By BruceBlaus. When using this image in external sources it can be cited as: Blausen.com staff. "Blausen gallery 2014". Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons.

Leaky Skin

Remember junior high science class where you looked at various things under the microscope? When you compare normal skin and eczema skin under a microscope (I’m told) the skin looks different at every layer.

To truly understand the difference, let’s discuss the three main layers of the skin. The first or top layer is known as the stratum corneum. It’s technically dead skin and what flakes off every 28 days. However, our stratum corneum is super important because it holds in water and keeps chemicals out of our body. The second layer of skin is the epidermis and is the live skin. Lastly, the third layer is the dermis and it’s connected to more of our blood vessels and nerve endings.

People who don’t have severe eczema, otherwise known as atopic dermatitis, tend to have normal skin. They have more immune cells in their skin than anywhere else in their body. Conversely people like me with atopic dermatitis have more “holes” in our skin that enables more toxins and chemicals the ability to get into the body. This is also known as “leaky skin.”

When atopic dermatitis or eczema skin is examined under the microscope, the stratum corneum is disorganized. In addition, the epidermis has holes, looks inflamed and swollen and shows that t-cells are going into the epidermis. When there are additional t-cells than normal it drives additional inflammation as they are constantly fighting infection. Essentially chronic eczema experiences a cycle of skin barrier dysfunction resulting in an abnormal immune activation response that in turn perpetuates the skin barrier dysfunction or otherwise known as  the itch scratch cycle.

There is hope  and the solution Dr. Eric Simpson suggests is safe, simple and cheap – use moisturizer. When we reduce the inflammation by using moisturizer, under the microscope, eczema skin begins to look closer to normal skin and less “holey.” Alleviating the itch, tends to reduce the itch scratch cycle and reduces inflammation in the skin.

Dr. Eric Simpson noted there are various studies that show how using more moisturizer results in less eczema and eczema flare ups. He presented a study of babies with parents who have eczema (as it tends to be genetically inherited disease) and that using moisturizer on the baby when they were only 3 weeks old reduced their risk for developing chronic eczema later by half.

You know which moisturizer works best for you. Eczema is a very tricky chronic disease, as what works for one person doesn’t necessarily work for someone else. It’s recommended you use whatever moisturizer feels good and isn’t too expensive. You can even use Vaseline if your eczema is really bad. I specifically avoid anything “natural” that could contain nickel, such as oats, nuts, seeds and also I avoid fragrances.


Post based on my notes from a lecture I attend by Dr. Eric Simpson October 2015 where he discussed the cause of atopic dermatitis.

Image by BruceBlaus. When using this image in external sources it can be cited as:Blausen.com staff. “Blausen gallery 2014”. Wikiversity Journal of Medicine. DOI:10.15347/wjm/2014.010. ISSN 20018762. (Own work) [CC BY 3.0], via Wikimedia Commons.