Eczema

What Is Eczema?

Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition characterized by dry, sensitive skin, itching, redness, and recurrent flares. It develops when the skin barrier becomes weakened and the immune system becomes overly reactive to environmental and internal triggers.

When the skin barrier is impaired, moisture escapes more easily and irritants, allergens, and microbes can penetrate the skin. This leads to inflammation, itching, and the familiar cycle of irritation and scratching that worsens eczema symptoms.

Eczema often follows a pattern of improvement and flare-ups, and in many individuals the condition is influenced by multiple factors including genetics, immune function, the skin microbiome, environmental exposures, and stress.

Why Eczema Develops

Eczema is not caused by a single factor. Instead, it reflects the interaction of several biological processes.

Barrier dysfunction

The outer layer of the skin does not hold moisture effectively, making skin dry and vulnerable to irritation.

Immune dysregulation

The immune system becomes over-reactive, leading to chronic inflammation and itching.

Skin microbiome imbalance

Changes in the skin microbiome, including increases and decreases in specific microbes such as Staphylococcus aureus, can worsen inflammation and barrier disruption.

Environmental triggers

Irritants, allergens, stress, and climate can activate inflammatory pathways and trigger eczema flares.

Common Triggers for Eczema Flares

Eczema symptoms often worsen when specific triggers activate the skin’s immune and inflammatory pathways.

Common triggers include:

• dry or cold environments
• harsh soaps or detergents
• fragrances and skincare irritants
• dust mites and environmental allergens
• food sensitivities in some individuals
• psychological stress
• infection or microbiome imbalance
• sleep disruption and systemic inflammation

Identifying and addressing individual triggers is often an important part of long-term eczema management.

Our Approach to Chronic Eczema

Dr. Larivee provides care for patients with complex or treatment-resistant eczema. Rather than focusing only on symptom suppression, care focuses on understanding the biological factors contributing to persistent inflammation and skin barrier dysfunction.

Treatment plans are individualized based on disease severity, prior treatment response, and the patient’s overall health.

Approaches may include:

1.Clinical evaluation

Review of eczema history, triggers, and prior treatments.

2.Skin barrier and topical care

Strategies that support hydration, barrier repair, and skin resilience.

3. Microbiome support

Address microbial factors contributing to inflammation.

4.Immune regulation

Evidence-informed therapies to calm inflammatory pathways.

5. Long-term skin stability

Focus on reducing flare cycles and supporting durable control.

Who This Care Is Designed For

This care model may be appropriate for patients who:

• have chronic or persistent eczema
• experience frequent flares or worsening symptoms
• have not achieved stability with conventional care
• want a physician-guided integrative approach
• are seeking a deeper understanding of what is driving their skin condition

This practice focuses on chronic inflammatory skin disease and may not be appropriate for urgent dermatologic care.

Schedule an introductory consultation to discuss your skin concerns and determine whether our integrative dermatology approach is appropriate for your care.

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