"What is eczema?
Eczema is also sometimes referred to as atopic dermatitis. The skin of people who experience eczema differs from those who don’t suffer.1 You'd probably be familiar with what eczema can look and feel like - areas of dry, itchy skin.2 But what's going in the skin?"
"How is the skin different in eczema?
First, you need to understand the different components of your skin, and the jobs they do. The skin comprises of three layers:3
The subcutis (deepest layer) – made up of fat, for thermal insulation and protection as you move 3
The dermis (middle layer) – contains hair follicles, sweat glands and tough connective tissue
The epidermis (top layer) – provides protection and contains the pigment responsible for skin colour
The epidermis is the layer that's affected by eczema.2 The very top layer of the epidermis is called the stratum corneum – literally “horny layer” in Latin. This layer is made up of flattened dead skin cells,4 embedded in a matrix of lipids5 (more on that soon), like bricks and mortar. The stratum corneum is what keeps moisture locked into our skin, and if it's not working properly then moisture can escape, causing dry and dehydrated skin.1"
Luckily, there are ways to help manage the dryness and itchiness or your eczema-prone skin.
"More on the matrix – the lipid matrix
Understanding the lipid matrix that glues your dead skin cells together is important to understanding eczema. This matrix is made up of different types of lipids, with three main ones doing the bulk of the work; ceramides, free fatty acids and cholesterol. When the balance of these three components is upset, the lipid matrix can't hold the dead skin cells together as well, allowing moisture to escape.6 Unfortunately, we don't yet know for certain what causes the components of the lipid matrix to disappear. It appears to be a combination of genetics, immune function or environmental factors.7 No matter the cause, once this barrier is impaired moisture can escape and environmental irritants can start to work their way inside, making your already dry skin inflamed and itchy.2 It's important to remember that scratching the itch further damages the skin's protective barrier layer.
Luckily, there are ways to help you manage your eczema-prone skin."
1. "ASCIA, Information for patients, consumers and carers; Eczema (atopic dermatitis) [internet], 2015 [updated 2015; cited 2018 May 11]. Available from: https://www.allergy.org.au/images/pcc/ASCIA_PCC_Eczema_2015.pdf
2. Victoria State Government, Better Health Channel; Eczema (atopic dermatitis) [internet], 2018 [updated 2018 April; cited 2018 May 11]. Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/eczema-atopic-dermatitis
3. Victoria State Government, Better Health Channel; Skin [internet], 2018 [updated 2018 April; cited 2018 May 11]. Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/skin
4. Novotny J, Hrabàek A, Vávrová K. Synthesis and structure-activity relationship of skin ceramides. Curr Med Chem. 2010; 17(21):2301–24
5. Janssens M, van Smeden J, Gooris GS, Bras W, Portale G, Caspers PJ, et al. Increase in short-chain ceramides correlates with an altered lipid organization and decreased barrier function in atopic eczema patients. J Lipid Res. 2012; 53:2755–2766.
6. Sajic D, Asiniwasis R, Skotnicki-Grant S. A Look at Epidermal Barrier Function in Atopic Dermatitis: Physiologic Lipid Replacement and the Role of Ceramides. Skin Therapy Lett. 2012; 17(7):6-9.
7. Hon K.L, Leung K.C, Barankin B. Barrier Repair Therapy in Atopic Dermatitis: An Overview. Am J Clin Dermatol. 2013; 14:389-399."Enter article content