Skin Care, Skin Care Problems

Eczema: Symptoms, Causes, Types & Treatment

Eczema: What It Is, Symptoms, Causes, Types & Treatment


What is eczema?

Eczema is a condition that causes the skin to become itchy, red, dry and cracked. It is also known as atopic dermatitis. Eczema is not contagious and is not caused by an infection.

Eczema is a chronic condition that causes inflammation of the skin. The inflammation leads to itchy, flaky and painful rashes on the skin. While the exact cause of eczema is unknown, it is believed to be related to overactivity of the immune system and genetics. People with eczema have sensitive skin that is easily irritated by various triggers.

Eczema is not contagious. It cannot spread from person to person through touch or other types of contact. The rashes and dry skin associated with eczema are caused by internal factors like genetics and immune system responses, not by infectious agents.

What are the types of eczema?

There are several types of eczema. Each type has unique triggers that can affect your skin’s barrier function, including:

It’s possible to have more than one type of eczema at the same time.

Symptoms of Eczema

Eczema is characterized by symptoms affecting the skin. The most common symptoms include:

  • Itchy skin – Eczema often causes very itchy skin that people feel compelled to scratch. The itchiness can be severe and make it difficult to sleep or focus.

  • Red, inflamed skin – Areas affected by eczema become red and inflamed. This is the body’s inflammatory response to the irritated skin.

  • Rash – Eczema rashes can weep, ooze fluid, and crust over when scratched. The rash can be dry and scaly or weep and appear wet.

  • Thickened, leathery skin – Chronic eczema causes thickening and hardening of the skin, giving it a leathery texture. This is called lichenification.

  • Cracked, scaly skin – The rash may appear dry with rough, scaly patches that flake or crack easily.

  • Raw, sensitive skin – Constant scratching can cause the skin to become raw and extremely sensitive. The skin barrier is damaged.

  • Swelling – Some eczema rashes involve swelling of the skin. The face, hands, and feet are common sites for swollen eczema rashes.

  • Skin discoloration – Eczema rashes can cause changes in skin color, including lightening or darkening of the affected area.

  • Small, raised bumps – Some eczema rashes involve small bumps resembling acne. This is called papular eczema.

The symptoms vary depending on the type of eczema, but itchy, inflamed, cracked, and irritated skin are hallmarks of the condition.

Who does eczema affect?

Eczema can affect anyone at any age. Symptoms usually appear during childhood and last into adulthood. You might be more at risk of having eczema if you have a family history or a diagnosis of:

Causes & Risk Factors for Eczema

Eczema is often caused by a combination of factors that lead to an overactive immune system response and inflammation of the skin. Some of the key causes and risk factors include:

Hypersensitive Immune System/Allergies

People with eczema tend to have oversensitive immune systems that overreact to triggers. This leads to increased inflammation and itchiness. Having allergies or asthma can increase the risk of developing eczema.


Eczema often runs in families. Specific genes have been identified that affect the skin’s barrier function. If one or both parents have eczema, a child has a higher risk of developing it.

Environmental Triggers

Irritants like soaps, detergents, perfumes, dust mites, pet dander and pollen can trigger eczema flare-ups. Bacterial or viral infections on the skin can also cause flare-ups in some people.

Stress and Hormones

Stress doesn’t directly cause eczema, but it can worsen symptoms. Stress leads to increased cortisol and inflammation, which can trigger flares. Hormonal changes like puberty or menopause can also influence eczema severity.

Types of Eczema

There are several different types of eczema, with the most common being atopic dermatitis.

Atopic Dermatitis

Atopic dermatitis is the most common form of eczema and accounts for over half of all cases. It often occurs in people with a personal or family history of allergies or asthma. Atopic dermatitis causes red, itchy, cracked, and scaly skin that can appear on any part of the body, but most often affects the folds of the arms, backs of the knees, wrists, ankles, and face.

Contact Dermatitis

Contact dermatitis occurs as a result of the skin coming into contact with an irritant or allergen. Contact dermatitis can be further divided into irritant contact dermatitis and allergic contact dermatitis. Irritant contact dermatitis occurs when the skin is exposed to things like chemicals, soaps, detergents, and other irritants. Allergic contact dermatitis is caused by an allergic reaction to something touching the skin, such as jewelry, cosmetics, poison ivy, or latex.

Dyshidrotic Eczema

Dyshidrotic eczema causes small, itchy blisters to form on the palms of the hands, edges of the fingers, and soles of the feet. It is characterized by intense itching and a burning sensation. The small blisters may ooze or crust over as they heal. The exact cause is unknown, but it tends to affect adolescents and adults more frequently than children.

Nummular Eczema

Nummular eczema presents as coin-shaped spots and patches that are red, itchy, and scaly. The lesions can appear anywhere on the body but commonly occur on the arms, legs, torso, and buttocks. This type of eczema is more common in middle-aged and elderly adults. The exact cause is unknown but dry skin and cold weather can trigger flares.

Seborrheic Dermatitis

Seborrheic dermatitis causes red, scaly, itchy skin and dandruff. It most often occurs on the scalp, face (including eyebrows), ears, chest, and back. This type of eczema is thought to be related to a yeast called malassezia that normally lives on the skin’s surface. The yeast grows rapidly in the sebum-rich areas listed above, causing inflammation and itching.

Eczema: What It Is, Symptoms, Causes, Types & Treatment

What triggers eczema to flare up?

Eczema affects each person diagnosed with the condition differently. What causes your symptoms to flare up might not trigger someone else with the condition. Common triggers that cause eczema include:

  • Dry weather (low humidity).
  • Fabrics or clothing material.
  • Makeup or skin care products.
  • Smoke and pollutants.
  • Soaps and detergents.
  • Stress or your emotional well-being.
  • Touching something you’re allergic to.

Do certain foods trigger eczema?

The connection between eczema and food allergies is unclear. If you have food allergies, then one of the reasons why you must avoid that food is that it may cause or worsen your eczema symptoms. Examples of common allergies include:

  • Peanuts.
  • Dairy.
  • Eggs.

Pay attention to what you eat. If your eczema flares up after you eat a certain food, then you might have an allergy to it. If you don’t have a food allergy, then there are no foods that will cause or worsen your eczema.

Is eczema an autoimmune disease?

While eczema can cause your immune system to overreact, it isn’t classified as an autoimmune condition. Research is ongoing to learn more about how eczema interacts with your immune system.

Diagnosing Eczema

Eczema can often be diagnosed through a simple physical exam by a doctor. The doctor will examine the rash and affected areas of skin for the characteristic signs of eczema, such as redness, dryness, crusting, oozing, and itchiness.

The doctor will also ask about the person’s symptoms and medical history. Understanding the pattern and timing of symptoms can help rule out other potential causes and point to eczema. Questions may include when the rash started, if it’s periodic or chronic, what seems to improve or worsen it, if it’s itchy, and if any family members have eczema or related conditions.

In some cases, allergy testing may be recommended. This is known as a skin prick test, in which small amounts of suspected allergens are pricked into the skin to observe any reaction. Common triggers like pollen, pet dander, dust mites, and molds can be tested. A positive reaction indicates an allergy that could be contributing to eczema flares.

A skin biopsy is rarely needed for diagnosis, unless the appearance is unusual or the doctor wants to rule out other disorders. A small sample of skin is taken and analyzed under a microscope. In eczema, characteristic immune system changes can be observed.

Getting an accurate diagnosis from a dermatologist can ensure the right treatments are pursued for effective eczema management. While eczema has no definitive cure, the symptoms can often be minimized with diligent skin care and avoidance of triggers.

Eczema Treatments

There are several treatment options available for managing eczema symptoms and flare-ups. The main goals of treatment are to heal the skin, prevent infection, reduce inflammation and itchiness, and prevent flare-ups. Common treatments include:

Emollients and Moisturizers

Emollients or moisturizers help hydrate and soothe the skin. They are a core part of eczema treatment and should be applied liberally and frequently, even when there are no signs of active eczema. Ointments, creams, lotions, bath oils, or soap substitutes that contain ingredients like ceramides, glycerin, and petrolatum are recommended.

Topical Corticosteroids

Topical corticosteroids help reduce inflammation and itch. They come in different strengths and are prescribed for short-term use to treat flare-ups. Lower strength corticosteroids are used on the face and sensitive skin areas. Prolonged use, especially of higher strength steroids, can cause side effects like skin thinning.

Oral Medications

For moderate to severe eczema, oral medications may be prescribed. These include immunosuppressants like cyclosporine which dampen the immune system reactions. Oral steroids may be used short-term for severe flares. Antihistamines help with itchiness and allergies. Antibiotics treat secondary infections.


Phototherapy uses ultraviolet light under medical supervision to treat eczema. Options like narrow band UVB therapy help reduce inflammation and itch. For severe, widespread eczema, photochemotherapy (PUVA) combines UV light treatment with an oral psoralen medication.

Biologic Therapy

Biologics are injectable medications that target specific parts of the immune system reaction underlying eczema. They are used for moderate to severe eczema unresponsive to other treatments. Dupixent is an FDA-approved biologic for eczema.

Lifestyle Changes

Certain lifestyle measures can help minimize eczema flare-ups. These include using mild cleansers, wearing soft fabrics like cotton, avoiding triggers like harsh detergents, managing stress, and keeping skin moisturized. Wet wrap therapy, which involves applying topical medications then wrapping the skin with wet bandages, helps treat severe flare-ups.

Eczema in Babies & Children

Eczema often first appears in babies and young children under the age of 5. About 10-20% of infants and children are estimated to develop symptoms of eczema. The condition usually starts with red, itchy rashes on the cheeks, chin, arms, legs or trunk.

Since babies and children have very sensitive skin, it’s important to be gentle. Use fragrance-free moisturizers and cleansers when bathing. Avoid frequent bathing, which can dry out the skin. Wear soft, breathable fabrics like cotton next to the skin. Identify and avoid triggers like laundry detergent, dust mites, pollen and pet dander.

To help prevent infection, keep children’s nails short and smooth to minimize skin damage from scratching. Use creams, gels or ointments to moisturize and soothe itchy skin. Try applying cool compresses to irritated areas for relief. If topical steroids are prescribed, use the lowest strength for the shortest time.

With gentle care and avoidance of triggers, many children can manage their eczema symptoms and prevent flare-ups. The condition often improves with age. Staying on top of skin care and moisturizing daily helps control eczema in babies and children.

Eczema in Adults

Eczema can develop at any age, even into adulthood. For some adults, eczema symptoms may flare up for the first time later in life. Others may have had childhood eczema that went away, only to reappear in adulthood.

There are a few factors that can contribute to adult-onset eczema:

  • Hormonal changes – Hormones like estrogen can trigger eczema flares. This is why some women first develop eczema during pregnancy or menopause.

  • Stress – High stress levels may worsen eczema in adults. Finding healthy ways to manage stress through exercise, meditation, therapy, or other methods can help prevent flares.

  • Environment – Irritants in the home or workplace environment can cause contact dermatitis leading to eczema. Identifying and minimizing exposure to these irritants is key.

  • Medications – Certain medications like NSAIDs, antibiotics, or blood pressure medications may trigger eczema as a side effect in some adults.

  • Aging skin – As skin ages, it loses moisture and natural oils more easily. This dryness can aggravate eczema symptoms.

Treatment options for adults are similar to those for children. Topical corticosteroids, moisturizers, and antihistamines are commonly used. Phototherapy with UV light may also be an effective treatment for some adults with severe eczema. The main goals are repairing the skin barrier, reducing inflammation, and preventing infections.

With proper treatment and avoidance of triggers, eczema can be managed successfully in adulthood. Working closely with a dermatologist is important.

Living with Eczema

Living with eczema can be challenging, but there are ways to manage symptoms and improve quality of life. Here are some tips:

Avoid Triggers

  • Identify and avoid anything that irritates your skin or causes flares. Common triggers include certain fabrics, temperature changes, stress, and harsh soaps/detergents. Keep a journal to help pinpoint your personal triggers.

Gentle Skin Care

  • Bathe in lukewarm water and limit baths to 5-10 minutes. Avoid scrubbing and use gentle, fragrance-free cleansers. Apply moisturizer within 3 minutes after bathing to seal in hydration. Look for thick, creamy moisturizers formulated for sensitive skin.

Manage Stress

  • Stress can worsen eczema flares. Practice relaxation techniques like meditation, yoga, or deep breathing. Get regular exercise, which can reduce anxiety. Talk to a therapist if stress is overwhelming.

OTC Medications

  • Over-the-counter hydrocortisone cream helps control mild itching and inflammation. Oral antihistamines like diphenhydramine or cetirizine can also provide relief from itching.

Support Groups

  • Join an eczema support group to connect with others dealing with the condition. This can provide emotional support and helpful tips from people going through similar challenges. Check sites like NAEC or AAD.

Outlook for Eczema

Eczema is a chronic condition without a cure, but symptoms can often be managed with proper treatment and lifestyle changes. Many children who develop eczema will outgrow it before reaching adulthood. However, eczema can persist and become a lifelong condition in some individuals.

For adults with chronic eczema, working closely with a dermatologist to find an effective treatment regimen is crucial. Avoiding triggers, moisturizing frequently, and using prescription medications as directed are key to minimizing flare-ups. Though challenging, it’s possible to achieve well-controlled eczema with consistent care and lifestyle adjustments.

While no definitive cure is available yet, researchers are actively investigating new eczema treatments that may help better manage this condition in the future. Emerging options like biologic drugs, microbiome-based therapies, and improved phototherapy methods provide hope for potential new ways to treat eczema down the road. Though more research is still needed, the ongoing quest for novel therapies signifies continued progress toward better solutions for controlling eczema symptoms long-term.