When people talk about eczema, they usually mean atopic dermatitis, its most common form. But eczema is the name for a group of skin conditions. They all cause red, itchy, and often cracked skin, but there are also different symptoms for each type.
This form of eczema starts with an intense itch. Once you give in to the urge to scratch, the telltale rash begins. When skin is very irritated, it can crack and bleed or ooze clear fluid.
The main symptoms are the same for almost everyone, but how often they happen, and how severe they are, vary from person to person. There are also some key differences, depending on your age.
Symptoms in babies:
- Appears mostly on the scalp and cheeks
- Dry, itchy skin
- Lesions that may ooze
- Fussiness and trouble sleeping because of itching
A skin infection may develop if your baby rubs the affected area.
Symptoms in children:
Skin may become swollen, change color, and thicken over time.
Symptoms in adults:
- Eczema is often on hands, on eyelids, and under the eyes
- Severely dry skin that is easily irritated and cracked
Skin may get thick and leathery over time.
Some adults get eczema only on their hands. Symptoms often follow this pattern:
- The skin looks chapped, red or brown, and irritated.
- The skin feels hot or burning and may itch.
- Patches of scaly and inflamed skin develop.
- Itchy, painful blisters may appear.
- The skin may crack and bleed or ooze and crust over.
This form of eczema is irritation or an allergic reaction to something that comes into contact with your skin, especially your hands or face. Symptoms may include:
- An intense itch and then a rash
- Skin that feels tender and may be painful
- An outbreak of hives or blisters that ooze and crust over
The skin can become thick, leathery, and cracked after repeated contact with your triggers.
This eczema is named after the term that means “disordered sweat.” It was once thought to be a problem with sweat glands. Signs appear only on the palms of the hands, the sides of the fingers, and sometimes the soles of the feet. When you have an outbreak, symptoms often follow this pattern:
- Severe itchiness and possibly pain or tingling, followed by tiny, itchy blisters
- Groups of blisters that may join together into bigger blisters
- Obvious sweat on blistered areas
- Peeling skin after the blisters go away
Over time, skin looks inflamed and scaly and gets cracks. Your nails may change color, thicken, and be ridged or pitted.
Nummular means “coin-like.” This form of eczema gets its name from the shape of the patches it creates, most often on your legs, forearms, or hands. Symptoms include:
- Tiny bumps that form after a skin injury, get crusty, and merge to make scaly coin shapes
- Intense itching, burning, or stinging that gets worse when sitting still or sleeping
- Dry skin between the patches
- Darkening of your regular skin color as the patches go away
This form of dermatitis often affects the scalp, especially in infants, and other areas rich in oil (or sebaceous) glands. It may go away in childhood but return in the teen years (especially in boys) and in adulthood. Unlike many other forms of eczema, it’s not always itchy.
Symptoms in babies include scaly and greasy patches on the scalp. It may affect the buttocks. It’s usually limited to infancy.
Symptoms in teens and adults:
- Dry, discolored skin over the problem veins
- Itchiness that often spreads to the top of the foot
- Swelling and discomfort in the leg or ankle that gets worse during the day and better when you sleep
Stasis dermatitis can lead to:
- Skin that darkens and becomes tough and scaly from the calf to the foot
- Very itchy and painful skin
- Sores that easily bleed
This is an unusual form of eczema that usually causes just one or two patches on a specific area, like the nape of the neck, the scalp, the eyelids, or the arms. Patches can even appear around the genitals or anus. Symptoms include:
- An intense itch that worsens as you scratch or rub it
- Itching that gets worse with stress or while sleeping
- Pain from scratching
Once a raised patch develops, it may:
- Look scaly, thick, and leathery
- Change color to red or violet from scratching
- Develop sores that bleed
- Become even itchier
From Mild to Severe: How Serious Is Your Eczema?
The seriousness of eczema symptoms can vary a great deal between people. With mild eczema, you may have nothing more than small areas of dry skin that get a bit itchy from time to time.
In more serious cases, eczema inflames skin all over your body and causes relentless itching that can be hard to ignore. It might even be hard to focus on school or work. In addition, you may scratch in your sleep, causing cuts and tears that lead to regular infection.
The inflammation often reddens lighter-colored skin noticeably. It may be harder to see on darker skin, but it sometimes causes gray, purple, or darker brown coloration.
When to Call Your Doctor About Eczema
No matter what type of eczema you might have, schedule a visit if:
- You get an itchy rash and have a family history of eczema or asthma.
- The inflammation doesn't respond within a week to treatment with over-the-counter hydrocortisone creams. You may need stronger forms of treatment.
- You get yellowish to light brown crust or pus-filled blisters over patches of eczema, especially if you’ve been scratching. You could have a bacterial infection that should be treated with an antibiotic. In fact, you’re also more likely to get viral and fungal skin infections.
- During a flare-up of eczema, you have contact with anyone with a viral skin disease such as cold sores or genital herpes. Having eczema puts you at higher risk of catching the herpes simplex virus.
- You get many painful, small, fluid-filled blisters in the areas of eczema. You may have eczema herpeticum, a rare but potentially serious complication caused by the herpes simplex virus.