What Is Eczema?

Eczema is not a specific disease, but rather a term that describes a group of inflammatory skin conditions that produce rashlike symptoms, such as irritated, itchy patches on the skin.

Here, learn all about eczema, including types, causes, treatments, and more.

Types of Eczema

There are several types of eczema. These include the following.

Atopic Eczema

Contact Eczema (Contact Dermatitis)

This type of eczema is a localized skin reaction to a substance in the environment that causes the skin to become inflamed and itchy.

Hand Eczema

Dyshidrotic Eczema

Small, itchy blisters on the soles of the feet and edges of the fingers, toes, and palms may be signs of dyshidrotic eczema. Stress and allergies are two possible triggers for this form of eczema.

Nummular Eczema

Nummular eczema typically appears as itchy, coin-shaped spots on the skin.

Stasis Dermatitis

This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.

Seborrheic Dermatitis

Scalp eczema is one type of seborrheic dermatitis, which happens when white or yellow scaly patches of skin develop in oily areas of the body. Other places this may appear include the face and ears, partly as a result of microorganisms that live on the skin (such as some types of yeast).

Signs and Symptoms of Eczema

For most people, the main symptom of eczema is itching, which can lead to scratching and rubbing that further irritates the skin. This can, in turn, lead to the “itch-scratch cycle,” or increased itching and scratching that worsens eczema symptoms.

Dry, itchy skin and rashes can appear on various parts of the body — particularly the face, hands, feet, insides of the elbows, the area behind the knees, and scalp. In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth.

Other skin symptoms associated with eczema include:

• Rough, leathery patches of skin
• Discolored, raised bumps (hives)
• Increased skin creases on the palms of the hands
• Small, rough bumps on the face, upper arms, and thighs
• Scaly skin patches
• Swollen, sore skin
• Skin color changes

Causes and Risk Factors of Eczema

There are several potential causes and risk factors of eczema, including having skin that’s unable to retain moisture well, possibly because of low production of fats and oils. Eczema is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. A compromised skin barrier causes skin to become dry and lose its protective properties.

Children are more likely to develop eczema if other allergic diseases — such as hay fever and asthma — run in the family, which suggests that there may be a genetic component to the condition.

Though dermatologists don’t necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.

• Soaps, detergents, shampoos, and dishwashing liquids
• Bubble bath liquids
• Dust or sand
• Cigarette smoke
• Perfumes and skin-care products that contain fragrances or alcohol
• Wool or synthetic fabrics
• Chemicals, solvents, and mineral oils
• Mold
• Pollen
• Pet dander
• Allergenic foods (such as peanuts, soy, and eggs)
• Dust mites
• A hot or dry climate
• High or low humidity
• Bacterial, viral, or fungal infections

In some cases, eczema symptoms are confused with insect bites or allergic reactions.

How Is Eczema Diagnosed?

To diagnose eczema, your doctor will first conduct a physical examination to look at the state of your skin and see if you have the characteristic rash of the condition.

They may perform a skin biopsy, if necessary (which involves removing a skin sample for examination), to confirm the diagnosis and rule out other skin conditions.

Treatment and Medication Options for Eczema

Because there is no cure for eczema, the goal of treatment is to reduce eczema symptoms, heal the skin, and prevent skin damage and flare-ups.

Medication, moisturizers, and at-home skin-care routines make up an effective treatment plan for many people who live with eczema.

Medication Options

Corticosteroids (ointments, creams, or lotions) that include drugs such as 0.1 percent fluocinonide (Vanos), among many others, in varying degrees of strength:

• Calcineurin inhibitors, like tacrolimus (Protopic) and pimecrolimus (Elidel)
• The phosphodiesterase 4 inhibitors crisaborole (Eucrisa) and roflumilast (Zoryve)

  [8]

• The janus kinase inhibitor ruxolitinib (Opzelura)

  [9]

For moderate and severe disease, treatments include:

• Phototherapy

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• Biologics, including the self-administered injectable drugs dupilumab (Dupixent) and tralokinumab-ldrm (Adbry)

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• Oral immunosuppressants, like cyclosporine (Neoral), methotrexate (Rasuvo), or mycophenolate (CellCept)
• The oral janus kinase inhibitors upadacitinib (Rinvoq)

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  and abrocitinib (Cibinqo)

  [13]

• Wet wrap therapy, which combines topical medicines and moisturizers with a wet gauze wrap

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Other treatments for itching include antihistamines, such as diphenhydramine (Benadryl), hydroxyzine, or doxylamine succinate (Unisom), which may help prevent nighttime scratching.

Diet Options

If you aren’t sure which foods may be triggering your symptoms, you may try an elimination diet for eczema. With this approach, you’ll eliminate potentially problematic foods before adding them back in, noticing how your skin reacts along the way.

Alternative and Complementary Therapies

Disparities and Inequities in Eczema

What's more, eczema doesn’t necessarily look red on people with skin of color; instead, it may appear darker brown, purple, or ashen gray, which may be more difficult to see, potentially delaying diagnosis and treatment.

Black Americans are more likely to experience unique forms of eczema, including papular eczema (which looks like small bumps on the legs, arms, and torso) and eczema with follicular accentuation (which develops around hair follicles and resembles goosebumps).

Eczema can lead to skin discoloration, as can scratching itchy areas. Darkened patches (hyperpigmentation) or lightened ones (hypopigmentation) can be a particular concern for people of color. Although skin tone eventually evens out on its own, the discoloration can linger for weeks, months, or longer.

Lifestyle Changes and Prevention of Eczema

• Follow a healthy skin-care routine, including using moisturizing cream or ointment two to three times a day.
• Use gloves when needed, such as when you’re at risk of coming in contact with irritants.
• Bathe smart, such as by only using mild soap and lukewarm water for your bath or shower and patting your skin dry instead of rubbing it.
• Stay cool by drinking lots of water, and avoid getting hot and sweaty.
• Wear loose clothes that are made of cotton and other natural materials.
• Keep your body temperature steady by avoiding sudden changes in temperature and humidity.
• Tame stress by recognizing the signs and taking steps to manage it.
• Limit exposure to known irritants and allergens as best you can.
• Don’t scratch affected skin areas.

Eczema Prognosis

Complications of Eczema

People with eczema are at risk of developing infections if they scratch themselves so much that they break the skin. In fact, infections from staphylococcus and streptococcus bacteria are common in people with atopic dermatitis.

People with atopic dermatitis may also get a severe and potentially fatal infection called eczema vaccinatum if they receive the live-virus smallpox vaccine.

Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. These infections include:

• Staph infections (and furuncles, or boils)
• Eczema herpeticum
• Cellulitis
• Impetigo

Other conditions associated with eczema include asthma, hay fever, food allergies, cardiovascular disease, alopecia areata, and depression and anxiety. The asthma medication montelukast (Singulair), which people with eczema may take, could increase the risk for these mental health disorders.

Support for People With Eczema

Asthma and Allergy Foundation of America Community

Filling out a form on the site indicating your areas of interest will give you free access to an online forum that includes discussion threads on eczema-related topics. Each time you log in you will see a stream of blog posts with daily news and the latest discussion threads.

Inspire

We recommend u this NEA-hosted forum for sharing support and advice about living with eczema. After registering for free, members are able to post questions or comments in discussions and receive written replies or reactions via “Support,” “Thanks,” and “Useful” buttons.

The Takeaway

• Eczema is an umbrella term for a group of chronic skin conditions that cause an itchy rash. Atopic dermatitis is the most common form of eczema, though there are several types, each with their own symptoms.
• Eczema generally causes itchy and inflamed skin, dry patches, hives, and skin color changes. It is not contagious and the exact cause is unclear, but it may be linked to genetic components.
• There is no cure for eczema, but you may be able to manage the severity of flare-ups by avoiding certain triggers, like soaps and detergents, cigarette smoke, perfumed skin-care products, pet dander, pollen, mold, and certain foods.
• To treat your eczema, keep your skin well-moisturized. Stress can also cause eczema flares, so be sure to prioritize your mental health. Steroidal topical treatments can help when symptoms become severe. You can always discuss your options with a doctor or dermatologist.