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Understanding Eczema

The Inflammation Inside

Atopic dermatitis (eczema) causes the immune system to send inflammatory signals to the surface, which can lead to itching and rashes.

Even when skin looks clear, inflammation is still active under the skin. The next flare-up is just waiting to happen.

Understanding What’s Underneath

Whether you have eczema or care for someone who does, living with eczema is hard. But did you know eczema is actually a term used to describe many different kinds of itchy, red rashes—also known as flare-ups?


“Atopic” refers to the body’s increased sensitivity to allergens or irritants. “Dermatitis” refers to the inflamed skin. You may have atopic dermatitis if you struggle with flare-ups that occur several times a year. Some people always show signs of the disease.

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Look at atopic dermatitis from the inside out and see what different cells are doing deep underneath the skin.

While the redness and rash of atopic dermatitis are visible on your skin, the real story may be happening beneath the surface.

Atopic dermatitis is more than a skin condition. It's a disease caused by an overactive immune system that leads to inflammation in your body.

It is this internal inflammation that causes the symptoms you know.

Atopic dermatitis is called the "itch that rashes" for a reason.

While scratching may offer short-term relief, in the long run you're actually making your atopic dermatitis—and the itch—worse.

This is called the itch-scratch cycle.

Your skin has 3 layers.

In healthy skin, the tough outer layer called the epidermis keeps foreign substances such as bacteria, viruses, and allergens from getting in.

When you have atopic dermatitis, the outer layer of skin is weaker and more susceptible to inflammation caused by immune cells in the body.

The damage done by scratching also contributes to the breakdown of skin cells, making it easier for foreign substances to get in.

Once these foreign substances have broken through the skin barrier, immune cells alert the body that It's under attack.

These immune cells travel to the lymph nodes, which are in the second layer of skin, called the dermis. Once in the lymph nodes, these immune cells activate your body's defenders, called T helper cells.

The immune cells release substances that cause the familiar redness and rash on the skin's surface.

Although these substances normally go away after a short time, if you have atopic dermatitis, the cells don't switch off like they should. Instead, they continue the inflammatory process, so the skin continues to react, even when your skin looks clear.

Even when you have no visible rash, the underlying inflammation is still active beneath your skin.

The itching leads to scratching, which further weakens the skin cells in the epidermis, allowing more foreign substances to get in and increases your risk of infection. And the itch-scratch cycle continues.

Sanofi Genzyme and Regeneron are committed to providing resources to advance research in areas of unmet medical needs among patients with inflammatory and immunological diseases.

The most obvious sign of atopic dermatitis is dry, itchy skin. Flare-ups are different for every person and can appear all over the body. Some other common external symptoms include:

  • Redness
  • Oozing
  • Swelling
  • Scaly areas
  • Crusting
  • Thick skin

To really understand atopic dermatitis, you have to look at the deeper cause within your body. The majority of people with moderate-to-severe atopic dermatitis report that itching can delay falling asleep and occasionally or frequently wakes them up at night.

The Reality

Millions of people in the U.S. suffer from a chronic form of eczema.

Hear what it’s like to live with chronic eczema and find out that more may be going on underneath the surface. If you’re a caregiver of a child with eczema, we know it can be a struggle for you as well.

Tia: It was horrible. My skin literally had split.

Tatyanna: People would ask me, did you get burned?

Zsa Zsa: It hurt so much that I’d run it under hot, hot water, because for the moment I forgot the pain.

Millions of people in the U.S. suffer from a chronic form of eczema. Here are three of their stories.

Zsa Zsa: My Name is Zsa Zsa.

Tatyanna: My name is Tatyanna.

Tia: My name is Tia. I have eczema around my mouth, around my eyes, on my ears, and around my neck, on these three fingers and on the side of my hand.

Tatyanna: The rashes cover a good 60% of my body.

Zsa Zsa: I’m burning right now in my legs from scratching last night.

Tia: It’s gonna itch, you gonna scratch, it’s gonna itch again, you gonna scratch. It’s like the itching just does not stop.

Zsa Zsa: Getting eczema anywhere is bad, but I think that one of the worst places is when it attacks my face. You know, that’s what people see about you. There have been times when it's blotchy everywhere. I look like a monster!

Tia: I think they always lookin.

Tatyanna: Growing up, I felt kind of like an alien.

Tia: What’s that on your arm? Did you catch something?

Tatyanna: I didn’t want to date. I didn’t want any boyfriends.

Tia: If a camera comes out, I don’t wanna be in the picture.

Zsa Zsa: I would just stay in my cubicle and not go out and see people.

Tatyanna: I never actually wanted to work. I thought if they saw my eczema, it would affect my position for the job.

Zsa Zsa: I’ve tried so many things to treat my eczema. Goat soap, shea soap, coconut soap.

Tia: The putting the creams and the lotions and all these different ointments that your doctor gives to you, the minute that you stop it’s coming back again.

Zsa Zsa: I mean, who would think that a skin problem would be debilitating? You know, but it's, it’s more than just a little scratching. It’s really intrusive. It’s almost like a foreign invader that comes into my body and just takes over. It’s like something that just rises up through my skin. I don’t know where it comes from.

The most common type of eczema is actually a chronic disease called atopic dermatitis. The rashes on the surface are caused by an overactive immune system and an abnormal skin barrier.

Tia: Oh, no. I never, I never knew that. No one that has eczema thinks of under the skin, at least I didn’t.

Tatyanna: I always thought it was an external problem. It makes more sense now that, um, it is an internal problem.

Zsa Zsa: This is kind of a new finding for me, makes me feel like I’m not alone. There’s going to be more work on my part because I’m not just a victim.

Talk to your doctor about atopic dermatitis.

Eczema Exposed

“It's this constant feeling of prickliness.
Almost like you're holding a cactus.”

- Heather
Actual eczema sufferer

Hear how people living with eczema describe what's going on underneath their skin and how they live with it.

Scratching the Surface

Atopic dermatitis is an immunological disease, which means it involves the immune system. With atopic dermatitis, your immune system is highly sensitive and can react to even the smallest allergens or irritants. This can cause inflammation underneath your skin, which may lead to frequent flare-ups. So those rashes on the surface are just the visible signs of a deeper inflammatory disease.

Uncover the Facts


Eczema is only skin-deep.






Eczema and atopic dermatitis are the same thing.






I only need to concentrate on preventing flare-ups of my atopic dermatitis.






When my skin is clear, atopic dermatitis is gone.






Atopic dermatitis can be triggered by allergens.






Changing my diet could help my atopic dermatitis.





You got 4 out of 6 right.

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