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.

atopic dermatitis on an arm
Atopic dermatitis rashes can be blotchy and itchy.iStock

Common Questions & Answers

What is the main cause of eczema?
A compromised skin barrier, which prevents the retention of fats and oils, while promoting water loss, causes eczema. Scientists don’t know why this happens, but genetics may play a role. A familial or personal history of asthma or hay fever are risk factors.
What does eczema look like?
Dermatologists can diagnose eczema. Skin symptoms of atopic dermatitis include rough, leathery, or scaly patches; small, red, raised bumps; creases on the palms of the hands; swollen, sore skin; skin that oozes or “weeps” fluid; and itchiness that comes and goes.
What foods should you avoid if you have eczema?
The potential link between eczema and diet is murky. But some people, especially children, with atopic dermatitis may have food allergies simultaneously. While there’s no proof an elimination diet alone can treat eczema, avoiding certain inflammatory foods may help some individuals’ symptoms.
Can you get rid of eczema?
There’s no cure for eczema, but avoiding known triggers and leveraging treatment options can help reduce your symptoms. First, keep skin moisturized with a fragrance-free cream or ointment. Topical corticosteroids and systemic medications may further help reduce irritation and keep flare-ups at bay.
What is the best home remedy for eczema?
To treat eczema at home, moisturize your skin with a cream or ointment. Complementary therapies include coconut and sunflower oil. Stress-relieving approaches, such as meditation and massages, may also help reduce flares.

Pictures of Different Types of Eczema

There are several other types of eczema besides atopic dermatitis.

These include:

Contact Eczema (Contact Dermatitis)

hand ring contact-dermatitis
Phanie/Alamy
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

hand eczema
Karen Hermann/Alamy
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.

Dyshidrotic Eczema

dyshidrotic-eczema
Scott Camazine/Alamy

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

nummular eczema
Phanie/Alamy

Compared to other types of eczema, nummular eczema appears differently: as itchy, coin-shaped spots on the skin.

Stasis Dermatitis

stasis dermatitis
Ocskay Mark/Alamy

This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.

Seborrheic Dermatitis

dandruff seborrheic dermatitis
iStock

Scalp eczema is one type of seborrheic dermatitis, which happens when white or yellow scaly patches of skin develop in oily areas of the body. Other places this may appear include the 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

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, behind the knees, and on the scalp.

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.

Learn More About Signs and Symptoms of Eczema

Causes and Risk Factors of Eczema

If you have eczema, your skin is unable to retain moisture well, possibly because of low production of fats and oils. Eczema is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes skin 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.

With eczema, your immune system causes inflammation.

Usually, this is a natural process that protects against infection and foreign bodies, but with eczema, this happens even in the absence of harmful substances.

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:

  • 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

eczema on hands
Irritants and allergens can trigger hand eczema symptoms.Philipp Oscity/Alamy

How Much Do You Know About Eczema?

Eczema is a common skin condition that millions of people in the United States live with. There are several different types of eczema, which vary in symptoms and how they’re treated. Test your knowledge and find out how much you know about eczema.

How Is Eczema Diagnosed?

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.

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.

Prognosis of Eczema

Some people who develop atopic dermatitis as an infant or young child get better over time.

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

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.

a woman with eczema
Primary treatment for eczema focuses on keeping skin moisturized.Getty Images

Treatment and Medication Options for Eczema

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:

For moderate and severe disease, treatments include:

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 or oral antibiotics, as well as antiviral or antifungal drugs.

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.

If you aren’t sure which foods may be triggering your symptoms, you may explore using an elimination diet for eczema. With this approach, you’ll eliminate potentially problematic foods before adding them back in, noticing how your skin reacts along the way.

Elimination diets are also used to diagnose autoimmune conditions like eosinophilic esophagitis (EoE), a chronic disease of the esophagus.

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;

massages with essential oils; and stress management techniques, such as yoga and meditation.

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 age 4 months 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:

  • 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 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 scratch affected skin areas.
Streptococcus pyogenes bacteria
Exposure to Streptococcus pyogenes bacteria is a common complication in people with eczema. Alfred Pasieka/Getty Images

Complications of Eczema

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.

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.

People with atopic dermatitis may also get a severe and potentially fatal infection called eczema vaccinatum if they receive the live-virus smallpox vaccine.

Other complications of atopic dermatitis include sleep deprivation, poor performance at work or school, depression and anxiety, and increased suicide risk.

Learn More About Eczema Complications

Research and Statistics: Who Has Eczema? How Many People Have Eczema?

Eczema can occur at any age, but it typically begins in infancy and early childhood.

According to the National Eczema Association (NEA), 31.6 million people in the United States — or 10 percent — have some form of eczema. Atopic dermatitis is the most dominant type, and it affects about 9.6 million U.S. children.

Related Conditions

As mentioned, eczema may be associated with asthma, hay fever, and food allergies, the latter of which is more common in children.

Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. They include:

Also associated with eczema, particularly atopic dermatitis, are depression and anxiety. The asthma medication montelukast (Singulair), which people with eczema may take, could increase the risk for these mental health disorders.

BIPOC and Eczema

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.

  • 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, 19.3 percent of Black children in the United States have atopic dermatitis, compared with 16.1 percent of white children.

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.

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.
Black 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).

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.

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.

Resources We Trust

National Eczema Association: What Is Eczema?

Skin of Color Society: Patient Dermatology Education — Eczema

American Academy of Dermatology: Eczema Resource Center

Eczema Support

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.

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

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