Key takeaways

  • Eczema is associated with an over-reactive immune system that responds to internal or external triggers by producing inflammation and symptoms like itching and rashes.
  • While eczema doesn’t indicate a weak immune system, it suggests the immune system is overly sensitive and reactive to certain irritants, leading to an imbalance of T helper cells and potential skin infections.
  • Eczema is not considered an autoimmune disease because, despite immune system dysregulation, the body does not attack its own skin cells; rather, allergens and irritants breach the skin barrier and cause symptoms.

Eczema is an umbrella term for various inflammatory skin conditions. Various factors contribute to eczema, including the overreactivity of the immune system, genetics, and the environment. The most common form of eczema is atopic dermatitis.

This article looks at the link between the immune system and eczema and answers questions such as how eczema impacts the immune system, if eczema results from a weak immune system, and whether eczema is an autoimmune condition.

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Image credit: SVPhilon/Getty Images

According to the National Eczema Association, people with eczema have an over-reactive immune system to a substance in or outside the body. The immune system responds by producing inflammation — referred to as the inflammatory response — which causes symptoms, including:

  • itching
  • pain
  • patches of skin that turn red, dark brown, purple, or gray, depending on a person’s skin tone
  • oozing
  • rashes

Further research corroborates that the immune system is one of the causes of eczema. Allergens or irritants cause overstimulation of the body’s immune system. This reaction manifests on the skin as inflamed or irritated patches of skin.

Some associations between the two are discussed below:

Eczema can lead to cellular imbalance

The immune system has various players to keep people safe from infection, allergens, cancer, etc. White blood cells called T helper lymphocytes (Th) are important for adaptive immunity, where the immune system learns to protect itself from foreign invaders, like bacteria. The two main T-lymphocyte types are Th1 and Th2 cells.

In people with eczema, instead of having a balance of these two cell types, there are more Th2 cells, which can lead to more inflammation and the following:

  • water loss from the skin barrier
  • allergens — like pollen or dust mites — entering the skin
  • irritants — like soap or detergent — entering the skin

A 2019 study corroborates that eczema occurs due to an impaired skin barrier and underlying inflammation due to tissue infiltration of Th2 cells and other cells the immune system produces.

Eczema can lead to skin infection

People with eczema have increased cutaneous colonization, which means more bacteria are present on the skin. This can make a person more susceptible to skin infections, especially if left untreated.

There is more colonization with a bacteria called Staphylococcus aureus among eczema patients, which can make a person more susceptible to impetigo. Impetigo is an itchy and painful skin infection.

Stress can worsen eczema

Stress may play a role in eczema flare-ups and affect how the immune system reacts.

Specifically, increased cortisol levels from stress and anxiety suppress the body’s immune system, triggering an inflammatory response like eczema. Cortisol can also impair skin barrier function, which may contribute to eczema flares.

Eczema and the immune system share a complex relationship. Having eczema does not mean a person has a weak immune system.

However, eczema may indicate that a person’s immune system is sensitive or over-reactive to certain irritants, so there may be dysregulation rather than weakness.

As part of the immune response, the body produces white blood cells — and other substances — to attack the irritants that invade the skin, leading to inflammation or symptoms. The fact that a person’s immune system reacts this way would indicate that it is not weak.

Still, in some cases, eczema may occur due to diseases that affect the immune system.

Immune deficiency

In rare cases, eczema may also be due to an underlying inherited immune deficiency, such as autosomal dominant hyper-IgE syndrome (AD-HIES). Immunodeficiency is a weakening of the immune system, meaning it is unable to fight infection adequately.

In AD-HIES, an inflamed, flaky skin rash (eczema) and skin infections develop at birth or early during infancy.

The National Eczema Association defines an autoimmune disease as a condition in which the immune system attacks the body’s own healthy tissues.

While an overactive or dysregulated immune system contributes to the development of eczema, it does not cause the body to attack skin cells. Instead, allergens or irritants enter the skin barrier and cause eczema symptoms.

Although eczema and autoimmune diseases are similar, eczema is technically not an autoimmune disease.

People with eczema usually have an overreactive or sensitive immune system to an allergen or irritant. The immune system responds by producing inflammation (inflammatory response), which causes eczema symptoms. People with eczema often have an overactive immune system rather than a weak immune system.

Still, people with eczema have an increased risk of skin infections due to the impairment of the skin barrier. Eczema patients tend to have more colonization with Staphylococcus aureus, making them more susceptible to bacterial infections like impetigo.

Although eczema and autoimmune diseases are similar, eczema is technically not autoimmune.