Tajinder Panesar, Kingston University UK

Eczema is a group of skin conditions, which can affect any age group, race sex or socio- economic group. In the United Kingdom atopic eczema affects 15-20% of schoolchildren and 2-3% of adults. The causes of eczema depend on the specific type, but many people with atopic eczema are sensitive to several allergens, which cause an excessive reaction to the immune system producing inflammation, irritated and sore skin. House dust mites are unlikely to be the main cause of eczema, but they can often worsen the skin condition by increasing sensitization and causing an allergic reaction. The specific mechanism that causes dust mites to trigger eczema is unknown, but it could be due to the tendency for many people who have eczema to be allergic to house dust mites. Often an imbalance in the immune system, where people have far more autoimmune cells than normal, leads to allergic symptoms. This can cause the skin cells to lose their barrier function so water is lost from the skin and irritants such as dust mite faeces and other allergens penetrate through the fragile skin.

Dust mites are mostly found in warm and damp places such as mattresses and bedding, as they feed on the flakes of human skin which are shed in bed. This also means that an eczema sufferer will have the most contact with this allergen while they are in bed, where more skin is exposed. So night time can be the worst time for itching and skin discomfort. Small uncontrolled studies have shown that reducing the exposure to dust mites can have a beneficial effect on eczema symptoms by using allergen proof bedding covers, which is the simplest and most effective measure to reduce house dust mite levels in the home. There seems to be an indirect relationship between eczema and house dust mites which both seem to be interlinked to bedding and vacuuming.

A recent study analysed the relationship between eczema and using allergen proof bed covers together with high filtration vacuuming. After six months study there was a significantly greater reduction in eczema severity in patients who used allergy control methods. This was due to a reduction of dust mites in the mattresses and in the carpets. Therefore it can be seen that dust mites and eczema seen to be related, and even though it may not be the main factor in triggering eczema, it plays an important role in relation to the lifestyle and environment we live in.

Possibly the most important way to reduce eczema or prevent it from becoming any more severe is to take precautionary measures by changing your living environment and lifestyle. Since house dust mites are most prevalent in moist and warm places, it is important to vacuum regularly, wash bed covers with hot water to get rid of any faecal matter from the mites, and to use appropriate allergy proof bedding with semi permeable fabrics, which prevent allergens from getting trapped in them.

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1. National Eczema Society

2. Charman C. Clinical evidence: Atopic eczema. BMJ 1999; 318: 1600-1604