Atopic dermatitis is an inflammatory skin condition — specifically, the most common kind of eczema. Both the immune system and the skin barrier play a role in the itchiness, irritation, and inflammation it causes. So, is atopic dermatitis an autoimmune disease or an allergy?

Depending on your triggers, your eczema may seem more like an allergy than an autoimmune disease. Many people with the inflammatory skin disease are triggered by irritants, such as the chemicals found in laundry detergent. As one MyEczemaTeam member wrote, “I’ve found scented soaps, detergents, dryer sheets, etc., can be very irritating to my eczema.” Meanwhile, if colds and other factors like stress trigger your flares, your atopic dermatitis may appear to be more of an autoimmune disease.

Allergic reactions occur when the immune system responds to an outside trigger. In contrast, an autoimmune disease develops when something within a person’s body causes an immune response. Atopic dermatitis has also been linked to certain genetic changes that affect the skin barrier and the immune system. This means that the skin condition may be passed down through families.

In this article, we will explore the complex nature of atopic dermatitis and whether specialists consider it to be an autoimmune or an allergic condition.

What Causes Atopic Dermatitis?

Atopic dermatitis causes itchy skin that can lead to poor mental health, poor sleep, scarring, and infections. It’s generally thought to be caused by a combination of factors, including:

• Genetic (inherited) factors
• Exposure to triggers
• A dysregulated immune system

Together, these elements can contribute to an impaired skin barrier. Filaggrin is a protein in the skin that helps you maintain a healthy skin barrier by binding skin cells together so that irritants have a harder time penetrating the skin. Many people with atopic dermatitis have a genetic mutation (change) that prevents them from producing enough filaggrin.

An overactive immune system also plays a part in atopic dermatitis flare-ups. Combine these with a trigger or irritant and you’ve got a perfect storm for atopic dermatitis.

What Is an Autoimmune Disease?

An autoimmune disease occurs when a person’s immune system attacks their 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.

An autoimmune disease occurs when a person’s immune system attacks their own body’s healthy tissues.

Atopic Dermatitis and Autoimmunity

One systematic review looked at 26 studies that compared over 1 million people with atopic dermatitis to over 15 million people without the condition. They found that people with atopic dermatitis were more likely to have other autoimmune health conditions. In particular, the skin condition was linked to:

• Ankylosing spondylitis
• Inflammatory bowel disease (like Crohn’s disease or ulcerative colitis)
• Celiac disease
• Alopecia areata
• Systemic lupus erythematosus (SLE)
• Sjögren’s disease
• Rheumatoid arthritis
• Thyroid disease
• Vitiligo

People with atopic dermatitis may be more likely to have autoimmune conditions like rheumatoid arthritis, inflammatory bowel disease, and others.

That said, despite the link to certain autoimmune diseases, researchers don’t think of atopic dermatitis as an autoimmune disease. According to the National Eczema Association, eczema is not technically considered an autoimmune disease, even though it has some characteristics in common with autoimmunity.

Rashes With Other Autoimmune Conditions

Rashes and skin disorders are common symptoms of many autoimmune disorders. In addition to eczema, some autoimmune diseases that can cause rashes include:

• Celiac disease
• Dermatomyositis
• Lupus
• Scleroderma
• Sjögren’s disease

Immune-mediated conditions like psoriasis and lichen planus also cause rashes.

Autoimmune diseases like lupus and Sjogren’s disease can cause skin rashes that look like atopic dermatitis.

A member of MyEczemaTeam 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 disease. It turns out that my first unusual rash I had one year ago was a clue,” they said.

Atopic dermatitis shares some similarities with, and is often linked to, autoimmune diseases. But eczema can also occur 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 atopic dermatitis. Future studies may help us understand whether this common type of eczema is truly an autoimmune disorder, an allergic condition, or a combination of both.

Allergic Conditions and Other Risk Factors for Atopic Dermatitis

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 atopic dermatitis than adults. Some children may also 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 flare or worsen include:

• Cleaning products
• Cosmetics
• Dust mites
• Fragrances (in lotion, soap, or detergent)
• Latex
• Pet dander
• Pollen
• Weather changes, including both hotter and cooler temperatures

An allergist or dermatologist can test you to see if you’re sensitive to allergens that might be contributing to your eczema symptoms.

“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 bodywash to hand soap and lip balm. I have bought new products that are safe for me, and after two weeks, my skin is clearer than it has been for months!” a MyEczemaTeam member shared.

Managing Atopic Dermatitis

Depending on your symptoms, your doctor may recommend prescription or over-the-counter treatment options, such as antihistamines or topical (on the skin) therapies. Lifestyle changes like wearing protective gloves and avoiding irritating fabrics may help your symptoms as well. Following your healthcare provider’s medical advice can help you gain control over your eczema and improve your quality of life.

Atopic dermatitis can be a challenging skin condition, as it can be linked to both autoimmune conditions and allergies. This makes it hard to pinpoint its exact cause. Knowing more about eczema can help you 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 you’re having a flare, it’s a good idea to see a healthcare provider. Your dermatologist or allergist can help figure out what’s causing your symptoms and the best way to treat them.

Join the Conversation

On MyEczemaTeam, people share their experiences with eczema, get advice, and find support from others who understand.

Do you have atopic dermatitis? Do you have an autoimmune condition or allergies that may be affecting your eczema? Let others know in the comments below.