Is eczema an autoimmune disease? What research says

Eczema is a group of skin conditions that make skin dry, itchy and inflamed, and a doctor confirms the diagnosis. Because the immune system plays a part in eczema, many people ask whether it is an autoimmune disease. This guide explains what the word autoimmune means, how health bodies describe eczema, what large studies have found about eczema and autoimmune diseases, and why the two get confused. It focuses on atopic eczema (atopic dermatitis), the most common type. The complete guide to eczema covers the condition as a whole.

What "autoimmune" means

MedlinePlus, the health site of the US National Library of Medicine, explains that your immune system normally protects you by attacking germs, such as viruses and bacteria, that get into your body. It can tell that germs are not part of you. In an autoimmune disease, the immune system attacks the healthy cells of your own organs and tissues by mistake.

MedlinePlus says there are more than 80 types of autoimmune disease, and gives examples. Alopecia areata is an autoimmune disease of the skin that causes hair loss. In type 1 diabetes, the immune system attacks the pancreas. In rheumatoid arthritis, it can attack the joints, lungs and eyes.

How health bodies describe eczema

The US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) calls atopic dermatitis a chronic, or long-lasting, disease that causes inflammation, redness and irritation of the skin. It says researchers know that genes, the immune system and the environment all play a part. On the immune system, NIAMS says: sometimes the immune system becomes confused and overactive, which can create inflammation in the skin, leading to atopic dermatitis.

The American Academy of Dermatology (AAD) describes biologic medicines for eczema as drugs that target or quiet the part of the immune system that is overactive. A 2025 review in the journal Frontiers in Immunology calls atopic dermatitis a common, recurring, chronic inflammatory skin disease.

These descriptions focus on an immune system that overreacts and causes inflammation. The public pages on atopic dermatitis from NIAMS, the AAD, the NHS and MedlinePlus that were read for this guide do not describe it as an autoimmune disease.

How the immune system drives the itch and the rash

NIAMS explains the chain of events in atopic dermatitis. Changes in the outer layer of the skin let moisture escape, and the dry skin becomes damaged and inflamed. Newer research suggests that the inflammation itself creates the feeling of itch. Scratching then damages the skin further and raises the risk of infection with bacteria.

Newer eczema medicines target single steps in this process. The AAD says two injected medicines, lebrikizumab and tralokinumab, work by blocking IL-13, a protein in the body that contributes to the inflamed skin and the damaged outer layer of skin that atopic dermatitis causes. It says another injected medicine, dupilumab, works by reducing the inflammation thought to lead to flares, and that it does not suppress the immune system, so it does not raise the risk of serious infections such as tuberculosis. These medicines are for moderate or severe eczema that has not responded to creams, and a doctor decides whether they fit.

Three ideas that often get mixed up

Three words come up again and again with eczema, and they mean different things:

• Inflammation is the body's response that causes redness, swelling, heat and pain or itch. MedlinePlus lists redness, swelling, heat and pain as the signs of inflammation. Eczema causes inflammation in the skin.
• Allergy is a reaction to something harmless, such as pollen or a food. The word "atopic" means linked to allergies, according to MedlinePlus Genetics. The AAD estimates that one third of children with atopic dermatitis later develop asthma and two thirds get hay fever. Yet MedlinePlus says atopic dermatitis is not caused by allergies.
• Autoimmunity is the immune system attacking the body's own healthy tissue by mistake, as described above.

Eczema clearly involves inflammation and is closely tied to allergies. How much it overlaps with autoimmunity is the open research question.

What large studies have found

Several large studies have looked at whether people with eczema have autoimmune diseases more often than people without it. They agree that they do.

A US hospital study (2019). Researchers writing in the Journal of the American Academy of Dermatology used a national sample of US hospital stays from 2002 to 2012. Autoimmune disease was found in 7.9 percent of adults with atopic dermatitis, compared with 5.7 percent of adults without it. In children, the figures were 2.0 percent with atopic dermatitis and 1.0 percent without. Atopic dermatitis was linked with 18 of the 32 autoimmune disorders studied in adults and 13 of the 24 studied in children.

A Swedish national study (2021). Researchers writing in the British Journal of Dermatology compared 104,832 people with atopic dermatitis with 1,022,435 people without it, matched by sex and age, using Swedish national health records. People with atopic dermatitis were more likely to have one or more autoimmune diseases. The link was strongest for autoimmune diseases of the skin, followed by those of the gut and of connective tissue, and it was stronger in people who had several autoimmune diseases.

A review of 26 studies (2025). A review in Frontiers in Immunology pooled 26 studies with 1,629,723 people with atopic dermatitis and 15,106,889 people without it. It found a clear link with autoimmune diseases in both adults and children, and it found that women were more likely than men to have an autoimmune disease as well. The diseases included celiac disease, lupus, Sjogren's syndrome, ankylosing spondylitis, alopecia areata, rheumatoid arthritis, vitiligo, thyroid disease and ulcerative colitis.

A review of antibody studies (2019). A review in Archives of Dermatological Research looked for signs of autoimmunity in the blood. It found that certain antibodies that react against the body's own proteins were more common in people with atopic dermatitis than in people without it. It said research has found several similarities between atopic dermatitis and autoimmune conditions.

MedlinePlus Genetics also says people with atopic dermatitis have a higher risk of other conditions related to inflammation, such as inflammatory bowel disease, rheumatoid arthritis and alopecia areata.

What the link means

A link between two diseases shows that they appear together more often than expected. It cannot show that one disease causes the other, or explain why they occur together. The researchers say so themselves. The 2025 review says further research is needed to investigate the relationship, and the 2019 antibody review says the underlying mechanisms are not well understood.

For a person with eczema, the numbers put the risk in context. In the US hospital study, 92.1 percent of adults with atopic dermatitis had no autoimmune disease recorded. Having eczema does not mean you have, or will get, an autoimmune disease. If you have symptoms beyond your skin, such as joint pain, patches of hair loss or ongoing stomach problems, tell your doctor so they can decide whether to look further.

Why eczema and autoimmune diseases get confused

The two share several features, which explains why people often group them together:

• Both run in families. MedlinePlus says autoimmune diseases tend to run in families. The NHS says atopic eczema is more likely when a parent has it.
• Both come and go. MedlinePlus says autoimmune symptoms can flare up and then go into remission. NIAMS describes the same pattern of flares and remissions in atopic dermatitis.
• Neither can be caught. MedlinePlus says you cannot catch an autoimmune disease from other people, and NIAMS says atopic dermatitis is not contagious.
• Some treatments overlap. MedlinePlus says treatment for autoimmune diseases usually aims to slow down the immune system and ease inflammation, often with corticosteroids. Steroid creams are also a main treatment for eczema. The AAD says baricitinib, a pill approved in Europe for moderate to severe atopic dermatitis, is approved in the United States for severe alopecia areata and some adults with rheumatoid arthritis.

Rare immune disorders that include eczema

In some people, eczema is one part of a wider immune disorder. MedlinePlus Genetics says atopic dermatitis can be a feature of separate disorders that affect the skin and the immune system, such as Netherton syndrome and IPEX syndrome. It also says that in a particular subset of people with atopic dermatitis, the immune system cannot protect the body well from germs, so they get infections again and again. MedlinePlus lists infections of the skin caused by bacteria, fungi or viruses among the complications of atopic dermatitis in general.

A doctor decides whether any tests are needed. The guide to what causes eczema explains the role of genes and the immune system, and the guide on how eczema is treated describes the medicines a doctor may offer, including those that act on the immune system.