Key takeaways
- Eczema is a common inflammatory skin condition. Characteristic features include itchy, rough patches of skin. While it commonly begins in childhood, it can also affect adults.
- Symptoms of eczema can vary depending on age and skin tone. However, common symptoms include dry, scaly skin; thickened or discolored patches; and intense itching, which can lead to skin infections. People with darker skin tones may experience patches of hyperpigmentation or hypopigmentation.
- Although there is currently no cure for eczema, treatments can help manage symptoms and prevent flare-ups. These include topical creams, oral medications, injectable medications, phototherapy, and home remedies. Identifying and avoiding triggers, such as irritants, allergens, and extreme temperatures, is also important.
Eczema affects 31.6 million people in the United States, which is nearly 10% of the population.
This article will examine eczema and its different types, and discuss the condition’s symptoms, causes, and treatment options.
Eczema is an inflammatory skin condition that may cause itchy, rough patches on a person’s skin.
Atopic dermatitis is the most common type and is often seen in childhood. AD is commonly used to describe eczema because it is the
Approximately 1 in 4 children develop AD, with symptoms often appearing by the age of 5 years. Experts previously thought that about 60% of people with AD no longer show symptoms by adolescence, but they now think that number is closer to 35%.
That said, around
AD is commonly used to describe eczema because it is the
That said, there are other forms of eczema, including:
- Contact dermatitis: This is a skin reaction that occurs when the skin comes into direct contact with a substance that causes irritation or an allergic reaction.
- Dyshidrotic eczema: Characterized by small blisters, dyshidrotic eczema refers to irritation of the skin on the palms of the hands and soles of the feet.
- Neurodermatitis: This leads to scaly patches on the feet, ankles, hands, wrists, elbows, shoulders, neck, and scalp. The eyelids, genital, and anal areas can also be affected. It occurs due to a localized itch, such as from an insect bite, cosmetic product, or emotional trigger.
- Discoid eczema: Also known as nummular eczema, this type presents itself as circular patches of irritated skin that can be crusted, scaly, and itchy.
- Stasis dermatitis: This refers to skin irritation of the lower legs. It is usually related to circulatory problems.
Symptoms vary by individual and may depend on factors such as age, skin tone, and severity.
In most cases, symptoms are mild. However, symptoms may come and go and vary in severity.
Flare-ups are periods when
The most common symptoms include:
- dry, scaly patches of skin
- thickened, discolored skin
- open, crusted, or weeping sores
- skin flushing
- itching
The appearance of skin affected by this condition will also depend on how much a person scratches their rashes.
For example, people with severe eczema may experience severe itching that could lead to continuous rubbing and scratching. This may cause skin infections like infected eczema.
The location, type, and severity of rashes may also vary depending on a person’s age.
Infants
Babies under the age of 2 may experience:
- rashes on the scalp and cheeks
- rashes that bubble up before leaking fluid
- rashes that cause extreme itchiness, which may interfere with sleeping
Childhood
Children from the ages of 2 to puberty may experience rashes that appear:
- behind the creases of elbows or knees
- on the neck, wrists, and ankles
- in the crease between the buttocks and legs
They may also experience:
- bumpy rashes
- rashes that can become lighter or darker
- skin thickening, also known as lichenification, due to constant scratching or rubbing, which can perpetuate an itch-scratch cycle
African American and Hispanic children may also have more severe eczema.
Adults
Adults may experience eczema rashes that could:
- be more scaly than those occurring in children
- appear in the creases of the elbows, knees, or nape of the neck
- cover much of the body
- be chronically itchy
People over 18 years old may also experience skin infections or very dry skin on the affected area.
Adults who developed eczema as children but no longer experience the condition may still have:
- dry or easily irritated skin
- hand eczema
- eczema on the eyelids
| Age | Location | Symptoms |
|---|---|---|
| Babies (under 2 years) | • scalp • cheeks | • rashes may bubble up before leaking fluid • extreme itchiness, which may interfere with sleeping |
| Children (2 to puberty) | • behind the creases of elbows or knees • neck • wrists • ankles • crease between the buttocks and legs | • bumpy rashes • rashes may become lighter or darker • skin thickening, also known as lichenification, which can then develop into a permanent itch |
| Adults (18+) | • creases of the elbows, knees, or nape of the neck • cover much of the body | • more scaly rashes • very dry skin on the affected areas • chronically itchy rashes • skin infections |
Skin tones
An eczema rash may appear gray or brown in people with dark skin tones, making the condition harder to see.
That said, people with darker skin tones may also get dark or light skin patches even after eczema symptoms go away. These patches are known as hyperpigmentation or hypopigmentation. They may last a long time.
A dermatologist can look at these patches and develop a treatment plan, which may include steroid creams.
There is no known cause of eczema. However, health professionals believe that it may develop from a combination of genetic and environmental factors.
Children are more likely to develop eczema if a parent has it or another atopic condition, such as asthma and hay fever. If both parents have an atopic condition, the risk is even higher.
- Irritants: These include soaps, detergents, shampoos, disinfectants, and juices from fresh fruits, meats, and vegetables.
- Allergens: Dust mites, pets, pollens, and mold can trigger eczema flares in some people.
- Microbes: These include bacteria such as Staphylococcus aureus, viruses, and certain fungi.
- Hot and cold temperatures: Very hot or very cold weather, high or low humidity, and perspiration from exercise can trigger eczema flares.
- Foods: Dairy products, eggs, nuts and seeds, soy products, and wheat can trigger eczema flares in susceptible people.
- Stress: This is not a direct cause of eczema, but it can worsen symptoms.
- Hormones: Females may experience increased eczema symptoms when hormone levels change, such as during pregnancy and at certain points in the menstrual cycle.
There is currently no cure for eczema. However, treatments aim to heal the affected skin and prevent symptom flare-ups.
A doctor will develop a treatment plan based on a person’s:
- age
- symptoms
- current health condition
For some people, eczema may go away over time. For others, it is a lifelong condition.
Medications
Several types of medications may help treat eczema symptoms.
- Topical corticosteroids: These anti-inflammatory medications (often in the form of creams or ointments) are applied directly to the skin to help relieve the main symptoms of eczema, such as inflammation and itchiness. They are available as over-the-counter (OTC) or prescription medications, depending on the strength needed.
- Oral medications: Rarely, in cases of moderate to severe eczema, a doctor may prescribe systemic corticosteroids or immunosuppressants, which are available as injections or oral tablets. People should only use these for short periods. Also, it is important to note that the symptoms may worsen upon stopping these drugs if the person is not already taking another medication for the condition.
- Antibiotics: Doctors prescribe antibiotics if eczema occurs alongside a bacterial skin infection.
- Antihistamines: These can reduce the risk of nighttime scratching, as they tend to cause drowsiness.
- Topical calcineurin inhibitors: These medications stop certain immune system cells from “switching on,” helping reduce inflammation and prevent flares.
- Topical JAK inhibitors: These target immune pathways to reduce inflammation. The JAK inhibitor ruxolitinib (Opzelura) is approved as a cream to treat mild to moderate eczema.
- Topical PDE-4 inhibitors: Crisaborole ointment (Eurcrisa) and roflumilast cream (Zoryve) block the PDE4 enzyme, reducing inflammation under the skin.
- Barrier repair moisturizers: These reduce water loss and work to repair the skin.
- Phototherapy: This involves exposure to ultraviolet (UV) waves and may help treat moderate AD.
To treat moderate to severe eczema, a doctor may prescribe a combination of topical and systemic treatments, such as biologics.
Biologics block specific proteins in the immune system that trigger inflammation, helping reduce eczema symptoms. However, they may cause mild, manageable side effects.
The Food and Drug Administration (FDA) has approved the following biologics to treat eczema:
- dupilumab (Dupixent)
- tralokinumab-ldrm (Adbry)
- lebrikizumab-lbkz (Ebglyss)
- nemolizumab-ilto (Nemluvio)
Two systemic JAK inhibitors have also been approved by the FDA to help treat moderate to severe AD:
- abrocitinib (Cibinqo)
- upadacitinib (Rinvoq)
Even after an area of skin has healed, it is important to keep looking after it, as it may easily become irritated again.
Home care
Some home remedies may help people with eczema support their skin health and alleviate symptoms, including:
- taking lukewarm baths
- applying moisturizer within 3 minutes of bathing to “lock in” moisture
- moisturizing every day
- wearing cotton and soft fabrics
- avoiding rough, scratchy fibers and tight-fitting clothing
- using a humidifier in dry or cold weather
- using a mild soap or a nonsoap cleanser when washing
- taking extra precautions to prevent eczema flares in winter
- gently patting the skin dry with a towel, rather than rubbing the skin after bathing or taking a shower
- avoiding rapid changes in temperature and activities that cause sweating
- learning and avoiding individual eczema triggers
- keeping fingernails short to prevent scratching and breaking the skin
People can also try various natural remedies for eczema, including aloe vera and coconut oil. These can help soothe dryness or irritation, but they should not replace standard treatments.
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The cause of eczema is unknown. However, certain triggers may cause eczema symptoms to flare up.
These may include:
- stress
- certain irritants, like soaps, detergents, and shampoos
- allergens, like dust mites and mold
- very hot or very cold temperatures
- some foods
There is currently no cure for eczema. But some different treatment options may help people manage their symptoms and reduce the risk of flare-ups.
These may include:
- systemic therapies
- phototherapy
- oral medications
- topical ointments
- home remedies
A person should speak with a doctor to develop the best treatment plan for them.
Eczema is an inflammatory skin condition that is more common in children, although it can persist into adulthood or first develop in adults.
The most common type is called atopic dermatitis (AD), which may cause discomfort and vary in severity. It can present differently depending on a person’s age. In people with darker skin tones, the symptoms may be harder to see for some people.
Although there is currently no cure, people can treat and help prevent eczema flares using home remedies, moisturizers, medications, and lifestyle changes.