Individuals with eczema experience itchy, dry, cracked skin. The most common areas that eczema may affect include the hands, elbow creases, or the backs of the knees.
The different types of eczema can appear all over the body. Treatment usually includes moisturizers and topical corticosteroids.
This article will explain the areas where eczema most commonly occurs, the types of eczema, and its symptoms. It will also touch upon triggers and treatment.
A note about sex and gender
Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.
According to the National Eczema Association, seven different types of eczema can affect various parts of the skin. These include the following:
- Seborrheic dermatitis: This type of eczema usually affects the scalp.
- Stasis dermatitis: This can affect the skin on the legs.
- Dyshidrotic eczema: This can affect the hands and feet.
- Neurodermatitis: This usually affects the feet, ankles, hands, wrists, elbows, shoulders, neck, scalp, and sometimes the genital and anal areas.
- Nummular eczema: This can affect the arms, legs, torso, and hands
- Contact dermatitis: This can affect parts of the body that experience exposure to irritants or allergens and usually occurs on the hands.
Different factors may trigger an eczema flare-up depending on the type of eczema a person has.
In people with atopic eczema, the immune system overreacts to triggers, which may include:
There are two types of contact dermatitis. The National Eczema Association reports that irritant contact dermatitis makes up 80% of cases.
The following can damage the skin cells in a person with irritant contact dermatitis:
- solvents and bleach
- detergents and soaps
- jewelry, scissors, or belt buckles that contain nickel
- makeup and hair dye
- clothes with metal snaps or zippers
- over-washing the hands with hot water and soap
- scratchy wool
The other type of contact dermatitis involves an allergic reaction. People with allergic contact dermatitis have an allergic reaction 1–2 days after exposure to substances such as:
- poison ivy or poison oak
- nail polish
- thimerosal, a preservative found in some topical antibiotics
Any external trigger that impacts the immune system can lead to dyshidrotic eczema. Examples include:
- metals, especially nickel
- laundry detergent
- seasonal allergies, such as hay fever
- hot, humid weather
- having sweaty palms
- jobs such as hairstyling or healthcare, which require a person to get their hands wet frequently
Neurodermatitis most commonly affects females aged 30–50 years who also have contact dermatitis or atopic dermatitis. Triggers for flare-ups of neurodermatitis include:
- tight clothing, especially items consisting of wool or synthetic fabrics
- insect bites
- nerve injury
- dry skin
Nummular eczema most often affects females. Triggers for this type of eczema include:
- very dry or sensitive skin
- trauma to the skin from insect bites, scrapes, or chemical burns
- other types of eczema and their triggers, such as contact dermatitis and nickel or stasis dermatitis and poor circulation
A combination of environmental and genetic factors can cause seborrheic dermatitis.
Common triggers include:
- recovery from a stressful event, such as a heart attack
- hormonal changes or illness
- harsh detergents, solvents, chemicals, and soaps
- cold, dry weather, or a change in season
- some medications, including psoralen, interferon, and lithium
- certain medical conditions, including HIV and Parkinson’s disease
This type of eczema links to issues with circulation in the legs.
Risk factors for developing stasis dermatitis include:
- varicose veins
- high blood pressure
- vein surgeries
- multiple pregnancies
- a history of blood clots in the legs
- congestive heart failure
- kidney failure
- lack of exercise
- a job that involves sitting or standing for hours
More than 85% of people with atopic eczema experience skin itching.
Some people also experience sore skin and poor sleep because of the itching, while others get rashes that weep fluid or bleed. Repeated scratching can cause skin hardening, which doctors may call “lichenification.”
Contact dermatitis also causes itching, crusting or scaly skin, and lesions or blisters. Some people may also experience the following:
- hypersensitivity to the sun and an increased risk of sunburn
- irritation from sunscreen
- oozing blisters
- sleep disturbances
- difficulty concentrating at work or school
People with dyshidrotic eczema can get a rash of painful, deep-seated blisters, known as “vesicles,” sometimes preceded by itching and burning sensations.
As the blisters heal, the skin dries, which can result in redness and peeling. The skin may become tender and dry, sometimes with painful cracks, leaving it susceptible to infection.
A person with neurodermatitis may develop thick, discolored patches of skin. Scratching patches of neurodermatitis can lead to open wounds that bleed, develop infections, scab, and scar. Scratching patches on the scalp may eventually lead to hair loss.
Nummular eczema may cause:
- coin-shaped lesions on the arms, legs, torso, and hands
- itching and burning sensations
- oozing or crusted lesions
- red, pinkish, or brown scaly and inflamed skin around the lesions
Common symptoms of seborrheic dermatitis include:
- flaking skin or dandruff
- patches of flaky white or yellow scales on top of oily skin
- an irritable rash that appears dark on skin of color and lighter on paler skin
- a ring-shaped rash in those with a type known as petaloid seborrheic dermatitis
Symptoms of stasis dermatitis include:
- ankle swelling
- orange-brown speckles, sometimes called “cayenne pepper spots”
- brown, purple, gray, or ashen discoloration in darker skin tones
- redness in lighter skin tones
- heaviness or aching after long periods of sitting or standing
Scientists do not know the exact causes of all the forms of eczema. However, genetic or environmental factors may be involved.
For instance, people with atopic eczema experience immune system overactivity, which causes inflammation. This damages the skin barrier and causes symptoms.
Some people with eczema have a genetic variant in the gene that produces a protein called filaggrin. The skin needs this protein to maintain the protective barrier of the outermost layer of skin. In people lacking filaggrin, moisture can escape from the skin, and pathogens such as bacteria can enter. This can result in very dry skin that is susceptible to infection.
On the other hand, exposure to an allergen or irritant can cause contact dermatitis. People who work with chemicals daily, such as mechanics, healthcare workers, and hairstylists, are susceptible to this form of eczema.
People can manage the dry skin associated with eczema with moisturizers. They can also do their best to avoid foods and other substances that trigger flares, such as fragrances, dyes, detergents, perfumes, and certain ointments.
A person with severe eczema symptoms may need the following medications:
A dermatologist can help by creating a customized treatment plan to manage persistent eczema.
A person can try to prevent eczema flare-ups by doing the following:
- choosing fragrance-free cosmetic products and detergents
- taking warm baths or showers for 5–10 minutes to hydrate the skin before locking in moisture with a moisturizer
- moisturizing when their skin feels dry
- wearing loose-fitting 100% cotton clothing to allow the skin to breathe
- avoiding extreme temperatures
Eczema is a common skin condition that causes itching, dryness, and cracked skin. Atopic eczema, also known as atopic dermatitis, is the most common type, usually affecting the hands, elbow creases, or backs of knees.
Causes may be genetic or environmental, and treatments can include moisturizers, antihistamines, and topical steroids.