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Eczema: Causes, Symptoms & Treatments

Mary Lucas, RN

Medically reviewed by Mary Lucas, RN

Written by Our Editorial Team

Last updated 12/16/2020

Eczema, also known as dermatitis, is an allergic skin disease that causes your skin to become red, inflamed and itchy.

If you have eczema, you may notice that your skin becomes dry and itchy around the inside of your elbows, behind your knees, on your hands and feet and on your face. If you scratch your skin, it may become swollen and itchier.

Although there’s no cure for eczema, a variety of treatment options are available that can help you to manage your symptoms and avoid outbreaks. 

Atopic dermatitis, the most common form of eczema, is most common in babies and children. It often disappears by itself during adulthood, although in some people, eczema can persist for years. People with eczema may also have a higher risk of developing other health conditions, such as hay fever and asthma.

Below, we’ve listed the symptoms of eczema, as well as the key factors that can cause eczema to develop. We’ve also explained how eczema is diagnosed and treated through medication and lifestyle changes. 

Symptoms of Eczema

The symptoms of eczema can vary between people. Some people with eczema may only have minor symptoms, while others may have severe symptoms that require ongoing treatment and attention. The most common symptoms of eczema include:

  • Dry, red, irritated skin that can itch and feel uncomfortable. The itching associated with eczema can be severe, and may become more serious at nighttime.

  • Red or brown-gray patches of skin. These patches may develop on the insides of your knees and elbows, your hands and feet, your wrists, neck, upper chest, face, buttocks and other areas of your body.

  • Thickened, scaly or cracked patches of skin in areas affected by eczema, as well as swelling and sensitivity if you scratch your skin.

  • Small, itchy, fluid-filled bumps in your skin, called papules, which may leak fluid when scratched. After leaking fluid, these bumps may develop a crust or scale. This type of eczema is referred to as papular eczema.

  • Worsening irritation, itching and discomfort if you scratch, pick at or otherwise touch affected areas of your skin.

The symptoms of eczema often come and go over time. You may experience flare-ups during certain times of year, or following exposure to factors that can increase your risk of developing eczema symptoms. 

In between these eczema flare-ups, you may have no eczema symptoms for weeks, months or even years.

Eczema can develop in one or several areas on your body, either one by one or at the same time. If you have eczema, you may also have other conditions, such as asthma or allergies, depression or anxiety, sleep loss and other skin conditions, such as ichthyosis.

For the most part, eczema tends to affect babies and children. Over time, it’s common for the symptoms to get better or disappear without treatment. When eczema flare-ups continue in adulthood, they’re usually less severe.

Other Types of Eczema

The most common type of eczema is atopic dermatitis. Atopic dermatitis affects more than 18 million adults in the United States alone. Because it’s such a widespread condition, it’s common for the term “eczema” to be used specifically to refer to atopic dermatitis.

However, there are also several other types of eczema, each of which has its own unique range of symptoms. Other types of eczema include:

  • Contact dermatitis. Contact dermatitis occurs when the skin comes into contact with an irritant, such as an irritating chemical, cosmetic product, building materials, medication or natural irritant such as sweat, saliva or urine.

    Contact dermatitis can also develop due to skin allergies, including from material such as poison oak, poison ivy and certain metals, such as nickel.

  • Nummular eczema. Nummular eczema is a condition that causes coin-shaped spots to form on the skin. Because of their appearance, these spots can be easy to confuse with common skin infections, such as ringworm (tinea corporis).

    Unlike atopic dermatitis, which is common in children, nummular eczema tends to occur at any age.

  • Hand eczema. Hand eczema only develops on the hands. It’s often caused by exposure to chemicals, including chemicals used in certain soaps and hand washing liquids. Hand eczema can also occur as part of an atopic dermatitis flare-up.

  • Stasis dermatitis, or venous eczema. This type of eczema develops on the lower legs on the ankles, feet and calves. It’s caused by weak blood circulation, which can result in fluid leaking out of the veins and into the skin.

  • Seborrheic dermatitis (seborrheic eczema). Seborrheic dermatitis is a type of eczema that typically affects the scalp, face and neck. In adults, it can cause dry and scaly areas of skin, itchiness and dandruff.

  • Lichen simplex chronicus (LSC). Lichen simplex chronicus is a type of eczema that’s caused by scratching of the skin. Like with other types of eczema, the skin may become thickened and scaled over time.

  • Asteatotic eczema. Asteatotic eczema is a type of eczema that typically develops on the legs. It can cause the skin to dry, resulting in fine cracks. Asteatotic eczema often affects the elderly, particularly those who spend time in overly dry environments.

  • Neurodermatitis. This type of eczema is most common in adults between the ages of 30 and 50, and can occur literally anywhere you can scratch. It’s characterized by intense itchiness, and generally doesn’t resolve itself without treatment. 

When Should You Talk to a Healthcare Professional?

Eczema typically isn’t dangerous. However, skin that’s affected by eczema — particularly severe eczema that causes open sores — can potentially become infected with certain bacteria, viruses and fungi.

In addition to the risk of becoming infected, eczema can be an irritating, unpleasant condition to live with. Talking to a healthcare professional can help you to learn more about options for managing and treating your eczema, allowing you to minimize the severity of your symptoms.

If you have persistent eczema, or if you get severe eczema flare-ups that cause you scratch at your skin until it breaks, it’s important to talk to a healthcare professional about treatment options

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What Causes Eczema?

Researchers aren’t yet aware of exactly what causes eczema. Current research indicates that it’s most likely caused by a combination of genetic factors and triggers that can make your skin become itchy, inflamed and painful.

According to the National Eczema Association, people with eczema typically have an overactive immune system. When triggered, the immune system produces inflammation, leading to the red, irritated skin that typifies eczema.

Eczema may also be related to certain genetic mutations. For example, research suggests that people with eczema may have a mutated version of the genes that produce filaggrin — a protein that’s integral in forming a protective barrier on the surface of the skin.

This genetic mutation may affect moisture levels in the skin, increasing the risk of bacterial and viral infections.

Many different things can trigger eczema. Possible eczema triggers include substances that can irritate your skin, certain emotions and feelings, bacterial or viral infections and a variety of other things. We’ve listed and explained these eczema triggers in more detail below.

Irritants and Allergens

Irritants are substances that irritate your skin. Many irritants can potentially trigger eczema and other skin conditions, including the following:

  • Smoke, whether from cigarettes, other tobacco products or a fireplace

  • Soaps, hand washes and other household cleaning products

  • Shampoos and lotions that contain cocamidopropyl betaine

  • Fabrics, including polyester and wool

  • Perfumes, fragrances and deodorants

  • Metals such as nickel, chromium, cobalt and mercury

  • Some ingredients used in glues, disinfectants, adhesives and personal care products

  • Leather dyes, temporary tattoos and other products that contain paraphenylene-diamine

  • Vaccines containing formaldehyde

Other common items, including certain natural products such as fruit and meat, can also contain substances that may irritate the skin and trigger eczema.

Allergens are naturally-occurring substances that you may come across while walking or doing other activities outside. Common allergens that can trigger eczema include pollen, dandruff, pet dander or urine, mold and dust mites.

Sweating

Sweating, whether due to exertion or temperature, can potentially trigger eczema. People with eczema may also develop flare-ups after wearing warm clothing to sleep, or in humid weather that causes sweating.

Exposure to heat can also trigger eczema. If you take a hot shower, bath or swim in hot water, you may notice your skin becoming red and irritated.

Infections

Although infections may not directly cause eczema, eczema that becomes infected because of bacteria or a virus may become more severe. Common germs that can infect eczema include:

  • Staphylococcus aureus (staph) bacteria

  • The herpes and molluscum contagiosum viruses

  • Fungal infections, such as ringworm (tinea corporis, cruris, capitis or pedis)

Dry Skin

Dry skin is a common eczema trigger. You may develop dry skin due to exposure to chemicals or substances, washing your skin excessively, or due to certain health conditions. Dry skin can also develop during winter due to cold weather and dry air.

Hormonal Changes

Changes in the production of certain hormones may trigger eczema flare-ups. This may affect women more than men. For example, there is some evidence that the hormones estrogen and progesterone may play a role in certain types of eczema.

Stress

Certain mental health factors, including anxiety and stress, can trigger eczema flare-ups. This may create a vicious cycle in which stress and anxiety worsen eczema, which in turn worsens your feelings of stress and anxiety.

No two cases of eczema are identical, meaning things that trigger eczema for others may not necessarily trigger eczema for you. You may also not notice an immediate reaction after being exposed to an eczema trigger — instead, it may take some time for your eczema to flare up.

Understanding your eczema triggers plays a major role in treating and managing eczema — a topic we’ve covered in more detail in the treatment section below.

Diagnosis of Eczema

If you have persistent eczema, it’s important to talk to a healthcare professional. Your healthcare provider will often be able to diagnose you with eczema by examining areas of your skin that are affected by eczema. 

As part of diagnosing eczema, your healthcare provider may also ask about your personal and family history of allergies, any recent or past exposure you may have had to hazardous chemicals or irritants, as well as any contact you may have had with plants such as poison oak or poison ivy.

Your healthcare provider may also ask if you smoke, have sleep problems, have used medications such as steroids or have previously been treated for any other skin conditions.

To determine the cause of your eczema, your healthcare provider may request that you take a blood test or other type of lab test. If they think that your eczema is triggered by allergies, you may be asked to complete a patch test to identify the specific allergens that affect your skin.

Eczema Treatment and Prevention

Dealing with eczema can be a frustrating, stressful experience. Although there currently isn’t a cure for eczema, there are several treatment options that can help you to successfully manage the symptoms of eczema and make your eczema flare-ups easier to control. 

Depending on your symptoms and the severity of your eczema, your healthcare provider may recommend a variety of medications, therapies and other treatment options for your eczema. 

For most people with eczema, managing symptoms involves several steps:

  • Using medication, both over-the-counter and/or prescription, to control symptoms

  • Identifying and avoiding your eczema triggers

  • Caring for your skin through regular moisturizing and bathing

  • Staying alert for signs of infection, such as pain, redness, heat or pus-filled bumps

Prescription Medications

Eczema is often treated using medications. Your healthcare provider may prescribe medication to control the itching caused by eczema, to treat infections caused by cracked skin or open sores, or to keep the inflammation caused by eczema under control.

Medications used to treat eczema include:

  • Corticosteroid creams. These creams help to control the itching associated with skin conditions such as eczema. Most eczema is treatable using mild to moderate strength topical corticosteroids.

    If you’re prescribed a topical corticosteroid, it’s important to only use it as prescribed by your healthcare provider. Overuse of topical steroids can lead to side effects, including thinning and thickening of your skin, as well as reactions such as topical steroid withdrawal.

  • Topical calcineurin inhibitors (TCIs). These nonsteroidal creams work by preventing parts of your immune system from causing eczema symptoms. Like with other medications, it’s important to use them only as directed by your healthcare provider.

    The two most common TCIs currently in use for eczema are Protopic® (tacrolimus) and Elidel® (pimecrolimus). Both of these medications require a prescription and may cause certain side effects, which you should discuss with your healthcare provider prior to use.

  • Topical PDE4 inhibitors. These medications work by blocking the effects of the enzyme Phosphodiesterase 4, or PDE4, which plays an important role in producing the inflammatory response that’s common in people with eczema.

    Currently, the only topical PDE4 inhibitor that’s approved for use in the United States is Eucrisa® (crisaborole). As with other eczema medications, it’s a prescription medication that you’ll need to discuss with your healthcare provider prior to use.

  • Immunosuppressants. These medications work by suppressing your body’s immune system. This can stop you from scratching areas of skin affected by eczema, help your skin to recover and reduce the risk of certain skin infections.

    Several immunosuppressant medications are used to treat eczema. The most common are azathioprine, cyclosporine and methotrexate. Like other medications used to treat eczema, these can cause side effects and should be discussed with your healthcare provider.

  • Biologic medications. These medications use human DNA to target diseases such as eczema at the immune system level. They’re administered subcutaneously (through the skin) or intravenously (into the vein).

    Currently, the only biologic medication approved for people with uncontrolled, moderate or severe eczema is Dupixent® (dupilumab). Like other eczema medications, it requires a prescription and can cause certain side effects.

  • Antibiotics. Although antibiotics don’t treat eczema itself, they can help to kill bacterial infections that can develop in eczema-affected skin. Your healthcare provider may prescribe a topical or oral antibiotic if you develop an infection during an eczema flare-up.

Over-the-Counter Products

Some over-the-counter products available at your local drugstore can help to treat and manage eczema symptoms. These include:

  • Dandruff shampoo. Eczema that affects the scalp, referred to as seborrheic dermatitis, may improve through the use of an over-the-counter anti-dandruff shampoo. For severe seborrheic dermatitis, your healthcare provider may recommend a prescription facial cream or rinse.

  • Moisturizer. Moisturizers can help to keep the outermost layer of your skin, referred to as the stratum corneum, stronger and better protected. Moisturizing, particularly with a moisturizer that contains plenty of oil, may help you to keep eczema under control.

    More information on moisturizing, including recommended ingredients, can be found on the National Eczema Association website

Other Treatments

Numerous other treatments are used to manage and improve the symptoms of eczema. These include:

  • Light therapy. For people who don’t respond to topical medications, light therapy — a form of therapy that involves exposing the skin to either natural sunlight or artificial UV radiation — may help to treat eczema.

    Although light therapy is often effective at treating eczema, it may cause side effects, including accelerated skin aging and an elevated risk of developing skin cancer.

  • Wet dressing. Also known as wet wrapping, this treatment involves wrapping up the eczema-affected skin in wet bandages and topical steroids. This treatment is typically used for people with large areas of eczema that itch and cause discomfort.

  • Relaxation and behavior modification techniques. People who scratch their eczema may benefit from relaxation and behavior modification techniques, which can reduce the need to scratch and prevent eczema from becoming more or severe or infected.

  • Counseling. Eczema can have a psychological toll, affecting everything from quality of life to self-confidence. People who feel stressed, embarrassed or unhappy due to their eczema may benefit from counseling and therapy.

Home Remedies and Lifestyle Changes

Making small changes to your daily life can help to ease the symptoms of eczema and make it easier to live with. If you have eczema, try the following home remedies and self-care tactics in combination with the treatment options recommended by your healthcare provider:

  • Avoid scratching. Scratching eczema irritates your skin and can increase your risk of developing infections. Instead of scratching, try pressing down on your skin, as this may provide relief without causing your eczema to worsen.

  • Use a moisturizer regularly. As we mentioned above, moisturizer can help to protect your skin and prevent the cracking that’s common with eczema. Try moisturizing your skin twice a day — once in the morning and one before bed — to keep it healthy.

    There’s no need to choose an expensive moisturizer. In fact, plain petroleum jelly is a great choice for managing eczema thanks to its low price and high oil content.

  • Bathe frequently to keep your skin moist. Take at least one bath or shower per day so that your skin stays moist, clean and healthy. To avoid irritating your skin, avoid hot water — instead, use lukewarm water and a gentle cleaner instead of soap.

  • Before bathing, prepare your bathtub. Before you take a bath, add a quarter-cup of baking soda to the water. This can help to relieve itching. Other good bath additives for eczema include gentle oils, colloidal oatmeal, vinegar, salt and mild bleach.

    The National Eczema Association has a series of guides to eczema and bathing that go into more detail about how to prepare your bath, specific ingredients, the most effective bathing methods and more.

  • Use a humidifier. Eczema can become worse in hot, dry weather, which may cause you to experience extra itching, skin flaking and discomfort. If you have a humidifier, use it to maintain a normal humidity level when you’re at home.

  • Avoid strong soaps that contain perfumes and dyes. Instead, stick to a gentle skin cleanser. Alternatively, you can use non-alkaline, superfatted soap, which has extra oil that may help to protect your skin.

  • Avoid tight, rough clothing that could irritate your skin. Instead, stick to cool, soft clothing that’s unlikely to cause irritation. If you’re out on a hot day or exercising, wear clothing that breathes well to reduce your risk of sweating excessively.

Prevention

Eczema isn’t contagious, meaning you don’t need to worry about passing it on to other people by spending time with them. Coming into contact with someone who has eczema won’t trigger yours, meaning you don’t need to worry about “spreading” or “catching” eczema from others.

If you have eczema, a few simple steps may help you to avoid flare-ups, or make any ongoing flare-ups less severe:

  • Avoid exposure to known irritants and allergens. Once you’re aware of substances that trigger your eczema, make an effort to avoid them. This may help you to minimize flare-ups and make your eczema easier to live with.

  • Avoid non-cotton fabrics. Fabrics such as wool and polyester are much more likely to irritate your skin than cotton. Stick to cotton when possible, both for clothing and for your sheets, blankets and other bedding.

  • After bathing, pat yourself dry. Rubbing your skin, even with a soft towel, can reduce your skin’s moisture content. After you bathe, pat yourself dry, then apply a moisturizer to keep your skin soft, smooth and protected.

  • If your eczema gets worse, talk to a healthcare professional. Eczema can be persistent even with the most careful treatment approach. If you notice that your eczema is coming back, getting worse or just not improving, let your healthcare provider know as soon as possible. 

Talk to a Healthcare Professional About Eczema

If you have eczema, or have a skin rash that you think is eczema, talking to a healthcare professional can help you learn more about your condition and the treatment options that are available to you.  

Consult with a licensed healthcare provider now to discuss your symptoms and learn more about what you can do to treat and manage eczema. 

If appropriate, the provider can write you a prescription on the spot and send it directly to a local pharmacy of your choice, allowing you to get the relief you need fast, all without having to go to a healthcare providers’ office. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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