Eczema: Causes vs. Triggers

Eczema is a complex skin condition that can be influenced by a variety of factors. Understanding the difference between the root causes of eczema and its triggers is essential for effective management and treatment of eczema. In this comprehensive guide, we’ll first dive into the differences between root causes vs. triggers for eczema. Then we’ll dive into the specific root causes and triggers for eczema, organized by external & internal factors for each. This will provide you with a deeper understanding of eczema and how to address it.

Below is a high-level overview of what you can expect:

  • Root Causes
    • External Root Causes
      • Bacterial Imbalances: Including the presence of Staphylococcus aureus (staph).
      • Fillagrin Deficiency: A genetic deficiency in fillagrin, a skin barrier protein.
    • Internal Root Causes
      • Bacterial Overgrowth: Involving species like Staphylococcus aureus and Helicobacter pylori.
      • Candida Overgrowth: An overgrowth of Candida yeast.
      • Mold Allergens: Allergic reactions to molds like Aspergillus and Penicillium.
      • Leaky Gut: Increased intestinal permeability, allowing harmful substances to enter the bloodstream.
  • Triggers
    • External Triggers
      • Environmental Factors: Such as pollen, dust mites, and pet dander.
      • Climate: Extreme weather conditions like hot and humid or cold and dry.
      • Skin Irritants: Harsh soaps, detergents, and chemicals.
    • Internal Triggers
      • Food: Certain foods like dairy, nuts, eggs, or soy.
      • Hormonal Changes: Fluctuations during puberty, pregnancy, or menstrual cycles.
      • Stress: Emotional stress leading to inflammation.

Understanding Root Causes vs. Triggers

While trying to reduce our symptoms, we can often be addressing triggers to try to resolve our eczema, when we should be focusing our efforts on the root causes. The difference in identifying these are important, because as we know, eczema is a complex skin condition that can flare up seemingly randomly. Below, I’ll address the differences between root causes and triggers, and then identify the different root causes and triggers tied to eczema.

A root cause refers to the underlying reason or source that leads to the development of a health condition. It is the primary factor or factors that contribute to the occurrence of the condition. Identifying the root cause is essential for effective treatment and prevention.

On the other hand, a trigger is an event, substance, or factor that initiates the symptoms or exacerbates an existing health condition. Triggers can vary from person to person and may include environmental factors, certain foods, stress, or specific activities. While triggers may worsen the symptoms, they do not necessarily represent the underlying cause of the condition. And thus, by removing a trigger, we are not necessarily getting fixing the condition, but just managing it.

Root Causes of Eczema

The causes of eczema can be broken down into two main categories: external issues and internal issues.

Skin defects refer to abnormalities or imbalances in the skin’s structure and function. The skin acts as a protective barrier, preventing irritants and allergens from entering the body. However, in individuals with eczema, this barrier is compromised, making the skin more susceptible to dryness, inflammation, and infection. Skin defects can include a weakened skin barrier, reduced production of natural moisturizing factors, and an overactive immune response in the skin.

On the other hand, imbalances in the body can also contribute to the development of eczema. These internal factors, when out of balance, can lead to inflammation, cause your eczema to flare, make your body more sensitive to the topical products your body comes in contact with as well as the different foods you ingest.

By understanding the underlying skin defects and imbalances in the body, individuals with eczema can take proactive steps towards managing their condition and improving their overall quality of life.

External Root Causes

Bacterial Imbalance

The skin’s pH naturally tends to be below 5, which is slightly acidic. This acidic environment is beneficial for individuals with eczema because it creates an inhospitable environment for the growth of certain bacteria, particularly Staphylococcus aureus.

Staphylococcus aureus is a common bacterium that can be found on the skin of healthy individuals. However, in people with eczema, the skin barrier is compromised, making it easier for bacteria to penetrate and cause infections & eczema flare-ups. Staph can be commonly found on the skin of people with eczema as well as in their noses.

The acidic pH of the skin helps to inhibit the growth of Staphylococcus aureus. This is because the acidic environment disrupts the bacterium’s ability to thrive and reproduce. By maintaining a pH below 5, the skin creates an unfavorable condition for the growth of Staphylococcus aureus, reducing the risk of infection and potential worsening of eczema symptoms.

Filaggrin Deficiency

Filaggrin is a protein that is important for maintaining the integrity and hydration of the skin. It plays a crucial role in the formation of the skin’s protective barrier. Mutations in the filaggrin gene (FLG gene) have been associated with various skin conditions, such as eczema, leading to impaired skin barrier function.

Maintaining a healthy skin pH balance and using products to maintain healthy skin can compensate for filaggrin deficiency and help protect your skin barrier from the outside, but are there other ways to compensate for the filaggrin deficiency?

Well, some individuals have also explored the use of L-histidine, a supplement that has shown promise in increasing fillagrin production and improving skin barrier function. People taking this have found this to provide similar effects to taking mid-potency topical corticosteroids. However, it is worth mentioning that, as of my knowledge, long term studies on ingesting L-histidine have not been done. In the studies I’ve found, there were no serious adverse effects found in people taking L-histidine supplements for 12 weeks (4g for adults & 0.8g for children).

Internal Root Causes

Many people start to experience eczema due to imbalances within their bodies, which are often triggered by stressful life events or changes. Stressful life events or changes can disrupt the body’s natural balance and trigger eczema flare-ups. When we experience stress, our body releases stress hormones like cortisol, which can affect our immune system and increase inflammation. This can lead to a heightened sensitivity and reactivity of the skin, making it more prone to eczema outbreaks. Below are the different imbalances in the body to be aware of.

Bacterial Overgrowth

  • Staphylococcus aureus (staph) and Helicobacter pylori (H. pylori) are two types of bacteria that commonly contribute to bacterial overgrowth in the gut.
  • Staphylococcus aureus is a common bacterium that can be found on the skin and in the nasal passages of healthy individuals. However, in some cases, it can also colonize the gut and lead to bacterial overgrowth. This can occur when the normal balance of bacteria in the gut is disrupted, allowing staph to multiply and thrive. Factors such as a weakened immune system, antibiotic use, or a compromised gut barrier can increase the risk of staph overgrowth.
  • Helicobacter pylori is a bacterium that specifically colonizes the stomach lining. It is a major cause of gastric ulcers and chronic gastritis. While it primarily affects the stomach, H. pylori can also have an impact on the overall gut microbiome. When present in large numbers, it can disrupt the balance of bacteria in the gut and contribute to bacterial overgrowth.
  • Reach out to your healthcare professional if you want to test for these bacterial overgrowths, you can use the GI Map stool test to diagnose for this.

Candida Overgrowth

  • Candida is a type of yeast that naturally exists in our bodies, particularly in the digestive system and on the skin. Normally, it is kept in check by the immune system and other beneficial bacteria. However, an overgrowth of Candida can occur, leading to a condition called candidiasis. Candidiasis can manifest in various ways, including skin conditions like eczema.
  • Candida produces toxic byproducts, such as acetaldehyde, which can disrupt the skin’s natural barrier function. This can make the skin more susceptible to allergens and irritants, potentially worsening eczema symptoms.
  • Additionally, Candida overgrowth can disrupt the balance of beneficial bacteria in the gut, leading to a condition called dysbiosis. This imbalance can further contribute to inflammation and skin issues, including eczema.
  • If you suspect Candida overgrowth may be contributing to your eczema or other skin conditions, it is advisable to consult with a healthcare professional. You can identify if you have Candida by requesting for an organic acid urine test. Candida can be shown on the GI Map stool test; however, false negatives can commonly occur, so it is not a consistently reliable way to test for candida.

Mold Allergens

  • Mold allergens, such as those from molds like Aspergillus and Penicillium, can be common triggers for eczema symptoms, especially in individuals who are allergic to mold spores. The organic acid test can be used to indicate if you have been exposed to molds; however, if these biomarkers are found, it can be beneficial to do further mycotoxin testing.

Leaky Gut

What is Leaky Gut?

Leaky gut, also known as increased intestinal permeability, is a condition where the lining of the intestines becomes more porous, allowing substances such as toxins, bacteria, and undigested food particles to leak into the bloodstream. This leakage can trigger an immune response and lead to various symptoms, including digestive issues, food sensitivities, fatigue, and inflammation.

How Do You Know You Have Leaky Gut?

The GI Map stool test is a diagnostic tool that can be used to assess gut health, including the presence of leaky gut. It is a comprehensive stool analysis that examines various markers, including inflammation, immune function, digestion, and gut microbiome balance. To diagnose leaky gut with the GI Map stool test, the test typically looks for markers such as zonulin, lipopolysaccharides (LPS), and other indicators of intestinal permeability. Elevated levels of these markers may suggest the presence of leaky gut.

If you suspect you may have leaky gut or any other gastrointestinal issues, it is recommended to consult with a healthcare professional who can evaluate your specific situation and guide you through the appropriate diagnostic process.

Other Internal Factors

Below are other internal factors you should be aware of. These factors below can be measure within the GI Map stool test and should be kept in mind when managing your eczema.

Akkermansia Mucinophilia

Akkermansia muciniphila is a type of bacteria that resides in the human gut. Its purpose is to break down and utilize the mucus layer that lines the intestines. This bacterium plays a crucial role in maintaining gut health and has been associated with various health benefits. Reduced levels of Akkermansia muciniphila may contribute to leaky gut syndrome and various gastrointestinal issues.

Fecalibacterium Prausnitzii

Fecalibacterium Prausnitzii is a type of bacteria that naturally resides in the human gut. It plays a crucial role in maintaining gut health and overall well-being. The main purpose of Fecalibacterium Prausnitzii is to produce butyrate, a short-chain fatty acid that acts as a source of energy for the cells lining the colon. Butyrate also has anti-inflammatory properties and helps maintain the integrity of the intestinal barrier. Low levels of Fecalibacterium Prausnitzii in the gut microbiota have been associated with various health conditions, including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), and obesity. It is believed that a decrease in this beneficial bacterium may contribute to gut inflammation and impaired gut function.

Butyrate, on the other hand, is a short-chain fatty acid produced by certain bacteria, including Fecalibacterium Prausnitzii, through the fermentation of dietary fiber. It serves as an important energy source for the cells lining the colon. The function of butyrate extends beyond being a mere energy source. It has several beneficial effects on the gut and overall health. Butyrate helps in maintaining the integrity of the gut barrier, reducing inflammation, and regulating the immune system. It also plays a role in promoting the growth of beneficial bacteria and inhibiting the growth of harmful bacteria in the gut.

Low levels of butyrate can indicate an imbalance in the gut microbiota or a diet lacking in fiber. Low butyrate levels have been linked to various gut disorders, including irritable bowel syndrome (IBS) and colorectal cancer. To maintain optimal levels of butyrate, it is important to consume a diet rich in fiber from sources like fruits, vegetables, whole grains, and legumes. These dietary fibers serve as fuel for the bacteria in the gut to produce butyrate. Additionally, promoting a diverse and healthy gut microbiota through the consumption of probiotic-rich foods or supplements may also help maintain adequate butyrate levels.

Secretory IgA (SIgA)

Secretory IgA (sIgA) is a type of antibody that plays a crucial role in the immune system’s defense against pathogens. It is found in various secretions, including saliva, tears, and mucus. In relation to eczema, sIgA helps maintain the balance of the skin’s microbiome and provides protection against harmful bacteria and allergens. It acts as a barrier, preventing these substances from penetrating the skin and triggering an immune response. If someone has a low level of sIgA, their ability to defend against pathogens and allergens may be compromised. This can lead to an increased risk of infections, including skin infections, and a heightened sensitivity to allergens, potentially worsening symptoms of eczema. It is important to consult with a healthcare professional if you suspect you have low levels of sIgA or are experiencing persistent eczema symptoms.

Triggers of Eczema

Eczema, also known as atopic dermatitis, can be triggered by various factors, both external and internal. It is important to note that these triggers should be managed when trying to treat your eczema. However, solely treating these is not an effective strategy (since these are triggers instead of root causes).

External Triggers

  1. Environmental Factors: Certain environmental conditions can worsen eczema symptoms. These include dry or low humidity climates, excessive heat or cold, and high levels of pollen or mold in the air.
  2. Climate: Extreme weather conditions, such as hot and humid weather or cold and dry weather, can trigger eczema flare-ups.
  3. Skin Irritants: Contact with irritants like harsh soaps, detergents, certain fabrics (wool or synthetic materials), and chemicals (fragrances, dyes, or preservatives) can cause eczema symptoms to worsen.

Internal Triggers

  1. Food: Some individuals with eczema may experience flare-ups after consuming certain foods. Common culprits include dairy products, eggs, nuts, soy, wheat, and seafood. However, food triggers can vary from person to person.
  2. Hormonal Changes: Hormonal fluctuations, such as those occurring during puberty, pregnancy, or menstrual cycles, can influence eczema symptoms. Some women may notice their eczema worsens during certain times of their menstrual cycle.
  3. Stress: Stress is an important factor to manage that can worsen most, if not all, conditions.

Conclusion

Now that you know about the differences between the root causes and triggers for eczema, you are better equipped to understand the different treatments for eczema and what each treatment is addressing.