Eczema is a group of inflammatory skin conditions that causes dry, itchy skin, scaly patches, rashes, blisters, and skin infections. More than 31 million people in the United States have some form of eczema. This condition can begin anytime, even in newborns and young children. Adults who develop eczema most commonly get it in their 20s or after age 50, but people can experience eczema at any age. There are multiple types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and neurodermatitis. This guide will provide information about the symptoms, triggers, and various types of eczema and how to treat them.

What is eczema?

Eczema is a chronic skin condition related to a dysfunctional skin barrier that affects hydration. Water can more easily escape the skin, leading to dryness and increasing the risk of infection. People with some types of eczema are often more sensitive to things like fragrances and allergens, which can cause an inflammatory response in the skin. Genetics are thought to play a role in developing eczema, and environmental factors, like harsh soaps and detergents, pollen, or cold and dry weather, can also contribute.


Recognizing symptoms of eczema

Eczema symptoms may begin with a red, itchy, bumpy rash. The skin will start to thicken as the person continues to itch the area. Infants generally get a widely distributed dry and itchy rash and are more likely to have facial involvement, particularly on their cheeks. The rash typically becomes more localized for older children and adults and may appear on the elbow, wrists, knees, and ankles, including on the underside of the elbows and knees. Eczema often gets better over time and can come and go or disappear altogether. It usually comes and goes in flare-ups when symptoms get worse and then better.


Treatment options for eczema

While there is no cure for eczema, many treatment options are available. Topical medications, like corticosteroid creams, can be applied directly to the skin to minimize inflammation and itching and are generally stopped once symptoms recede. Oral immunosuppressants or steroids can calm the immune system and control flares for people with moderate to severe eczema. However, these medications can have some side effects, including an increased risk of infection and certain cancers. Another option is biologics, a newer treatment engineered to block the immune system's response. Ultra-violet light therapy from an artificial lamp can also help with widespread eczema or localized rashes that have not improved with other treatments.

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Understanding eczema triggers

Identifying and avoiding triggers is important for people with eczema to avoid flare-ups and improve their skin. Common triggers for people with eczema include eggs, peanuts, soy, milk, fish, wheat, rice, and dust mites. Sweat and overheating can cause eczema flares, and some people may be sensitive to harsh detergents and soaps or non-breathable fabrics or wool. People with eczema should avoid any foods that cause flare-ups and wear cool, loose-fitting, breathable fabrics. Research also shows that using syndet bars, which contain mild synthetic detergents or surfactants that are milder than soap, can be beneficial for treating eczema.


Types of eczema

There are multiple types of eczema, including the following:

  • Atopic dermatitis: Atopic dermatitis is the most common form of eczema and is more common in children but can occur in adults. It is characterized by itchy, dry, red skin and is often associated with asthma and allergies.
  • Contact dermatitis: This type of eczema develops due to exposure to chemicals, materials, allergens, and irritants. Symptoms can vary depending on the specific allergen involved, ranging from mild redness and burning to severe blistering.
  • Dyshidrotic eczema: This type of eczema, also known as pompholyx, is characterized by tiny, itchy blisters resembling tapioca pudding on the palms, fingers, and soles of the feet.
  • Nummular eczema: Nummular eczema produces itchy, circular patches, usually on the arms and legs, that can get as large as three centimeters in diameter. It is also called discoid dermatitis.
  • Seborrheic dermatitis: This chronic form of eczema causes inflamed, scaly skin on areas with a high concentration of sebaceous glands, including the scalp, face, and chest.
  • Neurodermatitis: Also called lichen simplex chronicus, this form of eczema results from chronic scratching, which causes the skin to be thick, itchy, dry, and darker than the surrounding skin.

Woman scratching the eczema on her neck -aniaostudio- / Getty Images


Managing eczema in young children

To manage eczema in infants and children, practice gentle skincare to improve the skin barrier. Children with eczema should bathe in lukewarm water daily or every other day. You can also soak your child for 15 minutes in a bleach bath, adding 1/2 a cup of plain bleach to a tub full of lukewarm water and rinsing with plain water when finished. Do not use soap; use a fragrance-free, hypoallergenic cleanser on the sweaty areas and the hands and feet. Pat the skin dry, and apply any topical medications the pediatrician prescribes. Then, apply moisturizer. Use mild, fragrance-free detergents to wash clothes and dress children in soft, breathable fabrics. Keep your child's nails short and try to prevent scratching as much as possible to prevent infection.

baby with small red bumps in face globalmoments / Getty Images


Lifestyle and home remedies

Some things can help manage eczema in addition to taking prescribed medications. Here are some interventions to try:

  • Moisturize your skin twice daily, especially right after a bath or shower.
  • Apply anti-itch cream to the area no more than twice a day before moisturizing.
  • Take an oral allergy medication.
  • Try not to scratch. Keep your nails trimmed short, cover the itchy area, or wear gloves if needed.
  • Shower daily using warm water or soak for 10 minutes in a bath with colloidal oatmeal.
  • Take a bleach bath. Add 1/2 cup of regular bleach to a bathtub filled with warm water. Soak for five to ten minutes, then rinse with regular water. You can do this two or three times a week.
  • Use a humidifier to prevent the air in your home from getting too dry.
  • Wear cool, breathable clothing.
  • Avoid harsh soaps and detergents.

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Preventing flare-ups

Two things that people with eczema can do to prevent flare-ups are to avoid triggers and practice consistent skincare routines. Consistent skin care routines can help keep the skin moisturized, which can prevent it from drying out and becoming itchy. Research also shows that stress can affect eczema, particularly chronic stress. There are many ways to relieve stress, but it can take time to determine a strategy that works for you. Some techniques to try include:

  • Eating healthy, well-balanced meals.
  • Prioritizing sleep.
  • Establishing a regular exercise routine.
  • Practicing deep breathing exercises.
  • Avoiding excessive alcohol or substance use.
  • Making time for activities you enjoy.
  • Spending time with loved ones.
  • Knowing when you need more help and reaching out to a mental health professional.

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Education and awareness

Although more than 31 million Americans experience eczema, many misconceptions about the condition persist. It is essential to remember that eczema is not contagious, and it is much more than dry skin. Children with eczema have an increased risk of developing food and environmental allergies, allergic rhinitis, and asthma. If you have questions about eczema or have eczema and are looking for additional support, consider the organizations and online resources below:

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Complications of eczema

Because people with eczema have a dysfunctional skin barrier, they have an increased risk of viral, bacterial, and fungal skin infections. For example, about 10 percent of people without eczema are colonized with staph aureus compared to over 90 percent of people with eczema. They are also more at risk for infections caused by herpes simplex virus-1, which can lead to a life-threatening condition called eczema herpeticum. This medical emergency can lead to meningitis, encephalitis, and sepsis. Research also shows that people with eczema have an increased risk of depression and anxiety, which can significantly impact daily life.

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Talk to your doctor

Eczema is a complex, chronic, inflammatory skin condition that can affect more than the skin. Children with eczema are more likely to develop allergies, and adults are at higher risk for depression and anxiety. Learning to manage this condition with an effective skincare routine and avoidance of triggers can prevent flare-ups and complications. While there is no cure for eczema, many treatment options are available. Talk to your doctor about available treatment options and learn more about effective management.

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