What Is Eczema?
Eczema is a term for a group of conditions that make your skin inflamed or irritated. The most common type is atopic dermatitis or atopic eczema. “Atopic” refers to a person’s tendency to get allergic conditions such as asthma and hay fever.
Eczema affects about 10% to 20% of infants and about 3% of adults and children in the U.S. Most children outgrow it by their 10th birthday. Some people continue to have symptoms on and off for life.
There’s no cure, but most people can manage their symptoms by getting treatment and by avoiding irritants. Eczema isn’t contagious, so you can’t spread it to another person.
Eczema looks different for everyone. And your flare-ups won’t always happen in the same area.
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.
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
Your skin will probably be very dry, thick, or scaly. In fair-skinned people, these areas may start out reddish and then turn brown. Among darker-skinned people, eczema can affect skin pigments, making the affected area lighter or darker.
When to see your doctor
Call your doctor if:
- You notice signs of an infection, such as fever, redness, warmth, 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 are usually talking about when they say “eczema.”
- 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.
- Dyshidrotic eczema. This happens when your skin doesn’t protect itself the way it should.
- Nummular eczema. People who have this type get round sores, often after a skin injury like a burn or insect bite.
- Seborrheic dermatitis. This happens in areas of your body with lots of oil glands. When it’s on your scalp, it’s called dandruff.
- Stasis dermatitis. This type happens in people who have poor blood flow, usually in the lower legs.
Eczema Causes and Risk Factors
Experts aren’t sure what exactly causes eczema. It may be linked to your immune system’s response to something irritating. Problems in your skin’s barrier could also let moisture out and germs in.
Some people have flare-ups of the itchy rash in response to things like:
- Rough or coarse fabric
- Feeling too hot or cold
- Household products like soap or detergent
- Animal dander
- Respiratory infections or colds
No one test can spot eczema. Your doctor will probably diagnose it by looking at your skin and by asking a few questions.
Eczema treatment’s aim is easing and preventing itching, which can lead to infection.
Because your skin is dry and itchy, your doctor will recommend lotions and creams to keep it moist. You’ll use these when your skin is damp, such as after bathing, to help hold in moisture. Over-the-counter products like hydrocortisone cream and antihistamines can also help.
Cold compresses may soothe itching.
Your doctor may also prescribe creams and ointments with corticosteroids to ease inflammation. If the area becomes infected, you’ll probably need antibiotics.
Other options include tar treatments (chemicals that reduce itching), phototherapy (using ultraviolet light), and the drug cyclosporine.
The FDA has approved two medications called topical immunomodulators (TIMs) for mild to moderate eczema. Elidel and Protopic are skin creams that work by changing your immune system response to prevent flare-ups.
The FDA has warned doctors to use caution with Elidel and Protopic because of concerns over a cancer risk. The two creams 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) is FDA approved 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.
Complications from eczema include:
- Loss of sleep because of itching
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.
- Manage stress.
- 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 your bedroom.