Papular eczema is a skin condition that causes a rash of small, itchy bumps, or papules, to develop on the skin. The color of these rashes will vary depending on a person’s skin tone.

Eczema refers to a range of related skin conditions. When eczema looks like small bumps rather than a rash, doctors may refer to the condition as papular eczema.

This article will explain what papular eczema is, who is most likely to experience it, and how people can treat it.

There are several types of eczema, but the most common is atopic dermatitis. Some people may have both atopic dermatitis and papular eczema.

All types of eczema can affect people with any skin tone, but papular eczema with atopic dermatitis occurs more often in African American people.

Like other types of eczema, the symptoms of papular eczema and papular symptoms of eczema are linked to inflammation and faulty immune system responses.

There’s currently no cure for papular eczema, but people can use treatments and home remedies to help manage their symptoms and reduce flares. In some cases, a doctor may recommend systemic, or body-wide, treatments such as immunosuppressant drugs.

However, papular eczema may not respond to treatments as well as other forms of the condition.

What is the difference between atopic dermatitis and eczema?

The symptom that makes papular eczema different is how the eczema rash looks. Rather than appearing red and flaky, the rash comprises small bumps.

Papules can look similar to pimples but without pus. They may appear on the torso, arms, or legs. Papular eczema can be very itchy.

Other symptoms are the same as other forms of eczema and may include:

  • a scaly rash
  • dry, cracked skin
  • skin infections

On different skin tones

In darker skin tones, atopic dermatitis is more likely to involve papules, a thickening of the skin known as lichenification, and color changes that are different than those that appear in lighter skin types.

If inflammation occurs, lighter skin will present as red or pink, while darker skin tones may take on a violet, gray, or darker brown color.

People with darker skin may be less likely to receive an accurate diagnosis of eczema or atopic dermatitis as the symptoms may be harder to see or present differently to conventional descriptions of symptoms.

Eczema affects everyone differently. Papular eczema is more likely to affect African American people or people with darker skin.

Scientists do not yet know what causes eczema, but they believe that a person’s genes play a role. It is more likely to affect people who have eczema, asthma, or hay fever in their family.

People with eczema may have a problem with a gene that creates a protein called filaggrin. This plays a role in building a protective barrier on top of the skin.

A weakened barrier means that moisture can get out and bacteria, viruses, and other irritants can get in. This is why people with eczema tend to have dry skin that is prone to infections.

Eczema is an autoimmune condition. This means it results from the immune system overreacting.

Irritants can trigger the immune system and cause eczema outbreaks. Some triggers that cause the immune system to overreact include pollution, laundry detergent, and pollen.

Triggers are different for different people.

While there is no cure for eczema, people can use a range of treatments and remedies to ease their symptoms, depending on the type and severity of the condition.

  • Over-the-counter treatments: These include creams that can ease itching and prevent infection. They are available without a prescription.
  • Prescription products: A doctor may recommend a prescription cream or ointment such as PDE4 inhibitors, topical calcineurin inhibitors, and skin barrier creams.
  • Phototherapy: Phototherapy involves using a machine to emit ultraviolet B light onto the skin. This helps reduce itching and inflammation, increase vitamin D production, and strengthen the skin’s ability fight bacteria. Doctors may recommend phototherapy if a person has more severe eczema.
  • Biological medications: These medications work by targeting parts of the immune system that cause inflammation. They are often called biologics and are given via infusion.
  • Janus kinase (JAK) inhibitors: Ruxolitinib (Opzeulra) is a topical drug with approval from the Food and Drug Administration (FDA) for treating atopic dermatitis. Oral JAK inhibitors for atopic dermatitis include baricitinib (Olumiant).
  • Immunosuppressant and anti-inflammatory drugs: Cyclosporine (Neoral), Azathioprine (Imuran), and others can treat moderate to severe eczema.

Learn more about eczema treatments.

A number of home remedies can help manage eczema.

Moisturizing

Many people with eczema have dry skin, which can lead to eczema flare-ups. Using a moisturizer after every bath or shower can help prevent dry skin and flare-ups.

Try applying a generous layer of a fragrance-free product over the skin within 3 minutes of bathing or showering. Apply creams within 3 minutes of bathing.

Some people find that using complementary or natural remedies can help them manage flare-ups. These remedies include:

Coconut oil

Many people use coconut oil for eczema. Coconut oil can moisturize the skin and reduce the symptoms of dry skin conditions.

Applying virgin or cold-pressed coconut oil to damp skin may also reduce the amount of Staphylococcus bacteria on the skin. This can reduce the chances of developing an infection.

Aloe vera gel

People can also try aloe vera gel for eczema. Its antibacterial properties may help reduce skin infections. According to a 2019 review, aloe vera can also help promote skin integrity and retain skin moisture.

Apple cider vinegar

Diluted apple cider vinegar could also help with eczema. The skin is naturally acidic, which helps it protect against bacterial infection. Apple cider vinegar can help restore the skin’s natural acidic state, leaving it better able to protect itself from bacterial infections.

Sunflower oil

In adults, applying sunflower oil to the skin can help the skin’s barrier retain moisture. People can use it twice per day on damp skin. It’s important that people who are allergic to sunflower seeds do not use this remedy.

Cardiospermum

Using ointments containing extracts of the tropical cardiospermum vine may reduce inflammation and itching and kill bacteria on the skin.

Oatmeal bath

Adding colloidal oatmeal to a lukewarm bath can help soothe the skin.

To do this, follow the steps below:

  • Add oatmeal while running the bath.
  • Soak for 10–15 minutes.
  • Pat the skin with a towel after the bath, but leave it feeling damp.
  • Add moisturizer within 3 minutes of leaving the water.

What are some more natural and home remedies for eczema?

People cannot prevent papular eczema, but there are steps they can take to help prevent flare-ups or worsening symptoms.

Tips to help prevent eczema flares can include regularly moisturizing after baths and showers, and wearing soft, loose-fitting cotton clothing.

Identifying and avoiding exposure to triggers can also help in preventing eczema flares. Triggers are different for everyone but may include allergens such as:

Other irritants that can trigger eczema flares include:

  • some metals, particularly nickel
  • cigarette smoke
  • some soaps and detergents
  • certain fabrics, such as wool and polyester
  • antibacterial ointments and personal care products
  • disinfectants that contain formaldehyde
  • some shampoos
  • dyes and temporary tattoos

Stress and hot or cold weather can also trigger eczema for some people.

Making some dietary exchanges may also help manage eczema.

How can people prevent eczema flares in winter?

Here are some questions people often ask about papular eczema.

What does papular eczema look like?

Papular eczema appears as bumps or papules on the skin. Papules can look like acne, but they do not produce pus. They often appear as skin-colored, but on lighter skin tones, they may be pink or red, and on darker skin tones, they may be purple, gray, or darker than the surrounding skin.

How can I get rid of papular eczema?

As with other types of eczema, tips for preventing or managing papular eczema include moisturizing the skin with mild, fragrance-free products, bathing in lukewarm water, and avoiding triggers, such as dust, pet hair, and pollution, where possible.

Papular eczema is less common than other forms of eczema. People with darker skin are more likely to experience eczema papules.

Eczema in general is most common in children, but it can persist into adulthood.

In general, research indicates that eczema tends to clear up within 10 years in over 80% of children who have it and within 20 years in up to 95% of children who have it. Eczema is more likely to persist if a child develops the condition between the ages of 2 and 5 years.

Eczema can return in some adults, most frequently on the hands.