Over 31 million people in the U.S. live with eczema, a chronic skin condition that causes dry, itchy, red patches, but it’s still often misunderstood by those who don’t have it.
Ashley Ann Lora is an eczema advocate who navigates her condition in a very public way, documenting her flare-ups and progress for a growing online community. She has learned over time that although most people are well-meaning with their comments, it’s still frustrating to navigate the myths that persist about the skin condition.
“There are many misconceptions when it comes to eczema, and one of the biggest is that it’s just dry skin, when in reality it's so much more complex than that,” she says.
Lora has heard everything, from casual diet overhaul suggestions to claims that stress is the sole cause of her condition. Raising awareness about what’s real and what’s not is a big part of what motivates her to share the highs and lows of eczema publicly. It not only educates those who don’t live with it, but it helps others with eczema feel less alone.
“It’s so important to share the good days, the bad days, the discoloration that has come up because of my eczema, just so that people are aware of the severity and the impact that eczema can have on one's skin,” says Lora.
Below are seven eczema myths and misconceptions, debunked.
It’s Not Just Dry Skin
You don’t get eczema because you haven’t moisturized enough. Visible dryness is a definite part of the condition, but it isn’t an underlying cause.
Eczema is caused by a combination of factors: your genes, an overactive immune system, your environment, and emotional factors such as stress. When you have eczema, your skin barrier is weaker than it should be, which keeps it from holding in moisture well and keeping irritants out.
“What's actually happening in the skin is a shift in the immune system so that there's a lot more activity, and that leads to an allergic-like reaction,” says Amy Paller, MD, chair of the Department of Dermatology and director of the Skin Biology & Diseases Resource-Based Center at Northwestern’s Feinberg School of Medicine.
That immune activity drives inflammation, itch, and redness. In other words, even though it shows up on the surface of your skin, there’s a lot more going on underneath in your body’s systems that is causing the problems.
It’s Not Contagious
Because eczema often causes inflamed, cracked, or even oozing skin patches during severe flare-ups, it can look like an infection. This can lead to stigma about the condition and sometimes social isolation. But you can’t catch eczema from someone else.
“It's not contagious at all,” says Paller. “It's an immune abnormality in the skin.”
Your skin can get infected from eczema if you have blisters that break open and bacteria gets in, but the underlying condition can’t spread through contact.
You Didn’t Cause It
Lora says she often hears other people with eczema ask what they did to cause their condition. But eczema is influenced by factors that are often outside your immediate control, including immune responses and environmental exposures.
“It’s very common for people to blame themselves,” says Lora. “That's where I do my best to chime in and say, ‘Hey, no, no, no — it's so much more complex than that.’”
Eating the wrong food, using the wrong product, or failing to manage stress effectively can impact how often and badly your eczema flares, but your condition isn’t caused by these habits.
“Sure, are there action steps that we as people living with this condition can take to support our health and prevent the eczema from arising? Sure,” says Lora. “But do we have 100% control all of the time? No.”
There Isn’t a Magic Cure (but There Are Effective Treatments)
It’s tempting to believe that you can get rid of your eczema with the right product, diet, or routine, but the truth is eczema is a chronic condition you can manage but not eliminate.
“There’s no cure, but we do have some wonderful therapies,” says Paller. “It used to be that all we had were topical steroids. And they work very well and are still our first line of treatment. However, we now have a wide variety of topical nonsteroidal alternatives that give us a lot of different ways of treating this.”
Even people with moderate to severe eczema have systemic therapies that target specific pathways in the immune system, such as biologics, which have very few side effects.
“I've learned that for me, healing doesn't mean having clear skin,” says Lora. “Healing means loving the worst parts of myself, which includes having skin that flares some days and looks beautiful on other days.”
“Natural” Doesn’t Always Mean Safe
Paller says in her practice she’s seen a rise in popularity of “natural” skin care products that people assume are better for eczema-prone skin. But these products can have ingredients that irritate sensitive skin or trigger allergic reactions.
“Those natural products are often full of things that give you greater sensitivity on your skin and actually worsen your eczema,” she says.
Ingredients like essential oils and botanical extracts may sound appealing, but they can be problematic for people with a compromised skin barrier. Fragrance and plant-based ingredients are among the most common causes of contact dermatitis, which can overlap with or worsen eczema.
When in doubt, ask your dermatologist for the safest products for your skin.
It’s Not Always About Allergies
Eczema is often grouped together with allergic conditions, leading many people to assume it is directly caused by allergies. While you do have a higher risk of getting food allergies when you have eczema, there’s not a direct connection, says Paller.
“Everybody thinks that it relates to allergies, and it really doesn't,” she says.
Eczema is driven by immune dysregulation, with allergies sometimes acting as one of many contributing factors rather than the root cause. Allergens can trigger flare-ups in certain people, but they don’t fully explain why eczema happens.
Not Everyone “Grows Out of It”
Lora was told growing up that she would outgrow her eczema. Over half of children with eczema do, but that didn’t happen for her. She has since connected with many others who have had similar experiences, as well as people who developed eczema for the first time as adults.
“I had to learn that this is a condition that will come and go over time,” says Lora. “Will I have years where I won't experience eczema? Sure. But am I always open to the fact that it can come back? Yes. Understanding that helped me stop striving for something that wasn’t realistic. And I feel like that in and of itself was very healing for me.”
