What to Know About Eczema
Eczema is a chronic, inflammatory skin condition characterized by symptom flare-ups that include itchiness, rashes, dryness, blisters, and scaly patches. The causes of eczema are not fully understood.
There are several types of eczema, with atopic dermatitis being the most common. More than 31 million Americans have eczema, which can occur at any stage of life.
This article examines the types, symptoms, causes, diagnosis, and treatment of eczema.
Reproduced with permission from © DermNet New Zealand www.dermnetnz.org 2023
One in 10 Americans has atopic dermatitis, the most common type of eczema.
Types of Eczema
Although the symptoms are similar, there are several different types of eczema. They include:
Atopic dermatitis is the most common form of eczema, with itchy skin that develops into a rash when scratched. It usually develops by age 5 and can continue throughout your lifetime.
Contact dermatitis occurs when the skin reacts to something it touches. It typically starts as itchiness, followed by a rash and, in some cases, blisters.
Dyshidrotic eczema is caused by hypersensitivity to medications, personal care products, or sweat. The main symptom is tiny, itchy blisters on the hands and feet.
Hand eczema is marked by dry, irritated, and cracked skin on the hands. It is most common in people with jobs that require frequent handwashing or working with chemicals.
Neurodermatitis is characterized by an itchy patch that develops on the arms, legs, back of the neck, scalp, groin area, or genitals.
Nummular (discoid eczema) is characterized by a red or brown circle- or oval-shaped area on the skin. It is sometimes confused with ringworm and is common in men 55 to 65.
Stasis dermatitis is caused by low blood flow and almost always occurs in the lower legs, usually around the ankles.
Eczema Symptoms
Eczema symptoms are different for everyone. You can experience some, all, or just a few signs, and they can come and go. The most common eczema symptoms are:
Dry, sensitive skin
Inflamed, discolored skin
Scaly patches
Rough, leathery skin
Oozing or crusting skin
Swelling
Where Do Symptoms Appear?
Where eczema symptoms appear can depend on what type you have. For example, atopic dermatitis and contact dermatitis can occur anywhere on the body. Other types of eczema generally only appear on specific body parts, such as the hands, legs, or feet.
Psoriasis and eczema can have similar symptoms, such as rash and itchiness, but they are not the same. While eczema is a common inflammatory skin condition, psoriasis is a less common autoimmune disease that can cause inflammation throughout the body and lead to cardiovascular disease, type 2 diabetes, and other conditions.
What Causes Eczema?
Eczema is a complex condition with causes that are not yet fully understood. Environmental factors (such as where you live and what irritants you’re exposed to), genetics, and having an overactive immune system are all believed to play a role in developing eczema. Risk factors include a family history of eczema or allergies, high levels of stress, and extremely dry skin.
What Causes Eczema Flare-Ups?
Many triggers can cause eczema to flare up, and flare-ups often don’t occur until sometime after exposure to the trigger. Common triggers for eczema flare-ups include:
Exposure to allergens or irritants
Dry skin
Eczema in Babies and Children
Eczema in young children is common and almost always due to a family history of eczema or allergies. Up to 1 out of every 4 children is affected by eczema, and 60% of people with eczema develop it by the time they are 12 months old.
When eczema occurs in babies, it is usually due to something irritating their sensitive skin, such as cleansers or soaps, lotions, or home products. Dry air, cold, or food allergies can also trigger eczema in babies.
There is no cure for eczema in children, but it can usually be controlled through treatments such as moisturizers, prescription medications, and managing triggers.
Eczema is not contagious and cannot be caught or spread from one person to another.
How Eczema Is Diagnosed
A healthcare provider can usually diagnose eczema based on symptoms, an exam, and
family and health history. A patch test for allergies or skin biopsy might also need to be performed.
Management and Treatment of Eczema
Since there is no cure for eczema, treatments focus on managing symptoms and triggers, and reducing flare-ups.
Medication
Medications to treat skin itching and inflammation, keep skin moist, and prevent infection are sometimes used to treat eczema. They can include:
Barrier repair creams
Oral antibiotics
Oral cyclosporine (for eczema that doesn’t respond to other treatments)
Specialized light therapy (phototherapy) is considered a safe treatment for eczema and can be used in adults or children. The treatment uses special light bulbs or a laser two to three times a week. It is usually done in a healthcare provider’s office, although some patients can use at-home devices.
Lifestyle Changes
To manage eczema, it’s important to work with a healthcare provider to identify possible triggers, and work on limiting exposure to them. Adopting a skin care routine that includes bathing, using moisturizer, and being gentle with the skin is also important.
You can also manage itchy skin and other symptoms by using home remedies, including:
Using skin cleansers with low pH
Applying cold compresses
Taking an oatmeal or apple cider vinegar bath
Prevention Tips
There is no way to prevent eczema, but you can work to avoid flare-ups by:
Sticking to a skin care routine
Working with a healthcare provider to develop customized treatments
Eating an anti-inflammatory diet
Finding ways to decrease stress
When to Seek Care for Eczema
If you think you have eczema, seeing a healthcare provider to get a proper diagnosis is essential because eczema can mimic other conditions. Although eczema is not contagious, it can worsen without developing a treatment plan to manage the condition.
If you have eczema, you should always contact your healthcare provider regarding new or worsening symptoms.
Summary
Eczema is a chronic, inflammatory skin condition with complex causes that the medical community does not entirely understand. There are several types of eczema. Atopic dermatitis is the most common. Flare-ups, including itchiness, rashes, dryness, and other skin symptoms, characterize eczema. Eczema can't be prevented, but flare-ups and symptoms can be lessened by managing triggers, lifestyle changes, and, sometimes, medications.
