Eczema – causes, forms, triggers & effective care

What is eczema?

"Eczema" is a collective term for inflammatory skin conditions characterized by redness, itching, scaling, oozing, or thickening of the skin. In clinical practice, eczema is often used synonymously with "dermatitis." Common to the various forms of eczema is a compromised skin barrier and an overactive inflammatory response, which can be triggered by genetic factors, environmental stimuli, or allergens.

How does eczema develop? – The mechanisms

Eczema develops from an interplay of barrier weakness , immune reactions , and triggers . If the lipid matrix of the stratum corneum is disrupted (e.g., due to genetic factors, overly aggressive cleansing, or climate), the skin loses water (increased TEWL), becomes more permeable to irritants, and reacts more quickly with inflammation. The immune system responds with redness, itching, and—in chronic cases—thickening (lichenification). The skin microbiome can also become unbalanced, exacerbating inflammation.

Common forms of eczema

• Atopic dermatitis (atopic dermatitis): chronic and recurrent, often beginning in childhood; dry, itchy skin, often in the folds or on the face. Genetic predisposition (e.g., filaggrin variants), barrier defects, and environmental factors play a role.
• Contact dermatitis: irritant (caused by irritants such as surfactants and solvents) or allergic (delayed type IV reaction to, for example, fragrances, nickel, and preservatives). Common on the hands, face, or in cases of occupational exposure.
• Seborrheic dermatitis: Inflammatory, scaly areas in areas rich in sebaceous glands (scalp, nasolabial folds). The yeast Malassezia commensal is considered a contributing factor.
• Perioral dermatitis: papular-scaly lesions around the mouth; often triggered by over-care, occlusive cosmetics, or topical steroids.

Typical triggers & amplifiers

• Climate & Environment: Cold, dry heating air, UV overdose, air pollutants.
• Products & Materials: Harsh surfactants, fragrances, high alcohol content; wool or rough textiles.
• Lifestyle: stress, lack of sleep, smoking; excessive sweating and friction (sports, masks).
• Microbiome shifts: Overgrowth of certain germs (e.g. Staphylococcus aureus ) on inflamed skin.

Diagnosis & medical examination

Diagnosis is made clinically by dermatologists. If allergies are suspected , patch tests are helpful. Differential diagnoses (e.g., psoriasis, fungal infections, rosacea) must be ruled out. In severe, treatment-resistant cases, systemic therapies under specialist care are indicated.

Eczema care: The 5-pillar strategy for everyday life

1. Gentle cleansing: pH-neutral, perfume- and sulfate-free cleansers; lukewarm water; short shower times.
2. Barrier structure: rich emollients with ceramides, cholesterol, and free fatty acids; occlusive components to retain moisture.
3. Calm inflammation: Niacinamide, panthenol, colloidal oat; for acute flare-ups, doctor-prescribed topical steroids or calcineurin inhibitors.
4. Trigger management: Fragrance-free, low-alcohol formulations, suitable textiles; stress and sleep hygiene.
5. UV protection: daily sunscreen (mineral or hybrid) to minimize inflammation and hyperpigmentation.

Active ingredients with evidence in basic care

• Ceramides: key lipids of the skin barrier; improve TEWL and skin comfort.
• Niacinamide (vitamin B3): strengthens barrier functions, reduces redness and itching, supports ceramide synthesis.
• Panthenol & Allantoin: promote regeneration, reduce irritation.
• Colloidal Oat: soothes, relieves itching and strengthens the protective layer.
• Ectoin: protects cell structures from environmental stress (osmoprotection) and stabilizes sensitive skin.

Manage exacerbations wisely

During flare-ups, "less is more" is a good approach: a few, highly tolerable products; consistent re-fatting; and short-term, medically supervised anti-inflammatory treatment. After the flare-up has subsided, gradually return to active ingredients (e.g., niacinamide); do not start with strong acids or retinoids at the same time.

Lifestyle, Microbiome & Textiles

Humidity in the sleeping environment (humidity ≥ 40%), breathable, soft cotton or silk, gentle, fragrance-free laundry detergents. Stress reduction (breathing exercises, walks) reduces the urge to scratch. Short, lukewarm baths with moisturizing additives can combine relaxation with barrier care.

Luxury & sensory for eczema – no contradiction

Elegant, fragrance-free textures with clinically proven lipid profiles define modern luxury: tangible comfort, a calmer skin feel, less itching – without olfactory irritation. Premium routines like those from NATURFACTOR® combine dermatological wisdom with tactile and aesthetic finesse.

FAQ – Frequently Asked Questions

Do “natural” cosmetics automatically help with eczema?

Not necessarily. "Natural" is not synonymous with "compatible." Barrier-friendly formulations without potential allergens (especially fragrances) are crucial.

Can I chemically exfoliate?

In acute flare-ups: no. In stable phases: only very mild, rare, and always with rich moisturizing. If unsure, consult a dermatologist.

When to see a doctor?

For severe itching, sleep disturbances, weeping lesions, signs of infection, or when OTC care is not sufficient.

Conclusion

Eczema is complex but easy to manage: strengthen the barrier, control inflammation, avoid triggers, and consistently protect yourself from UV rays. High-quality, fragrance-free luxury care can reduce flare-ups and noticeably improve your quality of life.

Sources

1. NHS – Atopic eczema overview https://www.nhs.uk/conditions/atopic-eczema/
2. Cleveland Clinic - Eczema (Dermatitis)https://my.clevelandclinic.org/health/diseases/9998-eczema
3. NCBI Bookshelf – Atopic Dermatitis (StatPearls) https://www.ncbi.nlm.nih.gov/books/NBK448071/
4. European Academy of Dermatology & Venereology (EADV) – Patient info https://eadv.org/patient-corner/
5. DermNet NZ - Dermatitis https://dermnetnz.org/topics/dermatitis