Is Eczema an Autoimmune Disease?

Reviewed by: HU Medical Review Board | Last reviewed: May 2023

One of the main symptoms of atopic dermatitis (eczema) is skin irritation. This irritation can be caused by a few different things. But since eczema involves inflammation, many people wonder if it is an autoimmune disease.1,2

What is an autoimmune disease?

Your body spends a lot of energy training itself to fight germs or other threats. Your immune system has specific processes to recognize any problems quickly and fight them. But in some cases, this process goes wrong. When your body’s immune system attacks itself instead of germs or other invaders, you can develop an autoimmune disease.3,4

There are many autoimmune diseases. They include:3,4

  • Rheumatoid arthritis
  • Psoriasis
  • Lupus
  • Type 1 diabetes
  • Myasthenia gravis
  • Celiac disease
  • Inflammatory bowel diseases

This is only a small fraction of autoimmune diseases. There are many more, and they can affect nearly every part of the body.3,4

In each disease, the body’s immune system turns against itself by mistake. In rheumatoid arthritis, the body attacks the joints. In type 1 diabetes, the body destroys cells that produce insulin in the pancreas. Each autoimmune disease has its own way of attacking the body.3,4

What causes eczema?

There is no single cause for eczema. Instead, it is a combination of factors. Some of them involve changes in the surface of the skin (skin barrier). These changes can be due to:1,5

  • Genetics
  • An overactive immune system
  • Changes in the fats (lipids) that make up the skin

A weakened skin barrier lets in germs and allergens easier. This can lead to inflammation and itching. Scratching weakens the skin barrier even further.1,5

People with eczema also tend to have an overactive immune system. This can be due to genetics or problems with the way their body sends inflammation signals.1,5

Experts do not fully understand the underlying cause for this immune system issue. But they know the weakened skin barrier allows germs and other triggers into the body, which activates the immune system. This process then leads to eczema flare-ups.1,5

Environmental factors also play a role in eczema. Certain triggers in a person's environment can increase their eczema risk and symptom severity, including:1,5

  • Exposure to air pollution
  • Living in an urban area
  • Having other allergies (like to dust, mold, or certain foods)
  • Being exposed to certain chemicals

Comparing eczema and autoimmune diseases

Eczema and autoimmune diseases are alike in several ways. They both involve long-term (chronic) inflammation. Some of the same immune system processes are affected in each condition. There are autoimmune diseases, like psoriasis and lupus, that cause skin changes similar to those of eczema.2,5-7

Treatment options can also be similar. Drugs that suppress the immune system are often used in treating symptoms of both.2,5-7

However, there are differences between eczema and autoimmune conditions. For example, we know that changes in the strength of the skin barrier is a big factor in eczema. This can have a genetic cause that does not lead to the body attacking itself. The barrier is weakened because of changes in fats and proteins in the skin’s surface. It is also due to changes in the channels that control water and nutrient balance.1,8

Environmental triggers also work differently in eczema. Cold, dry air can make skin cracking and inflammation worse. Exposure to certain allergens can also lead to flares. These are external issues rather than internal ones. While some autoimmune diseases can have external triggers, these triggers kick-start the self-attack.1,3,4

Is eczema considered an autoimmune issue?

Overall, eczema is caused by several different factors working together. Some factors are similar to autoimmune issues. Other factors are not. This has caused a lot of debate among experts.2

Some experts are unsure whether to call eczema an autoimmune disease. Most agree that eczema is an inflammatory issue rather than an autoimmune one. This perspective may change over time, though, as they learn more about eczema and its causes.2

Research does suggest a link between having atopic dermatitis and developing an autoimmune disease. And it seems that the more severe a person's atopic dermatitis symptoms are, the more likely they are to have an autoimmune disease. But more research is needed to fully understand the link.9-11

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