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Eczema

By mijaco1 · September 23, 2023

Following on from feedback received on our Aloe soothing cooling gel, which is great for  dry skin and eczema I felt the need to dig a little deeper, the more knowledge we have as skin care therapists and massage therapists the better

The exact cause of eczema is not fully understood, but it is believed to be a combination of genetic and environmental factors. Some common factors that can trigger or worsen eczema include:

1. Genetics: Family history plays a significant role, as eczema often runs in families.

2. Immune system dysfunction: An overactive or dysfunctional immune response can contribute to eczema.

3. Skin barrier dysfunction: People with eczema tend to have a weakened skin barrier, making their skin more susceptible to irritants and allergens.

4. Allergens: Exposure to allergens like pollen, dust mites, pet dander, and certain foods can trigger eczema flare-ups in some individuals.

5. Irritants: Contact with harsh soaps, detergents, perfumes, or chemicals can irritate the skin and exacerbate eczema.

6. Climate and weather: Cold, dry weather can lead to skin dryness and worsen eczema symptoms.

7. Stress: Emotional stress can sometimes trigger or worsen eczema.

8. Hormones: Hormonal changes, such as those that occur during pregnancy or menstruation, can affect eczema.

9. Infections: Bacterial or viral infections can sometimes lead to eczema flare-ups.

Atopic eczema results from an overactive immune system that causes the skin barrier to become dry and itchy.  When an irritant or an allergen from outside or inside the body “switches on” the immune system, it produces inflammation on the surface of the skin. 

There is also a potential genetic component to eczema that includes a protein called flaggrin that helps maintain moisture in your skin; a flaggrin deficiency can lead to drier itchier skin

www.nationaleczema.org/eczema 

From Medscape …

Initially, excess water loss from the epidermis results in dehydration of the stratum corneum with upward curling of corneocytes. The outer keratin layers require 10-20% water concentration to maintain their integrity. A significant decrease in free fatty acids in the stratum corneum is present in people with asteatotic dermatitis. Stratum corneum lipids act as water modulators, and cutaneous loss of these lipids can increase transepidermal water loss to 75 times that of healthy skin.

When the stratum corneum loses water, the cells shrink. A significantly decreased cellular volume can stress the skin’s elasticity, creating fissures. Edema in the dermis leads to additional stretch on the overlying epidermis. Fissures rupture dermal capillaries, causing clinical bleeding. The disruption of cutaneous integrity can result in inflammation with risk of infection. Transepidermal absorption of allergens and irritants is increased as the epidermis is damaged, increasing susceptibility 

In general, sebaceous gland activity and sebum composition has largely been the focus of acne and seborrheic dermatitis but has largely been understudied for AD [37]. Skin barrier dysfunction is one of the main pathogenic factors in AD and the sebaceous glands contribute significantly to the skin barrier. Our findings suggest that there is sebaceous gland dysfunction at baseline in AD and would be worthy of further study and clinical evaluation. Future strategies may require therapies that incorporate normalization of sebum as part of the strategy for controlling AD but further studies are needed to better delineate how sebum is altered in lesional skin in addition to our presented findings in non-lesional skin.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800162/#:~:text=While%20ceramide%20deficiencies%20in%20the,to%20those%20without%20this%20disorder.

The acid mantle of the skin has been known for decades, though its roles in various aspects of skin physiology have only recently been elucidated. Acidity is critical for ensuring appropriate stratum corneum integrity, barrier function, and antimicrobial activity. Maintaining a normal pH through appropriate therapy is well known to benefit disease states such as atopic dermatitis, and acidification may even have preventative effects when instituted prior to onset of the atopic phenotype. There are many opportunities for enhancing the current body of knowledge in this area, including updating the published pH values for available cleansers and emollients, as well as exploring new acids for use in therapy. The consideration of pH normalization will continue to be an increasingly important aspect of a comprehensive treatment plan in atopic dermatitis and other cutaneous diseases.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4470210/

It’s important that as professional skincare therapists we understand skin types and skin conditions.  Check ingredients on your professional products to ensure you’re using the best ones for your client’s skin type and/or condition and I know it’s an obvious one but check  the pH levels of products both in salon or spa and encourage the client to do the same at home.

Take a look at our table below for an ingredient breakdown by skin type or condition.

IngredientBest for dry or dehydrated skin?
hyaluronic acidboth: be sure to apply an oil or moisturizers to lock it in
glycerindehydrated
aloedehydrated
honeydehydrated
nut or seed oil, such as coconut, almond, hempdry
shea butterdry
plant oils, such as squalene, jojoba, rose hip, tea treedry
snail mucindehydrated
mineral oildry
lanolindry
lactic aciddehydrated
citric aciddehydrated
ceramideboth: ceramides strengthen the skin’s barrier to help prevent moisture loss

https://www.healthline.com/health/beauty-skin-care/dry-vs-dehydrated#Extra-tips-for-misting-up-your-skin-health

Happy reading, please use this as a learning aid and adapt as necessary to accommodate different learner levels and needs.

As usual, thanks for your feedback, it’s very much appreciated and let me know if there’s any other topic you’re particularly interested in or need more in depth information about or your challenges and successes in treating dry skin and/or eczema conditions.

Kind regards

Catherine

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