Eczema and the Importance of the Physical Environment

The big idea:

There is a large relation between eczema and environmental triggers despite eczema being primarily a genetic condition.

What the study asked:

To what extent does the environment impact eczema’s severity and specifically which factor of the environment. Temperature? Location? etc.

What the study did:

• The study conducted a large ecological study between climatic factors and the level of the state and prevalence of eczema.

• This survey was also part of the National Survey of Children’s Health in the US which involved 79667 people from the US with 10072 reporting to have eczema.

• The survey was done through phone call interviews which were computer assisted - meaning interviewers were trained and there were quality control measures.

What the study found:

• The number of eczema cases has been rising for the past 3 decades with some suggestions that cases have been plateauing in the recent years.

  • Despite the lack of definitive epidemiologic data (due to a lack of data findings), it is unclear that the relation is definite between temperature, humidity, heat individually and the severity of eczema with the exception of shampoo exposure and cold weather which worsens flare ups.

• However, any of these 3 triggers mentioned acting together is shown to cause a flare up.

  • Real Life Scenario:

    • Children usually experience flare ups when going back to school, adults experience itchiness on long flights with low humidity and some deal with annoying eczema in northern Europe.

    • However, these problems can clear up once people are on holiday overseas. It could be supported by reduced stressors etc, but the prominent major change in environment can support the hypothesis that temperature, humidity, UV rays play a role in eczema severity.   

• Another Study showed that Black Caribbean children in London with eczema was 14.9% while in Kingston Jamaica only 5.6%. This shows that migration (warmer to cooler climate), population and ethnicity plays a part as well in flare up frequency where migrants develop eczema at a same or faster rate than resident population.

What does this mean for eczema:

While these are brief findings, there is scientific logic behind it to back them up. This gives new found awareness to patients with eczema to be more aware of the environment they live in and conscious of whether it would be favourable for their skin condition.

Link to article:

https://www.sciencedirect.com/science/article/pii/S0022202X15363193