What is eczema?
Eczema is a group of conditions that make your skin inflamed or itchy. “Atopic” refers to a person’s tendency to get allergies such as asthma and hay fever.
In the U.s., Eczema affects about 10% to 20% of infants and about 3% of adults and children. Most children get past it by their 10th birthday. Some people continue to have symptoms for life.
There is no cure, but most people can manage their symptoms by taking treatment and avoiding irritants. Eczema is not contagious.
Symptoms of eczema
Eczema is different for everyone. And in the same area, your flare-ups won’t always happen.
No matter which part of your skin is affected, eczema is itchy always. The itching sometimes begins before the rash. Your skin may also be:
- To dry
Symptoms in infants
In infants, the itchy rash can lead to oozing and scabs, mainly on the face and scalp. It can also occur on the arms, back, chest, and legs.
Symptoms in children
Children and adolescents usually have a rash in the folds of the elbows, behind the knees, on the neck, or on the wrists or ankles. The rash becomes scaly and dry.
Symptoms in adults
The rash usually occurs on your face, back of knees, wrists, hands, or feet.
Your skin will likely be very dry, thick, or scaly. In people with fair skin, these areas may start to be reddish and then turn brown. In people with darker skin, eczema can affect pigments in the skin, making the affected area lighter or darker.
When to see your doctor
Call your doctor if:
- You notice signs of infection, such as fever, redness, heat, or blisters
- Your eczema suddenly changes or gets worse
- Treatments don’t work
Types of eczema
Eczema includes conditions such as:
- Atopic dermatitis. This is what people usually talk about when they say “eczema”.
- Contact dermatitis. Almost everyone understands this at some point in their life. It happens when your skin comes in contact with something that causes a rash.
- Dyshydrosiform eczema. It happens when your skin isn’t protecting itself the way it should.
- Nummular eczema. People with this type have round sores, often after an injury to the skin such as a burn or an insect bite.
- Seborrheic dermatitis. It happens in the areas of your body with a lot of sebaceous glands. When it’s on your scalp, it’s called dandruff.
- Stasis dermatitis. This type occurs in people who have poor blood circulation, usually in the lower legs.
Causes of eczema and risk factors
Experts are not sure exactly what causes eczema. Things that can make it more likely include:
- An immune system response to something irritating
- Problems in the skin barrier that allow moisture and germs to penetrate
- A family history of other allergies or asthma
Some people have flare-ups of itchy rashes in response to things like:
- Rough or coarse tissue
- Feeling too hot or too cold
- Household products like soap or detergent
- Animal dander
- Respiratory infections or colds
No test can detect eczema. Your doctor will likely diagnose it by examining your skin and asking a few questions.
Since many people with eczema also have allergies, your doctor may order allergy tests to look for irritants or triggers. Children with eczema are particularly susceptible to allergy testing.
If your doctor diagnoses you with eczema, you may want to ask them:
- What’s the best way to hydrate my skin? Can I use over-the-counter products or need to prescribe something?
- Do I need to buy special soaps, lotions and laundry detergents? Do fragrance-free or sensitive skin products help?
- Are there any foods I should avoid to keep flares at bay?
- Are there any fabrics I should avoid wearing? What about the fabrics that I should wear more?
- Do pets make symptoms worse?
- Can I still exercise if sweating makes things worse?
- What if my symptoms do not improve or if I get an infection from scratching my skin?
- Does stress cause flare-ups?
- Are long periods without symptoms common?
- Are there ways to treat my skin to reduce my chances of another breakout?
Treatment of eczema
The goal of treating eczema is to relieve and prevent itching, which can lead to infection.
There are things you can do at home that can help relieve symptoms.
Moisturizers. Because your skin is dry and itchy, your doctor will recommend creams and lotions to keep it moist. Creams and ointments relieve inflammation and put water back into your skin to help it heal. Put them on several times a day, including right after a bath or shower. Petroleum jelly and mineral oil work well because they form a thick barrier on your skin.
Products containing glycerin, lactic acid, and urea can also help, as they help draw water into your skin. You will use them when your skin is damp, such as after a bath, to help retain moisture.
Hydrocortisone creams and antihistamines. Over-the-counter products which can help are antihistamines and hydrocortisone cream. Hydrocortisone is a steroid that helps fight redness, itching, and swelling. You can buy lotions and low strength creams at the store. If this doesn’t help, your doctor may prescribe something stronger.
It is safe to apply hydrocortisone to most parts of the body up to four times a day for 7 days, as long as you are not pregnant or breastfeeding. Keep it away from your eyes, genitals, and rectum.
Some people have a severe reaction to hydrocortisone. If you have difficulty breathing or swallowing, or if you notice a rash after using it, call 911 or your doctor.
Over-the-counter allergy medications may not work well for itchy skin caused by eczema. But antihistamines known to cause drowsiness can help you sleep if you take them before bed.