Is Eczema an Autoimmune Disease? Understanding the Link

Eczema is a common skin condition that can cause dry skin, itchiness, and rashes. There are seven types of eczema, but the most common form of eczema is called atopic dermatitis.

Although eczema is not an autoimmune disease, it can contribute to immune dysregulation and a heightened immune response, which may worsen eczema symptoms. It can also increase the risk of developing an autoimmune disease. People living with an autoimmune disease are also more likely to develop eczema.  

This article will explore the connection between eczema and autoimmune diseases and how the immune system influences the chronic skin condition. 

What Is Eczema?

Eczema is the most common inflammatory skin condition. There are seven types of eczema. 

Atopic dermatitis, the most common form of eczema, affects up to 10% of adults in the United States and developed world. Symptoms of atopic dermatitis include itchiness, dry skin, rashes, scaly patches, inflamed skin, discolored bumps, and blisters.

Other forms of eczema include:

• Contact dermatitis: Triggered by an irritant or allergen that touches the skin.‍
• Dyshidrotic eczema: Small, itchy blisters that form on the tips of fingers, toes and edges of palms and soles of the feet. 
• ‍Neurodermatitis: Thick, leather-like patches of skin that can be triggered by stress or irritation and are generally confined to one or two areas of skin.
• ‍Nummular eczema: Coin-shaped plaques that usually appear on the legs.
• ‍Seborrheic dermatitis: Affects oily areas of the body, like the face, nose, eyebrows, especially the scalp. In infants, this type of eczema is known as “cradle cap”.
• ‍Stasis dermatitis: Swelling, redness, and itching that occurs as a result of poor circulation in the legs.

Experts aren’t sure what causes eczema, but some of the factors that contribute to the development of the condition include:

• Genetics, or a family history of the condition.
• Certain environmental triggers.
• Stress.

Is Eczema an Autoimmune Disease?

No, eczema is not an autoimmune disease, it’s an inflammatory skin condition. Eczema is not defined as an autoimmune disease because the immune system does not attack a specific target in the body the way it does in people with autoimmune diseases. 

However, the immune system does play a role in the skin condition. A dysregulated or overactive immune system can contribute to or exacerbate eczema symptoms. 

One scientific article also suggests that people with atopic dermatitis (the most common form of eczema) have genetically altered immune responses that affect their skin’s barrier.

Another reason some people conflate eczema with an autoimmune condition is the cycle in which eczema symptoms come and go. People with eczema may experience symptoms only in the winter months or when exposed to a specific trigger, after which they can be symptom-free for several months.

Many autoimmune conditions, like irritable bowel disease (IBD) or psoriatic arthritis, are also marked by periods of flare-ups and remission. 

What Does It Mean to Have an Autoimmune Disease?

In autoimmune diseases, the immune system attacks healthy cells in your body by mistake. This can affect cells, tissues, and organs throughout the body. These attacks can cause a variety of symptoms, including weakening bodily functions. 

There are over 80 different types of known autoimmune diseases. Some are more common and easier to diagnose than others. Examples of autoimmune diseases include:

• Alopecia areata.
• Inflammatory bowel disease (IBD).
• Hyper and hypothyroidism.
• Lupus.
• Multiple sclerosis.
• Psoriasis.
• Psoriatic Arthritis.
• Rheumatoid arthritis.
• Type 1 diabetes.

Not all autoimmune diseases have known causes, but research suggests that many of these conditions are influenced by several factors, including genetics, environmental exposures, sex, race, and ethnicity. 

Most autoimmune diseases are chronic, meaning those affected have to manage symptoms throughout their lifetimes. But with the right treatment and lifestyle adjustments, many people with autoimmune diseases will experience extended periods of remission.

The Difference Between Eczema and Autoimmune Diseases

People with autoimmune diseases have immune systems that mistakenly attack healthy cells, tissues, and organs in their body. 

People with eczema, on the other hand, may have immune systems that act abnormally and contribute to their symptoms, but their immune systems do not mistakenly target healthy cells in their body. 

This is sometimes referred to as the difference between an “autoimmune” and “immune” response. A healthy immune system will only target foreign pathogens and invaders, like viruses or bacteria, sometimes referred to as a healthy “immune response.” Whereas an “autoimmune response” will attack normal, healthy body tissues.

Can Eczema Lead to Autoimmune Conditions?

Yes, having eczema can increase the risk of autoimmune conditions.

‍Research shows that people with atopic dermatitis are more likely to develop certain autoimmune conditions, including:

• Alopecia areata.
• Psoriatic arthritis.
• Sjögren’s syndrome.
• IBD.
• Vitiligo.
• Rheumatoid arthritis.
• Hypothyroidism.

People with autoimmune conditions are also more likely to develop eczema, especially if their autoimmune condition involves the skin or gastrointestinal (GI) system, like:

• Alopecia areata.
• Psoriasis. 
• Vitiligo.
• IBD.
• Celiac disease.

Research also suggests that if you have multiple autoimmune diseases, your risk for developing eczema increases.