Eczema (also known as atopic dermatitis) is an inflammatory skin condition that involves the immune system. But is eczema more of an allergy or an autoimmune disease? For many people with eczema, environmental irritants, such as the chemicals in some laundry detergents, can be a trigger, making it seem more like an allergy. Depending on your eczema triggers, your skin’s response may be more similar to an allergy than an autoimmune disease. However, colds and other immune events, including stress, may trigger an eczema flare, making it seem more like an autoimmune disease.

One MyEczemaTeam member wrote, “I’ve found scented soaps, detergents, dryer sheets, etc., can be very irritating to my eczema.”

An allergic reaction is an immune response to an outside trigger, while an autoimmune disease is an immune response to something within a person’s body. In fact, some doctors think eczema might be passed down through families because of certain genetic traits that affect the immune system. This is especially true of inherited atopic dermatitis, sometimes called atopic eczema, the most common type of eczema.

What Is an Autoimmune Disease?

An autoimmune disease occurs when a person’s immune system attacks the body’s healthy tissues. This immune dysfunction causes inflammation that makes symptoms worse. Autoimmune conditions can often be treated by suppressing immune function with medication.

Eczema and Autoimmunity

Eczema, a disease that leads to itchy skin and poor mental health, scarring, and infections, is generally thought to be caused by a combination of genetic (inherited) factors, exposure to triggers, and a dysregulated immune system. Together, they can contribute to a “leaky” skin barrier. Filaggrin, a protein in skin cells, is a component of skin that keeps the skin cells well connected and protects against irritants getting between skin cells. Many people with atopic dermatitis have a genetic mutation (gene change) that prevents them from producing enough filaggrin that works well to maintain a healthy skin barrier. An overactive immune system is also part of the equation for atopic dermatitis flare-ups. Add a trigger or irritant and you’ve got a perfect storm.

Some dermatology and immunology research suggests that eczema may have an autoimmune component. Scientists have seen that eczema is responsive to systemic (affecting the whole body) immunosuppressive medications, such as dupilumab (Dupixent). Immunosuppressive medications are drugs that slow down the activity of a person’s immune system. They are frequently used to treat autoimmune diseases.

While contact dermatitis has characteristics of an allergic reaction, some people may wonder about other types of eczema. For instance, are nummular and dyshidrotic eczema autoimmune diseases? According to the National Eczema Association, eczema is not technically considered an autoimmune disease, despite having some things in common with autoimmunity.

In one recent study, scientists looked at the general population of Sweden over 40 years. They found that atopic dermatitis was associated with several autoimmune health conditions, such as ankylosing spondylitis, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), alopecia areata, lupus, and rheumatoid arthritis.

Rashes With Other Autoimmune Conditions

Rashes and skin disorders that aren’t eczema are common symptoms of many autoimmune disorders. Autoimmune conditions that involve rashes include:

• Psoriasis
• Celiac disease
• Dermatomyositis
• Lupus
• Hypothyroidism
• Lichen planus
• Scleroderma
• Sjögren’s syndrome

A MyEczemaTeam member described their discovery that they had an autoimmune disease. “I found an important missing piece to my puzzle. I have recently been diagnosed (by advocating for myself) with Sjögren’s syndrome. It turns out that my first unusual rash I had one year ago was a clue,” they said.

Eczema shares some similarities with autoimmune disorders and is often associated with other types of autoimmune diseases. But sometimes eczema occurs in people who don’t have an autoimmune disease. Although the two issues are often related, eczema has other causes.

Ultimately, more research is needed to understand the causes of eczema and whether it’s an autoimmune or allergic condition or both.

Allergic Conditions and Other Risk Factors for Eczema

A combination of factors likely leads to the development of eczema. For example, age seems to play a role. Babies and children have a higher risk of developing eczema than adults, and they typically outgrow their eczema. Environmental factors such as cold, dry climates may also affect eczema development and flares.

Many people experience eczema with food allergies, allergic rhinitis (hay fever), or asthma. This combination is called the “atopic march” or “atopic triad.”

Common allergens and triggers that can make eczema worse or cause eczema flare-ups include:

• Cleaning products
• Cosmetics
• Dust mites
• Fragrances (in lotion, soap, or detergent)
• Latex
• Pet dander
• Pollen
• Weather changes, both heat and cold

An allergist or dermatologist can test you to see if you’re sensitive to irritants that might be contributing to your eczema symptoms. Your doctor may recommend prescription or over-the-counter treatment options, such as antihistamines or topical (on the skin) therapies. Wearing protective gloves, avoiding irritating fabrics, and following medical advice from your health care professionals can help you gain control over your eczema and improve your quality of life.

“I did patch testing and found out I am allergic to fragrance, lanolin, limonene, and linalool, among other things. These ingredients were in EVERY SINGLE THING I was using, from shampoo to body wash to hand soap and lip balm. I have bought new products that are safe for me and after two weeks, my skin is more clear than it has been for months!” a MyEczemaTeam member shared.

Eczema can be a challenging skin condition because it can be linked to both immune system issues and allergies. This makes it hard to pinpoint exactly what causes it. Knowing more about eczema helps people manage the condition better and live more comfortably. Doctors are still learning about the best ways to treat it, so if you think you might have eczema or if it’s bothering you, it’s a good idea to see a skin doctor or an allergist. They can help figure out what’s causing your symptoms and the best way to treat them.

Talk With Others Who Understand

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 52,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Do you have an autoimmune condition or allergies that may be affecting your eczema? Share your experience in the comments below, or start a conversation by posting on your Activities page.