I've had this picture in my head for many years now that there might be a link between asthma and eczema, and more recently, that eczema might actually cause asthma. So I set off on a quest to determine if this "theory" holds any merit.
I first became familiar with the asthma-eczema link back in 1985 when I was admitted to National Jewish Health for six months for my asthma. While there, I became friends with a few asthmatics who also had eczema.
One kid had to sit in a bathtub every morning for special treatment by one of the nurses or counselors, and he had to have his hands wrapped. After meeting him and listening to his stories, I felt fortunate to simply have asthma.
Recently I had a boy born with eczema, and considering I have a history of asthma I wanted to see what the odds were of him also developing asthma.
So, first we need some basic information about these diseases:
Eczema: "An allergic condition that targets your skin," According to Asthma for Dummies by William E. Berger. "The simplest way to define this non-contagious condition is the itch that rashes as a result of the itch scratch cycle. Scratching your dry skin causes it to rash, leading to more irritation and inflammation, further damaging your skin and making it even itchier -- resulting in even more scratching and increasingly irritated skin."I think that pretty much describes my boy. The fact that he has dry winter skin and drools exacerbates the problem. It looks kind of like this.
Eczema is also called atopic dermatitis and "frequently occurs with allergic rhinitis (hay fever or inflammation in the nasal passages) and can also precede other allergic conditions. As such, (eczema) can provide an early cue that you're at risk for developing other allergies and asthma."Statistics show that 30 percent of infants develop eczema between the ages of 4 and 6 months, and outgrow it by the time they are 3 to 5 years old. It usually begins as a red rash on the neck, cheeks, and may also spread to the arms and legs and back (which is where it occurs on my son).
Berger notes that "eventually, fissures and cracks can develop on your skin, allowing irritants, bacteria, and viruses to enter, often leading to complicating infections."
For those who have eczema into childhood, or develop it in childhood, it can be quite painful.
Asthma: This is chronic inflammation of the air passages in your lungs that may be "hypersensitive" to asthma triggers (which include allergens). Statisticians have determined that as many as 75 percent of asthmatics also have allergies, and often either have rhinitis, eczema or both.
For more detail on asthma, click here.
So what's the link?
1. National Jewish Health notes that, like asthma, eczema "can have a significant impact on the quality of life of individuals and their families. The itching can interfere with daily activities and make it hard to sleep"
2. Both asthma and eczema are associated with allergies (atopy).
3. They are also both associated with rhinitis.
4. Both are associated with inflammation (swelling). With asthma this swelling is in the air passages of the lungs, and with eczema it's on the skin.5. For can be controlled with corticosteroids.
6. As you can also read here, "Researchers say eczema in children may be an early sign of an allergic process that leads to inflammation and respiratory problems."
7. Researchers have discovered a gene defect that leads to both asthma and eczema, and it is estimated that as many as 60 million people around the globe are carriers of this gene. This discovery was important because it links the two, and may ultimately lead to a cure for both (or at the very least better medicines).
According to Medical News Today, "The gene in question produces filaggrin, a protein which prevents skin dryness. If your body lacks filaggrin, your skin can become inflamed and you could develop eczema. Lack of filaggrin may also mean more foreign bodies entering your lungs, this can lead to asthma."
8. Like asthma, the exact cause of eczema is unknown, although there are theories, like the hygiene hypothesis.
9. Both diseases are also genetic, meaning they generally occur in families with a history of atopic disease.10. And while asthma triggers may cause asthma to flare, eczema triggers may cause eczema to flare.
The Atopic March!
According to National Jewish Health, some experts refer to the combination of asthma, allergies and eczema as "The Atopic March." This is a series of immune disorders that often appear one after another. Over a period of years a person may develop one, or two, or all three.
So knowing a person has one of these conditions may make it easier to diagnose the others when symptoms occur. This should also provide an incentive to aggressively treat one in an attempt to prevent the others.
Does eczema lead to asthma?
In various studies, between 50 percent and 60 percent of those with asthma and eczema were found to have the gene defect.
Another study completed in Australia found that children with eczema were up to 50 percent more likely to develop asthma as they age as compared to those who did not have the skin condition. Other studies place the risk of developing asthma as high as 63 percent.
In some instances allergic conditions such as hay fever and even asthma can lead to eczema.
So what have we learned?
We've learned that there are quite a few similarities between these two diseases. Mostly, and regardless of whether it eventually disappears or not, the risk of someone with eczema later developing asthma is about 50 percent.
However, experts believe aggressive diagnosis and treatment of eczema and asthma will prevent a worsening of either condition, and prevent one from causing the other.