Introduction
It is estimated that around 10% of people will have eczema at some point in their life. Eczema is common among children aged between 6 to 7 years, with prevalence increasing in some countries with previously low eczema prevalence.
Although current eczema treatment options are effective, new options like cannabidiol (CBD) oils are gaining interest due to their plant-based origin. This article explores eczema, its etiological agents, symptoms and treatment options including CBD oil.
What Is Eczema?
Eczema is a non-infectious, chronic inflammatory condition of the skin which is characterised by inflamed, dry and itchy skin. Generally, symptoms of eczema are first observed at around 5 years of age and flare up periodically.
Since eczema is an inflammatory disease, it damages epidermal or skin cells disrupting their function, which leads to decreased retention of moisture making the skin dry and itchy.
Types of Eczema
Although dry and itchy skin is common to all types of eczema, different types have been classified based on their triggers.
According to the World Allergy Organization’s Nomenclature Review Committee, there are 2 main types of eczema:
- Atopic eczema: patients experience sensitivity to allergens and irritants and have high immunoglobulin E (IgE) levels.
- Non-atopic eczema: patients are not usually sensitized to triggers and don’t have high IgE levels.
Since eczema falls under the definition of dermatitis (inflammation of the skin), it is also important to understand that there are other types of dermatitis. One of the most common forms includes contact dermatitis which can be allergic (triggered by allergens) or non-allergic (triggered by irritants or toxins).
The main difference between eczema and contact dermatitis can be boiled to the type of inflammation reaction. Eczema is mediated by IgE antibodies while contact dermatitis is mediated by T cells. However, since both are forms of dermatitis, they do share common symptoms.
Symptoms of Eczema
Symptoms of eczema can be seen on any part of the skin including hands, elbows, neck, cheeks, lips, back, scalp, ankles, feet and, rarely, genitals. The most common symptoms include:
- Dry skin
- Crusty skin
- Itchiness
- Inflamed skin, rashes
- Oozing skin
- Small bumps
- Rough, leathery skin
People with eczema often present with allergies like hay fever and food allergies. Moreover, they also have a high chance of contracting bacterial and viral infections due to excessive scratching which might cause bleeding.
Causes of Eczema
There is no one cause for eczema. In most cases, it is a combination of various risk factors and triggers which cause eczema. Some of the causes include:
- Genetics: Certain gene mutations can affect the integrity of the skin which can let bacteria and other irritants persist and cause damage, leading to eczema.
- Family history: People with eczema in their family are prone to eczema and should ensure to get any suspected symptoms checked out.
- Environment: Numerous allergens (e.g.: pollen, dust mites, pet dander, food allergens), irritants (e.g.: harsh soaps, smoke, fabrics) and environmental conditions like humidity can trigger and even worsen eczema.
- Emotions: A cross-sectional study found a significant association between eczema and stress, with 18.3% of patients presenting with a high level of perceived stress.
No matter the cause, the immune system of the patient is always triggered which leads to an inflammatory reaction leading to even more damage to the skin.
The condition can flare up sometimes which weakens the skin’s integrity. As the skin goes through repeated cycles of inflammation the skin becomes drier and itchier. Managing the condition during a flare-up is thus crucial since it affects quality of life.
What is the best treatment for eczema?
Although eczema can’t be cured, there are effective treatment options available:
- Moisturisers: Moisturisers hydrate the skin and seal in moisture, thus preventing or slowing down the drying of the skin throughout the day.
- Topical/Oral steroids: Steroids are anti-inflammatory drugs which will decrease inflammation in the skin and thus reduce itching. Topical steroids can be applied locally while oral steroids have a systemic effect.
- Immunosuppressants: Immunosuppressants like azathioprine, cyclosporine and methotrexate are usually prescribed for severe eczema.
- CBD oil: Many animal studies have shown that CBD gels can reduce inflammation. Petrosino et al. (2018) also demonstrated that CBD causes anti-inflammatory effects in an allergic contact dermatitis model. A small US-based study observed that using 1% topical CBD decreased the eczema area and severity index (EASI) score by 34.5%.
Conclusion
Eczema is a relapsing, inflammatory condition of the skin which presents with dry, inflamed and itchy skin. It has a multifactorial etiology which includes genetics, environment, family history and even the skin microbiome. Although it can’t be cured, effective treatment strategies have been developed. Recently, CBD for eczema management has been gaining interest because of its anti-inflammatory properties.
References
- Hafsia, M., Kacem, I., El Maalel, O., Maoua, M., Brahem, A., Aroui, H., … & Mrizek, N. (2019). Relationship between hand eczema severity and occupational stress: a cross‐sectional study. Dermatology Research and Practice, 2019(1), 8301896.
- Johansson, S. G. O., Bieber, T., Dahl, R., Friedmann, P. S., Lanier, B. Q., Lockey, R. F., … & Williams, H. C. (2004). Revised nomenclature for allergy for global use: Report of the Nomenclature Review Committee of the World Allergy Organization, October 2003. Journal of allergy and clinical immunology, 113(5), 832-836.
- Maghfour, J., Rundle, C. W., Rietcheck, H. R., Dercon, S., Lio, P., Mamo, A., … & Yardley, H. (2021). Assessing the effects of topical cannabidiol in patients with atopic dermatitis. Dermatology online journal, 27(2).
- Petrosino, S., Verde, R., Vaia, M., Allarà, M., Iuvone, T., & Di Marzo, V. (2018). Anti-inflammatory properties of cannabidiol, a nonpsychotropic cannabinoid, in experimental allergic contact dermatitis. Journal of Pharmacology and Experimental Therapeutics, 365(3), 652-663.
- Williams, H., Stewart, A., von Mutius, E., Cookson, W., Anderson, H. R., & of Asthma, I. S. (2008). Is eczema really on the increase worldwide?. Journal of Allergy and Clinical Immunology, 121(4), 947-954.
- Mayo Clinic (2024, May 15). Atopic dermatitis (eczema). Atopic Dermatitis (Eczema). Retrieved June 14, 2024, from https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273
- National Eczema Association (n.d.). Immunosuppressants. Immunosuppressants. Retrieved June 14, 2024, from https://nationaleczema.org/eczema/treatment/immunosuppressants/
