Eczema, also known as atopic eczema or atopic dermatitis, is an inflammatory skin disease. It is caused by an overactive immune system and compromised skin barrier.

Many people with eczema also have other health conditions that are often related to an overactive, sensitive immune system. Some of these conditions may have existed before the eczema diagnosis, but others may develop later as a result of the eczema or its treatments.

Comorbidities and Complications

When someone has multiple health conditions at the same time, these conditions are known as comorbidities. When someone has a medical problem resulting from a disease that makes treatment more difficult, it is known as a complication. In people with eczema, having a comorbidity can sometimes complicate eczema treatment and make a person more sick.

Children, adolescents, and adults with eczema are all more likely than their peers to have comorbidities. Plus, the more severe someone’s eczema symptoms are, the more likely they are to have worse health and to visit the doctor more often.

Allergies and Asthma

As many as 3 out of 5 people with eczema go on to develop asthma or allergic rhinitis (seasonal allergies). In addition, 3 out of 10 people with eczema have food allergies.

Eczema, allergies, and asthma are all related atopic diseases (allergic disorders) caused by the overactivity of the immune system. Normally, the immune system attacks germs and foreign particles while leaving the body’s healthy tissues alone.

However, in atopic diseases, the immune system mistakenly becomes activated by other substances called allergens:

• Food allergies occur when the immune system reacts to proteins found in food.
• Seasonal allergies or hay fever develop when the immune system responds to substances like pollen, dust, mold, or pet dander.
• Asthma occurs when the immune system reacts to substances in the lungs, leading to inflammation and swelling of the airways.

These conditions often occur in a specific order. A person typically develops eczema first, and is then diagnosed with food allergies, seasonal allergies, and finally asthma. Together, this pattern is called the “atopic march” or “atopic triad.”

The atopic march doesn’t always occur in this exact pattern. Some people with eczema do not develop allergies or asthma. A person may also develop allergies or asthma before getting eczema.

If you or your child has eczema, it may help to watch for symptoms of other immune-related conditions. Talk to your doctor if you notice any health changes:

• Food allergies may cause hives (an itchy, bumpy rash) or swelling or tingling in the mouth, lips, face, or throat.
• Seasonal allergies can lead to a runny or stuffy nose; watery, red, itchy eyes; and sneezing.
• Asthma may cause chest tightness, shortness of breath, wheezing, and coughing attacks.

Learn more about how eczema, allergies, and asthma are connected.

Autoimmune Disorders

Eczema has also been linked to several other conditions that also affect the immune system. Autoimmune disorders are conditions in which the immune system attacks the body’s normal tissue. Eczema leads to an increased risk of developing:

• Inflammatory bowel disease — This is characterized by inflammation of the digestive system. There are two forms of inflammatory bowel disease: ulcerative colitis and Crohn’s disease.
• Alopecia areata — This condition leads to hair loss when the immune system attacks the hair follicles, resulting in patches of hair loss on the scalp or face
• Vitiligo — This skin condition develops when the immune system damages the cells that contain pigments, leading to lighter-colored patches of skin or sometimes hair
• Systemic lupus erythematosus — Inflammation occurs throughout the body in this condition, leading to joint pain, tiredness, rashes, and organ problems
• Rheumatoid arthritis — This condition causes joint pain, damage, and swelling
• Chronic urticaria — People with this condition have hives that persist for six weeks or more

Bacterial, Fungal, and Viral Infections

One of the main purposes of the skin is to protect the body by keeping out germs. Eczema damages the skin barrier, leading to wounds and cracks in the skin. This increases the risk that bacteria, fungi, or viruses will enter the body and cause an infection. In particular, people with eczema are at risk of infections from Staphylococcus aureus, a type of bacteria.

If you have eczema, you may need to take extra steps to help prevent skin infections:

• Wash your hands regularly, including before applying any medication or moisturizers.
• Use a tool such as a metal spoon to remove topical creams and lotions from a tub, rather than dipping your fingers in.
• Take bleach baths up to three times a week to kill any bacteria on your skin; make sure to properly dilute the bleach, only stay in the bath for about 10 minutes, and apply plenty of moisturizer after.
• If you have frequent infections, ask your doctor about using an antiseptic wash.
• If signs of infection appear, such as blisters, weeping skin, warm skin, soreness, or a fever, tell your doctor right away.

Eye Problems

Some people with eczema develop eye conditions. These may include:

• Eyelid swelling
• Eye infections
• Cataracts
• Keratoconus (a condition in which the surface of the eye bulges outward)
• Inflammatory eye disorders such as vernal keratoconjunctivitis and atopic keratoconjunctivitis
• Contact dermatitis of the eyelids

To protect your eyes, try not to touch them or rub them. If you notice any eye or vision changes, talk to your dermatologist or ophthalmologist (eye doctor).

Learn more about treating eczema around your eyes.

Epilepsy

Children with eczema, allergies, or asthma have a slightly higher chance of developing seizures. The more immune conditions a child has, the more likely seizures become. It’s not entirely clear what causes epilepsy (a seizure disorder), but researchers believe that inflammation may help trigger it in some cases.

Blood Disorders

An eczema diagnosis can make it more likely that a child will develop anemia (low levels of red blood cells). Anemia can cause extreme tiredness and weakness, dizziness, pale skin, shortness of breath, an irregular heart rhythm, and headaches.

Some research has found that people with eczema are more likely to develop lymphoma, a blood cancer that affects the immune cells. It’s possible that the inflammation seen in eczema can cause cells to turn cancerous. Immunosuppressive eczema treatments like cyclosporine may slightly increase cancer risk.

Other studies have found that people with eczema are actually less likely to develop other blood cancers like acute lymphoblastic leukemia. Researchers haven’t found any link between eczema and acute myeloid leukemia.

Bone Problems

Eczema can lead to weaker bones for both children and adults. People with eczema may be more likely to experience broken bones. Doctors think that bone problems often occur as a complication of taking corticosteroids, a common eczema treatment.

If you or your child is taking steroid medications for eczema, ask your doctor about potential long-term health risks. You can help keep the bones strong by eating foods with high levels of calcium and vitamin D, taking calcium or vitamin D supplements, and getting regular physical activity. Researchers are also developing medications for atopic dermatitis that do not contain steroids, which could lead to fewer complications.

Heart Disease

Eczema may lead people to develop heart disease risk factors like high blood pressure, high cholesterol levels, obesity, and diabetes. This may be partly because people with eczema are more likely to have lifestyle factors that can lead to heart disease, such as smoking, drinking alcohol, and getting less physical activity. Also, certain medications used to treat atopic dermatitis can have side effects on the heart.

Whether eczema actually raises the risk of heart disease itself is less clear. Some studies have found that people with eczema are more likely to experience heart disease or stroke. People with more severe atopic dermatitis, or who had the condition for a long period of time, had the highest risk.

However, other studies have not found a link between eczema and heart problems. Researchers aren’t entirely sure whether eczema puts a person at risk for heart disease.

Mental Health Conditions

People with eczema are more likely to develop mental or behavioral disorders, including anxiety, depression, and attention deficit hyperactivity disorder.

Doctors don’t know exactly how eczema can cause mental health issues. Some possibilities include:

• People with eczema may feel embarrassed or self-conscious about the appearance of their skin. They may isolate themselves or have lower self-esteem.
• Children with eczema may be bullied.
• Eczema or allergies may restrict a person’s ability to do some of the things they want to do, such as own pets, wear different types of clothes, or participate in sports or outdoor activities.
• The intense itching that comes with eczema can make it hard to sleep, and not getting enough sleep can increase the risk of mental disorders like anxiety and depression.
• Eczema causes the body to produce cytokines (inflammatory molecules) that may travel to the brain and affect cognitive or psychological functions.

Mental health support can come in several forms. Some people with eczema choose to see a counselor or therapist. Others may participate in a support group. Doctors may also recommend medication such as antidepressants.

Learn more about how eczema can affect your mental health.

Eczema as a Symptom

Often, eczema occurs on its own. However, some people may develop skin problems as a result of another disorder. Health conditions that may lead to eczema include:

• Immune dysregulation, enteropathy, polyendocrinopathy, or X-linked syndrome
• Multiple allergies, severe dermatitis, or metabolic wasting syndrome
• Netherton syndrome, a rare hereditary disorder

The Impact of Comorbidities

Comorbidities can cause additional strain for people with eczema. They can lead to worse overall health and increased health care costs.

If you have other health conditions, it is important to work with your doctor to make sure these other issues are also being treated. Managing comorbidities may improve your health and lead to a better quality of life.

Condition Guide

• Eczema — An Overview
• Eczema Symptoms
• Eczema — The Path to Diagnosis
• Eczema vs. Psoriasis: Are They One and the Same?
• Treatments for Eczema
• Types of Eczema
• What Causes Eczema?