What Is Eczema?
Eczema is a common skin condition that causes itchiness, rashes, dry patches, and infection. It's a type of dermatitis, which is a group of conditions that can inflame or irritate your skin. The most common type is atopic dermatitis or atopic eczema. “Atopic” means that you're more likely to get allergic conditions such as asthma and hay fever.
Most people can manage their symptoms by getting treatment and by avoiding irritants, things that can affect your skin when you come into contact with them. Extreme itchiness is the No. 1 overall symptom of eczema, and scratching that itch only makes it worse.
Over 31 million Americans have eczema. The periods of time when symptoms are at their worst are called "flare-ups." These can last for days or even weeks.
Eczema looks different for everyone. And your flare-ups won’t always happen in the same area.
No matter which part of your skin eczema affects, it's almost always itchy. The itching sometimes starts before the rash. Your skin may also be:
Symptoms in infants
In infants, the itchy rash can lead to an oozing, crusting condition, mainly on the face and scalp. It can also happen on their arms, legs, back, and chest. Newborn babies can show symptoms within the first few weeks or months after birth.
Symptoms in children
Children and teens usually have a rash in the bends of their elbows, behind their knees, on their neck, or on their wrists or ankles. The rash turns scaly and dry.
Symptoms in adults
The rash usually happens on your face, the backs of your knees, wrists, hands, or feet.
Your skin will probably be very dry, thick, or scaly. In fair-skinned people, these areas may start out reddish and then turn brown. In darker-skinned people, eczema can affect skin pigments, making the affected area lighter or darker.
Flare-ups can sometimes last for several days or weeks.
When to see your doctor
Contact your doctor right away if you've been taking steps to manage your symptoms and notice any of the following:
- Signs of an infection, such as a fever, redness, warmth, pus, or blisters
- Your eczema suddenly changes or gets worse
- Treatments aren’t working
Types of Eczema
Eczema includes conditions such as:
Atopic dermatitis. This is what people usually mean when they say “eczema.” This is the most common form, and it affects more than 7% of American adults. Other allergic disorders, like asthma and hay fever, can trigger it. It often starts in childhood.
Contact dermatitis. Nearly everyone gets this at some point in their lives. It happens when your skin comes into contact with something that causes a rash. The trigger can cause irritation or an allergic reaction. Triggers are unique to each person and vary by the two types of contact dermatitis:
- Irritant dermatitis is the more common kind and is more closely linked to people with atopic dermatitis. Triggers may include skin care products, soaps and detergents, jewelry made with nickel, and industrial chemicals like solvents and cement.
- Allergic dermatitis flares when your skin comes into contact with something you’re allergic to. Common allergens include poison ivy, nickel and other metals, fragrances and beauty products with fragrances, rubber, latex, and the preservative thimerosal. For some people, it takes sunlight to cause a reaction.
Dyshidrotic eczema. This is a less common but more challenging form of eczema. It causes outbreaks of tiny blisters on the palms of the hands, soles of the feet, and sides of the fingers. Sweat or irritants like metals may trigger it.
Neurodermatitis. This type of eczema tends to cause just one or two intensely itchy patches, often on the back of the neck, an arm, or a leg. Risk factors include having another form of eczema, like atopic or contact dermatitis, or just very dry skin. Some mental health issues like anxiety disorder and obsessive-compulsive disorder (OCD) can also trigger it. Women between the ages of 30 and 50 have a higher chance of getting it than other people.
Nummular eczema. This coin-shaped eczema often appears after a skin injury like a burn or insect bite. You’re more likely to get nummular eczema if you or your family members have atopic dermatitis, allergies, or asthma.
Seborrheic dermatitis. This happens in areas of your body with lots of oil glands. When it’s on your scalp, it’s called dandruff. It shares a common link with some other skin conditions, like psoriasis, acne, and rosacea, as well as a variety of other diseases.
Stasis dermatitis. This type happens in people who have poor blood flow, usually in the lower legs. Unlike some other types of eczema, these plaques don't mean you have abnormal genes. Some lifestyle habits raise the risk too, like being overweight or not getting enough activity.
Experts aren’t sure what exactly causes eczema. Things that may make it more likely include:
- An immune system response to something irritating
- Problems in your skin’s barrier that let moisture out and germs in
- A family history of other allergies or asthma
Is eczema contagious?
No. You can’t catch eczema from someone or pass it on to others.
Eczema Risk Factors
Stress and genes are among the most common risk factors for getting eczema. But there are more, including:
- Having very dry skin
- Using hair care or skin products with certain allergens
- Food allergies
- Living in cold, damp areas or swampy, hot areas
Who gets eczema?
- You're more likely to get eczema if someone in your family has it. It's not entirely genetic, but genes increase the chances.
- Eczema shows up most before you turn 5, and most children will outgrow eczema.
- If you get eczema as an adult, you're more likely to get it either in your 20s or over age 50.
- Atopic dermatitis is more common in children, while forms like nummular eczema are more typical in adults.
Some people have flare-ups of the itchy rash in response to things like:
- Rough or coarse fabric or clothing
- Feeling too hot or cold
- Household products like soap or detergent
- Dander from animal hair or fur
- Infections or colds
No one test can spot eczema. Your doctor will probably diagnose it by looking at your skin and asking a few questions.
If your doctor diagnoses you with eczema, you might want to ask them:
- What’s the best way to add moisture to my skin? Can I use over-the-counter products, or do you need to prescribe something?
- Do I need to buy special soaps, lotions, and laundry detergent? Do fragrance-free or sensitive-skin products help?
- Are there foods that I should avoid to keep flares at bay?
- Are there fabrics that I shouldn't wear? What about fabrics should I wear?
- Do pets make symptoms worse?
- If sweating makes things worse, can I still exercise?
- What’s next if my symptoms don’t improve or I get an infection from scratching my skin?
- Does stress lead to flare-ups?
- Are long periods of time without symptoms common?
- Are there ways I can treat my skin to reduce my chances of another flare-up?
The aim of eczema treatment is easing and preventing itching, which can lead to infection.
Your doctor may also prescribe creams and ointments with corticosteroids to ease inflammation. If the area becomes infected, you’ll probably need antibiotics.
The FDA has approved two medications called topical immunomodulators (TIMs) for mild to moderate eczema. Elidel cream and Protopic ointment work by changing your immune system response to prevent flare-ups. They can reduce inflammation and itching.
The FDA has warned doctors to use caution with Elidel and Protopic because of concerns over a cancer risk. The two products also carry the FDA's "black box" warning on their packaging to alert doctors and patients to these potential risks. The warning advises doctors to prescribe Elidel and Protopic for only a short time after other eczema treatments have failed in adults and children over the age of 2. It should not be used in kids under age 2.
A biologic drug called dupilumab (Dupixent) has FDA approval for moderate to severe eczema. Biologics block certain proteins from binding to receptors on your cells. This eases or prevents inflammation by keeping your immune system from overreacting. Tralokinumab (Adbry) is another injectable biologic drug.
Other medication options for eczema include:
- Azathioprine (Azasan)
- Mycophenolate mofetil (CellCept)
- Phosphodiesterase inhibitors (Eucrisa ointment)
- Ruxolitinib (Opzelura cream)
- Upadacitinib (Rinvoq)
Some things you can do at home may help ease symptoms.
Moisturizers. Because your skin is dry and itchy, your doctor will recommend lotions and creams to keep it moist. Creams and ointments ease inflammation and put water back in your skin to help it heal. Put them on several times a day, including right after you take a bath or shower. Petroleum jelly and mineral oil work well because they form a thick barrier over your skin.
Products with glycerin, lactic acid, and urea may also help because they help pull water into your skin. You’ll use these when your skin is damp, such as after bathing, to help hold in moisture.
Hydrocortisone creams and antihistamines. Over-the-counter products like hydrocortisone cream and antihistamines can also help. Hydrocortisone is a steroid that helps keep redness, itching, and swelling at bay. You can buy low-strength creams and lotions at the store. If those don’t help, your doctor may prescribe something stronger.
It’s safe to put hydrocortisone on most body parts as many as four times a day for up to 7 days, as long as you’re not pregnant or breastfeeding. Keep it away from your eyes and private parts.
Some people have a severe reaction to hydrocortisone. If you have trouble breathing or swallowing, or notice a skin rash after you use it, call 911.
Over-the-counter allergy meds may not work well for itchy skin caused by eczema. But antihistamines that are known to cause drowsiness can help you sleep if you take them before bed.
Colloidal oatmeal. Add this finely ground oatmeal to a lukewarm bath. It contains starches that seal in moisture to keep your skin hydrated and help to block irritants.
Wet wraps. When your eczema is flaring, soak some gauze, bandages, or pieces of soft clothing in cool water and put them on your skin. The coolness will relieve itching, and the moisture will help creams or lotions work even better. Carefully cover the area with a dry layer (such as pajamas) and leave in place for several hours or overnight.
Talk to your doctor to find out how often you can use wet wrap therapy. If you do it too much, it can cause an infection in your skin.
Coal tar. People have used this product for more than 2,000 years to treat eczema and other skin problems. Although it’s messy and many people don’t like the strong smell, it may help soothe your skin.
Calamine lotion can be put in the refrigerator and helps relieve itching quickly.
Relaxation techniques. There’s a strong link between stress and your skin. Plus, you’re likely to scratch more when your emotions are running high.
Self-hypnosis, meditation, and biofeedback therapy have all been shown to ease eczema symptoms. You may also want to see a therapist. They can help you change habits or negative thought patterns that may be adding to your skin problems.
Eczema Health Disparities
Research shows that 1 in 10 Americans will get eczema during their lifetime. But adult women are more likely to get it than men.
In the U.S., boys and girls are equally likely to have eczema, or about 11% of each gender. The condition is more common among non-Hispanic Black children than with any other race. For example, 2021 data from the CDC reports around 14% of Black kids under 17 had eczema, compared to 9% for non-Hispanic Asian children.
Among adults, multiracial and White people have the highest incidence. One reason may be that they’re more likely than people of other races to see a doctor for a diagnosis. At the same time, Black children and adults are more likely to have a more serious and persistent form of eczema. That may be due to lack of insurance, reliable transportation, and other barriers to seeking care.
Physical differences also may explain some of the disparities. For example, researchers believe that Black people tend to have drier skin, compared to Asians. And people with eczema lose their skin moisture more quickly.
Eczema can lead to skin infections from scratching or cracking. That can break down your skin’s barrier against bacteria and other germs. Complications with eczema can include some or all of the following:
- Asthma or hay fever. Either of these can happen before or after diagnosis.
- Food allergies. These can cause hives.
- Darker or lighter skin areas. This is more common in people with a darker skin color.
- Skin infections. If you get a skin infection, it can be life-threatening, so watch out for these and tell your doctor right away.
- Sleep problems. Eczema can cause these because of the itchiness.
Living with Eczema
Eczema can lead to many complications. But there are ways to manage your daily life and routine if you have the condition. These tips may help you avoid flare-ups and reduce costs.
Since eczema is linked to allergens in food, there's no one specific diet you should stick to if you have eczema. With that said, it's good to focus on anti-inflammatory foods that are less likely to lead to an allergic reaction. Foods that can often be inflammatory include:
- Red meat
- Processed meats (lunch meats, hot dogs, bacon)
- Fried foods
- Foods and drinks with added sugar
- Trans fats
- Refined carbs (white bread, pastries)
- Snack foods such as cookies, chips, and crackers
It's also important to keep in mind that allergies are highly individual. It may take time to learn your specific allergy triggers. Some foods, like dairy, can cause inflammation even if you're not allergic and can eat them without troublesome symptoms. In time, you can find the right diet for you, whether it's paleo, Mediterranean, gluten-free, or something else.
It's also important to drink plenty of water. Water helps keep your skin from drying out, which can cause flare-ups.
There are several things you can do to ease itchiness, the main symptom of eczema:
- Use a cold compress at the itch site.
- Softly pat the itchy skin. Don't scratch it.
- Take an apple cider vinegar bath.
- Make sure your clothing is soft and breathable.
- Try to avoid sitting on rough things, like grass or carpet.
- Moisturize during the day with a product containing ceramides.
Eczema and mental health
There’s a strong link between eczema and emotion. While stress, anxiety, and depression don’t cause eczema, they can set off a physical reaction that includes inflammation. This can make flare-ups worse.
It works the other way as well. Having eczema can make it more likely that you’ll have issues with mental health. One study found that more than 30% of adults with eczema also have a diagnosis of depression, anxiety, or both. Kids who have the condition are 2 to 6 times more likely to also have anxiety, depression, or attention deficit hyperactivity disorder (ADHD) than those who don’t. If they have other atopic conditions such as asthma, their risk goes up.
There are many things you can do to help yourself manage your mental health when you have eczema. Meditation, spending time outside, and exercise are some things that can help you handle stress and feel calmer.
If you have symptoms of depression for 2 weeks or more, talk to your doctor right away. They may suggest that you join a support group or start therapy with a mental health professional. Signs of depression to watch for include:
- Feeling sad, empty, or hopeless
- Being unable to concentrate
- Low energy
- Loss of interest in hobbies or activities you usually enjoy
- Thoughts of suicide
The average out-of-pocket cost for living with eczema is about $600 per year, but it can be as high as around $5,000 per year, depending on how much care you need and how serious your condition is.
Because experts are unsure of the exact causes of eczema, it's best to treat the symptoms and reduce triggers for flare-ups. Speak with your doctor or dermatologist about what the root of your eczema might be and how to best manage it. Treatments tend to include a mixture of medications and home remedies.
Can eczema be cured?
There is currently no cure for eczema. But with the right treatments, like meds, ointments, over-the-counter drugs, and home remedies, you can control and manage the symptoms.
What to expect with eczema
Almost 50% of children will outgrow their eczema as they get older and reach puberty. For others, it could last a lifetime. If you have eczema, there are ways to treat it, but it may take some time to find the right treatment for you. There will be times when flare-ups only last days and other times where they last weeks. There may also be long periods of time when you don't have any flare-ups. Just keep in mind that this doesn't mean the eczema has gone away. Stay away from inflammatory foods and triggers such as stress.
Eczema Flare-Up Prevention
A few tips can help you prevent outbreaks or keep them from getting worse:
- Moisturize your skin often.
- Avoid sudden changes in temperature or humidity.
- Try not to sweat or get too hot. Keeping cool and keeping your home comfortable can reduce itching.
- Manage stress, and take time for yourself to relax.
- Get regular exercise. It can help to control stress and increase circulation.
- Avoid scratchy materials such as wool.
- Don’t use harsh soaps, detergents, or solvents.
- Pay attention to foods that might trigger symptoms, and try to avoid them.
- Use a humidifier in rooms where you spend the most time.
- If your baby is more likely to have eczema because of a family history, it’s best to breastfeed them exclusively for the first 3 months of life, or longer if possible. Doctors advise continuing breast milk for at least up to 6 months (preferably 1 year) as you introduce your baby to solid food. Babies should also be protected from such potential allergens as pet hair, mites, and molds.
You can manage your eczema by living a healthy and well-balanced lifestyle. Avoid triggers like stress, harsh soaps, and rough or scratchy clothing. Keep your skin well-moisturized. This can help you prevent flare-ups and cut down on itchiness. If you feel your eczema is getting worse, let your doctor or dermatologist know right away.