Eczema (Atopic Dermatitis): Causes, Treatment, and More - Healthline

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Eczema is a very common skin condition that causes itchy, red, dry, and irritated skin. The condition is also called atopic dermatitis.

It typically starts during infancy or early childhood and can persist into adulthood. However, eczema can occur in people of any age.

There are a few different types of eczema. The type of eczema you have can determine what type of rash you develop and where on your body it occurs.

Photo examples of the different types of eczema are shown below. Keep reading to learn more about eczema, including causes, how to treat flares, and how to prevent them.

Examples of eczema rashes

The cause of eczema isn't completely understood. However, researchers think that it's triggered by an overactive immune system.

Eczema tends to flare when your skin is exposed to external irritants, which cause your immune system to overreact. We've listed common triggers for flare-ups below.

Additionally, researchers have found that some people with eczema don't make enough of a protein called filaggrin (filament aggregating protein). This protein is responsible for helping your skin stay moisturized and healthy.

Eczema triggers

An eczema flare-up happens when one or more eczema symptoms appear on the skin. According to the National Health Service (NHS), research has shown that external and internal factors can contribute to flares of eczema. Common triggers include:

• chemicals or preservatives found in cleansers and detergents
• scented products
• cigarette smoke
• external allergens such as pollens, mold, dust, or dust mites
• rough scratchy material, like wool
• synthetic fabrics
• sweating
• temperature changes
• stress
• food allergies
• animal dander
• upper respiratory infections

There are a number of different types of eczema, including the following:

The main symptom of eczema is itchy, dry, rough, flaky, inflamed, and irritated skin. It can flare up, subside, and then flare up again.

Eczema can occur anywhere but usually affects the arms, inner elbows, backs of the knees, cheeks, and scalp. It's not contagious and sometimes becomes less severe with age.

Other symptoms include:

• intense itching
• red or brownish-gray patches
• small, raised bumps that ooze fluid when scratched
• crusty patches of dried yellowish ooze, which can signal infection
• thickened, scaly skin
• sore or raw-feeling skin

Many people find their symptoms get worse at night, making it difficult to sleep. Scratching eczema further irritates and inflames the skin. This can cause infections that must be treated with antibiotics.

Sometimes, mild eczema can be managed at home by avoiding triggers and keeping skin moisturized. However, it's best to see a doctor when symptoms are hard to manage or are getting worse. It's a good idea to make a medical appointment if your:

• eczema isn't responding to over-the-counter treatments
• symptoms are keeping you awake at night
• symptoms are making it hard to complete everyday tasks
• skin is blistering or weeping fluids
• skin is peeling
• skin is getting thick or scaly

A dermatologist, allergist, or primary care doctor can help you identify the correct treatment for eczema. The right treatment for you will depend on the type and severity of your eczema. You might find it helpful to combine more than one treatment.

Options include:

Medications

Oral over-the-counter (OTC) antihistamines can relieve itching. They work by blocking allergic reactions triggered by histamine. However, they can cause drowsiness, so it's best to take them when you don't need to be alert.

Examples include:

Cortisone (steroid) creams and ointments can relieve itching and scaling. But they can have side effects after long-term use, including:

• thinning of the skin
• irritation
• discoloration

Low potency steroids, like hydrocortisone, are available OTC and can help treat mild eczema. High potency steroids for moderate or severe eczema can be prescribed by a doctor.

A doctor might prescribe oral corticosteroids when topical hydrocortisone isn't helping, These can cause serious side effects, including bone loss.

To treat an infection, a doctor may prescribe a topical or oral antibiotic.

Immunosuppressants are prescription medications that prevent your immune system from overreacting. This prevents flare-ups of eczema. Side effects include an increased risk of developing cancer, infection, high blood pressure, and kidney disease.

Therapies

Light therapy, or phototherapy, uses ultraviolet light or sunlamps to help prevent immune system responses that trigger eczema. It requires a series of treatments and can help reduce or clear up eczema. It can also prevent bacterial skin infections.

Lifestyle changes

Stress can trigger symptoms or make them worse. Ways to reduce stress include:

• doing deep breathing exercises
• practicing yoga
• meditating
• listening to relaxing music
• prioritizing a good night's sleep

A cold compress can help alleviate itching, as can soaking for 15 to 20 minutes in a warm or lukewarm bath.

Alternative treatments

Alternative treatments may help calm the symptoms of eczema. Because of potential side effects, always check with your doctor before using an herbal supplement or beginning an exercise routine. Popular home remedies include:

There's no specific test that can be used to diagnose eczema. Often, a doctor can diagnose the condition by talking with you about your symptoms and examining your skin. Sometimes, a patch test might be done to help find eczema triggers.

A patch test can pinpoint certain allergens that trigger symptoms, like skin allergies associated with contact dermatitis

During a patch test, an allergen is applied to a patch that's placed on the skin. Your skin will become inflamed and irritated if the allergen is a trigger for you.

There are a few factors that can increase your risk of developing eczema.

Eczema is more common in children who suffer from asthma or hay fever as well as adults who develop these conditions before age 30.

People with family members who have eczema are also at higher risk of developing the condition.

Eczema can lead to some complications, including:

• Sleep troubles. Eczema can cause difficulty sleeping and disrupt your sleep hygiene.
• Skin infections. Repeated scratching can leave your skin open to bacteria and viruses that can cause infections.
• Asthma and hay fever. Eczema can often lead to developing asthma or hay fever, especially in children younger than age 12.
• Thick and scaly skin. Scratching can cause your skin to harden and thicken over time.
• Additional types of eczema. Often, having one type of eczema can increase your risk of another developing.

You can take steps to prevent eczema flare-ups. You and your doctor can discuss some of the changes that might work best for you.

Common steps to prevent flare-ups include:

• reducing stress
• avoiding known triggers
• keeping skin clean
• reducing shower or bath times to 10 minutes or less
• avoiding very hot shower or bath water
• keeping skin moisturized
• using dye and scent-free laundry, bath, and makeup products
• taking any prescriptions as directed
• avoiding itching skin

There's no cure for eczema, but you can effectively manage symptoms with the right treatments. Treatment might include a combination of lifestyle changes and medications.

In some cases, eczema can cause additional health complications such as infections, asthma, or worsening skin. Fortunately, finding the right treatments can help prevent complications.

Talk with a doctor if you're having trouble managing eczema or if your symptoms have been getting worse. They can help you find a treatment plan that works for you and reduces your flare-ups.