There are two types of eczema: 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.

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 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:

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.

  • Genetic mutationsThe overactivity of the immune systemEnvironmental factors such as dry weather or stress

Intrinsic Eczema Symptoms 

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

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.

  • Intense itchinessPainful and sore skinDifficulty sleepingRashes that bleed or ooze liquid due to excessive scratchingDry skinDiscolored skinThickening and hardening of the skin because of scratching

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.

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.

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

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.

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.  

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.
  • Learn More:
  • Eczema Causes and Triggers
  • 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.

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.

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.

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