Is Eczema an Autoimmune Disease? What Research Shows

If you have eczema, you might wonder whether your immune system is attacking your own skin. While eczema involves immune system dysfunction, the short answer is no—eczema is not classified as an autoimmune disease. However, the relationship between eczema and immunity is more complex than a simple yes or no.

What Makes a Disease Autoimmune?

In autoimmune diseases like type 1 diabetes or lupus, your immune system mistakenly attacks specific healthy cells in your body. The immune system targets your own tissue as if it were a foreign invader.

With eczema (also called atopic dermatitis), your immune system doesn't attack your skin cells directly. Instead, it overreacts to external triggers like allergens, irritants, or bacteria that get through your damaged skin barrier. This makes eczema an immune-mediated condition rather than an autoimmune one.

How the Immune System Is Involved in Eczema

Eczema involves what doctors call Type 2 inflammation. When you have eczema, certain immune cells (called Th2 cells) release proteins called cytokines that trigger inflammation in your skin. About 80% of people with atopic dermatitis have this type of inflammation occurring in their bodies.

The process works like this: Your skin barrier has tiny cracks that let allergens and irritants penetrate. Your immune system spots these foreign invaders and launches an inflammatory response to protect you. This causes the itching, redness, and rashes you experience.

The Role of Skin Barrier Dysfunction

Many people with eczema have mutations in a gene called filaggrin, which helps build your skin's protective barrier. About 20-30% of people with atopic dermatitis have this genetic mutation, compared to 8-10% of people without the condition. When your skin barrier is weak, it loses too much water (causing dry, scaly skin) and lets allergens enter more easily.

The Connection Between Eczema and Autoimmune Diseases

While eczema itself isn't autoimmune, research shows a strong link between the two. People with eczema are 2.5 times more likely to develop at least one autoimmune condition and 3.5 times more likely to have multiple autoimmune diseases.

Studies have found associations between atopic dermatitis and several autoimmune conditions, including:

• Alopecia areata (autoimmune hair loss)
• Vitiligo (autoimmune skin pigmentation disorder)
• Rheumatoid arthritis
• Inflammatory bowel disease
• Type 1 diabetes

Scientists are still researching why this connection exists. It may be related to shared genetic factors or chronic immune system activation.

What This Means for Your Treatment

Understanding that eczema is immune-mediated rather than autoimmune has helped researchers develop better treatments. Many newer medications target specific parts of the Type 2 immune response, reducing inflammation without suppressing your entire immune system.

Effective management typically includes:

• Repairing and protecting your skin barrier with moisturizers
• Reducing inflammation with topical medications
• Avoiding triggers that cause flares
• Using targeted therapies that calm specific immune responses

When to See a Dermatologist

See a dermatologist if your eczema is severe, not responding to over-the-counter treatments, or interfering with your daily life. You should also consult a doctor if you develop symptoms of other conditions, especially if you have a family history of autoimmune diseases.

While eczema isn't autoimmune, it's a chronic condition that deserves proper medical care. A dermatologist can create a personalized treatment plan based on your specific symptoms and triggers.