Why Am I Always Getting Sick?
Atopic dermatitis (AD), also commonly known as eczema, is associated with an increased risk of skin infections due to the damage to the skin barrier. When the skin is healthy and intact, it protects the body from all sorts of germs, but when AD flares up and causes breaks in the skin, or it causes intense itching which leads to scratching that can damage the skin, it creates an opening for bacteria, fungi, or viruses to enter the body and cause infections. Recently, researchers determined that it’s not just infections of the skin that people with AD are prone to: AD also seems to increase the risk of developing infections throughout the body.1
Dysfunction in the immune system
The increased risk of infections – even infections of the skin – aren’t just related to the damaged skin barrier, although that is significant. Another factor seems to be a defective immune defense in people with AD. Several studies have demonstrated that the immune response in people with AD is different than those without the disease – and the differences cause a defective response to bacteria and viruses.1
The same dysfunction in the immune response is seen in people with asthma and allergic rhinitis (also known as hay fever), too. Asthma and allergic rhinitis are characterized as “atopic diseases” – the word “atopic” means the tendency to develop an allergic response to common allergens. It’s estimated that 50% of people with AD develop either asthma or allergic rhinitis, and some people develop all three.1
Making the link between atopic diseases and infections
In a recent study, researchers looked at adults with AD compared to adults in the general population, using data from the National Health Interview Survey from 2010 and 2012. Adults with AD had a higher rate of infections, including sinus infections, head or chest cold, flu, pneumonia, strep throat or tonsillitis, gastrointestinal illness, and infectious disease.1
The researchers then segmented people with AD into three categories:
- Those with no other atopic disease (they just had AD)
- Those with at least one other atopic disease (AD plus asthma or allergic rhinitis)
- Those with all three (AD, asthma, and allergic rhinitis)1
When researchers looked at the data from these categories, they saw that people who have more atopic disease also have a greater increase of infections. For example, when looking at sinus infections over the past year, 14% of people with AD had experienced sinus infections versus 33.7% of those with AD plus one other atopic disease and 62.3% of those with all three atopic diseases.1
Behavioral factors also contribute to greater infections
In addition to the dysfunction in the immune system, researchers note that the behavioral changes seen in people with atopic disease may also contribute to the increased risk of infections. Studies have shown that people with severe atopic disease tend to have reduced physical activity and avoid outdoor activities, due to irritation from airborne allergens and sun exposure. However, the lack of sun exposure can result in lower vitamin D levels. Given that both exercise and vitamin D levels are powerful contributors to immune function, researchers suggest that these lifestyle behaviors seen in people with severe atopic disease may also contribute to their risk of more infections.1
Reducing the risk of infections
While infections aren’t always avoidable, there are steps that can be taken to minimize your exposure:
- Wash your hands often.
- Stay up-to-date on vaccinations.
- Stay at home when you’re sick.
- Cook foods to proper temperature.
- Promptly refrigerate leftovers.
- Avoid contact with friends or relatives when they’re sick.2
Have you been diagnosed with atopic dermatitis?