What Is Eczema? Symptoms, Causes, Diagnosis, Treatment, Prevention
Eczema is not a specific disease, but rather a term that describes a group of inflammatory skin conditions that produce rash-like symptoms, such as irritated, itchy patches on the skin.
It’s also known as dermatitis (skin inflammation), atopic eczema (“atopic” means a genetic tendency toward allergic hypersensitivity), or simply atopic dermatitis.
The word “eczema” is often used interchangeably with “atopic dermatitis,” though clinically speaking, atopic dermatitis is the most common type of eczema.
Atopic dermatitis is the most severe and chronic (long-lasting) form of eczema. It’s characterized by inflamed skin that may crack and release a clear fluid when scratched (an effect known as weeping).
These include:
Small, itchy blisters on the soles of the feet and edges of the fingers, toes, and palms may be signs of dyshidrotic eczema. Stress and allergies are two possible triggers for this form of eczema.
Compared to other types of eczema, nummular eczema appears differently: as itchy, coin-shaped spots on the skin.
This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.
Scalp eczema is one type of seborrheic dermatitis, which happens when white or yellow scaly patches of skin develop in oily areas of the body. Other places this may appear include the face and ears, partly as a result of microorganisms that live on the skin (such as some types of yeast).
People with eczema have very dry, itchy skin and rashes on various parts of the body — particularly the face, hands, feet, insides of the elbows, behind the knees, and on the scalp.
In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth.
For most people, the main symptom of eczema is itching, which can lead to scratching and rubbing that further irritates the skin. This can, in turn, lead to the “itch-scratch cycle” or increased itching and scratching that worsens eczema symptoms.
Other skin symptoms associated with eczema include:
If you have eczema, your skin is unable to retain moisture well, possibly because of low production of fats and oils. Eczema is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes skin to become dry and lose its protective properties.
It’s not clear what causes certain people to develop eczema, specifically atopic dermatitis.
Children are more likely to develop eczema if other allergic diseases — such as hay fever and asthma — run in the family, which suggests that there may be a genetic component to the condition. Read more about conditions related to eczema below.
Though dermatologists don’t necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.
In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema.
In some cases, eczema symptoms are confused with insect bites or allergic reactions.
To diagnose eczema, your doctor will first conduct a physical examination to look at the state of your skin and see if you have the characteristic rash of the illness.
They may perform a skin biopsy (remove a skin sample for examination) to confirm the diagnosis and rule out other skin conditions.
But about one-half of adults with atopic dermatitis had it as a child.
Atopic dermatitis in adults often lasts a long time, and there is no way to determine if it will go away or last a lifetime. But the frequency and severity of symptoms usually decrease over time, and you can control atopic dermatitis through treatment, moisturizing, and by avoiding irritants that cause flare-ups.
There is no cure for eczema, and the goal of treatment is to reduce eczema symptoms, heal the skin, and prevent skin damage and flare-ups.
Medication, moisturizers, and at-home skin-care routines make up an effective treatment plan for many people who live with eczema.
For moderate and severe disease, treatments include:
Other treatments for itching include antihistamines, such as diphenhydramine (Benadryl), hydroxyzine, or doxylamine succinate (Unisom), which may help prevent nighttime scratching.
RELATED: The Consumer’s Guide to Biologics for Atopic Dermatitis
Elimination diets are also used to diagnose autoimmune conditions like eosinophilic esophagitis (EoE), a chronic disease of the esophagus.
There is no proven way to prevent getting eczema. Nonetheless, research suggests children who are breastfed until they’re age 4 months may be less likely to get it. Alternatively, partially hydrolyzed formula, which contains processed cow milk protein, may also reduce a child’s chance of developing atopic dermatitis.
People with eczema are at risk of developing infections if they scratch themselves so much that they break the skin.
People with atopic dermatitis may also get a severe and potentially fatal infection called eczema vaccinatum if they receive the live-virus smallpox vaccine.
Eczema can occur at any age, but it typically begins in infancy and early childhood.
Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. They include:
The authors of the review also noted that African American children are 1.7 times more likely to develop atopic dermatitis compared with European American children, even when adjusting for household income, parental education level, metropolitan versus rural environment, and health insurance coverage status.
Another finding detailed in the review: African American children are 3 times more likely to be diagnosed with atopic dermatitis during a dermatologist visit than European American children, even though they are significantly less likely to seek dermatological care, while Asian American kids are 7 times more likely compared with white kids.
The itching due to eczema has been shown to have a greater impact on Black patients, who also tend to have more severe disease, per the NEA.
Eczema can lead to skin discoloration, as can scratching itchy areas. Darkened patches (hyperpigmentation) or lightened ones (hypopigmentation) can be a particular concern for people of color.
Although skin tone eventually evens out on its own, the discoloration can linger for weeks, months, or longer.
Changes in skin color can be improved with appropriate treatment for the underlying eczema and inflammation.
Filling out a lengthy form indicating your areas of interest will give you free access to an online forum that includes discussion threads on eczema-related topics. Each time you log in you will see a stream of blog posts with daily news and the latest discussion threads.
We recommend this NEA-hosted forum for sharing support and advice about living with eczema. After registering for free, members post questions or comments in freewheeling discussions and receive written replies, or reactions via “Support,” “Thanks,” and “Useful” buttons.
Eczema is an umbrella term for a group of chronic skin conditions that cause an itchy rash. Atopic dermatitis is the most common form of eczema. Other types include contact dermatitis and dyshidrotic eczema. Symptoms vary somewhat between forms, but eczema generally causes itchy and inflamed skin, dry patches, hives, and skin color changes. It is not contagious and the exact cause is unclear, but it may be linked to genetic components.
Eczema is an autoimmune condition, and it is chronic. This means there is no cure, but several treatment methods can help to manage symptoms, such as avoiding irritants that spark flare-ups. Irritants greatly vary, but some include soaps and detergents, cigarette smoke, perfumed skin care products, pet dander, pollen, mold, and certain foods.
To treat your eczema, keep your skin well moisturized. Stress can also cause eczema flares, so be sure to take care of your mental health as well. Steroidal topical treatments can help when symptoms become severe. You can always discuss your options with a doctor or dermatologist.
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