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16-06-2026

Eczema and Dry Skin: Symptoms, Causes, Tests, Treatment

Eczema and dry skin are very common skin conditions that affect people of all ages. Although they are often considered simple skin irritations, in many cases they are associated with deeper dysfunctions involving the immune system, the skin barrier, nutritional status, or even gut function.
Dry skin is characterized by reduced hydration and increased sensitivity of the epidermis, while eczema, particularly atopic dermatitis, is a chronic inflammatory condition with periods of flare-ups and remission. Persistent itching, redness, and skin irritation can significantly affect quality of life.

Modern Functional Medicine approaches skin disorders more holistically by investigating potential underlying factors such as chronic inflammation, food sensitivities, gut dysbiosis, and nutritional deficiencies.

Epidemiological Data

Eczema is among the most common chronic skin diseases worldwide. It is estimated that approximately 15–20% of children and 5–10% of adults experience some form of atopic dermatitis. In recent years, incidence has been increasing, particularly in industrialized countries. Environmental factors such as air pollution, urbanization, the use of chemical cleaning products, and dietary changes appear to contribute significantly.

In Greece, recent studies show an increasing prevalence of atopic dermatitis in both children and adults. At the same time, dry skin is particularly common among elderly individuals and among people with diabetes mellitus, hypothyroidism, or an allergic predisposition.

Eczema often coexists with:

  • Allergic rhinitis
  • Asthma
  • Food allergies or intolerances

This association suggests that skin inflammation is closely linked to the overall function of the immune system.

Symptoms and Signs

The clinical presentation varies depending on disease severity and the patient’s age.

The most common symptoms include:

  • Dryness and roughness of the skin. The epidermis easily loses moisture and becomes more sensitive.
  • Intense itching. This is the hallmark symptom of eczema and often worsens at night.
  • Redness and inflammation. Skin lesions appear irritated and warm.
  • Scaling and small cracks. In severe cases, painful fissures may develop.
  • Thickening of the skin. Chronic scratching leads to lichenification and hardening of the epidermis.
  • Secondary infections. Damaged skin becomes more vulnerable to bacterial or fungal infections.

In children, lesions most commonly appear on the elbows and knees, whereas in adults, the hands, neck, and face are more frequently affected.

Beyond skin-related symptoms, many patients experience sleep disturbances, fatigue, and psychological distress due to chronic inflammation and persistent itching. Many patients also exhibit increased skin sensitivity to everyday irritants. Contact with soaps, disinfectants, wool clothing, or sudden temperature changes may immediately worsen itching and redness. In several cases, the skin develops increased reactivity even to personal care products that were previously well tolerated.

Chronic atopic dermatitis often presents with alternating periods of remission and flare-ups. Flare-ups may be associated with psychological stress, infections, seasonal changes, or dietary factors. In more severe forms, patients report difficulty concentrating, irritability, and a significant impairment of daily life due to constant itching and sleep disruption.

Underlying Causes

Eczema and dry skin are considered multifactorial conditions. Their development is associated with the interaction of genetic, immunological, environmental, and metabolic factors.

  • Skin Barrier Dysfunction: Many patients have impaired function of the skin’s protective barrier. This results in increased water loss and easier penetration of allergens and microbes.
  • Immune Dysregulation: Overactivity of the immune system leads to chronic inflammation and increased production of inflammatory cytokines. This explains why eczema often coexists with other allergic diseases.
  • Environmental Factors: Detergents, cosmetics, air pollution, and cigarette smoke can worsen inflammation and skin dryness.
  • Gut Microbiome Dysbiosis: Imbalances in intestinal microflora may affect immune system function and enhance inflammatory skin responses.
  • Food Sensitivities: In some patients, foods such as dairy products, gluten, or processed foods appear to aggravate symptoms.
  • Nutritional Deficiencies: Low levels of vitamin D, zinc, and omega-3 fatty acids have been associated with increased severity of atopic dermatitis.
  • Stress and Hormonal Factors: Chronic stress and sleep disturbances affect immune function and may trigger eczema flare-ups.
  • Oxidative Stress and Chronic Inflammation: Oxidative stress appears to play an active role in chronic skin inflammation. Increased production of free radicals may damage cellular membranes and worsen skin barrier function. Factors such as poor diet, sleep deprivation, chronic stress, and air pollution increase the body’s oxidative burden.
  • Hormonal and Metabolic Disorders: Certain metabolic or hormonal disorders are associated with persistent dry skin and increased skin sensitivity. Hypothyroidism, diabetes mellitus, and hormonal changes during menopause may affect epidermal lipid production and normal skin renewal. For this reason, chronic dry skin should not always be viewed solely as a cosmetic issue.
Laboratory Tests for Disease Investigation

(a) Conventional Laboratory Tests

  • Complete Blood Count (CBC): Evaluates the presence of inflammation or allergic reactions. Elevated eosinophils may be associated with atopic conditions.
  • Immunoglobulin E (IgE): A marker of allergic predisposition that is often elevated in patients with eczema. In addition, specific IgE testing for allergens can detect possible sensitization to foods or inhaled allergens.
  • Vitamin D: Vitamin D contributes to immune regulation and skin barrier function.
  • Zinc: Essential for healing and epidermal regeneration.
  • Thyroid Function Tests (TSH, FT3, FT4): Hypothyroidism may cause persistent dry skin and skin sensitivity.
  • Glucose,  HbA1c: Diabetes mellitus is associated with dryness, itching, and increased risk of infections.
  • Skin Culture: Detects bacterial or fungal infections.
     

(b) Functional Medicine Tests

Functional Medicine testing evaluates not only whether a value falls within normal laboratory ranges, but also whether it is optimal for proper physiological function. In this way, early dysfunctions associated with chronic inflammation and impaired skin repair can be identified.

(c) Other Tests

  • Patch Tests: Investigation of allergic contact dermatitis.
  • Dermatological Biopsy: Histological examination of skin lesions.
Therapeutic Approaches

(a) Conventional Treatments
Treatment mainly focuses on restoring the skin barrier and controlling inflammation.

  • The primary therapeutic options include:
  • Moisturizing and emollient creams for daily skin protection.
  • Topical corticosteroids for flare-up management. Prolonged use may cause skin thinning.
  • Topical calcineurin inhibitors for sensitive areas such as the face and eyelids.
  • Antihistamines for itch control.
  • Antibiotics in cases of secondary infection.
  • Phototherapy or biologic agents in severe forms of atopic dermatitis.
     

(b) Natural Therapies
The functional approach aims to reduce inflammation and improve the underlying factors contributing to the disease.

Nutrition
An anti-inflammatory diet may substantially improve symptoms. Increased consumption of the following is recommended:

  • Fatty fish rich in omega-3 fatty acids.
  • Vegetables and fruits high in antioxidants.
  • Olive oil and nuts.
  • Foods containing probiotics.

At the same time, reducing sugar, processed foods, and potential food sensitivities may significantly help.

Lifestyle
Proper daily skin care is essential:

  • Lukewarm bathing instead of very hot water.
  • Mild fragrance-free cleansers.
  • Regular moisturizing after bathing.
  • Avoidance of harsh detergents and synthetic fabrics.

Stress management and improved sleep may also reduce the frequency of flare-ups.

Role of the Gut Microbiome
Restoring intestinal balance is a key objective of the functional approach. Adequate fiber intake, consumption of foods with natural probiotics, and reduction of ultra-processed foods may support gut microbiota and help regulate inflammation. In some cases, combinations of probiotics and prebiotics are used for several weeks, especially when symptoms such as bloating or indigestion coexist.

Exercise and Sleep
Moderate physical activity helps regulate inflammation and improve psychological well-being. However, excessive sweating may irritate the skin in patients with atopic dermatitis. Sleep quality is also important, as chronic insomnia increases inflammatory activity and may worsen itching.

Supplements and Herbal Therapies

  • Omega-3 fatty acids, usually 1000–3000 mg daily, with anti-inflammatory effects.
  • Vitamin D, with dosage individualized according to laboratory findings.
  • Probiotics for supporting intestinal microflora.
  • Zinc for enhancing healing and immune function.
  • Aloe vera and colloidal oatmeal for topical soothing action.

Although many supplements may provide potential benefits, indiscriminate use is not always safe. High doses of vitamins or combinations of multiple supplements without supervision may lead to adverse effects or interactions with medications.

References
  1. Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018 Jun 21;4(1):1. doi: 10.1038/s41572-018-0001-z. PMID: 29930242.
  2. Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, Trakatelli M, Puig L, Stratigos A; EADV burden of skin diseases project team. Prevalence of most common skin diseases in Europe: a population-based study. J Eur Acad Dermatol Venereol. 2022 Jul;36(7):1088-1096. doi: 10.1111/jdv.18050. Epub 2022 Mar 22. PMID: 35274366; PMCID: PMC9415115.
  3. Stefanou G, Gregoriou S, Kontodimas S, Sfaelos K, Vakirlis E, Kourlaba G. Prevalence of adult self-reported atopic dermatitis in Greece: results from a nationwide survey. Eur J Dermatol. 2022 Sep 1;32(5):597-606. English. doi: 10.1684/ejd.2022.4335. PMID: 36468734.
  4. Fasseeh AN, Elezbawy B, Korra N, Tannira M, Dalle H, Aderian S, Abaza S, Kaló Z. Burden of Atopic Dermatitis in Adults and Adolescents: a Systematic Literature Review. Dermatol Ther (Heidelb). 2022 Dec;12(12):2653-2668. doi: 10.1007/s13555-022-00819-6. Epub 2022 Oct 5. PMID: 36197589; PMCID: PMC9674816.
  5. Girolomoni G, de Bruin-Weller M, Aoki V, Kabashima K, Deleuran M, Puig L, Bansal A, Rossi AB. Nomenclature and clinical phenotypes of atopic dermatitis. Ther Adv Chronic Dis. 2021 Mar 26;12:20406223211002979. doi: 10.1177/20406223211002979. PMID: 33854747; PMCID: PMC8010850.

At Diagnostiki Athinon, we treat prevention with the seriousness it deserves. This is where science meets personalized care.

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