What Is Eczema?
How to cure eczema permanently, or can you? This comprehensive article will guide you on managing eczema effectively, focusing on the crucial role of anxiety and stress. Eczema, derived from the Greek word “ekzein” meaning “to boil over” or “break out,” is a chronic skin condition caused by an overactive immune system. It leads to itchy, cracked, rough, and inflamed patches of skin. Common triggers include foods like milk and nuts, and environmental elements such as smoke, soaps, fragrances, and pollen. Some eczema types may even cause blisters.
There are several types of eczema, including dyshidrotic eczema, nummular eczema, stasis dermatitis, contact dermatitis, and neurodermatitis. The most common is atopic dermatitis, or “atopic eczema,” where “dermatitis” denotes “skin inflammation.”
How Common Is Eczema?
About 10.1%, or 31.6 million Americans suffer from atopic eczema. It affects one in ten people, most often starting in early childhood. Around 9.6 million American children under 18 have atopic dermatitis, with 75% experiencing mild eczema. Childhood eczema rates have increased steadily from 8% to 12% since 1997. Notably, about one in four adults report initial eczema symptoms.
Eczema affects men and women equally but is more common in adult females, more frequent among multiracial or white adults, and more prevalent in African-American/Black and European-American children compared to Hispanic children. Individuals with personal or family histories of asthma, environmental allergens, or food allergies are at higher risk.
How Anxiety and Stress Can Trigger Eczema and Its Flares
Increasing evidence shows that anxiety and stress can significantly exacerbate eczema symptoms. Emotional stress triggers hormone imbalances—especially increasing cortisol—which disrupts the skin’s barrier function, leading to flare-ups. Stress also weakens immune responses, increasing skin inflammation, and prolonging healing times.
According to Pfizer’s Dr. Mark Levenberg, stress initiates a ‘fight or flight’ response releasing cortisol that suppresses immune function while increasing inflammation, worsening eczema symptoms. This creates a vicious cycle: itchiness leads to scratching, causing sleep disturbances, which further heighten anxiety and exacerbate eczema.
A 2024 meta-analysis in Clinical and Experimental Allergy reported that atopic eczema significantly increases the risk of stress, depression, and anxiety (with risk increases of roughly 15-17%). Severity of eczema correlates positively with depression risk, highlighting how skin inflammation impacts mental health and vice versa. This underscores the necessity of addressing mental wellness in managing eczema flare-ups.
Other Causes of Eczema
Though there are not many exact reports on the causes of atopic eczema, researchers believe a combination of genes and triggers are the two most important contributors to the disease.
Some research has shown that people who suffer from eczema may be missing one particular gene that creates a protein called filaggrin that is used to help our bodies maintain a healthy protective barrier on the top skin layer. Without that, moisture can escape and bacteria and viruses can enter the skin, making the skin dry and prone to infections.
Eczema sufferers also have an overly reactive immune response system which triggers inflammation whenever something outside or inside their bodies comes into contact with them. It is this inflammation that causes the red, itchy and scaly skin symptoms and skin infections common to most types of eczema.
Stress can also cause an increase in the hormone cortisol in your body, and your skin can then become abnormally oily and trigger an eczema outbreak.
General Eczema Symptoms
The symptoms of atopic eczema varies from one patient to another. It may be milder than others’ conditions, but it can affect anyone regardless of their age. Some patients outgrow the condition, while others will continue to have it throughout their lives.
The common symptoms of eczema are redness and itching on scaly, dry skin. Sometimes, your sensitive skin can even feel some burning, or there could be some open, crusted or weeping sores in cases of severe eczema.
Eczema rashes usually look white but they can sometimes be grey or brownish too, especially in people of colour, making such outbreaks harder to see, though they may also get dark or light skin patches even after eczema symptoms disappear. These patches are called hyperpigmentation (skin become darker in colour due to an excess of melanin), depigmentation (colour loss in the skin, hair or eyes due to the deposition of melanin) or hypopigmentation (white patches on the skin due to vitiligo, an autoimmune disorder in which the pigment-producing cells are damaged).
For infants under the age of two, eczema symptoms can include rashes on the scalp, cheeks, and behind the creases of elbows and knees that can cause itchiness and keep the babies crying and irritated.
Those who had eczema when they were young might not be affected by it anymore, but could still suffer from dry or easily irritated skin, hand eczema, or even eczema on their eyes.
Stages of Eczema
Eczema can usually be divided into three stages:
(1) Chronic Stage
Eczema usually starts during infancy and it is most likely to happen before they are 12 months old. However, sometimes it occurs later in childhood. Eczema usually disappears without treatment but occasionally flares up again later in life. Childhood eczema often improves with time.
(2) Acute Stage
Acute eczema is usually a result of a skin sensitivity to irritants or triggers such as allergens, chemicals or fabrics. You might notice a skin irritation immediately following contact, or your skin could heal in a few weeks as it clears up.
(3) Sub-Acute Stage
During the healing period, eczema often flares back up and if it is not treated with care, it may become worse than before. Stress and hormones can also lead to flare-up. However, it is unlikely that the rash will come back into full force.
Diagnosis
There is no need for laboratory tests to diagnose eczema. A dermatologist may examine your skin and review your medical records before making an official diagnosis. They might also test for allergies by using allergy patches or arrange for blood tests.
If you think a particular food may be causing your child’s skin condition, talk to your pediatrician about testing for specific foods.
How To Cure Eczema Permanently – Is It Possible?
While there is currently no permanent known cure for eczema, many patients achieve long-term control or remission through proper management. Childhood eczema can be outgrown, but some adults face lifelong flare-ups. Effective treatment targets inflammation, itch relief, and skin repair to prevent worsening.
When you get eczema, it is important to work closely with your dermatologist for a plan to control the itch, heal the skin, prevent further eczema flare and infections.
Treatment varies depending on your age, medical history, the severity of your symptoms, among other factors. It may take some time for you to see positive changes in your skin. There are some things you need to do yourself if you want to keep your skin healthy, such as keeping your body and skin clean.
Treatment Options
(A) Medications
(1) Emollients
Emollients are moisturising products that are used to hydrate dry and itchy skin, mostly for mild to moderate eczema. It is to be applied directly to the skin to reduce water loss and help reduce flare-ups.
If prescribed by your doctor, it is important to use your emollient daily, even if you do not have the symptoms. Gently pat your skin dry and apply the emollient while your skin is still moist, in order to maintain the moisture. When treating an active flare up, use a generous amount of emollient frequently, though inflamed skin should be treated with a topical corticosteroid too.
(2) Hydrocortisone Steroids
Your dermatologist may prescribe certain medications for your eczema, such as corticosteroid creams, solutions, gels, foams and ointments. Made with hydrocortisone steroids, these medications, from mild over-the-counter treatments to stronger prescription medicines, can swiftly relieve you of itching and inflammation.
Side effects from these medications are rare when you use the medicines as directed, but symptoms such as thinning skin and stretch marks have been reported.
(3) Crisaborole (Eucrasia)
Crisaborole (Eucrasia), a prescription topical steroid cream for treating mild to moderate cases of atopic dermatitis, may be an effective treatment option. Applied twice daily to patients 2 years and older, it has been proven to be effective in reducing inflammation on the skin.
(4) Phototherapy
Ultraviolet (UV) light can be used to treat moderate to severe cases of eczema. UV radiation also help to tame an overly reactive immune system, though too much of it can lead to skin aging faster or an increase in the risk for skin cancer. Hence, doctors usually start by giving patients the lowest possible doses of UV light and then monitor their reactions closely.
There are two types of phototherapy: light therapy and PUVA therapy. In the former, your skin will get exposed to UVA rays, UVB rays or a combination of both two to five times weekly, while for the latter, you take psoralen, a prescription medication that makes the skin more sensitive to UVA light. This medication is mainly for patients with no results from just UV therapy.
(5) Dupixent (dupilumab)
Dupixent (dupilumab) can be injected into adult eczema patients with moderate to severe forms of the disease. This drug is used particularly in patients whose eczema is not controlled adequately by topical therapies, or where such topical therapies are not advisable.
(6) Immunosuppressants
An alternative treatment for eczema is immunosuppressive medications, which slow down immune reactions in cases where they are needed most. This treatment is used mostly for moderate to severe eczema as they can be used to help stop the itchy symptoms of eczema so that the skin can heal properly.
(7) Antihistamines
Antihistamines, which are often used to treat allergic conditions, may also be helpful for reducing the occurrence of eczema. These medicines may be helpful for preventing itching caused by skin conditions, particularly when they occur in children.
(8) Allergy Shots
For severe allergies that don’t respond well to medications, a doctor may recommend allergen immunotherapy, or “ allergy shots .” These shots are composed of small amounts of the substances to which you’re allergic.
If you suffer from severe allergies that do not seem to be responding to medication, then an allergist might suggest allergen immunotherapy, or “allergy shots” that contain small amounts of the substances that you are allergic to, to help build immunity to your allergen triggers so that you experience fewer flare-ups.
(B) Natural Remedies and Lifestyle
How to cure eczema permanently? Currently, there is no definitive cure for eczema, but you can significantly improve and manage your condition effectively with the right combination of treatments and remedies.
(1) Natural Treatments
Natural treatments can be used together with eczema medications to better manage your condition. Natural products, including aloe vera gel, olive oil, coconut oil, apple cider vinegar, or even Zinda Tilismath, an ancient herbal medicine, can help soothe cracked, damaged skin. These products can help fight inflammation and harmful bacteria to relieve pain and prevent infections. Although they cannot cure eczema permanently, they can help better manage your symptoms and prevent flare-ups.
You can purchase these natural products in health stores or online stores, or you can also just buy an aloe vera plant and use the gel directly from its leaves. As much as possible, try to use such natural products with as few ingredients as possible, as ingredients such as preservatives, alcohol, fragrances or colours may irritate your skin too. Dab a small amount on your skin to test for sensitivity, and then use it sparingly in the first few days to ensure you are not allergic to it before using it with the normal dosage.
(2) Internal Herbs
You can also consider using quercetin and freeze-dried stinging nettles, which are non-sedating and safe antihistamines, for itching and inflammation. Severe eczema sufferers can use licorice extract as it is a natural cortisol, although it is recommended to talk to your doctor as it may increase your blood pressure.
(3) Vitamin D
Research have shown that eczema patients tend to have low levels of vitamin D, so it is important for eczema sufferers to increase their sun exposure, include vitamin D rich foods such as tuna fish, beef liver, salmon, eggs and sardines in their diet, or take a vitamin D supplement daily.
(4) Oatmeal Baths
Natural home remedies such as oatmeal baths can sometimes help soothe the itchiness and infections on your skin. Use warm water or lukewarm water to fill a tub. Sprinkle about 1 cup of oatmeal (rolled and uncooked whole oats) into the water-filled tub. You can choose to rub yourself lightly with a mild soap if needed. Although it is not necessary, it is recommended to finely ground the oats before use. Then soak for about 10 to 15 minutes. After the bath, gently pat yourself dry, and while your skin is still damp, apply a natural moisturiser such as honey, olive oil or aloe vera and keep warm with a towel for a while thereafter.
(5) Acupuncture
Acupuncture, a traditional Chinese medicine (TCM) technique may be effective for treating eczema. Although there is not actually enough evidence yet to recommend acupuncture treatment specifically for eczema, a recent research in 2021 shows that acupuncture is a safe and effective treatment for food allergy and eczema, with the ability to reduce skin itching, allergic reaction and wheal size in atopic dermatitis. Another study in 2018 shows that acupuncture significantly improves symptoms of eczema such as insomnia, itchiness and the quality of life.
Acupuncture may help stimulate several body systems, especially the nervous and immune systems to help restore balance, the skin barrier, lower inflammation, reduce discomfort and encourage healing in the body.
(C) Self-Care and Prevention
Besides the above treatment methods and medications, there are some things that you can do to help ease your symptoms and prevent further outbreaks and eczema flare-ups.
(1) Do Not Scratch the Itchy Areas
One of the most painful problems of eczema is that it can often become very itchy and you will be very tempted to scratch the affected areas on the skin. But note that doing so will cause the disease to worsen, and you will damage your skin, causing it to thicken and become leathery, or you could even suffer from bleeding.
To reduce the possible of scratching yourself frequently, keep your nails short and clean, wear long-sleeved clothes and try to rub your skin gently with your fingers, and for babies, anti-scratch mittens may stop them from scratching their skin.
(2) Avoid Triggers
Common triggers of atopic eczema can include irritants such as fabrics, soaps and detergents such as shampoo, washing liquid, petroleum jelly and bubble bath, food allergies, environmental triggers such as cold and dry weather, cigarette smoke, or allergens such as house dust mites, pet fur, pollen and moulds.
It is best if you could work with a doctor or dermatologist to establish what might trigger your eczema flare as you can then try to avoid the triggers. For instance, if you found out that certain fabrics cause your skin to flare up, you can avoid wearing such fabrics. If you found that a certain type of shampoo may affect your skin, switch to another brand.
Eczema may sometimes be triggered by emotional stress, but there isn’t any specific reason for this. For some people, stress makes their eczema symptoms worsen; for others, simply knowing they have eczema might cause them to feel stressed.
(3) Dietary Changes
Certain foods, including eggs and cow’s milk, may cause an allergic reaction, which could lead to skin irritation and eczema. However, it is wise to consult a doctor first before you avoid these foods, especially as young children may need the nutrients from these foods.
Conclusion
Eczema is often a lifelong inflammatory condition worsened by stress and anxiety, which can create a vicious cycle of flare-ups. How to cure eczema permanently remains unachieved, but with comprehensive treatment—including addressing mental health—and lifestyle modifications, symptoms can be controlled effectively, improving quality of life.