11 Top Eczema Myths—And The Truth to Improving Your Skin
It’s estimated that 35 million Americans suffer from this cranky skin condition marked by itchy, red, and inflamed patches. But despite how common eczema is, so are the misunderstandings that surround it. Enough! With the help of top eczema experts, we’ve fleshed out the most oft-repeated myths, so you can get clear about this chronic condition—and help clear up your skin.
Myth: There’s Only One Type of Eczema
Eczema is actually an umbrella term for several different types of itchy skin conditions, says Mona Gohara, M.D., an associate clinical professor of dermatology at Yale University School of Medicine. “When most people talk about eczema, they’re probably referring to atopic dermatitis—the most common type,” she says, which causes dry, scaly rashes. There’s also contact dermatitis, caused by a reaction to something that touched your skin; dyshidrotic eczema, or blisters on hands and feet; nummular eczema, a.k.a. discoid eczema, which causes tough-to-treat coin-shaped spots; seborrheic dermatitis, more commonly known as dandruff (yes, your flaky scalp is a form of eczema); and stasis dermatitis, triggered by circulatory issues.
Myth: Eczema Is Contagious
While we can understand not wanting to rub elbows with someone who has a visible rash, you can’t catch eczema. “Eczema is a condition determined by your genes,” says Joshua Zeichner, M.D., director of cosmetic and clinical research in dermatology at Ichan School of Medicine at Mount Sinai Medical Center in New York City. Your skin’s barrier (its outermost layer, made up of skin cells and lipids) doesn’t work so well, causing microscopic cracks that lead to water loss and inflammation. While the skin may appear red and flaky, this is actually a sign of inflammation, not a contagious infection, he says.
Myth: Eczema Is Just Dry Skin
We all get run-of-the-mill dryness sometimes, especially in winter months—but we all don’t have eczema. For those that do, a faulty skin barrier = teeny-tiny openings in the skin’s surface that not only let moisture escape, but also give irritants and allergens an all-access pass to your body. Then your immune system gets involved and sets off an inflammatory response to fight these invaders. That’s why eczema isn’t just marked by flaky skin, but also itching, redness, and rashes, and often needs more than just moisturizer to calm down.
Myth: Eczema Can Be Cured
While some babies will grow out of atopic dermatitis, the majority will have the condition on and off throughout their lifetime. “Unfortunately, we can’t change your genetics, but we can change the way your genes are expressed and keep eczema under control,” says Dr. Zeichner. The goal in treating eczema is about preventing future flare-ups and controlling symptoms when you do have one. However, if your type of eczema stems from allergic contact dermatitis, removing the irritant or allergen will solve your problem for good.
Myth: Eczema Is Caused by a Food Allergy
Many people think their itching and scaling is a result of something they’re eating: dairy, gluten, peanuts, etc. Doctors do know where this myth comes from. “We see many patients, especially children, who have both eczema and food allergies—about 30% of people have the two issues,” says Emma Guttman-Yassky, M.D., director of the Center for Excellence in Eczema at the Ichan School of Medicine at Mount Sinai Medical Center in New York City. “But typically, we see the eczema first and then the food allergy, so we know food is not the cause.” Researchers theorize that the same breakdown in your skin barrier allows allergens into your system, prompting allergies, which suggests it’s your eczema that may lead to allergies—and not the other way around.
Myth: Eczema Is Always Worse in the Winter
Eczema is a year-round problem. For some people, the dry, cold air robs skin of its moisture, making eczema flare. But for others, summer is the season of suffering. Simply feeling hot can trigger the release of histamines (a naturally occurring chemical that causes an immune response) throughout your body, causing itchy skin. And during the summer, there’s a lot of exposure to water (even sweat counts) and other skin-drying agents such as chlorine. Plus, in warm weather, many people skimp on moisturizer, which experts say is still essential for keeping your skin barrier intact and preventing flare-ups.
Myth: Eczema Is Only in Certain Spots
You may see only a few patches of irritated, inflamed skin, but eczema is an issue that affects the entire surface of your skin. “Even in areas where you don’t have any active rashes, the skin barrier is not working as well as it should be working, and the skin is dry,” says Dr. Zeichner. So spot-treating patches is in the only part of the solution. To keep the skin’s barrier healthy, use gentle cleansers and moisturizers formulated with ceramides, humectants such as glycerin, and fatty acids all over your body.
Myth: Eczema Is No Big Deal
It’s not just the occasional itch. “Eczema is a significant medical issue and has a profound psychosocial impact as well,” says Dr. Zeichner. For one, severe itch can interfere with sleep. The condition can also affect self-esteem, relationships, and more. One large scale study in the Journal of the European Academy of Dermatology and Venerology found that 57% of participants with atopic dermatitis missed at least one day of work due their skin condition in the last year, and 57% were struggling with emotions about hiding their eczema, feeling guilty about it, or experiencing intimacy issues because of their eczema.
Myth: Eczema Responds Best to Natural Products
Skin-care products made only with botanicals aren’t necessarily tops for the eczema-prone, says Dr. Gohara. While some oils and natural ingredients have anti-inflammatory properties and can deliver serious hydration to parched skin, others can do more harm than good. For example, studies have shown that olive oil, contrary to popular opinion, can compromise skin’s barrier. And other oils such as rose hip and lavender can be irritating on sensitive skin. Choosing skin-care products with a short list of ingredients and no fragrance, alcohol, or dyes is more important than seeking out natural ingredients.
Myth: Eczema Is Only Treated Topically
For mild to moderate eczema, your dermatologist may send you home with a medicated ointment or a topical corticosteroid. But in more severe cases, your treatment may also include an inflammation-fighting injection known as a biologic drug. Dupixent (Dupilumab), which was FDA-approved in 2017, binds to a protein in your skin and stops the inflammatory cascade that happens with eczema. And there are more, non-topical options on the way: In a promising clinical trial recently published in the Journal of Allergy and Clinical Immunology, an oral medication called upadacitinib led to 70% of patients achieving a 75% reduction in eczema symptoms.
Myth: Eczema Is Mostly a Pediatric Problem
Atopic dermatitis is often thought to be more common in babies, but a review published in the British Journal of Dermatology shows it’s almost as common in adults over 60 as it is in children under 18. Experts say age-related changes in the skin—including a decline in skin’s barrier function, a slowdown in the immune system—make skin more vulnerable, and an increase of Staphylococcus aureus (Staph) bacteria, which is present in most people with eczema, can trigger AD or make it worse.
Types of eczema: National Eczema Association. (n.d.). “An Overview of the Different Types of Eczema.” nationaleczema.org/eczema/types-of-eczema/
Eczema and food allergies: National Institute of Health. (n.d.). “Scientists Identify Unique Subtype of Eczema Linked to Food Allergy.” nih.gov/news-events/news-releases/scientists-identify-unique-subtype-eczema-linked-food-allergy
Atopic dermatitis and quality of life: Journal of the European Academy of Dermatology and Venerology. (2019). “Atopic Eczema: Burden of Disease and Individual Suffering, Results From a Large EU Study in Adults.” ncbi.nlm.nih.gov/pubmed/31002197
Eczema and plant oils: International Journal of Molecular Sciences. (2018). “Anti-Inflammatory and Skin Barrier Repair Effects of Topical Application of Some Plant Oils.” ncbi.nlm.nih.gov/pmc/articles/PMC5796020/#B62-ijms-19-00070
New eczema drug: Journal of Allergy and Clinical Immunology. (2019). “Upadacitinib in Adults With Moderate to Severe Atopic Dermatitis: 16-week Results From a Randomized, Placebo-Controlled Trial.” ncbi.nlm.nih.gov/pubmed/31786154
Atopic dermatitis and the elderly: British Journal of Dermatology. (2019). “Atopic Dermatitis in the Elderly: A Review of Clinical and Pathological Hallmarks.” onlinelibrary.wiley.com/doi/abs/10.1111/bjd.17896