Eczema Causes and Treatment: When Internal Imbalance Surfaces on the Skin

Eczema is a chronic inflammatory skin condition characterised by redness, dryness, cracking, itching, and weeping lesions. Affecting approximately 15-20 per cent of the global population, this condition is not simply a surface-level skin problem but the outward expression of a systemic disturbance rooted in the body’s internal balance. Genuine treatment aims not to suppress symptoms but to uncover the underlying causes and restore the body’s natural equilibrium.

Key Facts at a Glance

What Is Eczema?

Eczema (also known as dermatitis) is a group of inflammatory conditions that arise when the skin’s protective barrier weakens. As the body’s largest organ, the skin forms the first line of defence against external threats. When this barrier breaks down, moisture loss accelerates, allergens and microbial agents penetrate the tissue easily, and the immune system shifts into a state of chronic alarm.

Eczema is not a single condition. It takes different forms depending on triggering factors, the area of involvement, and the patient’s age. Although each form has its own mechanism, the common denominator remains the same: internal imbalance manifests on the skin.

Types of Eczema

Atopic Eczema (Atopic Dermatitis)

The most common type, typically beginning in infancy or childhood. Genetic predisposition plays a determining role in individuals with a family history of asthma, allergic rhinitis, or eczema. However, genetics alone is not the full explanation; without environmental triggering factors, the predisposition remains silent.

Typical areas of involvement:

• In infants: face, cheeks, and scalp
• In children: inner elbows and backs of the knees
• In adults: backs of the hands, neck, and around the eyes

Detergents, synthetic fabrics, sudden temperature changes, dry air, and psychological stress are among the known triggers. Once the itch-scratch cycle begins, the skin barrier sustains further damage and the risk of infection increases.

Seborrhoeic Dermatitis

Appears in areas where sebaceous glands are most active: sides of the nose, eyebrows, scalp, and behind the ears. Cradle cap in newborns is an early form of this condition. The interaction between Malassezia fungi and the sebaceous glands triggers local inflammation.

Seborrhoeic dermatitis characteristically shows seasonal fluctuation. It worsens in winter months and improves with summer sunshine. Stress, sleep disturbances, and alcohol consumption increase the frequency of flare-ups.

Discoid (Nummular) Eczema

Forms circumscribed, coin-shaped scaly plaques on the extremities, particularly the legs and arms. Generally more common in adult men. The lesions are intensely itchy and are exacerbated by dry winter air, hot showers, or contact with woollen fabrics.

Discoid eczema is more resistant to treatment compared to other types. Its tendency to become chronic is high, and it significantly affects the patient’s quality of life.

Varicose Eczema (Stasis Dermatitis)

Appears on the lower legs, particularly around the inner ankle. It develops on the basis of chronic venous insufficiency: valve failure in the leg veins causes blood pooling, increases tissue pressure, and impairs skin nutrition. Redness, oedema, brown pigmentation, and the risk of ulceration are distinguishing features of this form.

Varicose eczema cannot be regarded solely as a skin condition. Addressing the structural problem in the circulatory system must be the foundation of treatment.

What Are the Symptoms?

Although symptoms vary by type, the following are commonly observed:

• Redness and itching: Usually the first sign; itching intensifies at night
• Dryness and cracking: The skin’s moisture barrier is compromised
• Scaling and crusting: In chronic phases, the skin thickens (lichenification)
• Weeping vesicles and blisters: Serous fluid oozes during acute flare-ups
• Colour changes: Dark or light pigmentation remains after prolonged lesions

These symptoms fluctuate in cycles of flare-up and remission. Identifying trigger factors is the first step in reducing flare frequency.

What Are the Root Causes?

The Modern Medicine Perspective

Current dermatological research defines eczema as a multifactorial condition. Genetic predisposition (particularly filaggrin gene mutations), immune system dysregulation, and environmental triggers form a triple pincer.

Gut flora disruption (dysbiosis) is gaining increasing recognition as one of the root causes of eczema. Research on the gut-skin axis has demonstrated that intestinal microbiome imbalance triggers systemic inflammation that manifests on the skin. Studies of children with atopic dermatitis have found notable differences in gut flora compared to healthy control groups.

Reduced liver detoxification capacity is another critical factor. When the liver cannot adequately fulfil its role of filtering toxins from the blood, the body resorts to alternative elimination pathways. The skin is one of these backup channels. When the toxin burden increases, skin inflammation becomes unavoidable.

Additional factors include:

• Food sensitivities: Dairy, eggs, wheat, soy, and peanuts are among the most common triggering foods
• Environmental allergens: House dust mites, animal hair, mould spores
• Stress and sleep disturbances: Elevated cortisol disrupts immune balance
• Vitamin D deficiency: Reduces the skin’s antimicrobial peptide production

For more information on dysbiosis and liver function, please see our Dysbiosis page.

Traditional Medicine and the Energetic Interpretation

From the Eastern medicine perspective, eczema is the outward expression of Qi (life energy) deficiency in the Lung and Kidney meridians. This approach does not reject modern medicine’s organic findings; it adds an energetic dimension.

The lung meridian and skin connection: In Traditional Chinese Medicine, the lungs govern the skin. The lungs’ “protective Qi” (Wei Qi) functions as a shield protecting the skin against external influences. When this energy weakens, the skin becomes vulnerable; external pathogens such as wind, cold, and dampness penetrate easily.

The relationship between breath quality and skin health finds a modern counterpart as well. The co-occurrence of asthma and atopic dermatitis — clinically described as the “atopic march” — supports this meridian connection.

Blood deficiency and skin dryness: In traditional medicine, blood is considered the fundamental substance that nourishes and moisturises tissues. When blood is insufficient or stagnant, the skin dries, cracks, and loses its elasticity. The modern counterpart is the skin findings observed in iron deficiency anaemia and peripheral circulation disorders.

Kidney energy and chronicity: The kidney is the reservoir of the body’s fundamental life energy. Kidney Yin deficiency manifests with chronic dryness and heat signs; Yang deficiency presents with coldness, oedema, and low resistance. The kidney-liver energy imbalance plays a determining role in varicose eczema.

How Is It Treated?

In integrative medicine, eczema treatment aims not merely to suppress symptoms but to rebalance the whole body. The treatment plan consists of four layers:

1. Restoring the Gut Ecosystem

Correcting dysbiosis is the cornerstone of eczema treatment. Reducing intestinal permeability (leaky gut), providing probiotic and prebiotic support, and eliminating inflammatory foods are the components of this layer. During the elimination diet process, dairy products, gluten, refined sugar, and processed foods are removed for a defined period; as symptoms improve, foods are reintroduced in a controlled manner.

2. Strengthening Liver Detox Capacity

Supporting the liver’s Phase I and Phase II detoxification pathways is critically important in reducing the toxin burden. Milk thistle (silymarin), dandelion root, artichoke leaf, and turmeric are among the phytotherapeutic agents used for this purpose. A dietary pattern that respects the liver’s morning cleansing cycle increases treatment effectiveness.

3. External Support for the Skin Barrier

Moisturisers, emollients, and natural oils (jojoba, black seed, acai) accelerate skin barrier repair. Bathing habits are reviewed: short, lukewarm showers are preferred; harsh soaps and synthetic fragranced products are discontinued. During acute flare-ups, cold compresses and oatmeal baths relieve itching.

4. Stress Management and Lifestyle

Chronic stress keeps the hypothalamic-pituitary-adrenal axis continuously active and disrupts immune balance. Breathing exercises, regular physical activity, adequate sleep, and psychological support when needed are integral parts of the treatment. Improving breath quality offers dual benefit in terms of both stress management and the lung-skin connection emphasised in traditional medicine.

Living with Eczema: Practical Recommendations

Alongside the treatment process, there are important daily considerations:

• Clothing: Choose loose-fitting cotton garments; avoid woollen and synthetic fabrics
• Room humidity: Use a humidifier in dry environments; ideal room humidity is between 40-60 per cent
• Nail care: Keep nails short; unconscious scratching during sleep creates a risk of injury
• Trigger diary: During flare-up periods, record what you ate, what you were exposed to, and your stress level
• After water contact: Apply moisturiser within three minutes of bathing or hand washing

These simple habits can significantly reduce the frequency of flare-ups.

To understand the systemic dimension of skin conditions more deeply, please see our article on The Root Causes of Skin Diseases. For another chronic skin condition that shares similar mechanisms, our Psoriasis Treatment page will also be informative.

Frequently Asked Questions

Is eczema contagious?

No. Eczema is not a contagious condition. It cannot be transmitted from one person to another through direct contact or shared items. Eczema is a condition related to the individual functioning of the immune system and skin barrier. However, cracks in eczematous skin can create a susceptibility to secondary bacterial or viral infections; these infections may be contagious.

Can eczema be completely cured?

Eczema is a chronic condition, and it would not be accurate to promise a definitive cure with the assurance that “it has completely gone and will never return.” However, with the right treatment approach, symptoms can be largely brought under control, flare-up periods become less frequent, and their severity decreases. Restoring gut flora, liver support, and eliminating triggers constitute the most effective strategy for long-term remission.

Do children grow out of eczema?

In approximately 60-70 per cent of children with atopic eczema, symptoms significantly improve or completely resolve by adolescence. However, this does not apply to every child. Early support for gut health, identification of food sensitivities, and protection of the skin barrier increase the likelihood of lasting improvement. Delaying treatment on the expectation that “they will grow out of it” increases the risk of the condition becoming chronic.

Are cortisone creams harmful?

Topical corticosteroids are safe and effective medications when used for the right indication and for controlled durations. Problems arise with prolonged and unsupervised use: skin thinning, crack formation, local immune suppression, and rebound flare-ups. In the integrative approach, corticosteroids are used as short-term bridge therapy to control acute flare-ups; the long-term strategy focuses on correcting the underlying causes.

Is there a connection between eczema and diet?

There is a direct and strong connection. Gut-skin axis research has established that dietary quality is one of the fundamental variables determining skin health. Processed foods, refined sugar, and trans fats increase intestinal permeability and trigger systemic inflammation. Omega-3 fatty acids, fermented foods, fibre-rich vegetables, and antioxidant-rich fruits are protective nutrients that suppress inflammation.

Appointment and Evaluation

Success in eczema treatment is directly proportional to the identification of individual triggers and the creation of a personalised treatment plan. The integrative eczema protocol at our clinic includes a detailed history, gut health evaluation, liver function analysis, and nutritional planning.

If you wish to have an eczema assessment for yourself or your child, or to complement your existing treatment with an integrative perspective, you can book an appointment.

Dr. Recep Celik | Integrative Medicine and Natural Treatment Applications, Alanya