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Eczema vs. Dry Skin

Medically Reviewed by Stephanie S. Gardner, MD on March 22, 2022

Both dry skin and eczema can make skin scaly, itchy, and red. Dry skin is a trigger for eczema, which is also called atopic dermatitis. And eczema is one possible cause of dry skin.

Because these conditions have overlapping symptoms, it can be hard to tell them apart. Here's a primer on eczema vs. dry skin and how to know which one you or your child has.

Dry Skin vs. Eczema

Dry skin is a very common skin condition. It affects people of all ages, although skin does become drier and thinner as you get older.

Your environment can also affect the dryness of your skin. All of these things strip skin of moisture:

  • A cold climate
  • Indoor heating
  • Long hot showers
  • Frequent hand washing
  • Harsh soaps or detergents

Eczema isn't quite as common as dry skin. It affects about 12% of children and 7% of adults in the United States. Often the symptoms start in childhood.

The outer layer of your skin works as a barrier to hold moisture in your skin and keep out germs, allergens, and irritants. Eczema happens when this layer doesn't work like it should. Your skin dries out as a result. Allergens like food or pet dander literally get under your skin and set off bouts of symptoms.

A combination of genes, a faulty immune response, and environmental triggers cause eczema. The condition tends to run in families. So if you have it, your children might too.

Your genes set the stage for eczema by creating a weaker skin barrier. Then triggers like these set off flares of skin symptoms:

  • Allergens such as pollen and pet hair
  • Tobacco smoke
  • Pollutants
  • Stress
  • Foods like dairy, wheat, or nuts
  • Harsh soaps and detergents
  • Rough fabrics like wool

Is Dry Skin a Risk for Eczema?

Dry skin doesn't cause eczema, but it can set off symptom flares in people who are already at risk. When skin gets very dry, it becomes cracked and scaly. This makes it easier for irritants to get inside.

Dry skin is also a symptom of eczema. If you have an eczema flare, dry skin may be the first sign. And because the two conditions look so much alike, it can be hard to figure out which one you have.

How to Tell the Difference

Subtle differences can help you figure out whether you or your child has dry skin or eczema. Your family history and medical history can give you clues. Eczema is more common in people with asthma and allergies. Some children with the condition are allergic to one or more types of food.

Next, look at what symptoms you or your child has. Both conditions cause dry and itchy skin, but there are some notable differences between the two.

Dry skin is:

  • Tight
  • Rough
  • Flaky
  • Cracking or peeling
  • Reddish

Eczema skin is:

  • Red or gray in patches
  • Bumpy with blisters that ooze fluid and then form a crust
  • Cracked or scaly
  • Thick
  • Raw from scratching

Eczema looks different in children as they get older. Infants tend to get it in places like their face, scalp, arms, and legs. Older children often get scaly patches only on the insides of their elbows and the backs of their knees.

Treatment Options

Making a few changes at home may be enough to solve dry skin. Most of these tips are also helpful for dryness related to eczema.

Take shorter showers. Standing under a hot spray for too long pulls moisture from your skin. Try to limit your showers and baths to 10 minutes or less. Keep the water lukewarm, and use a gentle cleanser that won't irritate your skin.

Moisturize. When you get out of the shower, seal in the water with a moisturizer. Ointments and creams hydrate better than lotions. Look for gentle, fragrance-free products with ingredients like lipids and ceramides, which form a protective barrier on the skin. If you or your child has eczema, the National Eczema Association offers recommendations for products that won't irritate sensitive skin.

Use gentle products. Read the ingredients list on all personal care products you buy for yourself and your child. Look for shampoos, soaps, and detergents marked "fragrance-free," "unscented," and "dye-free." They're less likely to irritate skin.

Turn on a humidifier. It's an easy way to add moisture to the air, especially during the dry winter months.

Eczema Medications

Many different medications relieve eczema symptoms like itching, redness, and inflammation. Ask a dermatologist which of these products might work best for you or your child.

  • Over-the-counter antihistamines, hydrocortisone, or shampoo
  • Prescription topical medicines such as steroids and calcineurin inhibitors
  • Steroid pills

If eczema covers a large part of your body and topical treatments haven't helped, your doctor might suggest phototherapy, also called light therapy. Exposure to ultraviolet light from a machine sometimes helps clear up stubborn eczema flares.

Other medicines work on your immune system to prevent eczema flares. Methotrexate (Rheumatrex, Trexall), azathioprine (Azasan, Imuran), and cyclosporine (Neoral, Sandimmune) calm your immune system so that it doesn't overreact and inflame your skin.

Biologic drugs block the parts of your immune system that lead to skin inflammation. Two biologics are approved to treat eczema:

  • Dupilumab (Dupixent)
  • Tralokinumab-Idrm (Adbry)

These medications are meant for people whose skin hasn't improved with topical medications. Biologics come as injections.

Janus kinase (JAK) inhibitors block the immune signals that cause skin inflammation. The two approved JAK inhibitors for eczema are abrocitinib (Cibinqo) and upadacitinib (Rinvoq). They come in a pill.

Any of these medications can cause side effects. That doesn't mean you'll have any problems, only that you should be aware of them. Before you or your child starts on any new treatment, ask your doctor what side effects it might cause and how to manage them.

When to Talk to Your Doctor

Dry skin is often easy to treat yourself with moisturizers and other home remedies. Call your doctor if:

  • Your symptoms don't improve with treatments you've tried or they get worse
  • The itching really bothers you or keeps you awake
  • You have open cuts or sores from scratching

If you think your child has eczema, see their pediatrician for a diagnosis. The doctor can send you to a pediatric dermatologist if your child needs a prescription medication.

You may be able to manage eczema in yourself with home remedies and over-the-counter treatments. If your symptoms don't improve, see your primary care doctor or a dermatologist for advice. Also call if a treatment your doctor prescribed hasn't helped, or you have signs of an infection like redness and pain.

Show Sources

SOURCES:

American Academy of Dermatology: "Dermatologists' Top Tips for Relieving Dry Skin," "Dry, scaly, and painful hands could be hand eczema."

Boston Children's Hospital: "Atopic Dermatitis and Eczema Symptoms & Causes."

Cincinnati Children's: "What is Eczema?"

Cleveland Clinic: "Dry Skin," "Eczema."

Intermountain Healthcare: "Eczema."

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