I first became familiar with a possible 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 listening to his stories, I felt fortunate to simply have asthma.
A few years ago, we had a son born with eczema and, considering I have a history of asthma, I wondered what the odds were of him also developing asthma.
According to Asthma for Dummies by William E. Berger. "The simplest way to define this non-contagious condition (eczema) 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. 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. So eczema can provide an early cue that a person is at risk for developing other allergies and asthma.
Statistics suggest that 30 percent of infants develop eczema between the ages of four and six months, but outgrow it by the time they are three to five years old. It usually begins as a red rash on the neck and cheeks, and may also spread to the arms, 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, the disease can be quite painful.
Researchers have found that as many as 75 percent of asthmatics also have allergies, and often either have rhinitis, eczema or both.
So what's the link between eczema and asthma?
Here are some connections between the two diseases:
- 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."
- Both asthma and eczema are associated with allergies (atopy).
- Both are associated with rhinitis.
- Both are associated with inflammation (swelling). With asthma, this swelling is in the air passages of the lungs. With eczema it's on the skin.
- Researchers say eczema in children may be an early sign of an allergic process that leads to inflammation and respiratory problems.
- Researchers have discovered a gene defect that may lead to both asthma and eczema. It is estimated that as many as 60 million people worldwide carry this gene. This discovery was important because it clearly links the two ailments and may ultimately lead to a cure for both (or at 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, and this can lead to asthma.
- Like asthma, the exact cause of eczema is unknown, although there are theories, such as the hygiene hypothesis.
- Both diseases are genetic, meaning they generally occur in families with a history of atopic diseases.
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, 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.
A study in Australia found that children with eczema were up to 50 percent more likely to develop asthma as they age, 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, have been found to 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, the risk of someone with eczema later developing asthma is about 50 percent.
However, experts believe aggressive diagnosis and treatment of eczema and asthma can prevent a worsening of either condition, and can also prevent one from causing the other.