Eczema

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Introduction

What is eczema?

Eczema, also known as atopic dermatitis, is a common chronic skin condition marked by itching, inflammation, redness and swelling of the skin. Eczema is a form of dermatitis. Eczema itself is not dangerous, and it is not contagious. Eczema is an allergic condition that is most common in babies and children and usually resolves by adulthood.

Eczema occurs when skin is more sensitive to certain substances than normal. The appearance, severity, symptoms and triggers of eczema vary between individuals. There is currently no cure for eczema, but eczema can be controlled with regular medical care and a good treatment plan. Some types of eczema can be prevented by avoiding stress, irritants, and things that cause allergic reactions.

Eczema is generally not a serious condition, but there is a potential for complications, such as a secondary bacterial or fungal infection of the eczema rash. Seek prompt medical care if you have symptoms of eczema. Early diagnosis and treatment can help reduce your risk for complications.

Symptoms

What are the symptoms of eczema?

Symptoms of eczema can differ in severity, frequency and duration among individuals. Symptoms frequently begin in infancy, reoccur during childhood, and disappear during adulthood. Flare-ups, however, can be unpredictable throughout your lifetime.

Skin areas affected by eczema can exhibit a variety of characteristics including:

  • Blistering

  • Darkening of the area of skin affected by eczema (hyperpigmentation)

  • Dryness

  • Flaking

  • Inflammation (swelling, irritation and warmth)

  • Scaling

  • Small red bumps

  • Thickening of the affected skin due to frequent scratching

Scratching the area affected by eczema generally does not relieve the itching and can lead to increased inflammation, more intense itching, and harder scratching.

Symptoms that might indicate a serious condition

In some cases, scratching can lead to potentially serious complications, such as a secondary bacterial or fungal infection and cellulitis. Seek prompt medical care if you have any of these symptoms:

High fever (higher than 101 degrees Fahrenheit)

  • Increase or change in the type of drainage from the blisters

  • Open sores or lesions

  • Redness, swelling and warmth of the skin surrounding the eczema rash

Causes

What causes eczema?

Eczema occurs when skin is more sensitive to certain substances than normal. Eczema often occurs in patches and may appear as rashes that come and go and then may disappear altogether.

The exact cause of eczema is not known, but it is linked to allergies and an abnormal immune system response. Certain triggers can cause an eczema flare-up in people with sensitive skin. Common triggers include:

  • Abrupt changes in temperature (from hot to cold or the reverse)

  • Allergens, such as plants or animal dander

  • Chemicals, such as acids, solvents and dyes

  • Food preservatives

  • Fragrances and perfumes

  • Latex and rubber

  • Nickel, a metal often used in the manufacture of jewelry

  • Poison ivy, poison oak, and poison sumac

  • Soaps and detergents

  • Some medications

  • Stress

  • Upper respiratory infection

  • Wool-containing fabric

    What are the risk factors for eczema?

    A number of factors increase the risk of developing eczema. Not all people who are at risk for eczema will develop the condition. Risk factors include:

    • Individual allergen sensitivity

    • Personal or family history of allergies

    • Personal or family history of asthma

    Reducing your risk of eczema outbreaks

    It may be possible to prevent eczema outbreaks. You can lower your risk of outbreaks by :

    • Avoiding exposure to any known allergen or irritant that triggers a skin reaction

    • Avoiding situations in which your skin will be exposed to wet or hot conditions for long periods of time

    • Seeking regular medical care and following your treatment plan for allergies and other skin conditions

    Treatments

    How is eczema treated?

    Eczema is a chronic condition that is not curable. However, with a well-integrated, medically monitored plan of care, symptoms can be effectively controlled, and people with eczema can lead active, comfortable lives. A good treatment plan is individualized to your medical history, the specific type and severity of your eczema, the specific cause, and other factors.

    A combination of treatments that include lifestyle changes, medications, and other treatments as appropriate is the most effective way to control eczema and prevent flare-ups.

    Lifestyle changes and general treatments for eczema

    Lifestyle changes and considerations for treating eczema include:

    • Avoiding alcohol and caffeine

    • Avoiding hot tubs, steam baths, saunas, and chlorinated swimming pools

    • Avoiding scratchy clothes

    • Drinking plenty of fluids

    • Getting skin patch testing, in which small amounts of common allergens are applied methodically to the skin to determine what substances are triggering the allergic response that leads to the eczema

    • Minimizing skin dryness by using lotion specifically designed for sensitive skin

    • Preventing flare-ups by avoiding exposure to the specific allergen or allergens that induce the condition

    • Using a cool mist vaporizer or home humidifier

    • Using a perfume-free moisturizer

    • Using an oatmeal-based soap, such as Aveeno, to help relieve itching and inflammation

    • Using ice bags or cool wet compresses to help relieve itching and inflammation

    • Using mild soaps and not over washing or harshly scrubbing skin

    Medications used to treat eczema

    In moderate to severe cases of eczema, medications may be prescribed. Medications may include:

    • Antibiotics or antifungal drugs, which treat secondary bacterial or fungal infections

    • Antihistamines, which reduce itching

    • Corticosteroid cream, which reduces inflammation

    These medications can all have side effects, so they should only be used under the direction of a licensed health care clinician.

    What are the possible complications of eczema?

    When left untreated, eczema can develop into an escalating cycle of itching, scratching and inflammation. In some cases, the excessive scratching can introduce bacteria or fungus into the layers of the skin, resulting in infections that can be serious in some people. Complications include:

    • Bacterial or fungal infection of the skin

    • Cellulitis (an infection of the skin and surrounding tissues caused by a growing bacterial or fungal infection)

    • Open sores and lesions

    • Permanent change in skin texture or scarring

    • Permanent skin discoloration

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    Medical Reviewer: William C. Lloyd III, MD, FACS
    Last Review Date: 2018 Nov 14
    1. What Is Atopic Dermatitis. National Eczema Association. http://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis-2/what-is-atopic-dermatitis/
    2. Allergic Diseases Resource Center. World Allergy Association. http://www.worldallergy.org/adrc/
    3. Atopic Eczema. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001856/
    4. Tierney LM Jr., Saint S, Whooley MA (Eds.) Current Essentials of Medicine (4th ed.). New York: McGraw-Hill, 2011.
    5. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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