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Is Eczema an Autoimmune Disease?

Medically reviewed by Kevin Berman, M.D., Ph.D.
Posted on March 10, 2022

Eczema (also known as dermatitis) is an inflammatory skin condition that involves the skin’s immune system — but is it an autoimmune disease? For many people with eczema, environmental irritants can be a trigger, such as the chemicals in some laundry detergent. In that kind of eczema, called contact dermatitis, your skin’s response may be more similar to an allergic reaction than to an autoimmune disease. That’s because an allergic reaction is an immune response to an outside trigger, while an autoimmune disease is an immune response to something in a person’s own body.

That said, there are genetic aspects of eczema that lead some experts to believe the condition may be an inherited disorder of the immune system. This is especially true of atopic dermatitis, the most common type of eczema.

What Is an Autoimmune Disease?

An autoimmune disease occurs when a person’s immune system acts inappropriately, becomes overactive, and attacks their body’s healthy tissues. Autoimmune diseases lead to inflammation that can exacerbate symptoms. These conditions can often be treated by suppressing immune function.

Eczema and Autoimmunity

Eczema, a condition that leads to itchy skin, is generally thought to be caused by a combination of genetic predisposition, exposure to triggers, and an overactive immune system. Experienced together, they can contribute to a “leaky” skin barrier. Filaggrin (a protein) is a component of strong skin. Many people with atopic dermatitis have a genetic mutation that prevents them from producing enough filaggrin to maintain a healthy skin barrier. An overactive immune system is also part of the equation for atopic dermatitis flare-ups. Add a triggering exposure, and you’ve got the perfect storm.

Some research supports the idea eczema may have an autoimmune component. That’s in part because scientists have seen that eczema is responsive to immunosuppressive medications. Immunosuppressive medications are drugs that inhibit the activity of a person’s immune system. They are frequently used to treat autoimmune diseases.

People with one autoimmune condition frequently have others. This suggests there may be a link among such conditions. In one recent study, scientists looked at the general population of Sweden over a 40-year time span. They found that atopic dermatitis was associated with several autoimmune conditions, including ankylosing spondylitis, lupus, and rheumatoid arthritis.

It’s important to note that skin rashes may be a common symptom of many autoimmune disorders, but not all of those related rashes are necessarily eczema in nature. Such rashes can appear different from eczema both to the naked eye and when they are studied under a microscope.

Autoimmune conditions that can have a skin rash as a symptom include:

  • Behcet’s disease
  • Celiac disease
  • Dermatomyositis
  • Lupus
  • Hypothyroidism
  • Lichen planus
  • Scleroderma
  • Sjogren’s syndrome

Although eczema shares some similar aspects to autoimmune diseases and is often associated with other types of autoimmune diseases, many experts still don’t define it as such. Sometimes eczema occurs in people who don’t have an immune deficiency at all. Although the two issues are often related, eczema can have other causes.

Ultimately, more research is needed to understand the causes of atopic dermatitis and whether eczema is an autoimmune condition.

Other Causes of and Risk Factors for Eczema

It’s likely that a combination of factors precipitate the development of eczema. For example, age seems to play a role. Babies and children are more likely to develop eczema than adults are. Cold, dry climates may also affect the development of eczema.

Many people experience eczema in conjunction with food allergies, allergic rhinitis, and asthma. This combination is called the “atopic march” or “atopic triad.”

Common allergens that can make eczema worse include:

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

An allergist or dermatologist can test you to see if you’re sensitive to specific ingredients that might be contributing to your eczema symptoms. Wearing protective gloves, avoiding irritating fabrics, and following treatment advice from your health care providers can help you gain control over your eczema.

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Posted on March 10, 2022
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Kevin Berman, M.D., Ph.D. is a dermatologist at the Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Learn more about him here.
Anastasia Climan, RDN, CDN is a dietitian with over 10 years of experience in public health and medical writing. Learn more about her here.

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