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Scratching the Itch: Eczema’s Symptoms, Causes, and Treatments Explained

Author: Simone Maimon

Editors: Serena Tsao, Suri Liu

Artist: Coco Zhou


The second most prevalent skin disease, second to acne, is eczema, commonly recognized for a persistent, irritating scratch. Around 10% of the world experiences some form of dry red skin, sometimes pain, and sleep deprivation. Usually, these symptoms manifest in crevices or extremities, including hands, elbows, feet, etc. But, what exactly causes eczema? 

Currently, scientists don’t have an exact answer. But, they have identified a few risk factors that have illuminated various aspects of the disease. For example, eczema has a genetic component to susceptibility, such as the filaggrin gene (FLG). FLG contains instructions for filaggrin, a protein in the skin responsible for protecting against environmental irritants. This aligns with the environmental component of eczema, which includes different conditions, such as when one is exposed to scratchy clothes, chemicals, or even just dry weather.

Additionally, genes that regulate the immune system have also been implicated in eczema, including genes for T-cells, cytokines, and immunoglobulins. Furthermore, a risk factor for children having eczema is if their parents have allergies. This indicates that there is also an innate, immune reaction to certain environmental triggers. It is important to note, however, that unlike psoriasis or lupus, eczema isn’t an autoimmune disease: the immune system isn’t attacking the skin as if it’s foreign. Instead, it’s likely more of an “overreaction” to external stimuli, causing different inflammatory responses.

Another factor associated with eczema is a differing bacterial composition on the surface of the skin. Similar to the more well-known ‘gut microbiome,’ which can affect health in various ways, the skin microbiome may also be a factor in eczema irritation. If harmful bacteria start to grow on the skin, it can cause the skin barrier to deteriorate. At the same time, it is also possible that eczema causes a poor skin microbiome as well. Currently, which one is causational is unknown.  

Currently, scientists are creating new treatments for eczema, as there is still no cure. Common treatments include regular moisturizers, which can alleviate irritation due to excessively dry skin, addressing an environmental factor. These lotions are topical treatments, meaning applied locally to the skin rather than digested. Typically, topical treatments are responsible for reducing inflammation, accelerating healing, and reducing symptoms locally. Alternatively, biological treatments can also be administered. This includes probiotics, which address the lacking skin microbiome, or treatments that stimulate or suppress the immune system. However, these treatments are less common due to the ease and efficacy of topical ointments.

Fancy treatments aside, even simple changes can alleviate the persistent itch. This includes fixes as simple as incorporating a daily skincare routine, or as odd as taking shorter, cooler showers. Hot showers, although they can feel refreshing in the moment, eventually can cause more inflammation and irritation.

Ultimately, scientists are still researching to understand the pathophysiology of eczema, as there are still plenty of unanswered questions regarding the genetic correlation, allergic response, and effect on the skin microbiome. We are still working to create more effective treatments and potentially cure eczema once and for all.

Citations:

Berg, S. (2024, October 25). What doctors wish patients knew about managing eczema. American

Eczema stats. National Eczema Association. (2025, February 27). https://nationaleczema.org/eczema-

Nemeth, V. (2024, March 1). Eczema. StatPearls [Internet].

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