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Eczema

Treatment outlook Emerging
Brianna.
Written by Public Health and Communications Consultant
Reviewed by Expert in Emergency Medicine, Functional Medicine, and Longevity Science

Skin is the largest organ in your body. It's also your first line of defense against infection. When you have a chronic skin condition, your skin can't protect you from infection as well.

Eczema is one of the most common chronic skin conditions in both children and adults. It causes dry, sometimes flaky skin that easily cracks, leaving you vulnerable to bacteria and other microorganisms that cause infection.

What Is Eczema?

Eczema, also called atopic dermatitis, is an inflammatory skin condition that affects up to 30% of children and 10% of adults all around the world (Nemeth et al., 2024). It manifests as a dry, itchy, inflamed rash that can be really uncomfortable.

There are many different causes for eczema, but it's tough to pinpoint a specific cause for any one person. Research is still developing in this area, but studies show that several regenerative treatments can improve eczema, prevent flare ups, and improve your quality of life.

What Causes Eczema?

The root causes of eczema aren't fully understood, but there are a few factors that contribute to its development. Eczema appears to run in families, suggesting a genetic component, but there's also evidence supporting allergies, stress, and other factors.

Genes

Researchers have identified two different types of genes that may contribute to eczema: skin barrier genes and immune-related genes (Nemeth et al., 2024). The most likely culprit is the filaggrin gene, which gives your body instructions for creating a protein called filaggrin that helps support your skin's function as a barrier. Mutations in the filaggrin gene may make your skin more vulnerable to environmental irritants and allergens—and that vulnerability can contribute to eczema. Other skin barrier genes may also play a role, including the ceramide synthase gene.

Immune-related genes have also been linked to eczema. The genes responsible for regulating T-cells, cytokines, and immunoglobulins are suspected. However, genetic testing isn't usually considered in the diagnosis of eczema.

Gut-Skin Axis

Your gut microbiome influences your health from head to toe—including your skin. This relationship is called the gut-skin axis and research suggests it influences the development of eczema. Research shows that the proportion of harmful bacteria (Clostridia, Clostridium difficile, Escherichia coli, and Staphylococcus aureus) is higher in people who have eczema, while the proportion of beneficial bacteria (Bifidobacteria, Bacteroidetes, and Bacteroides) is lower.

Clostridia and Escherichia coli may also contribute to eczema through another mechanism. They can cause eosinophilic inflammation, which can lead to an eczema flare up (Lee et al., 2018).

Stress

The mind-body connection explains how different aspects of your health influence each other. If you're feeling mentally unwell or stressed, that may manifest in physical symptoms and vice versa. So it's unsurprising that there may be a direct link between eczema and your mind. The type or level of stress you're experiencing can also influence how itchy or bothersome your eczema is (Lönndahl et al., 2023).

Dietary Triggers

The things you eat have a strong influence on your body, including your skin. Certain foods can trigger and even prolong an eczema flare up. Research shows that eliminating white flour products, gluten, dairy, and nightshades can help improve eczema. And adding vegetables, fruit, and fish oil to your diet may also help (Nosrati et al., 2017).

Nutritional Deficiencies

Initial findings suggest that there may be a link between eczema and nutritional deficiencies—specifically vitamin D. Several studies show evidence that vitamin D supplementation may help improve eczema and maybe even prevent it (Nielsen et al., 2024). There are similar findings for fatty acids, so further study in this area is promising.

Who Is at Risk?

Age and race may influence your risk for eczema. It's more common in children than adults, and Black people have higher rates of eczema than non-Hispanic white people in the United States. Research suggests that Black children may be up to 2.1 times more likely to develop this itchy skin condition than white children (Croce et al., 2021).

Environmental factors also increase your risk for eczema. Black children who live in racially segregated communities have more severe eczema than those who don't. And lower socioeconomic status has similar outcomes (Croce et al., 2021). Adults also experience these differences.

What Are the Symptoms?

The symptoms of eczema vary. Most people experience persistent itching, inflammation, and dry skin. You may also experience blisters, flaking, scaling, and other symptoms.

Your skin tone influences the way eczema looks. In lighter skin tones, it is usually red. In darker skin tones, it may darken the skin or appear purple or ashen. In either case, the skin may feel rough and bumpy (National Eczema Association, 2022).

Common areas for eczema flares are the hands, feet, ears, knees, ankles, elbows, and face. However, it isn't limited to these areas—it can affect any area of skin.

How Is Eczema Diagnosed?

Getting a diagnosis for eczema depends on the signs and symptoms you have. Your primary care provider or other general provider can diagnose eczema. However, itching, discolored, dry, and rough skin can be symptoms for several different skin conditions, so seeing a dermatology specialist can help confirm your diagnosis by ruling out other conditions, if needed.

A dermatology specialist has several tools at their disposal to examine and diagnose skin conditions. They'll collect your medical history, ask about environmental exposures, and visually examine your skin. If they are unsure about a diagnosis, a dermatology specialist can collect a small biopsy to confirm but this isn't necessary in most cases.

Skin biopsies can usually be done in an office. Your provider will administer medicine to numb you and scrape a bit of skin off the affected area for analysis under a microscope. They'll be looking for signs of spongiosis, which is extra fluid between your skin cells arranged in small sacs called spongiotic vesicles, and extra T-cells (Tokura et al., 2025). This differentiates eczema from other skin conditions, like psoriasis.

If you have a darker skin tone, you may want to choose a provider who has experience working with people of color.

How Is Eczema Treated with Regenerative Therapies?

There are a number of ways to manage eczema, both with medication and other therapies.

Phototherapy

Using phototherapy, also called light therapy, is a popular way to manage eczema symptoms. Certain wavelengths of light disrupt the processes in your skin that cause eczema symptoms. Narrowband UVB and broadband UVB light may help, but narrowband is more effective and causes fewer side effects (Molla, 2024; Lee, 2024).

You'll visit your provider for phototherapy sessions. The length and frequency of sessions will depend on your individual circumstances and can vary from once a week to several times a week for several months.

Sunlight may also help improve eczema symptoms since it includes UVB rays—but it also contains UVA rays. Both types of UV rays can also cause damage to your skin and other parts of your body, including sunburn and increased risk for skin cancer (Environmental Protection Agency, 2026). Some people may notice that their eczema improves in summer months when they're exposed to more sunlight as a result.

Bacteriotherapy

Many patients who have eczema have a bacteria called Staphylococcus aureus, which worsens the inflammation caused by eczema. Researchers have found that another bacteria, Staphylococcus hominis A9 (ShA9), that is present on healthy skin can kill S. aureus through a process called bacteriotherapy.

ShA9 also prevented S. aureus from producing a toxin that promotes inflammation, even if it didn't kill the S. aureus. This shows that bacteriotherapy may be an effective way to treat the inflammation people with eczema experience (Nakatsuji et al., 2021). Bacteriotherapy shows promise as a future treatment for eczema, but it's still being studied so it isn't commercially available as of yet.

Education

The mind-body connection isn't just related to stress—it also explains why education can help you manage eczema symptoms. People who are taught how to manage their eczema experience short-term improvement in their symptoms. These improvements were observed in both individual and group education interventions, but there's no evidence of long-term effectiveness (Singleton et al., 2024).

Topical Medication

Your provider may prescribe topical medication to help manage your eczema symptoms. These medications, which include topical corticosteroids and Janus kinase (JAK) inhibitors, come in cream, lotion, or ointment form. You will apply a small amount to the affected area as directed. For many people, this will help clear the skin and stop uncomfortable symptoms like itching (Lax et al., 2024).

What Are Possible Complications?

Effectively managing eczema symptoms can help prevent complications. The main complication caused by eczema is infection. Because it compromises your skin barrier, it can make it easier for bacteria and other microorganisms to infect your skin (Wang et al., 2020).

An infection can make your skin feel warmer than usual, cause a fever, cause pus and other fluid to ooze from the affected area, or other symptoms. If you suspect you have an infection, make sure you see a healthcare provider for proper diagnosis and treatment.

Can Eczema Be Prevented?

Eczema can't always be prevented, especially if there isn't a specific allergen or environmental factor playing a role. Keeping the skin moisturized, getting outside to absorb the UVB rays from sunlight, and using any medications as prescribed may help prevent flare ups. Avoiding allergens and other environmental irritants can also help.

If you have dietary triggers, avoiding those is a great way to prevent an eczema flare up. If you aren't sure if you have dietary triggers, try an elimination diet to see if your eczema improves. You can start by eliminating dairy, gluten, and/or nightshades. There are plenty of substitutes you can use in your diet if you find that these foods aggravate your eczema.

Make sure you're getting enough vitamins and minerals. Since vitamin D deficiency is linked to eczema and essential fatty acids and other nutrients might also be linked, avoiding nutrient deficiency can help improve eczema and prevent flare ups.

Takeaway

Eczema is likely caused by both genetic and environmental factors. There are numerous ways to manage eczema symptoms using medication, education, light therapy and other methods. Managing your symptoms is important to help prevent infections and keep your skin healthy. And addressing root causes through focusing on gut health and avoiding dietary triggers can go a long way in improving your daily quality of life.

If you’re looking for a provider, you can browse vetted eczema treatment clinics across the U.S. in our directory.

Frequently asked questions

Common questions about regenerative approaches to Eczema.

Eczema is caused by genes, stress, and environmental factors. Genes that influence your skin barrier's function and your immune system may play a role. Stress, exposure to skin irritants, and allergies can cause the onset of an eczema flare up.

No, eczema is not contagious. You can't catch it from or pass it to anyone else.

No, eczema isn't an autoimmune disease. It's an inflammatory skin condition.

Flare ups of eczema can be caused by environmental exposures and allergies. Allowing your skin to dry out can also play a role.

There is evidence to suggest that eczema may be caused by genetic factors. Researchers suspect that genes influencing the function of your skin barrier and your immune system may be a root cause, but more research is needed to confirm these hypotheses.

There is no permanent cure, but eczema can go into long remission where skin stays clear for months or years. Consistent moisturizing, treating flares early, and limiting irritant exposure do most of that work. Elimination diets are riskier than they look: controlled trials show little benefit unless a food allergy is confirmed by challenge, and removing a food can cost tolerance to it. About one in five children put on elimination diets go on to have immediate reactions to the removed food, a third of them anaphylaxis.

Often, at least in children. Many kids who develop eczema early see it clear substantially by adolescence as the skin barrier and immune system mature. Some carry it into adulthood, though, and others find it fades in childhood and returns during a stressful or hormonal stretch.

Scratching does not spread eczema the way an infection spreads, but it makes things worse. Each scratch damages the barrier, ramps up inflammation, and feeds the itch-scratch cycle that lets flares expand. Broken skin also invites bacterial infection, so moisturizing and calming the itch keeps a flare contained.

A typical flare lasts a few days to a few weeks, depending on how fast the trigger is removed and the skin soothed. Consistent moisturizing and treatment usually settle one within one to three weeks; an ignored trigger, scratching, or a secondary infection drags it out. Flares that keep returning signal an underlying driver.

Yes, adult-onset eczema is more common than people expect, appearing first in your thirties, forties, or later. It can be switched on by high stress, hormonal shifts, new irritant exposures at work, or emerging food and contact sensitivities. Because adults assume eczema is a childhood condition, persistent itchy patches often get mistaken for a passing rash.

For many people moderate sunlight helps, because ultraviolet light calms the immune response in skin, the principle behind clinical phototherapy. The catch is dose: too much sun, overheating, and sweat trigger flares, and sunburn sets the skin back. Brief exposure without burning is the sweet spot, while severe eczema calls for supervised phototherapy. Skip the sun approach if you take a photosensitizing drug such as doxycycline or a thiazide, use tacrolimus or pimecrolimus cream, or have a history of skin cancer.

Eczema on the scalp can cause temporary hair loss, though it rarely does permanent damage. The culprit is the scratching and inflammation, not eczema attacking the follicles, so hair usually grows back once scalp inflammation settles. Sudden or patchy loss that does not track with your eczema is worth checking.

Nighttime itching has a physiological basis: the skin loses more moisture in the evening, body temperature rises under bedding, and cortisol, the body's natural anti-inflammatory hormone, dips. With fewer daytime distractions you also notice it more. Moisturizing before bed and keeping the bedroom cool take some of the edge off.

References

Croce, E.A., et al. (2021). Reframing racial and ethnic disparities in atopic dermatitis in Black and Latinx populations. Journal of Allergy and Clinical Immunology. 2021 Nov;148(5):1104-1111. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8578465/.

Environmental Protection Agency. (2026). Ultraviolet (UV) Radiation and Sun Exposure. Retrieved from https://www.epa.gov/radtown/ultraviolet-uv-radiation-and-sun-exposure.

Lax, S., et al. (2024). Systematic review ranking potent topical steroids, JAK inhibitors, and tacrolimus as the most effective topical treatments, providing context for integrative layering. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11629051/.

Lee, R., et al. (2024). RCT showing narrowband UVB and combined UVA/NBUVB phototherapy are both effective and safe for chronic atopic dermatitis in adults. Retrieved from https://pubmed.ncbi.nlm.nih.gov/38284204/.

Lee, S.Y., et al. (2018). Microbiome in the gut-skin axis in atopic dermatitis. Allergy Asthma Immunology Res. 2018 Jul;10(4):354-362. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6021588/.

Lönndahl, L. et al. (2023). Psychological stress and atopic dermatitis: A focus group study. Ann Dermatology. 2023 Oct;35(5):342-347. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC10579569/.

Molla, A. (2024). A comprehensive review of phototherapy in atopic dermatitis: Mechanisms, modalities, and clinical efficacy. Cureus. 2024 Mar 25;16(3):e56890. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11043791/.

Nakatsuji, T., et al. (2021). Phase 1 trial demonstrating topical Staphylococcus hominis A9 bacteriotherapy reduces S. aureus burden and improves atopic dermatitis severity. Nat Med. 2021 Apr;27(4):700-709. doi: 10.1038/s41591-021-01256-2. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8052297/.

National Eczema Association. (2022). Eczema in skin of color: What you need to know. Retrieved from https://nationaleczema.org/blog/eczema-in-skin-of-color/.

Nemeth V., et al. (2024). Eczema. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538209/.

Nielsen, A.Y., et al. (2024). Vitamin D supplementation for treating atopic dermatitis in children and adults: A systematic review and meta-analysis. Nutrients. 2024 Nov 28;16(23):4128. Retrieved from https://pubmed.ncbi.nlm.nih.gov/39683522/.

Nosrati, A., et al. (2017). Dietary modifications in atopic dermatitis: patient-reported outcomes. J Dermatolog Treat. 2017 Sep;28(6):523-538. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC5736303/.

Singleton, H., et al. (2024). Systematic review finding educational and psychological interventions reduce short-term eczema symptoms, supporting the mind-skin connection. Cochrane Database Syst Rev. 2024 Aug 12;8(8):CD014932. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11318083/.

Tokura Y., et al. (2025). What is "eczema"? Journal of Dermatology. 2025 Feb;52(2):192-203. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC11807370/.

Wang V., et al. (2020). The infectious complications of atopic dermatitis. Ann Allergy Asthma Immunol. 2021 Jan;126(1):3-12. Retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC7411503/.

About this article

Written by

Brianna.

Brianna Graham, MPH, is a public health expert and communications consultant with eight years of experience in health administration, nonprofit work, and edu...

Medically reviewed by

Dr. Justin Mazur, MD, CFMP

Dr. Justin Mazur is a board-certified emergency medicine physician with more than 20 years of clinical experience in Brooklyn and New York City. He received ...

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