What Is Eczema?
Eczema is a common skin condition marked itchy and inflamed patches of
skin. It is also known as atopic dermatitis. It is more common in babies and
young children. It occurs on the faces of infants, as well as inside the elbows
and behind the knees of children, teenagers, and adults. It is caused by an
overactive immune system. Up to 20 percent of children and one to three percent
of adults develop atopic dermatitis, according to the American Academy of
Dermatology. In rare cases, atopic dermatitis can first appear during puberty
or adulthood. It affects males and females equally.
What Are the Types of Eczema?
When people refer to eczema, they usually mean atopic dermatitis, which
is the common and chronic type of eczema. Other types include:
- Contact dermatitis is caused by contact with
irritants. Burning, itching, and redness occur. When the irritant is removed,
the inflammation goes away.
- Dyshidrotic dermatitis affects fingers, palms of
the hand, and soles of the feet. It causes itchy, scaly patches of skin that
flake constantly 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 leg. It is more common in
- 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 Causes Eczema?
An eczema flare-up is when one or more eczema symptoms appear on the
skin. The cause of eczema is not fully understood.
It is thought to be triggered by an overactive immune system that
responds aggressively to the presence of irritants.
Eczema is sometimes caused in part 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 distinguish
between the two, which causes inflammation.
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
- a sudden drop in humidity
Other triggers include stress, food allergies, animal dander, and upper
What Are the Symptoms of Eczema?
Eczema is characterized by itchy, dry, rough, flakey, inflamed, and
irritated skin. It can flare up, subside, and then flare up again. It can occur
anywhere but usually affects the arm, inner elbow, back of the knee, or head
(particularly the cheeks and the scalp). It is not contagious and becomes less
severe with age.
Red or brownish-gray patches are common symptoms. Small, raised bumps
that ooze fluid when scratched are another symptom. Scratching causes them to
become crusty, which can signal infection. Thickened, scaly skin is another
Eczema can cause intense itching. Scratching further irritates and
inflames the skin. This can cause infections that must be treated with
What Are the Risk Factors of Eczema?
Several factors can increase the risk of developing eczema.
Eczema is more common in children who suffer from asthma and/or hay fever
or 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 disease.
How Is Eczema Diagnosed?
To diagnose eczema, a physician will order a complete physical exam and
ask questions about symptoms.
While no specific test can diagnose eczema, a patch test can pinpoint
certain allergens that trigger symptoms, such as skin allergies associated with
contact dermatitis (a type of eczema). During a patch test, an allergen is
applied to a patch that is placed on the skin. If you are allergic to that
allergen, your skin will become inflamed and irritated.
How Is Eczema Treated?
A dermatologist, allergist, or primary care physician can help you
identify the correct treatment for eczema.
Oral over-the-counter antihistamines may relieve itching. They work by
blocking histamine, which triggers allergic reactions. Examples include:
- cetirizine (Zyrtec)
- diphenhydramine (Benadryl)
- fexofendaine (Allegra)
- loratidine (Claritin)
Several antihistamines can cause drowsiness and should be taken at
Cortisone (steroid) creams and ointments relieve itching and scaling.
They should not be used long-term because of side effects including thinning of
the skin, irritation, and discoloration.
Low-potency steroids like hydrocortisone are available over the counter.
High-potency steroids may help patients who don’t respond to low-potency
steroids. In severe cases, a doctor may prescribe oral corticosteroids. These
can cause serious side effects including bone loss.
If there is an infection, a doctor may prescribe a topical or oral
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, high blood pressure, and kidney
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, as well as prevent
bacterial skin infections.
Stress can trigger or exacerbate symptoms. Ways to reduce stress
include deep breathing exercises, yoga, meditation, and listening to relaxing
music. Prioritizing a good night’s sleep can help lower stress.
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 primary care physician before
using an herbal supplement or beginning an exercise routine. Popular home
- green, black, or oolong tea
- borage oil
- primrose oil
- relaxation techniques such as meditation, yoga,
progressive muscle relaxation, or guided imagery
How Is Eczema Prevented?
Lifestyle changes like 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
People with atopic dermatitis should avoid scratching. To prevent
breaking the skin, it can help to rub rather than scratch the areas that are
Because dry skin can trigger an eczema flare up, a dermatologist can
recommend an ointment- or cream-based moisturizer that will help soothe your
What Is the Outlook for Eczema?
There is no cure for eczema. In some cases, eczema can cause additional
Skin infections like impetigo are brought on by constant itching. When
scratching breaks the skin, bacteria and viruses can enter. Signs of this
include redness, pus-filled bumps, cold sores, or fever blisters. If these
symptoms appear, immediately contact a physician.
Neurodermatitis is also caused 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 the skin condition. Support groups also help sufferers 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 want to avoid intense physical activity during an