If you have eczema, you may wonder whether you have a weak immune system. However, your skin’s strong reaction to typically harmless triggers — like perfume, pet dander, or certain foods — doesn’t mean your immune system is frail. In fact, eczema is actually an overreaction by your immune system. That’s why it results in redness, swelling, and itchy skin after you’re exposed to certain elements. Fortunately, there are many ways to treat or avoid eczema flare-ups. Keeping stress levels low and being aware of individual triggers can help. Medications and topical treatments are also options you can discuss with your doctor.

Is eczema a sign of a weak immune system?

No, having eczema doesn’t automatically mean you have a weak immune system. It does mean that your immune system is sensitive, often overreacting to things that aren’t real threats to your body.  Some people with eczema have a primary immunodeficiency disorder that may make them more likely to get infections. But eczema can also affect people with healthy immune systems.

Is eczema caused by a weak immune system?

Eczema isn’t believed to be the result of a weak immune system. But researchers don’t know exactly what causes eczema, according to the National Eczema Association (NEA). Experts think genes and a variety of triggers are contributing factors. When you have eczema, the skin barrier that would normally keep out allergens, bacteria, and other germs isn’t working as it should. Instead of keeping unwanted elements out, breaks in your skin’s barrier allow them to seep in, according to 2018 research. Once allergens or other substances are inside your body, your immune system reacts. It sends out an army of white blood cells that release chemicals and other substances to destroy the invaders. These substances are responsible for your skin’s inflammation. Think about when you cut yourself or skin a knee. Your immune system responds to the injury by producing redness, itching, swelling, and pain at the site. This is a good thing — proof that your immune system is strong and healthy.

Can eczema be a sign of other conditions?

Eczema isn’t a sign that you have other illnesses. However, it can look similar to or happen alongside other conditions. Symptoms like itchy and red skin are also common with other skin conditions that are easy to mistake for eczema. These conditions are:
  • Psoriasis: an autoimmune disease that causes your skin cells to multiply too fast
  • Hives: large red welts on the skin caused by an allergic reaction
  • Cutaneous T-cell lymphoma: a cancer of the white blood cells that starts in the skin
  • Scabies: a skin infestation by a type of mite
  • Ringworm: a skin infection caused by a fungus
Eczema is sometimes part of a cluster of allergic conditions that healthcare professionals call the atopic march. These include:
  • asthma
  • allergic rhinitis (hay fever or seasonal allergies)
  • food allergies
If you have one of these three conditions, you’re more likely to have another one. In addition, your eczema may be more severe if you have one of these primary immunodeficiency diseases:
  • Wiskott-Aldrich syndrome
  • Hyper IgE syndrome
  • Ipex syndrome 
  • some types of severe combined immune deficiency (SCID)

Can eczema be caused by stress?

Your emotions are closely linked to the overall appearance and health of your skin, according to 2020 research. Stress can trigger eczema flare-ups and make symptoms worse.  When you’re feeling overwhelmed or threatened, your body releases certain chemicals, including stress hormones like adrenaline and cortisol. These substances suppress your immune system, boost inflammation, and weaken your skin’s barrier even more. Stress and eczema may become connected in a cycle. The more your eczema flares, the more stressed you may become. And the more stressed you are, the more your eczema flares. Although it’s hard to rid yourself of stress entirely, reducing stressors in your life may help you better manage your eczema. Try these relaxation techniques to discourage stress from showing up on your skin:
  • Take a few minutes each day to close your eyes and breathe deeply or meditate.
  • Read a few chapters of a good book or watch one of your favorite movies.
  • Write in a journal or try an adult coloring book.
  • Light some candles and take a warm bath.
  • Go for a walk outside or hang out in your garden or a local park.
  • Listen to soothing music or tune into a new podcast.
If you’re often under a lot of stress or you feel overwhelmed trying to manage your eczema, it’s important to seek support. Talk with a counselor or therapist, or join an eczema support group through an organization such as the NEA.

What’s the root cause of eczema?

Researchers don’t know exactly what causes eczema. It’s likely that there isn’t one single cause, but rather a combination of factors that lead to eczema.  If you have eczema, it’s possible you’ve inherited genes that make your skin more susceptible to irritation. Chances are, one or more of your immediate family members also has eczema, allergies, or asthma. Differences in your skin’s barrier is another possible cause of eczema. Some people with eczema have mutations in the gene that codes for a protein called filaggrin. This protein typically helps the skin barrier stay healthy and strong, and a mutation in this gene is often found in people with eczema, according to 2009 research.  When the skin barrier isn’t functioning as it should, allergens and germs seep in and moisture seeps out. Dried-out skin is more likely to react strongly to substances in your environment that are typically harmless. A number of triggers can also set off eczema symptoms. Everyone’s triggers are different, but common ones may include:
  • soaps, detergents, and other chemical irritants
  • allergens such as dust mites, pet dander, pollen, and mold
  • allergies to foods such as dairy or wheat
  • stress

The takeaway

Though you might be tempted to blame a weak immune system for skin flare-ups, your immune system is not at fault. Eczema is actually the result of an overreaction by your immune system. Typically harmless substances — such as pollen or pet dander — are often the source of your body’s strong reaction.