The longer eczema persists, the more challenging it becomes to manage and resolve effectively, as outlined below.
- Chronic Inflammation Cycle: When eczema persists, the skin remains in a constant state of inflammation. This prolonged inflammatory response not only damages the skin barrier, making it increasingly difficult for the skin to repair itself, but over time, the immune system becomes hyper-reactive, causing more frequent and intense flare-ups.
- Skin Barrier Degradation: Long-term eczema progressively weakens the skin's protective barrier (stratum corneum). This barrier normally prevents moisture loss and blocks irritants and allergens. As the barrier becomes more compromised, the skin becomes:
- More susceptible to irritants
- Less able to retain moisture
- More prone to infections
- More sensitive to environmental triggers
- Dry, red and irritated
- Nerve and Immune System Remodeling: Chronic eczema can actually cause neurological and immunological changes:
- Nerve endings become more sensitive
- Immune cells develop a "memory" of inflammatory responses
- The skin becomes more reactive to potential triggers
- Microbiome Disruption: Prolonged eczema disrupts the skin's natural microbiome. The balance of beneficial and harmful bacteria becomes altered, which can:
- Increase skin inflammation
- Reduce natural healing mechanisms
- Make the skin more vulnerable to secondary infections (like, bacterial infections)
These cumulative effects make early intervention and consistent management crucial for preventing the progression and entrenchment of eczema. The longer eczema remains untreated, the more complex and challenging it becomes to restore normal skin function.
Treatment strategies should focus on:
- Repairing the skin barrier
- Reducing inflammation
- Managing triggers
- Restoring skin microbiome balance