What Is Eczema?

Eczema, also known as dermatitis, refers to a group of chronic skin conditions that cause inflammation, redness, itching, and discomfort. While "dermatitis" broadly means skin inflammation, not all forms are considered eczema. However, the two terms are often used interchangeably.

Eczema is typically long-term, with periodic flare-ups that vary in severity. It affects people of all ages, from infants to older adults, and it often coexists with other conditions like asthma or allergies. Understanding the various forms, symptoms, causes, and treatments can empower individuals to manage this condition effectively.

Types of Eczema

There are several types of eczema, each with unique features, triggers, and treatment approaches.

Atopic Dermatitis

This is the most common type of eczema, often starting in childhood. It causes red, itchy, and inflamed patches, usually on the face, neck, elbows, and knees. Around 30% of the U.S. population is affected, particularly children and teens, though about 7% of adults also live with this condition.

Contact Dermatitis

Contact dermatitis develops when the skin reacts to an irritant or allergen, such as soap, metal, or cosmetics. It's one of the most widespread types, impacting up to 20% of individuals at some point in life. Avoidance of the triggering substance usually helps manage this condition.

Seborrheic Dermatitis

Seborrheic dermatitis appears in oily skin areas like the scalp, eyebrows, and around the nose. It causes red, scaly, and itchy patches. This type may also appear in skin folds and is associated with conditions like Parkinson’s disease or HIV. It affects between 3-10% of the population.

Dyshidrotic Eczema

This form is known for producing small, itchy, fluid-filled blisters on the hands and feet. Most common in adults between ages 20 to 40, it can be intensely uncomfortable and may worsen under stress or in hot, humid weather.

Nummular Eczema

Nummular eczema, or discoid eczema, features round, itchy plaques, often on the arms or legs. It tends to affect men aged 50–65 and women aged 15–25. The prevalence is variable, but it may affect up to 9% of people globally.

Stasis Dermatitis

This type usually occurs in the lower legs due to poor blood circulation. It presents with swelling, redness, scaling, and sometimes open sores. It’s most common in adults over 50 with venous insufficiency or a history of leg injuries or surgery.

Asteatotic Eczema

Also called eczema craquelé, this type appears in older adults, especially during winter. It causes dry, cracked, and itchy skin, primarily on the arms and legs. Over 70% of adults over 60 may experience this condition due to low humidity and indoor heating.

Neurodermatitis

This form starts with an itch and leads to scaly, thickened skin patches due to repeated scratching. It affects adults aged 30 to 50 and often appears on the neck, wrists, or ankles. A cycle of itching and scratching can make symptoms worse and lead to infection.

Recognizing the Symptoms

Eczema symptoms vary by type but generally include:

  • Dry, flaky skin

  • Intense itching, particularly at night

  • Red or discolored rashes (gray, brown, or purple in darker skin tones)

  • Fluid-filled blisters that may ooze and crust

  • Thickened or cracked skin

  • Swelling and soreness from scratching

These symptoms often come and go, with periods of remission followed by flare-ups.

Causes and Risk Factors

The precise cause of eczema remains unclear, but it's understood to involve an overactive immune response and a weakened skin barrier. Risk factors include:

  • Family history of eczema, asthma, or allergies

  • Living in urban or dry climates

  • Exposure to irritants (chemicals, soaps, detergents)

  • Contact with allergens (dust, pet dander, pollen)

  • Stress and hormonal changes

  • Cold weather or low humidity

  • Wearing wool or synthetic fabrics

In many cases, flare-ups are triggered by environmental or emotional factors.

How Eczema Is Diagnosed

A clinical evaluation is often enough for diagnosis. Your healthcare provider will examine the skin's appearance and ask about your symptoms, family history, and lifestyle. In some cases, additional tests may be needed:

  • Patch testing to identify allergens

  • Skin biopsy to rule out conditions like psoriasis or fungal infections

  • Blood flow tests for stasis dermatitis to evaluate venous insufficiency

Referral to a dermatologist may be necessary for persistent or severe cases.

Treatment Options

There’s no cure for eczema, but several treatments can help control symptoms and improve quality of life. Treatment depends on the type, severity, and personal response.

Moisturizing

Frequent use of fragrance-free moisturizers helps repair the skin barrier and reduce dryness. Use ointments or creams that contain:

  • Petroleum jelly

  • Ceramides

  • Hyaluronic acid

  • Glycerin

Avoid products with parabens, alcohol, or synthetic fragrances.

Anti-Inflammatory Medications

Topical corticosteroids are the frontline treatment for reducing inflammation and itching. Other options include:

  • Calcineurin inhibitors (e.g., tacrolimus, pimecrolimus)

  • Oral antihistamines for nighttime itching

  • Immunomodulators targeting specific immune responses

  • Systemic corticosteroids or biologics in severe cases

  • Phototherapy for treatment-resistant eczema

Antibiotic and Antifungal Treatments

If eczema becomes infected, antibiotics (topical or oral) may be required. For seborrheic dermatitis, antifungal shampoos and creams are effective.

Preventing Flare-Ups

While eczema can’t always be prevented, these steps can minimize symptoms and flare frequency:

  • Identify and avoid known triggers

  • Keep skin hydrated with daily moisturizers

  • Take lukewarm (not hot) showers

  • Use gentle, fragrance-free soaps and shampoos

  • Wear breathable, non-irritating clothing

  • Use a humidifier in dry environments

  • Rinse sweat off promptly after workouts

  • Avoid scratching to prevent skin damage

Look for products with the National Eczema Association Seal of Acceptance™ as they are generally free of common irritants.

Living With Eczema

Beyond physical discomfort, eczema can affect sleep, concentration, confidence, and mental health. Studies show a higher incidence of anxiety and depression among people with eczema.

To improve emotional well-being:

  • Manage stress through mindfulness, yoga, or breathing exercises

  • Talk to a mental health professional if eczema impacts your mood

  • Stay socially connected with supportive friends or online communities

  • Eat a balanced diet and stay active to support immune and skin health

Consistency is key. Establishing a skincare routine, avoiding triggers, and following your treatment plan can help you lead a fulfilling life despite the condition.

When to See a Doctor

Seek medical advice if:

  • Symptoms interfere with sleep or daily activities

  • Over-the-counter treatments fail

  • You notice signs of infection (pus, redness, warmth)

  • You develop symptoms suddenly without known triggers

  • You feel emotionally overwhelmed or depressed due to eczema

Timely care can help reduce complications and improve your skin health.

Final Thoughts

Eczema is more than a skin issue—it’s a complex, often lifelong condition that can affect many aspects of life. Understanding your specific type, recognizing triggers, and using a personalized treatment plan can make a huge difference. While there's no permanent cure yet, many people live comfortably by managing symptoms and making proactive skincare and lifestyle choices.