) drugs are frequently employed. Some such drugs and drug types include monoclonal antibodies, JAK inhibitors, steroids, calcineurin inhibitors, methotrexate, mycophenolate mofetil, and cromoglycate. Phosphodiesterase inhibitors are also sometimes used to induce vasodilation.

Have any supplements been studied for eczema?

Several supplements have and continue to be investigated for eczema, though at present, the only ones approaching credibility from clinical trials are vitamin D[3] and probiotics.[4] They are also mechanistically plausible. Vitamin D is known to help regulate the immune system and plays a role in the formation of filaggrin, which helps to maintain the skin's moisture barrier. Some probiotics play a significant role in regulating the immune system to reduce excessive inflammation, maintain the gut barrier and prevent further inflammation.

How could diet affect eczema?

The use of partially hydrolyzed whey protein infant formula may reduce the risk of eczema later in life.[5] In addition, sufficient levels of vitamin-d, zinc, and selenium are associated with a lower risk of eczema, though besides vitamin D, it's not clear if they are causally linked.[6]

Are there any other treatments for eczema?

Fabric selection may play a meaningful part in reducing itching. Fabrics with scratchier fibers and wider spaces between fibers, such as wool, are worse, whereas cotton, silk, and ultrafine wool may be better choices.[7] There is also interest in a number of alternative fabrics treated with antibacterial agents, such as silver, zinc oxide, and borage oil, with some clinical evidence in particular for silver, though more research is needed.[8] Phototherapy with narrow-band UV-B and UV-A1 has also seen a considerable amount of research and is likely effective for reducing the severity of eczema.[9]

What causes eczema?

Genetics plays a considerable role, and a number of mechanistically plausible genes have been linked to eczema risk.[10] Additionally, microbiome disruption is highly common in eczema, and with the vital role in immune regulation that the microbiome plays, this is plausible.[11] Other possible factors include smoking, maternal alcohol consumption and stress/anxiety, being born in winter, phthalate exposure, and hard water. The early-life use of antibiotics[12] and acetaminophen are also associated with eczema, though it's possible that this is due to a dysfunctional immune system leading both to the need for those medications as well as eczema.

Looking for a Supplement guide?

Our Supplement Guides give you unbiased research-based recommendations that you can immediately apply to improve your health. Eczema (Atopic Dermatitis) is related to the following Supplement Guide:
Examine Database: Eczema (Atopic Dermatitis)
What works and what doesn't?

Unlock the full potential of Examine

Get started

Don't miss out on the latest research

  1. ^Weidinger S, Beck L, Bieber T, Kabashima K, Irvine AAtopic dermatitisNat Rev Dis Primers.(2018 June)
  2. ^Jochen Schmitt, Sinéad Langan, Stefanie Deckert, Ake Svensson, Laura von Kobyletzki, Kim Thomas, Phyllis Spuls, Harmonising Outcome Measures for Atopic Dermatitis (HOME) InitiativeAssessment of clinical signs of atopic dermatitis: a systematic review and recommendationJ Allergy Clin Immunol.(2013 Dec)
  3. ^Kim G, Bae JHVitamin D and atopic dermatitis: A systematic review and meta-analysisNutrition.(2016 Sep)
  4. ^Ruixue Huang, Huacheng Ning, Minxue Shen, Jie Li, Jianglin Zhang, Xiang ChenProbiotics for the Treatment of Atopic Dermatitis in Children: A Systematic Review and Meta-Analysis of Randomized Controlled TrialsFront Cell Infect Microbiol.(2017 Sep 6)
  5. ^Julien Sauser, Sophie Nutten, Nanda de Groot, Sophie Pecquet, Dagmar Simon, Hans-Uwe Simon, Jonathan M Spergel, Sibylle Koletzko, Carine BlanchardPartially Hydrolyzed Whey Infant Formula: Literature Review on Effects on Growth and the Risk of Developing Atopic Dermatitis in Infants from the General PopulationInt Arch Allergy Immunol.(2018)
  6. ^Alexandra R Vaughn, Negar Foolad, Melody Maarouf, Khiem A Tran, Vivian Y ShiMicronutrients in Atopic Dermatitis: A Systematic ReviewJ Altern Complement Med.(2019 Jun)
  7. ^Joanna Jaros, Claire Wilson, Vivian Y ShiFabric Selection in Atopic Dermatitis: An Evidence-Based ReviewAm J Clin Dermatol.(2020 Aug)
  8. ^Cristina Lopes, Diana Silva, Luís Delgado, Osvaldo Correia, André MoreiraFunctional textiles for atopic dermatitis: a systematic review and meta-analysisPediatr Allergy Immunol.(2013 Sep)
  9. ^Pérez-Ferriols A, et alPhototherapy in Atopic Dermatitis: A Systematic Review of the LiteratureActas Dermosifiliogr.(2015 June)
  10. ^Weidinger S, Novak NAtopic dermatitisLancet.(2015 Sept)
  11. ^Zhifeng Fang, Lingzhi Li, Hao Zhang, Jianxin Zhao, Wenwei Lu, Wei ChenGut Microbiota, Probiotics, and Their Interactions in Prevention and Treatment of Atopic Dermatitis: A ReviewFront Immunol.(2021 Jul 14)
  12. ^T Tsakok, T M McKeever, L Yeo, C FlohrDoes early life exposure to antibiotics increase the risk of eczema? A systematic reviewBr J Dermatol.(2013 Nov)
  13. ^A Wollenberg, S Barbarot, T Bieber, S Christen-Zaech, M Deleuran, A Fink-Wagner, U Gieler, G Girolomoni, S Lau, A Muraro, M Czarnecka-Operacz, T Schäfer, P Schmid-Grendelmeier, D Simon, Z Szalai, J C Szepietowski, A Taïeb, A Torrelo, T Werfel, J Ring, European Dermatology Forum (EDF), the European Academy of Dermatology and Venereology (EADV), the European Academy of Allergy and Clinical Immunology (EAACI), the European Task Force on Atopic Dermatitis (ETFAD), European Federation of Allergy and Airways Diseases Patients’ Associations (EFA), the European Society for Dermatology and Psychiatry (ESDaP), the European Society of Pediatric Dermatology (ESPD), Global Allergy and Asthma European Network (GA2LEN) and the European Union of Medical Specialists (UEMS)Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: part IJ Eur Acad Dermatol Venereol.(2018 May)
  14. ^Bath-Hextall F, Delamere FM, Williams HCDietary exclusions for improving established atopic eczema in adults and children: systematic review.Allergy.(2009-Feb)
  15. ^National Eczema AssociationManaging Itch
  16. ^Maria J Martin, Miguel Estravís, Asunción García-Sánchez, Ignacio Dávila, María Isidoro-García, Catalina SanzGenetics and Epigenetics of Atopic Dermatitis: An Updated Systematic ReviewGenes (Basel).(2020 Apr 18)
  17. ^Alan D Irvine, W H Irwin McLean, Donald Y M LeungFilaggrin mutations associated with skin and allergic diseasesN Engl J Med.(2011 Oct 6)
  18. ^Elke Rodríguez, Hansjörg Baurecht, Esther Herberich, Stefan Wagenpfeil, Sara J Brown, Heather J Cordell, Alan D Irvine, Stephan WeidingerMeta-analysis of filaggrin polymorphisms in eczema and asthma: robust risk factors in atopic diseaseJ Allergy Clin Immunol.(2009 Jun)
  19. ^Yunling Li, Yin Li, Wei Li, Xiaoxuan Guo, Sha Zhou, Huiwen ZhengGenetic polymorphisms in serine protease inhibitor Kazal-type 5 and risk of atopic dermatitis: A meta-analysisMedicine (Baltimore).(2020 Jul 10)
  20. ^Jingyao Liang, Yumei Liu, Rujun Xue, Lijie Chen, Huiheng Chen, Lei Shao, Jianqin Wang, Xibao ZhangInterleukin 4 -590C/T (rs2243250) Polymorphism Is Associated With Increased Risk of Atopic Dermatitis: Meta-Analysis of Case-Control StudiesDermatitis.(Mar/Apr 2017)
  21. ^Jian Zhao, Ze-Yu Chen, Lin-Feng LiAssociation Between the IL-10-1082G/A, IL-10-592A/C, and IL-10-819G/A Polymorphisms and Atopic Dermatitis Susceptibility: A Meta-AnalysisGenet Test Mol Biomarkers.(2019 May)
  22. ^Yuan Zhang, Hui-Cong Wang, Chao Feng, Min YanAnalysis of the Association of Polymorphisms rs5743708 in TLR2 and rs4986790 in TLR4 with Atopic Dermatitis RiskImmunol Invest.(2019 Feb)
  23. ^Anna Pothmann, Tanja Illing, Cornelia Wiegand, Albert A Hartmann, Peter ElsnerThe Microbiome and Atopic Dermatitis: A ReviewAm J Clin Dermatol.(2019 Dec)
  24. ^H Alexander, A S Paller, C Traidl-Hoffmann, L A Beck, A De Benedetto, S Dhar, G Girolomoni, A D Irvine, P Spuls, J Su, J P Thyssen, C Vestergaard, T Werfel, A Wollenberg, M Deleuran, C FlohrThe role of bacterial skin infections in atopic dermatitis: expert statement and review from the International Eczema Council Skin Infection GroupBr J Dermatol.(2020 Jun)
  25. ^Robert Kantor, Ashley Kim, Jacob P Thyssen, Jonathan I SilverbergAssociation of atopic dermatitis with smoking: A systematic review and meta-analysisJ Am Acad Dermatol.(2016 Dec)
  26. ^Feifei Qiu, Chun-Ling Liang, Huazhen Liu, Yu-Qun Zeng, Shaozhen Hou, Song Huang, Xiaoping Lai, Zhenhua DaiImpacts of cigarette smoking on immune responsiveness: Up and down or upside down?Oncotarget.(2017 Jan 3)
  27. ^Yu Ting Ng, Fook Tim ChewA systematic review and meta-analysis of risk factors associated with atopic dermatitis in AsiaWorld Allergy Organ J.(2020 Nov 2)
  28. ^A-S Halling-Overgaard, C R Hamann, R P Holm, A Linneberg, J I Silverberg, A Egeberg, J P ThyssenAtopic dermatitis and alcohol use - a meta-analysis and systematic reviewJ Eur Acad Dermatol Venereol.(2018 Aug)
  29. ^Monika Calov, Farzad Alinaghi, Carsten Robert Hamann, Jonathan Silverberg, Alexander Egeberg, Jacob Pontoppidan ThyssenThe Association Between Season of Birth and Atopic Dermatitis in the Northern Hemisphere: A Systematic Review and Meta-AnalysisJ Allergy Clin Immunol Pract.(2020 Feb)
  30. ^Bo L Chawes, Klaus Bønnelykke, Jakob Stokholm, Nadja H Vissing, Elín Bjarnadóttir, Ann-Marie M Schoos, Helene M Wolsk, Tine Marie Pedersen, Rebecca K Vinding, Sunna Thorsteinsdóttir, Lambang Arianto, Henrik W Hallas, Lene Heickendorff, Susanne Brix, Morten A Rasmussen, Hans BisgaardEffect of Vitamin D3 Supplementation During Pregnancy on Risk of Persistent Wheeze in the Offspring: A Randomized Clinical TrialJAMA.(2016 Jan 26)
  31. ^Debra J PalmerVitamin D and the Development of Atopic EczemaJ Clin Med.(2015 May 20)
  32. ^Nasya Amalia, David Orchard, Kate Louise Francis, Emma KingSystematic review and meta-analysis on the use of probiotic supplementation in pregnant mother, breastfeeding mother and infant for the prevention of atopic dermatitis in childrenAustralas J Dermatol.(2020 May)
  33. ^Minghui Sun, Jing Luo, Hanmei Liu, Yue Xi, Qian LinCan Mixed Strains of Lactobacillus and Bifidobacterium Reduce Eczema in Infants under Three Years of Age? A Meta-AnalysisNutrients.(2021 Apr 25)
  34. ^Shuya Sun, Guizhen Chang, Litao ZhangThe prevention effect of probiotics against eczema in children: an update systematic review and meta-analysisJ Dermatolog Treat.(2021 May 18)
  35. ^Wenshu Chen, Lei Wang, Hao Yao, Huan Dai, Rongying Zheng, Weixi ZhangPrepregnancy BMI, gestational weight gain and risk of childhood atopic dermatitis: A systematic review and meta-analysisPediatr Allergy Immunol.(2021 Jul)
  36. ^Carmen W H Chan, Bernard M H Law, Yun-Hong Liu, Alexandra R B Ambrocio, Natasha Au, Melody Jiang, Ka Ming ChowThe Association between Maternal Stress and Childhood Eczema: A Systematic ReviewInt J Environ Res Public Health.(2018 Feb 25)
  37. ^Minyoung Jung, Min-Ji Kim, Seonwoo Kim, Yechan Kyung, Minji Kim, Ji Young Lee, Hye-In Jeong, Bo Ra Lee, Jihyun Kim, Kangmo Ahn, Yong Mean ParkEffect of prenatal phthalate exposure on childhood atopic dermatitis: A systematic review and meta-analysisAllergy Asthma Proc.(2021 Jul 1)
  38. ^Yung-Sen Chang, Michelle K Trivedi, Ayan Jha, Yen-Feng Lin, Liezeel Dimaano, Maria T García-RomeroSynbiotics for Prevention and Treatment of Atopic Dermatitis: A Meta-analysis of Randomized Clinical TrialsJAMA Pediatr.(2016 Mar)
Examine Database References
  1. Skin Quality - Callaway J, Schwab U, Harvima I, Halonen P, Mykkänen O, Hyvönen P, Järvinen TEfficacy of dietary hempseed oil in patients with atopic dermatitisJ Dermatolog Treat.(2005 Apr)
  2. Eczema Symptoms - Lee J, Jung E, Koh J, Kim YS, Park DEffect of rosmarinic acid on atopic dermatitisJ Dermatol.(2008 Dec)
  3. Eczema Symptoms - Farahani AM, Aryanian Z, Memariani Z, Mozaffarpur SA, Shirafkan HA Comparison of the Effect of Topical Preparation of L. and Hydrocortisone on Hand Eczema: A Double-Blind Randomized Controlled Trial.J Altern Complement Med.(2021-Apr)
  4. Eczema Symptoms - Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst EOral evening primrose oil and borage oil for eczema.Cochrane Database Syst Rev.(2013-Apr-30)
  5. Skin Dryness - Verallo-Rowell VM, Dillague KM, Syah-Tjundawan BSNovel antibacterial and emollient effects of coconut and virgin olive oils in adult atopic dermatitisDermatitis.(2008 Nov-Dec)
  6. Wound Healing - Gebicki J, Sysa-Jedrzejowska A, Adamus J, Woźniacka A, Rybak M, Zielonka J1-Methylnicotinamide: a potent anti-inflammatory agent of vitamin originPol J Pharmacol.(2003 Jan-Feb)