What Exactly Is Eczema? Symptoms, Causes, and Triggers Explained

1. Dry, Itchy Skin (often intense, especially at night)

2. Red or Inflamed Patches That May Look Rough, Scaly, or Swollen

Inflammation beneath the surface of the skin causes visible redness on lighter tones and darker, ashy, or purplish patches on deeper tones. These areas often feel warm and irritated, with a rough or scaly texture. Swelling is also common, as the immune system sends extra blood flow and activity to the area, creating that raised, inflamed look.

3. Tiny Fluid-Filled Bumps That Can Ooze or Crust When Scratched

During flare-ups, some people develop small, raised bumps or blisters filled with fluid. When scratched, these can break open and leak a clear liquid, which later hardens into a crust. While this is a natural part of the inflammatory process, it also makes the skin more prone to infection, which is why keeping nails short and avoiding scratching is strongly advised.

4. Thickened, Leathery Skin From Long-Term Scratching (Lichenification)

When eczema persists for a long time or when scratching becomes frequent, the skin begins to toughen up in self-defence. This results in a process called lichenification, where the skin becomes visibly thicker, tougher, and sometimes darker. While it’s the body’s way of protecting itself, it often leads to even more irritation and discomfort, creating a vicious cycle.

5. Darkened or Discoloured Patches in Some Skin Tones (Post-Inflammatory Hyperpigmentation)

Eczema doesn’t just cause short-term irritation, it can also leave behind marks long after a flare has calmed. On darker skin tones, eczema often results in areas of hyperpigmentation, where the affected patches heal darker or lighter than the surrounding skin. This isn’t dangerous, but it can be distressing and may take months to fade.

Eczema also tends to appear in different places depending on age. Infants and young children commonly develop it on the face, scalp, and the bends of the elbows or knees, where skin folds trap moisture and friction. In adults, it’s more likely to appear on the hands, eyelids, neck, and inside the creases of the elbows and knees. These areas are exposed to frequent movement, washing, or environmental irritants, making them more prone to flare-ups.

 What Are The...

Eczema doesn’t come from a single source. Instead, it develops through a mix of internal and external factors that all work together to weaken the skin barrier and trigger inflammation. Here are the main causes explained:

1. Skin Barrier Dysfunction

Think of the skin barrier as a brick wall: skin cells are the “bricks,” and proteins and lipids act as the “mortar” holding them together. In eczema, this wall is weakened because of missing or reduced levels of key components like ceramides and filaggrin. As a result:

• • Moisture escapes more easily, leaving skin dry and tight.

  • Irritants, allergens, and microbes can slip through the barrier, leading to irritation and infection.

This dysfunction is one of the biggest reasons eczema-prone skin needs extra moisturisation and gentle care.

2. Genetics

Family history plays a major role in eczema. If your parents or close relatives have eczema, asthma, or seasonal allergies, you’re more likely to develop the condition. Researchers have discovered that some people carry variations in certain genes, particularly the filaggrin (FLG) gene, that affect the skin’s ability to protect itself. Filaggrin is a protein that helps keep the skin barrier strong and hydrated. Without enough of it, the skin loses moisture more quickly and becomes more sensitive to irritants.

3. Overactive Immune Response

In people with eczema, the immune system tends to go into overdrive. Even small amounts of dust, soap, or pollen can set off a chain reaction where the body treats these harmless substances as threats. This triggers inflammation, leading to redness, swelling, and intense itching. It’s essentially the immune system misfiring, protecting the skin too aggressively and, in the process, causing more harm than good.

4. Environmental Factors

External conditions don’t directly cause eczema, but they play a huge role in triggering flare-ups. Common environmental factors include:

• • Harsh weather (cold, dry air or sudden temperature shifts)

  • Household irritants like detergents, soaps, and fragrances

  • Allergens such as dust mites, pet dander, mould, or pollen

  • Stress and lifestyle factors, which can amplify the skin’s sensitivity

These triggers interact with an already weakened skin barrier and overactive immune system, making flare-ups more frequent or more severe.

Eczema arises from a combination of genetics + weakened skin barrier + immune system sensitivity, made worse by environmental triggers. While you can’t change your genes, protecting your skin barrier and managing triggers can go a long way in keeping symptoms under control.

What Are The...

While eczema often has a genetic foundation, flare-ups usually happen when everyday triggers set off the already sensitive skin barrier. Identifying and avoiding these triggers can make a big difference in managing symptoms.

1. Irritants

Everyday products like soaps, shampoos, detergents, fragrances, and even some household cleaners can strip away the skin’s natural oils. For people with eczema, whose skin barrier is already fragile, these substances can quickly lead to dryness, burning sensations, or flare-ups.

2. Allergens

Dust mites, pet dander, pollen, and mold are common allergens that can inflame the skin. For some, certain foods like milk, eggs, or nuts may also trigger reactions. Unlike irritants, allergens set off the immune system, causing inflammation and worsening eczema symptoms.

3. Weather

Cold, dry air in the winter pulls moisture out of the skin, while hot, humid weather in the summer can increase sweating—both of which can aggravate eczema. Sudden shifts in temperature, such as moving from an air-conditioned room into the heat, can also shock the skin and trigger itching.

4. Stress

Emotional stress doesn’t directly cause eczema, but it often makes it worse. Stress hormones like cortisol can interfere with skin repair and increase inflammation, making flare-ups more intense and the itch-scratch cycle harder to resist.

5. Sweating and Heat

Excess sweating creates a warm, moist environment on the skin, which can sting or burn eczema patches. Sweat also contains salts that can irritate broken or sensitive skin, leading to redness and discomfort.

6. Clothing

Rough fabrics, particularly wool and some synthetic fibers, can rub against the skin and trigger irritation. Tight clothing that traps heat and sweat can also worsen flare-ups, which is why soft, breathable fabrics like cotton are usually better choices.

7. Dietary Factors (for Some People)

Not everyone with eczema has food-related triggers, but for those who do, certain foods can worsen inflammation. Acidic foods (like tomatoes or citrus), dairy, soy, gluten, or nuts are sometimes linked to flare-ups. Keeping a food diary can help spot personal patterns.

Triggers don’t cause eczema on their own, but they act as sparks that light up flare-ups on sensitive skin. By learning what sets off your symptoms, you can take proactive steps to avoid them and keep your skin calmer.

Managing and Calming Flare-Ups

Managing eczema starts with the right skincare. Explore dermatologist-approved, fragrance-free moisturisers and cleansers designed to strengthen the skin barrier, available now on Threebs. [click here]

Although there isn’t a cure for eczema, it can be managed successfully with the right approach. Daily moisturising is key. Using rich, fragrance-free creams or ointments helps lock in hydration and protect the skin barrier. Switching to gentle cleansers that won’t strip the skin can also make a big difference.