Health

What Is Eczema? Symptoms, Causes, Diagnosis, Treatment, Prevention


Eczema is not a specific disease, but rather a term that describes a group of inflammatory skin conditions that produce rash-like symptoms, such as irritated, itchy patches on the skin. It’s also known as dermatitis (skin inflammation), atopic eczema (“atopic” means a genetic tendency toward allergic hypersensitivity), or simply atopic dermatitis. What’s the Difference Between Eczema and Atopic Dermatitis? The word “eczema” is often used interchangeably with “atopic dermatitis,” though clinically speaking, atopic dermatitis is the most common type of eczema. Atopic dermatitis is the most severe and chronic (long-lasting) form of eczema. It’s characterized by inflamed skin that may crack and release a clear fluid when scratched (an effect known as weeping). People with atopic dermatitis often experience flares, during which symptoms worsen, and remissions, when symptoms improve or clear up, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.e60dc2a1-f33c-4a05-9b50-8e3e8e59762972505bcf-faa8-43c8-962e-1e939ba15874
FAQ
Pictures of Different Types of Eczema There are several other types of eczema besides atopic dermatitis, according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292d65cf79-ec3d-4def-865f-b17ee93bf302 These include: 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
If you have dry, thick, scaly patches on the hands that may crack and bleed (like contact eczema), you may have hand eczema. Various irritants and allergens may be responsible for a hand eczema flare.e60dc2a1-f33c-4a05-9b50-8e3e8e5976292389b838-eeb9-4585-bf93-6f485a5ee54d 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
Compared to other types of eczema, nummular eczema appears differently: 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
Seborrheic dermatitis happens when white or yellow scaly patches of skin develop in oily areas, such as the scalp (as dandruff), face, and ears, partly as a result of microorganisms that live on the skin (such as some types of yeast). Learn More About Types of Eczema
Signs and Symptoms of Eczema Symptoms People with eczema have very dry, itchy skin and rashes on various parts of the body — particularly the face, hands, feet, insides of the elbows, and behind the knees. In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth. 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. 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 Eczema is not contagious — it cannot spread directly between people, notes the National Eczema Association (NEA).e60dc2a1-f33c-4a05-9b50-8e3e8e5976296d6292e5-eb21-4edf-b301-ea1dd13c26d4 Learn More About Signs and Symptoms of Eczema
Causes and Risk Factors of Eczema Causes Skin affected by eczema is unable to retain moisture well, possibly because of low production of fats and oils. It is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes it to become dry and lose its protective properties. It’s not clear what causes certain people to develop eczema, specifically atopic dermatitis. 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. Read more about conditions related to eczema below. 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. According to the NEA, with eczema, your immune system causes inflammation.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b86d40de-abbf-4af1-a6f0-359e8d628bae Usually, this a natural process that protects against infection and foreign bodies, but with eczema, this happens even in the absence of harmful substances, notes an article published in November-December 2019 in the Indian Journal of Dermatology .e60dc2a1-f33c-4a05-9b50-8e3e8e59762903fb6e15-073b-41e4-805d-42111c976d85 In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema. Eczema triggers may include a wide range of irritants, allergens , and other substances, such as:e60dc2a1-f33c-4a05-9b50-8e3e8e597629b86d40de-abbf-4af1-a6f0-359e8d628bae 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. Learn More About Eczema Causes and Risk Factors
How Is Eczema Diagnosed? Diagnosis 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 illness. They may perform a skin biopsy (remove a skin sample for examination) to confirm the diagnosis and rule out other skin conditions . To better understand your symptoms and their potential causes, your doctor will also ask you questions about your personal and family medical history, especially as it pertains to allergic conditions and skin-related issues, according to the Cleveland Clinic.e60dc2a1-f33c-4a05-9b50-8e3e8e597629b6075d87-29b9-470d-83b0-929a5477db36 e60dc2a1-f33c-4a05-9b50-8e3e8e5976291549a0f2-28e3-458e-b82b-fa76c3f20162 Your doctor may also give you a blood test to look for signs of a recent immune reaction, as well as allergy tests to determine possible allergic triggers for your skin flare-ups, notes National Jewish Health.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297920157e-3209-4358-a1a2-58c2ef211fd9 Prognosis of Eczema According to the American Academy of Dermatology, people who develop atopic dermatitis as an infant or young child get better over time.e60dc2a1-f33c-4a05-9b50-8e3e8e597629405009ab-7f70-4f52-b0d6-836e6ad28728 For some, the condition disappears on its own by age 2. But about one-half of adults with atopic dermatitis had it as a child.
Duration of Eczema Duration Atopic dermatitis in adults often lasts a long time and there is no way to determine if it will go away or last a lifetime. But the frequency and severity of symptoms usually decrease over time, and you can control atopic dermatitis through treatment, moisturizing , and by avoiding irritants that cause flare-ups. Atopic dermatitis may be harder to control if you have a family history of eczema or if it began at an early age, covers a large portion of your body, or occurs along with allergies and asthma, according to an article published in the World Allergy Organization Journal .e60dc2a1-f33c-4a05-9b50-8e3e8e597629155ca55b-5ec5-4eed-985a-278fea7889d1
Treatment and Medication Options for Eczema Treatment There is no cure for eczema, and 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 Topical treatments include:e60dc2a1-f33c-4a05-9b50-8e3e8e5976293ff3cbfb-2216-49c8-b2b2-b7ef85fb7b56 Corticosteroids (ointments, creams, or lotions) that include drugs such as 0.1 percent fluocinonide cream (Vanos), and come in varying degrees of strength Calcineurin inhibitors (TCIs), like tacrolimus (Protopic) and pimecrolimus (Elidel) The PDE4 inhibitor crisaborole (Eucrisa) The JAK inhibitor ruxolitinib (Opzelura)e60dc2a1-f33c-4a05-9b50-8e3e8e597629628bd3b4-807d-41e1-97ad-ccbc9dd86a97 For moderate and severe disease, treatments include: Phototherapye60dc2a1-f33c-4a05-9b50-8e3e8e597629f4aaf1d9-4abc-4400-b2aa-cfec2c8000a0 Biologics, including the self-administered injectable drugs dupilumab (Dupixent) and tralokinumab-ldrm (Adbry)e60dc2a1-f33c-4a05-9b50-8e3e8e597629da061b61-39c0-493b-a73d-09d11e281106 Oral immunosuppressants, like cyclosporine (Neoral, Sandimmune, or Restasis) , methotrexate (Trexall or Rasuvo) , or mycophenolate (CellCept) The oral JAK inhibitors upadacitinib (Rinvoq) e60dc2a1-f33c-4a05-9b50-8e3e8e5976296dcbb024-6c42-4e00-9b7e-235afa313931 and abrocitinib (Cibinqo)e60dc2a1-f33c-4a05-9b50-8e3e8e59762925d483ed-172a-49d1-a466-62e8550af0aa Wet wrap therapy , which combines topical medicines and moisturizers with a wet gauze wrap.e60dc2a1-f33c-4a05-9b50-8e3e8e5976296aab6194-b09e-4398-8d54-d3a8af0df5c0 Other treatments for itching include antihistamines, such as diphenhydramine (Benadryl) , hydroxyzine, or doxylamine succinate (Unisom) , which may help prevent nighttime scratching. RELATED: The Consumer’s Guide to Biologics for Atopic Dermatitis Skin infection treatment may include topical antibiotics or oral antibiotic, antiviral, or antifungal drugse60dc2a1-f33c-4a05-9b50-8e3e8e5976299f163c1a-7dd5-462b-8ce2-24de9efceceb Diet Options Changing your diet isn’t a surefire way to control eczema symptoms, but it may help. Food allergies and eczema can produce similar skin symptoms, so if there are certain foods that trigger this reaction — maybe it’s eggs for you and peanuts for another person — you’ll want to avoid them, notes the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629659d7fc1-6c56-467d-8120-39fb5970c7e5 If you aren’t sure which foods may be triggering your symptoms, you may explore using an elimination diet . With this approach, you’ll eliminate potentially problematic foods before adding them back in, noticing how your skin reacts along the way, says InformedHealth.org.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d7326bc1-db53-4f98-bdda-fa98ad7602b4 Elimination diets are also used to diagnose autoimmune conditions such as eosinophilic esophagitis (EoE) , a chronic disease of the esophagus, according to the American College of Gastroenterology . Alternative and Complementary Therapies Some people have also used complementary or alternative remedies to treat their eczema . These include, for example, baths that contain oatmeal , baking soda, or unscented oils;e60dc2a1-f33c-4a05-9b50-8e3e8e59762902e735e2-2591-41c9-a7a7-99cf57cf0997 massages with essential oils ; and stress management techniques, such as yoga and meditation, according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629d1201a78-d5f3-4ab7-af01-4e6af0c87dbe Learn More About Treatment for Eczema: Medication, Alternative and Complementary Therapies, Diet Changes, and More Prevention of Eczema There is no proven way to prevent getting eczema. Nonetheless, research suggests children who are breastfed until they’re 4 months old may be less likely to get it. Alternatively, partially hydrolyzed formula, which contains processed cow milk protein, may also reduce a child’s chance of developing atopic dermatitis. If you have eczema, you can take the following steps to prevent flare-ups, per the Cleveland Clinic:e60dc2a1-f33c-4a05-9b50-8e3e8e597629319d3a48-6a11-498d-9c9a-9148edea8925 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. That means while working outside or if you have to put your hands underwater (to absorb sweat, wear cotton gloves under plastic gloves). Bathe smart , such as by using only 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 avoiding getting hot and sweaty. Wear loose clothes — that is, those 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 itch affected skin areas.
Complications of Eczema Complications 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. Up to 90 percent of people with eczema have staph bacteria on their skin, and many develop active infections that further worsen their condition, according to the NIAID.e60dc2a1-f33c-4a05-9b50-8e3e8e597629165ecfbb-fd82-43c9-9fb1-d17ef5228a5b Additionally, the herpes simplex virus (a common cause of cold sores) may infect people with eczema. The virus can cause an infection called eczema herpeticum, which may spread throughout the body, and it can be fatal if it travels to the brain, lungs, or liver , notes the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629a002fbca-9e05-482a-a1b9-d2f1f92173cb People with atopic dermatitis may also get a severe and potentially fatal infection called eczema vaccinatum if they receive the live-virus smallpox vaccine.e60dc2a1-f33c-4a05-9b50-8e3e8e5976298b1bb05b-1e28-49ce-9186-2577f0b9b611 Other complications of atopic dermatitis include sleep deprivation , poor performance at work or school, depression and anxiety, and increased suicide risk, according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e5976294b230d0e-05ee-4bd9-bd46-5fae71bb3305 Learn More About Eczema Complications
Research and Statistics: Who Has Eczema? How Many People Have Eczema? Research and Statistics Eczema can occur at any age, but it typically begins in infancy and early childhood. Estimates suggest that about 9.6 million children in the United States — about 13 percent — have atopic dermatitis, according to a study published in June 2019 in the Journal of the American Academy of Dermatology .e60dc2a1-f33c-4a05-9b50-8e3e8e59762985dee497-6092-42ee-9dd7-fc7a6bfacacd National survey data suggest the one-year prevalence of atopic dermatitis among American adults was 10.2 percent in 2010 and 7.2 percent in 2012. But the surveys used different questions: The former referred to “dermatitis, eczema, or any other red, inflamed skin rash” and the latter to “eczema or skin allergy.” Whatever the case, about 25 percent of adults with atopic dermatitis first experienced symptoms during adulthood.e60dc2a1-f33c-4a05-9b50-8e3e8e59762985dee497-6092-42ee-9dd7-fc7a6bfacacd
Related Conditions Related Conditions As mentioned, eczema may be associated with asthma, hay fever, and food allergies, the latter of which is more common in childrene60dc2a1-f33c-4a05-9b50-8e3e8e597629f26c68ee-e13b-4662-bbb1-8b8455fb38cc, according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629fed7008c-da6d-4226-b258-5d52d0847b1e Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. They include: Staph infections (and furuncles or boils) Eczema herpeticum Cellulitis Impetigo Also associated with eczema, particularly atopic dermatitis, are depression and anxiety. The asthma medication Singulair (montelukast) , which people with eczema may take, could increase the risk for these mental health disorders.e60dc2a1-f33c-4a05-9b50-8e3e8e59762964301eb8-2bad-4297-9f4b-1454874ed924
BIPOC and Eczema BIPOC Atopic dermatitis can affect people of all races and ethnicities. The following represents the impact of the disease on different populations in the United States, according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629e6727377-5201-4fcb-a217-f1833675649b White: 11 percent African American or Black: 10 percent Asian or Pacific Islander: 13 percent Native American: 13 percent Black children are much more likely to experience atopic dermatitis than other kids. According to a review of racial differences in atopic dermatitis published in Annals of Allergy, Asthma, and Immunology in 2018, 19.3 percent of Black children in the United States have atopic dermatitis, compared with 16.1 percent of white children.e60dc2a1-f33c-4a05-9b50-8e3e8e5976297c808397-9bf1-4f91-8028-c8f19b5936fc The authors of the review also noted that African American children are 1.7 times more likely to develop atopic dermatitis compared with European American children, even when adjusting for household income, parental education level, metropolitan versus rural environment, and health insurance coverage status. Another finding detailed in the review: African American children are 3 times more likely to be diagnosed with atopic dermatitis during a dermatologist visit than European American children, even though they are significantly less likely to seek dermatological care, while Asian American kids are 7 times more likely compared with white kids. Eczema doesn’t necessarily look red on people with skin of color; instead, it may appear darker brown, purple, or ashen grey, according to the Skin of Color Society.e60dc2a1-f33c-4a05-9b50-8e3e8e59762987f98a4d-90d8-4be5-84b1-784d544722f5 This difference in the appearance of eczema can lead doctors who aren’t trained to recognize the condition on skin of color to overlook it and not offer needed treatments. African 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), according to the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629895ba8c2-c9af-4aab-a28d-9dd652c5472a The itching due to eczema has been shown to have a greater impact on Black patients, who also tend to have more severe disease, per the NEA. 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, according to the Skin of Color Society. Changes in skin color can be improved with appropriate treatment for the underlying eczema and inflammation. Prescription creams and certain cosmetic procedures performed in a doctor’s office can help lighten darkened areas, although preventing discoloration in the first place by carefully managing eczema and inflammation is the best approach, says the NEA.e60dc2a1-f33c-4a05-9b50-8e3e8e597629549dda83-014b-44df-b27f-3b432992e522
Eczema Resources We Love Resources Favorite Orgs for Essential Info About Eczema (Atopic Dermatitis) National Eczema Association (NEA) The NEA is the most prominent U.S. organization devoted solely to education, research, patient support, and advocacy related to atopic dermatitis and other forms of eczema. We love their eczema fact sheets, glossary of skin-care terms, and informative webinars. Plus, they have a yearly family-friendly Eczema Expo each summer at a vacation destination. National Eczema Society (NES) This society is one of the most visible resources in the United Kingdom to educate people about eczema, provide help for people with the disease, and support research. Perhaps their most unique resource is a confidential telephone and email hotline that people in the United Kingdom can call Monday through Friday, 8 a.m. to 8 p.m. local time. e60dc2a1-f33c-4a05-9b50-8e3e8e597629dc23ab7e-662d-4dc9-b5a0-d9f0cb9c93b1 Favorite Orgs for Essential Info About Skin and Allergic Diseases, Including Eczema American Academy of Dermatology (AAD) The AAD says it is the largest professional dermatologic association, with more than 20,500 physicians as members worldwide. They publish information about a variety of skin conditions, and we recommend checking out the robust resource center with information about childhood and adult eczema.
Asthma and Allergy Foundation of America (AAFA) Because allergens can trigger eczema flareups, it makes sense to stay on top of information about managing allergies. The AAFA’s site has a wealth of information about allergies, for both adults and kids. Favorite Annual Meetings for Eczema Patients Eczema Expo The NEA’s annual expo provides a vacation retreat for people and families affected by eczema. The four-day event includes activities; educational seminars; camps for infants, children, and teens; and hotel accommodations that are as free of potential allergens as possible. The next Eczema Expo is June 25 through 28, 2020, in Orlando, Florida. The organization offers a limited amount of needs-based scholarships to help people attend. Favorite Alternative Medicine Resource National Eczema Association — Complementary and Alternative Treatments This NEA page offers information about how acupuncture, Ayurvedic medicine, natural oils, and other alternative treatments can help to ease eczema symptoms. e60dc2a1-f33c-4a05-9b50-8e3e8e5976294362708b-bd30-4c0d-acd2-d1c29e1d1f89 Favorite Online Support Networks AAFA Community Filling out a lengthy form 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 this NEA-hosted forum for sharing support and advice about living with eczema. After registering for free, members post questions or comments in freewheeling discussions and receive written replies, or reactions via “Support,” “Thanks,” and “Useful” buttons.
Favorite Sites for Eczema Relief Products AAFA Store Find household products that are certified “Asthma & Allergy Friendly,” and therefore less likely to trigger eczema flare-ups, through the Asthma and Allergy Foundation of America’s online store. NEA Store The National Eczema Association has an online store of sensitive skin–friendly products that bear the NEA Seal of Acceptance, meaning they are intended for people with moderate to severe skin conditions. Get moisturizers, cleansers, detergents, and other items designed to protect and not irritate your skin. Favorite Resource for Diet Advice Elimination Diets — NEA on Eczema and Food Allergies Avoiding food allergy triggers may help you manage eczema, but sometimes you need help identifying precisely what the triggers are. This is where an elimination diet may help. This approach involves omitting a food you think is problematic and then reintroducing it to see what happens. We love this article with information from the dermatologist Peter Lio, MD, which delves into some of the misconceptions about the diet, as well as the link between eczema and what you eat. Favorite Resource for Becoming an Advocate NEA Advocacy Action Center We love that the NEA has made it so easy to advocate for better healthcare policies. Their Advocacy Action Center enables people to browse legislation related to eczema in various states. If you wish to “take action,” you can click on a button and fill out an online form to send a message to your local lawmaker.
Favorite Eczema Tracking App Eczema Tracker Information is power when it comes to managing eczema symptoms and flare-ups. Eczema Tracker allows you to take a photo of flare-ups and monitor your condition, as well as track and analyze a wealth of information concerning your triggers, allergies, and skin. The app even provides local pollen, weather, mold, and humidity information to help you manage your symptoms. It uses your data to find trends that may lead to flare-ups. Eczema Tracker is available only for iOS in the Apple Store. It is a free app. e60dc2a1-f33c-4a05-9b50-8e3e8e597629d149586f-2677-4143-9477-bae5fd5f877a Favorite Eczema Spa Retreat Eczema Expo Spa Treatments Participants in the 2019 NEA Eczema Expo were able to enjoy spa treatments at a local day spa in consultation with a dermatologist who could help them to choose the best treatments for their skin condition. We hope they will do this again in 2020!

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