What is Eczema?
Eczema (eg-zuh-MUH) is the name for a group of inflammatory skin conditions that cause itchiness, dry skin, rashes, scaly patches, blisters and skin infections. There are seven different types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis and stasis dermatitis. For lighter skin, eczema can present as red, inflamed skin. For darker skin tones, eczema can present as brown, purple, gray or ashen. Itchy skin is the most common symptom of eczema.
More than 31 million Americans have some form of eczema. Eczema can begin during childhood, adolescence, or adulthood — and it can range from mild to severe. Newborn babies can experience eczema within the first weeks and months after birth. Young children with eczema can experience patches of skin that are extremely dry; itchy skin that can lead to blisters and skin infections due to excessive scratching. Adults can also experience eczema and adult eczema is most commonly developed when someone is in their 20s or over the age of 50.
Many people with eczema use the phrase “flare-up” to describe a phase of eczema when they are experiencing one or more acute symptoms or side effects from prolonged itchiness. Moisturizers, antihistamines, topical steroid creams and corticosteroids are among the potential courses of eczema treatments usually recommended by healthcare providers, dermatologists and the American Academy of Dermatology (AAD).
Severe eczema may include periods of flare-ups that can last many days or even several weeks. Severe eczema comes with additional complications beyond itchy skin and rashes and can lead to hospitalization if left untreated. People with severe eczema are also at higher risk for food allergy and asthma, a triangulation of conditions that commonly co-occur known as the Atopic March.
Sometimes eczema is confused with other skin diseases, like psoriasis, so it’s important to get a diagnosis. A dermatologist or other qualified healthcare professional will also have expert knowledge on treatment options — and they’re often an invaluable partner in developing your symptom management plan and in stopping future flare-ups.
What is atopic dermatitis?
Atopic dermatitis, the most common type of eczema (sometimes referred to as “atopic eczema”), results from an overactive immune system that causes the skin barrier to become dry and itchy. Eczema is not contagious. You can’t “catch it” from someone else. While the exact cause of eczema is unknown, researchers do know that people develop eczema because of an interaction between genes and environmental triggers. Many people with eczema often report comorbid symptoms of hay fever, allergic asthma and food allergies. Proper, consistent skin care is essential in the prevention and management of eczema.
What are the causes of eczema?
There is no “main” cause of eczema. In fact, there are seven types of eczema and each has at least one cause, if not more. Some of the most common causes are a family history of eczema, being exposed to certain environmental triggers and stress.
Overactive immune system: Atopic dermatitis, the most common type of eczema, results from an overactive immune system that causes the skin barrier to become dry and itchy. This condition can occur on any part of the body and has varied symptoms.
Many factors can contribute to eczema, including an interaction between your environment and your genes. When an irritant or an allergen from outside or inside the body “switches on” the immune system, it produces inflammation, or a flare-up, on the surface of the skin. This inflammation causes the symptoms common to most types of eczema. Creases of the skin, especially the flexural areas behind the knees, elbows, lower legs and other areas of skin that rub against each other can lead to irritation.
Genetics: There is also a potential genetic component to eczema that includes a protein called “filaggrin” that helps maintain moisture in your skin; a filaggrin deficiency can lead to drier, itchier skin. If you have family members with atopic dermatitis and certain other types of eczema, you may be at an increased risk.
Environment: Along with having a family history of eczema, many common household items are also potential environmental irritants and can cause allergic reactions leading to an eczema flare.
Common triggers of eczema may include:
- Extended exposure to dry air, extreme heat or cold
- Some types of soap, shampoos that cause dander, bubble bath products, body wash, and facial cleansers
- Laundry detergents and fabric softeners with chemical additives
- Certain fabrics like wool or polyester in clothing and sheets
- Surface cleaners and disinfectants
- Natural liquids like the juice from fruit, vegetables and meats
- Fragrances in candles
- Metals, especially nickel, in jewelry or utensils
- Formaldehyde, which is found in household disinfectants, some vaccines, glues and adhesives
- Isothiazolinone, an antibacterial found in personal care products like baby wipes
- Cocamidopropyl betaine, which is used to thicken shampoos and lotions
- Paraphenylene-diamine, which is used in leather dyes and temporary tattoos
- Dust mites and living in dirty spaces
Stress: Emotional stress can also trigger an eczema flare-up, but it’s not exactly known why. Some people’s eczema symptoms and flare-ups get worse when they’re feeling “stressed.” Others may become stressed, just knowing they have eczema, and this can make their skin flare up.
Is eczema contagious?
Eczema is not contagious. You can’t “catch it” from someone else. While the exact cause of eczema is unknown, researchers do know that people develop eczema because of an interaction between genes and environmental triggers.
What are the symptoms of eczema?
The most important thing to remember is that eczema and its symptoms are different for everyone. Every individual’s skin care routine will also impact the affected areas of the skin differently. Your eczema may not look the same on you as it does on another adult or on your child. Different types of eczema may even appear in different affected areas of the body at different times.
Eczema almost always includes itchy skin. The scientific term for itch is “pruritus.” For many people, the itch can range from mild to moderate. Sometimes the itch gets so bad that people scratch it until it bleeds. This is called the “itch-scratch cycle.”
Symptoms of eczema often include:
- Dryness, sensitive skin
- Inflamed, discolored skin
- Rough, leathery or scaly skin, appearing as scaly patches
- Oozing or crusting
- Areas of swelling
You might have all of these symptoms of eczema or only just a few. You might have some flare-ups or your symptoms could go away entirely. Eczema can appear red in lighter skin, whereas people of color may experience eczema as ashen skin, grey skin, darker brown or purple in color. Black Americans are more likely to report severe symptoms associated with eczema. The best way to find out if you have eczema is to consult with a healthcare provider, such as a dermatologist who has experience diagnosing and treating eczema.
Some people mistake symptoms of psoriasis for eczema, although the two conditions are different. Many people with eczema also report similar symptoms to hay fever, allergic asthma and food allergies. Proper, consistent skin care is essential in the prevention and management of eczema.
How many types of eczema are there?
There are seven main types of eczema and it can sometimes be hard to tell the difference between symptoms of atopic dermatitis and other types. In fact, many of the symptoms, causes and treatment options overlap. Here’s what you can generally expect from the most common types.
- Atopic dermatitis: Atopic dermatitis, the most common type of eczema, affects more than 9.6 million children and about 16.5 million adults in the United States alone. The hallmark symptom is itching, but the itching can cause other symptoms such as rashes, pain, and poor sleep caused by itching. People with atopic dermatitis can also experience the breaking down of the skin barrier, which can weaken the immune system. This skin condition can appear anywhere on their body and oozing rashes can form as a result.
- Contact dermatitis: If the skin becomes inflamed or irritated after coming into contact with a substance, you might be experiencing contact dermatitis. This version displays typical eczema symptoms, but what sets it apart from the other types is that it happens as a reaction to an environmental trigger.
- Dyshidrotic eczema: Dyshidrotic eczema causes small blisters on the hands, feet and edges of the fingers and toes. This form of eczema is sometimes referred to as hand eczema or foot eczema, though other types can affect these areas too. The cause of this form is unknown, though it affects more men than women.
- Neurodermatitis: Experiencing an intense itching could be a sign of neurodermatitis, which affects 12% of the population. Affected areas are often visible because of the skin lines, scales, and discoloration that form from excessive itching. While it can appear anywhere, it is most common on the feet, ankles, hands, wrists, elbows, shoulders, neck and scalp.
- Nummular eczema: Scattered circular patches are often a sign of nummular eczema, also known as discoid eczema and nummular dermatitis. Often, these patches ooze or can be very dry and sensitive.
- Seborrheic dermatitis: Seborrheic dermatitis usually affects the scalp. Those with this condition often experience a constant itch, a rash around the scalp, and other symptoms. Shampoos for seborrheic dermatitis are often a good treatment option.
- Stasis dermatitis: Stasis dermatitis (also called gravitational dermatitis, venous eczema, and venous stasis dermatitis) occurs when there’s poor circulation in the legs. Symptoms are usually contained in the leg and can include itchy skin, redness in lighter skin tones that may appear brown, purple, gray or ashen in darker skin tones, and dry skin.
Is there a cure for eczema?
There is no known cure for eczema. But there are treatments, which can help you manage and/or minimize symptoms. To find the best treatment for you, talk with a dermatologist or qualified medical professional.
What is the best treatment for eczema?
The best treatment option for eczema depends on individual preference, severity of the condition, age of the person with eczema and the type of eczema. To find the best treatment for you or a loved one, consult with a dermatologist. Usually a dermatologist will create a treatment plan consisting of a skin care routine, natural treatments, over-the-counter products and/or prescribed medications. It’s important to note that it could take some time, as well as trial and error, to find the best treatment for you or your child.
What are common treatments for eczema?
Depending on your age and severity of your eczema, treatments may include:
- Medical grade moisturizing creams
- Prescription topical medications, including topical corticosteroids
- Over-the-counter (OTC) home remedies
- Phototherapy (also known as light therapy)
- Injectable biologics
Many people with eczema also find success with various natural and alternative treatments, including:
With natural and alternative treatments, you should consult a healthcare professional before starting any of them.
How do you manage eczema flares?
For most types of eczema, managing flares comes down to these basics:
- Know your triggers so that you can avoid exposure
- Implement a daily bathing and moisturizing routine
- Use over-the-counter creams and prescription medication consistently and as prescribed
How do I find a dermatologist who specializes in eczema?
You can look for eczema experts using the National Eczema Association’s Eczema Provider Finder.
How do I find eczema-friendly products?
One way to avoid household products that may trigger eczema is to look for products with the National Eczema Association Seal of AcceptanceTM. When you see the Seal, you can be sure the product is free from ingredients on the Ecz-clusion List and has undergone rigorous testing and scientific review.
How do I find support and resources for eczema?
If you or a loved one is diagnosed with eczema, it can be very overwhelming to try to figure out the cause or the best way to manage symptoms. While it’s normal to feel overwhelmed, it’s also important to know you’re not alone. The National Eczema Association and the wider eczema community can be a place to find support, solidarity and resources which might help with the physical or mental health impacts of this condition.