Many people with eczema also have allergies, although they are different conditions. Interaction between the skin barrier, the immune system, and gut bacteria may explain the link.
One type of eczema doctors associate with allergies is called atopic dermatitis. The way these conditions develop is complex, but having atopic dermatitis as a child
This article explains the relationship between eczema and allergies, what makes them different, and ways to treat them.
Eczema and allergies often co-occur, but they are different conditions.
Allergies
Allergies occur when the immune system mistakenly reacts to a substance as though it is a threat.
For example, if the immune system reacts to pollen, a person has a pollen allergy, also called hay fever. This can cause a range of symptoms, such as:
- sneezing
- itchy or watery eyes
- hives
Eczema
Eczema is a skin condition that causes dry skin and itchiness.
There are several types of eczema, but atopic eczema, which doctors also call atopic dermatitis, is the
Another type of eczema, allergic contact dermatitis, also has a link to allergies. However, this form of eczema only occurs upon direct contact with an allergen, affecting the area of skin the allergen touched. For example, if a person is allergic to nickel, they may get eczema around their finger if they wear a ring that contains nickel.
Although eczema and allergies often occur together, they are distinct. Not everyone with eczema has allergies, and vice versa.
Both eczema and allergies involve atopy, which is a
Atopy can start at a young age, beginning with childhood atopic eczema. Doctors
Contributing factors
The exact way these conditions develop is complex. Factors that may contribute to both include:
- Skin barrier dysfunction: People with atopic dermatitis have skin that loses too much moisture, leading to dryness. This
may be due to a lack of ceramides. A dysfunctional skin barrier can allow allergens and irritants to get through, resulting in reactions. - Immune dysregulation: Atopic eczema and allergies both involve the immune system. According to the National Eczema Association, it is currently unclear whether a dysfunctional skin barrier directly leads to sensitization of the immune system to allergens or if other factors are also involved.
- Gut flora: A
2021 review of previous research suggests an imbalanced microbiome also contributes to both conditions. The microbiome is the collection of bacteria, fungi, and other microbes that live in the body. - Genetics: Genes play a significant role in the link between eczema and allergies. Individuals with a family history of either eczema or allergies are more prone to both conditions.
People with eczema could have any type of allergy, but some are more common than others.
The atopic march typically begins with eczema before progressing to food allergies, asthma, or respiratory allergies. Respiratory allergies involve substances people breathe in, leading to allergic rhinitis, which affects the nose and airways.
A
The risk is higher in those with multiple food allergies.
The answer to this question is complex. In the case of allergic contact dermatitis, where a person only has eczema when they touch an allergen, the allergen directly causes symptoms.
Atopic eczema is less straightforward. Having atopic eczema as a child appears to
Once a person has an allergy, allergens can act as eczema triggers. This means that one condition influences and exacerbates the other.
Allergens are not the only potential trigger for atopic eczema, though. Irritants such as the following can also lead to symptoms:
- perfumes
- harsh soaps
- rough fabrics
- dry weather
- stress
The symtpoms of eczema and allergies can include the following:
Eczema symptoms
A person with eczema may experience:
- dry or scaly skin
- an inflamed, itchy rash
- cracked skin
Allergic rhinitis symptoms
Symptoms of allergic rhinitis can include:
- itching of the eyes, nose, or throat
- nasal congestion
- rashes
- sneezing
Food allergy symptoms
Food allergies can cause:
Severe allergic reactions can result in anaphylaxis.
Anaphylaxis: Symptoms and what to do
Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:
- hives
- swelling of the face or mouth
- wheezing
- fast, shallow breathing
- a fast heart rate
- clammy skin
- anxiety or confusion
- dizziness
- vomiting
- blue or white lips
- fainting or loss of consciousness
If someone has these symptoms:
- Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
- Dial 911 or the number of the nearest emergency department.
- Lay the person down from a standing position. If they have vomited, turn them onto their side.
- Stay with them until the emergency services arrive.
Some people may need more than one epinephrine injection. If the symptoms do not improve in 5–15 minutes, or they come back, use a second pen if the person has one.
Specific substances will trigger a person’s allergy symptoms.
Doctors may suggest trying to identify these by keeping a symptom and food diary. Over time, the diary may show patterns, helping a person determine which substance is the cause. If this does not work, a doctor may suggest allergy testing.
Atopic eczema triggers can be more complex or varied than allergy triggers. Certain allergens may be triggers, but so may many other things. A symptom diary can help identify these, but allergy testing may not be helpful.
To keep a symptom diary, people can:
- use a notebook or app to track their symptoms daily
- note what they were doing when the symptoms appeared
- record factors that could have contributed, such as food, stress, weather, or contact with animals
Effectively managing eczema and allergies can involve various factors.
Treatment for eczema
Atopic dermatitis treatment involves:
- Trigger avoidance: Depending on the person, this may mean wearing smooth, soft fabrics, using different household and cosmetic products, wearing rubber gloves when cleaning, or reducing stress.
- Daily skin care: Taking lukewarm baths or showers, patting the skin dry gently, and moisturizing within
3 minutes with an emollient can help lock moisture into the skin. During flare-ups, a doctor may prescribe topical steroid creams to apply. - Anti-inflammatory therapy: This can include topical steroids or other medications, such as oral steroids or
immunomodulators . - Light therapy: In some cases, a doctor may suggest light therapy, also called phototherapy. This involves exposing the skin to specific types of light to improve symptoms.
For allergic contact dermatitis, avoiding triggers may be all that is necessary.
Treatment for allergies
Allergy treatment often involves allergen avoidance.
Antihistamines can help reduce symptoms. In some cases, doctors may suggest immunotherapy, which aims to desensitize the immune system to specific allergens, reducing the severity of reactions.
In severe cases, a doctor may prescribe medications such as oral corticosteroids to reduce inflammation. Collaboration between dermatologists and allergists ensures a comprehensive and integrated treatment plan for individuals with both conditions.
Asthma and allergy resources
To discover more evidence-based information and resources for living with asthma and allergies, visit our dedicated hub.
Eczema and allergies often occur together in individuals with atopy, which is an issue with the immune system. The connection between these conditions also seems to involve genetics, the microbiome, and dysfunction in the skin’s protective layer.
Allergens can worsen eczema, but they are not the only trigger in cases of atopic dermatitis. To manage both, it may help to figure out what triggers symptoms. People can do this with the help of a doctor or by using a symptom diary.
Treatment for eczema includes taking care of the skin, using creams or ointments, and avoiding triggers that cause flare-ups. Some individuals with allergies may also benefit from immunotherapy, a treatment that helps the body become less sensitive.