Different types and stages of eczema affect 31.6 million people in the United States, which is over 10% of the population. Many people use the word eczema when referring to atopic dermatitis, which is the most common type. The term atopic refers to a collection of conditions that involve the immune system, including atopic dermatitis, asthma, and hay fever. The word dermatitis refers to inflammation of the skin.
Certain foods, such as nuts and dairy, can trigger symptoms. Environmental triggers include smoke, pollen, soaps, and fragrances. Eczema is not contagious.
Some people outgrow the condition, whereas others will continue to have it throughout adulthood. This article will explain what eczema is and discuss its symptoms, treatments, causes, and types.
The symptoms of atopic dermatitis can vary depending on the age of the person who has it. Atopic dermatitis is common in infants, with dry and scaly patches appearing on the skin. These patches are often intensely itchy. Continuous rubbing and scratching can lead to skin infections. Learn how to identify infected eczema here. In most cases, however, eczema is mild. The most common symptoms of atopic dermatitis include:
- dry, scaly skin
- skin flushing
- open, crusted, or weeping sores
Some of the symptoms of eczema are different in people with darker skin. Learn more here. People with severe eczema will need more intensive treatment to relieve their symptoms. Most people with the condition develop it before the age of 5 years. However, an estimated 60% of children will no longer show symptoms by adolescence. People with the condition will often experience periods of time when their symptoms worsen, followed by periods of time when their symptoms will improve or clear up. The symptoms in children and adults may be different. The following sections will outline some of these differences in more detail.
Symptoms in infants
The following atopic dermatitis symptoms are common in infants under the age of 2:
- rashes on the scalp and cheeks
- rashes that bubble up before leaking fluid
- rashes that can cause extreme itchiness, which may interfere with sleeping
Symptoms in children
The following atopic dermatitis symptoms are common in children age 2 and above:
- rashes that appear behind the creases of elbows or knees
- rashes that appear on the neck, wrists, ankles, and the crease between the buttocks and legs
- bumpy rashes
- rashes that can become lighter or darker
- skin thickening, also known as lichenification, which can then develop into a permanent itch
Symptoms in adults
The following atopic dermatitis symptoms are common in adults:
- rashes that are more scaly than those occurring in children
- rashes that commonly appear in the creases of the elbows or knees or the nape of the neck
- rashes that cover much of the body
- very dry skin on the affected areas
- rashes that are permanently itchy
- skin infections
Adults who developed atopic dermatitis as a child but no longer experience the condition may still have dry or easily irritated skin, hand eczema, and eye problems. The appearance of skin affected by atopic dermatitis will depend on how much a person scratches and whether or not the skin is infected. Scratching and rubbing can further irritate the skin, increase inflammation, and make the itching worse.
There is currently no cure for eczema. Treatment for the condition aims to heal the affected skin and prevent flares of symptoms. Doctors will suggest a treatment plan based on an individual's age, symptoms, and current state of health. For some people, eczema goes away over time. For others, however, it is a lifelong condition. The sections below will list some treatment options.
There are several things that people with eczema can do to support skin health and alleviate symptoms. For example, they can try:
- 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 non-soap cleanser when washing
- taking extra precautions to prevent eczema flares in winter
- air drying or gently patting the skin dry with a towel, rather than rubbing the skin dry after bathing or taking a shower
- where possible, avoiding rapid changes of temperature and activities that cause sweating
- learning and avoiding individual eczema triggers
- keeping fingernails short to prevent scratching from breaking the skin
People can also try various natural remedies for eczema, including aloe vera, coconut oil, and apple cider vinegar.
Doctors can prescribe several medications to treat the symptoms of eczema, including:
- Topical corticosteroid creams and ointments: These are anti-inflammatory medications and should relieve the main symptoms of eczema, such as inflammation and itchiness. People can apply them directly to the skin. A range of topical corticosteroid creams and ointments are available online. Some people may benefit from prescription-strength medications, however.
- Systemic corticosteroids: If topical treatments are not effective, a doctor may prescribe systemic corticosteroids. These are available as injections or oral tablets. People should only use them for short periods of time. 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.
- Antiviral and antifungal medications: These can treat fungal and viral infections.
- Antihistamines: These can reduce the risk of nighttime scratching, as they tend to cause drowsiness.
- Topical calcineurin inhibitors: This drug suppresses the activities of the immune system. It decreases inflammation and helps prevent flares.
- Barrier repair moisturizers: These reduce water loss and work to repair the skin.
- Phototherapy: This involves exposure to UVA or UVB waves. This method can treat moderate dermatitis. A doctor will monitor the skin closely throughout the treatment.
Even though the condition itself is not currently curable, each person should have a tailored treatment plan. Also, even after an area of skin has healed, it is important to keep looking after it, as it may easily become irritated again.
The specific cause of eczema remains unknown, but many health professionals believe that it develops due to a combination of genetic and environmental factors. Children are more likely to develop eczema if a parent has it or another atopic condition. If both parents have an atopic condition, the risk is even higher. Some environmental factors can bring out the symptoms of eczema. These factors include:
- Irritants: These include soaps, detergents, shampoos, disinfectants, juices from fresh fruits, meats, and vegetables.
- Allergens: Dust mites, pets, pollens, and mold can all lead to eczema. This is known as allergic eczema.
- Microbes: These include bacteria such as Staphylococcus aureus, viruses, and certain fungi.
- Hot and cold temperatures: Very hot and very cold weather, high and low humidity, and perspiration from exercise can bring out eczema.
- Foods: Dairy products, eggs, nuts and seeds, soy products, and wheat can cause eczema flares.
- Stress: This is not a direct cause of eczema, but it can make the symptoms worse.
- Hormones: Females may experience increased eczema symptoms when their hormone levels are changing, such as during pregnancy and at certain points in the menstrual cycle.
There are several types of eczema. Besides atopic dermatitis, other types include:
- Allergic contact dermatitis: This is a skin reaction that occurs following contact with a substance or allergen that the immune system recognizes as foreign.
- Dyshidrotic eczema: This refers to irritation of the skin on the palms of the hands and soles of the feet. It is characterized by blisters.
- Neurodermatitis: This leads to scaly patches of skin on the head, forearms, wrists, and lower legs. It occurs due to a localized itch, such as from an insect bite.
- Discoid eczema: Also known as nummular eczema, this type presents as circular patches of irritated skin that can be crusted, scaly, and itchy.
- Stasis dermatitis: This refers to skin irritation of the lower leg. It is usually related to circulatory problems.
Eczema is a common inflammatory skin condition. The most common type is called atopic dermatitis. Eczema is most common in children, but the majority grow out of it by the time they reach adolescence. Although there is currently no cure, people can treat and prevent eczema flares using home remedies, moisturizers, medications, and lifestyle changes.