Intrinsic Eczema: Everything You Need to Know

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Eczema, also known as atopic dermatitis, is an inflammatory skin condition that leads to dry, scaly skin and rashes. In more severe cases, skin infections can develop.

There are two types of atopic dermatitis: extrinsic and intrinsic. Intrinsic eczema is characterized by normal immune system antibody levels and is not caused by an allergen, while extrinsic eczema is associated with high levels of antibodies and allergies.

This article discusses the symptoms, causes, and treatment options for intrinsic eczema.

Person with scaly eczema scratching skin on neck

aniaostudio / Getty Images

What Is Intrinsic Eczema?

Atopic dermatitis is often marked by high levels of a specific antibody known as immunoglobulin E (IgE). Antibodies are specialized proteins created by the immune system to help fight off pathogens or other foreign substances in the body.

People with atopic dermatitis may also have other types of atopic conditions, such as allergies, which are conditions that arise because of immune system oversensitivity.

In people with intrinsic eczema, the levels of IgE are typically normal and there are no other atopic conditions present.

Research has examined the immune system’s role in intrinsic eczema and has found that although there is no connection to higher levels of IgE, other immune activations may take place that could play a role. These activations happen to specific cells known as T cells, which are cells that activate other immune cells to fight off infections and other pathogens.

Intrinsic Eczema vs. Extrinsic Eczema

Intrinsic eczema is marked by normal IgE levels and a lack of atopic diseases. Extrinsic is the opposite; when people have this type of eczema, high levels of IgE and other atopic conditions are typically found. Roughly 20% of eczema cases are considered to be intrinsic.

Though the distinction between intrinsic and extrinsic atopic dermatitis is often made by professionals, it remains controversial.

Intrinsic Eczema Causes

While researchers have yet to find a direct cause of intrinsic eczema, there is evidence to support that several factors may come into play in regard to its development. These factors include:

  • Genetic mutations
  • The overactivity of the immune system
  • Environmental factors such as dry weather or stress

Risk Factors for Intrinsic Eczema

The biggest risk factor associated with intrinsic eczema is family history. If a person in your family has it, you are more likely to get it. While extrinsic eczema may be associated with an allergy risk factor, intrinsic is not.

Intrinsic Eczema Symptoms 

The symptoms of intrinsic eczema are the same as those with extrinsic eczema. They include:

  • Intense itchiness
  • Painful and sore skin
  • Difficulty sleeping
  • Rashes that bleed or ooze liquid due to excessive scratching
  • Dry skin
  • Discolored skin
  • Thickening and hardening of the skin because of scratching

When to See a Healthcare Provider

If you experience any signs of a rash that is intensely itchy and interferes with your day-to-day life, you should see your healthcare provider. They will be able to provide you with treatment to help reduce the itch and clear up the rash.

Intrinsic Eczema Diagnosis

Typically, a physical examination is all that’s needed to diagnose eczema. Your healthcare provider will collect your symptoms and examine the affected area to determine if it's eczema or something else. They may also ask if anyone in your family has eczema.

If they are looking to diagnose between intrinsic and extrinsic, your healthcare provider will likely order tests to check your IgE levels. This will help them determine the subtype of your eczema.

In some cases, a skin biopsy, which removes a sample of tissue to be examined in a lab, may be performed to determine this, but a blood test is often used to determine levels of IgE.

Intrinsic Eczema Treatment

While there is no cure for intrinsic eczema, there are treatment options that can help lessen the itch and improve the skin’s overall health. Treatment options for intrinsic eczema include:

  • Skin moisturizers
  • Topical corticosteroids to help reduce inflammation in the skin and reduce itchiness
  • Medications that suppress the immune system, such as calcineurin inhibitors
  • Biologics, which are genetically engineered proteins that are artificially manufactured as medications to help reduce inflammation

Intrinsic Eczema and the Skin Barrier

People with eczema often have a weakened skin barrier, which is a protective layer that helps to keep out allergens and irritants while keeping in moisture. Improving the skin barrier can be a great way to improve eczema. Research has shown that various plant oils such as almond oil, borage oil, and argan oil may be a beneficial natural way to improve the skin barrier.  

Summary

Intrinsic eczema is a type of atopic dermatitis that is characterized by its underlying physiological mechanism, or lack thereof. In people with eczema, elevated levels of a specific antibody known as IgE typically are present. However, intrinsic eczema lacks those high levels, making it its own subtype. Additionally, some research supports that immune system overreaction in different immune cells may take place in intrinsic eczema.

Even though intrinsic and extrinsic have different IgE levels, they share the same symptoms, diagnosis, and treatment. For people with both types, improving the skin barrier can help greatly when it comes to symptom relief.

A Word From Verywell 

Coping with eczema, whether intrinsic or extrinsic, can be difficult. This is because there is no cure, and some treatment options don't work for everyone. It's important to remember that eczema can be managed with the right type of treatment and skin care.

When looking to keep your eczema at bay, it's important that you speak to your healthcare provider. They will be able to diagnose your subtype and help you find the best treatment option for your specific case.

Frequently Asked Questions

  • Is intrinsic eczema curable?

    Intrinsic eczema, like all other types of eczema, is not curable. Since the direct cause of eczema is unknown, it is hard to find a cure. However, there are various treatment options that can help prevent the symptoms and flare-ups that are associated with intrinsic and other types of eczema.

  • What is the difference between extrinsic and intrinsic eczema?

    Intrinsic and extrinsic eczema are the same when it comes to many things: diagnosis, treatment, and symptoms. However, the two are not exactly alike. This is because people with intrinsic eczema lack the hallmark characteristic of high levels of IgE antibodies and allergic conditions that are typically present in people with extrinsic eczema.

  • How can you prevent eczema flare-ups?

    Preventing eczema flare-ups can be difficult, but not impossible. To do so, you can:

    • Improve your skin barrier.
    • Keep your skin moisturized at all times.
    • Manage stress levels.
    • Avoid scented or harsh soaps or detergents.
    • Wear clothing that doesn’t cause itchiness of the skin.
    • Avoid dry climates if possible.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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