What is eczema?
Eczema, also called atopic dermatitis, is a common skin condition marked by itchy and inflamed patches of skin.
It’s often seen in babies and young children, appearing on the faces of infants. But eczema can come in a variety of types in children, teens, and adults. Read on to learn what causes the skin condition and how to treat its symptoms.
What are the types of eczema?
When people refer to eczema, they usually mean atopic dermatitis, which is characterized as dry, itchy skin that often appears with a red rash. This is the most common and chronic type of eczema.
Other types include:
Contact dermatitis is caused by contact with irritants. Burning, itching, and redness occur. The inflammation goes away when the irritant is removed.
Dyshidrotic dermatitis affects fingers, palms of the hands, and soles of the feet. It causes itchy, scaly patches of skin that flake or become red, cracked, and painful. The condition is more common in women.
Nummular dermatitis causes dry, round patches of skin in the winter months. It usually affects the legs. It’s more common in men.
Seborrheic dermatitis causes itchy, red, scaly rashes, particularly on the scalp, on the eyebrows, on the eyelids, on the sides of the nose, and behind the ears.
What are the symptoms of eczema?
The main symptom of eczema is itchy, dry, rough, flakey, inflamed, and irritated skin. It can flare up, subside, and then flare up again.
Eczema can occur anywhere but usually affects the arms, inner elbows, backs of the knees, or head (particularly the cheeks and the scalp). It’s not contagious, and, in some cases, becomes less severe with age.
Other symptoms include:
- intense itching
- red or brownish-gray patches
- small, raised bumps that ooze fluid when scratched
- crusty patches of dried yellowish ooze, which can signal infection
- thickened, scaly skin
Scratching eczema further irritates and inflames the skin. This can cause infections that must be treated with antibiotics.
What causes eczema?
The cause of eczema is not fully understood. But it’s believed to be triggered by an overactive immune system that responds aggressively when exposed to irritants.
Eczema is sometimes caused by an abnormal response to proteins that are part of the body. Normally, the immune system ignores proteins that are part of the human body and attacks only the proteins of invaders, such as bacteria or viruses.
In eczema, the immune system loses the ability to tell the difference between the two, which causes inflammation.
An eczema flare-up is when one or more eczema symptoms appear on the skin. Common triggers of eczema flare-ups include:
- chemicals found in cleaners and detergents that dry out the skin
- rough scratchy material, like wool
- synthetic fabrics
- raised body temperature
- temperature changes
- sudden drop in humidity
- food allergies
- animal dander
- upper respiratory infections
What are the risk factors of eczema?
Several factors can increase your risk of developing eczema.
Eczema is more common in children who suffer from asthma or hay fever, or adults who develop these conditions later, usually before the age of 30.
People with family members who have eczema are also at higher risk of developing the condition.
How is eczema diagnosed?
There’s no specific test that can be used to diagnose eczema. If your doctor has seen the condition before, they may be able to recognize it by looking at your symptoms.
A patch test can pinpoint certain allergens that trigger symptoms, like skin allergies associated with contact dermatitis (a type of eczema).
During a patch test, an allergen is applied to a patch that’s placed on the skin. If you’re allergic to that allergen, your skin will become inflamed and irritated.
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How is eczema treated?
A dermatologist, allergist, or primary care doctor can help you identify the correct treatment for eczema. You may also find it helpful to combine more than one treatment.
Some options include:
Oral over-the-counter (OTC) antihistamines may relieve itching. They work by blocking histamine, which triggers allergic reactions. Examples include:
- cetirizine (Zyrtec)
- diphenhydramine (Benadryl)
- fexofenadine (Allegra)
- loratadine (Claritin)
Several antihistamines can cause drowsiness, so it’s recommended they be taken when you don’t need to be alert.
Cortisone (steroid) creams and ointments can relieve itching and scaling. But they can have side effects after long-term use, which include:
- thinning of the skin
Low-potency steroids, like hydrocortisone, are available over the counter. If your body isn’t responding to low-potency steroids, high-potency steroids can be prescribed by a doctor.
In severe cases, a doctor may prescribe oral corticosteroids. These can cause serious side effects, including bone loss.
To treat an infection, a doctor may prescribe a topical or oral antibiotic.
Immunosuppressants are prescription medications that prevent the immune system from overreacting. This prevents flare-ups of eczema. Side effects include an increased risk of developing cancer, infection, high blood pressure, and kidney disease.
Light therapy, or phototherapy, uses ultraviolet light or sunlamps to help prevent immune system responses that trigger eczema. It requires a series of treatments, and can help reduce or clear up eczema. It can also prevent bacterial skin infections.
Stress can trigger or exacerbate symptoms. Ways to reduce stress include:
- doing deep breathing exercises
- practicing yoga
- listening to relaxing music
- prioritizing a good night’s sleep
A cold compress can help alleviate itching, as can soaking for 15 to 20 minutes in a warm or lukewarm bath.
Alternative treatments may help calm the symptoms of eczema. Because of potential side effects, always check with your doctor before using an herbal supplement or beginning an exercise routine. Popular home remedies include:
- green, black, or oolong tea
- coconut, sunflower, borage, and primrose oils
- relaxation techniques, like meditation, yoga, progressive muscle relaxation, or guided imagery
How is eczema prevented?
Lifestyle changes such as stress reduction and improved sleep can reduce the likelihood of an eczema flare-up. Avoid irritants, like rough fabrics, harsh soaps, and detergents. Cold weather can also dry out the skin and trigger flare-ups.
People with atopic dermatitis should avoid scratching. To prevent breaking the skin, it can help to rub rather than scratch the areas that are itchy.
Because dry skin can trigger an eczema flare-up, a dermatologist can recommend an ointment- or cream-based moisturizer that will help soothe your skin.
What is the outlook for eczema?
There’s no cure for eczema, but symptoms can be effectively managed with the right treatments. These may include a combination of lifestyle changes and medications. In some cases, eczema can cause additional health complications.
Skin infections, like impetigo are brought on by constant itching. When scratching breaks the skin, bacteria and viruses can enter.
Neurodermatitis is also caused by frequent itching. It leaves skin thickened, red, raw, and darker in color. This is not a dangerous condition but may result in permanent discoloration and thickening of skin even when eczema is not active. Scratching can also cause scarring.
Many people with eczema report feeling embarrassed and self-conscious about their skin. Receiving proper treatment and getting stress under control can help calm symptoms. Support groups can also help people cope.
Vigorous exercise can be difficult for people with eczema because sweating can bring on a bout of itching. Dress in layers so you can cool down while exercising. You may also want to avoid intense physical activity during an eczema flare-up.