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Eczema Explained: The Science Behind Your Flares

Eczema Explained: The Science Behind Your Flares

Maria Barkas
October 21, 2025

If you live with the relentless itch, redness, and discomfort of eczema, you also probably have an entire graveyard of half-used creams living under your sink that promised relief but never delivered.

Eczema is not a surface-level rash; it is a visible sign of an internal, chronic inflammatory process.

To achieve long-term relief and limit flare ups, we must address the root causes fueling the inflammation inside your body.

What’s Happening Inside Your Body

Eczema is a chronic inflammatory condition - meaning that suffering you feel on the surface, is caused by an overreactive immune system inside your body.

When your immune system is triggered, it releases signaling proteins called cytokines, which start the inflammation. These chemical messengers travel straight to the skin, causing the initial redness and swelling. But for eczema, the reaction goes one step further: this inflammation activates your skin's emergency responders, the mast cells.

Mast cells are specialized immune cells, heavily concentrated in the skin, acting as alarm systems, and packed with the chemical - histamine. Histamine is a chemical your body naturally produces as part of its immune response to communicate that a threat is present.

The mast cells then quickly unleash histamine, and that is what creates the severe, defining agony of a flare. Histamine forces your blood vessels to dilate - causing intense flushing and heat - and sends the agonizing, relentless signal directly to your brain to… itch.

Even deeper inside, your gut health also plays a critical role.

Imbalances in your gut microbiome - the community of beneficial bacteria - are linked to a constant state of immune activation, which only increases your overall body inflammation. This ongoing internal stress makes your skin far more likely to launch this histamine response the moment any trigger is encountered.

Now that we understand how a flare physically happens, the next question is why?

Your Triggers

So why is your immune system triggered in the first place?

When external and internal pressures meet, they overwhelm your body’s ability to cope. To truly gain control over your eczema, you need to identity and manage these primary categories of triggers:

Trigger Type	Examples & Impact
Internal & Lifestyle (Fuels the Fire): These factors determine your body's *baseline sensitivity* - the internal environment that decides whether your immune system will overreact.	Stress and Poor Sleep: Increases the hormone cortisol, which is pro-inflammatory and weakens the skin's defenses. Refined Sugar & Alcohol: Causes rapid insulin spikes and/or direct histamine release, triggering inflammatory cytokines that hit the skin. Gut Imbalance & Sensitivities: Low levels of beneficial bacteria, or sensitivities to certain food compounds, drive continuous systemic inflammation. Hormonal Shifts, Illness, & Nutrient Deficiencies: Fluctuations from the menstrual cycle, chronic infections, and low levels of critical nutrients place the immune system under constant stress and can alter its sensitivity.
External (Initiates the Attack): These substances bypass the skin's defenses and force your immune system to launch an emergency response.	Aeroallergens: Airborne threats like mold, pollen, and dust mites easily enter through a compromised skin barrier or airways, forcing the immune system to launch an inflammatory cascade. Contact Irritants: Substances like fragrances, harsh soaps, or nickel chemically damage the skin's barrier, creating easy entry points that lead to localized inflammation and histamine release.
The Skin Barrier (The Compromised Defense): The condition of your skin barrier is both a result AND trigger. Your barrier dictates how severely you react to every other trigger.	Compromised Barrier: Eczema-prone skin often has a weak barrier, allowing irritants to sneak in and causing a major problem: the skin struggles to hold onto moisture. The loss of hydration leads to the characteristic dryness, tightness, scaling, and relentless itching of eczema.

Trigger Type

Examples & Impact

Internal & Lifestyle (Fuels the Fire):

These factors determine your body's baseline sensitivity - the internal environment that decides whether your immune system will overreact.

Stress and Poor Sleep: Increases the hormone cortisol, which is pro-inflammatory and weakens the skin's defenses.

Refined Sugar & Alcohol: Causes rapid insulin spikes and/or direct histamine release, triggering inflammatory cytokines that hit the skin.

Gut Imbalance & Sensitivities: Low levels of beneficial bacteria, or sensitivities to certain food compounds, drive continuous systemic inflammation.

Hormonal Shifts, Illness, & Nutrient Deficiencies: Fluctuations from the menstrual cycle, chronic infections, and low levels of critical nutrients place the immune system under constant stress and can alter its sensitivity.

External (Initiates the Attack):

These substances bypass the skin's defenses and force your immune system to launch an emergency response.

Aeroallergens: Airborne threats like mold, pollen, and dust mites easily enter through a compromised skin barrier or airways, forcing the immune system to launch an inflammatory cascade.

Contact Irritants: Substances like fragrances, harsh soaps, or nickel chemically damage the skin's barrier, creating easy entry points that lead to localized inflammation and histamine release.

The Skin Barrier (The Compromised Defense):

The condition of your skin barrier is both a result AND trigger. Your barrier dictates how severely you react to every other trigger.

Compromised Barrier: Eczema-prone skin often has a weak barrier, allowing irritants to sneak in and causing a major problem: the skin struggles to hold onto moisture. The loss of hydration leads to the characteristic dryness, tightness, scaling, and relentless itching of eczema.

While it may seem like anything and everything could be a trigger, your triggers and your body’s resilience are unique.

From Reaction to Prevention

Treating eczema requires a holistic strategy to raise your “flare threshold”, and actively building resilience against your triggers.

In order to accomplish this, you must first lower your baseline level of inflammation, which fuels the immune response. Start with those internal, external, and lifestyle factors:

Calm the System: Focus on nutrients known to fight inflammation and limit processed foods and simple sugars; Nurture your gut with sources of probiotics; Lower your cortisol, by implementing better sleep hygiene and stress management practices.
Audit your Environment: Assess your living space for potential aeroallergens and irritants that can wreak havoc on your body.

Your regimen must also be a defense mechanism for your skin's compromised shield. Book a consult with me so that we can set you up with a regimen that focuses on repairing the skin microbiome, and sealing in hydration to provide the physical structure needed to repair and resist external irritants.

The only way to find your unique tipping point is through deliberate observation. Our goal is to isolate the specific, unique combination of internal and external factors that, when combined, overwhelm your system and lead to a flare. Understanding these personal patterns is the key to lasting prevention.

Ready to End the Cycle?

You now have the knowledge to understand that your eczema flares begin within. No more wasting money on creams that only treat the surface, and provide short term relief. True, sustainable relief requires a targeted strategy that calms your immune system, strengthens your gut, and repairs your barrier from the inside out.

Book a consultation with me for personalized guidance and care, and additional resources to stop the itch and heal your skin.

Best,

Maria