What Is Eczema? Causes, Symptoms, and Treatment

Types of eczema

There are several different types of eczema, including:

• Atopic dermatitis (the most common)

• Dyshidrotic eczema (affects the hands and feet)

• Contact dermatitis (caused by an allergen or irritant to the skin)

• Nummular eczema (coin-shaped rash)

• Stasis dermatitis (often in the lower legs and related to poor blood flow)

• Seborrheic dermatitis (dandruff)

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What causes eczema?

Eczema is a rash caused by inflammation in the skin. The exact reason for the inflammation isn’t entirely clear and depends on the type of eczema you have. There are likely many factors that can contribute to eczema, including: 

• Your genetics and family history 

• Immune function 

• Triggers

• Stress

Some people with eczema have a genetic mutation in the protein filaggrin. This protein helps to keep the skin barrier intact and the skin moisturized. If you don’t make enough filaggrin, it may make your skin more prone to inflammation. 

Your immune system also plays a role in eczema. There are certain immune system cells that can be overactive in eczema — leading to more inflammation. 

Eczema triggers

There are many different triggers for eczema. These triggers may vary depending on the type of eczema you have. Common eczema triggers include:

• Pet dander

• Dust mites

• Soaps and detergents

• Perfumes

• Excessive sweat and overheating

• Certain clothing

• Dry skin

• Stress

• Illness

• Extreme weather changes

Eczema can happen in anyone, but it tends to peak in childhood. And it’s very common. In fact, over 30 million people in the U.S. are living with some form of eczema. People with eczema are more likely to have other health conditions, including: 

• Seasonal allergies 

• Food allergies 

• Asthma

• Depression

• Anxiety

Someone is also more likely to have eczema if they have a family history of either of these conditions. 

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Eczema symptoms

The most common symptom of eczema is an itchy rash that may come and go. The itching can be so severe that it disrupts your sleep or impairs your quality of life.

Other symptoms depend on the type of eczema you have and how severe it is. These other symptoms can include:

• Scaly patches

• Dry or leathery skin

• Oozing or crusty patches

• Fluid-filled blisters

• Discolored skin

What does eczema look like?

Eczema doesn’t look the same in everyone. The rash of eczema can vary widely depending on your age, skin tone, and the type of eczema you have. 

In fairer skin, the eczema rash is usually pink or red. In darker skin tones, it may not appear red at all. The inflammation may cause the skin to look darker, gray, or purple. If you have concerns about eczema and have darker skin, try to find a healthcare professional who’s familiar with how eczema looks on pigmented skin. 

Where does eczema appear?

The places eczema usually shows up on the body can change with age and depends on the type you have. 

In infants and toddlers, eczema often appears on the:

• Scalp (cradle cap)

• Cheeks

• Outer surface of the elbow

• Knees

• Torso (less common)

In older children and adults, eczema often shows up in body folds and creases. You can see the rash in areas like the:

• Back of the neck

• Eyelids

• Hands

• Feet

• Elbow fold

• Back of the knees

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How is eczema diagnosed?

A healthcare professional can usually make the diagnosis of eczema using your history of symptoms and a physical exam. But there are times when the rash of eczema may look like other skin conditions. 

Sometimes eczema looks like:

• Psoriasis

• Ringworm

• Scabies

• Urticaria (hives)

• Folliculitis

If a healthcare professional isn’t sure about the diagnosis, they may recommend further testing to confirm the diagnosis. This may include:

• Skin biopsy: The healthcare professional removes a very small sample of skin. Then a specialist closely examines the sample under a microscope to see if the inflammation looks like eczema.

• Patch test: Small patches with common allergens (things you may be allergic to) are put on your skin. If an itchy rash develops, you’re probably allergic to that specific allergen. 

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Treatment for eczema

Treatment for eczema includes the use of: 

• Creams

• Ointments

• Prescription medications

• Light treatment (phototherapy)

Which treatment you use depends on what type of eczema you have, how severe it is, and your preferences. 

The goals of eczema treatment are clear skin, to minimize symptoms, and to reduce or eliminate flares. Treatment varies from person to person, and it may take a bit of trial and error to find the best plan for you. 

Medications for eczema

Many types of medications work well for eczema. Treatment for mild eczema is usually topical (applied to the skin). And you can often use over-the-counter (OTC) medications to relieve symptoms. Some topical treatments are useful to treat skin dryness. Others work to reduce inflammation. And it’s common to combine different treatments at once. 

If you have mild eczema, a healthcare professional may recommend treatment with:

• OTC emollients (moisturizers), such as Aquaphor or Vaseline

• Topical steroids, such as hydrocortisone or triamcinolone

• PDE4 inhibitors, such as Eucrisa (crisaborole)

• Calcineurin inhibitors, such as pimecrolimus or tacrolimus

Moderate to severe eczema may require systemic treatment. This may come in the form of oral medication or injections. These options include:

• Systemic steroids, such as prednisone

• Immunosuppressants, such as methotrexate and cyclosporine

• JAK inhibitors, such as Rinvoq (upadacitinib) and Cibinqo (abrocitinib)

• Immune modulators, such as Dupixent (dupilumab) and Adbry (tralokinumab)

Light therapy for eczema

Light therapy (phototherapy) may also help improve hard-to-treat or widespread eczema. Ultraviolet (UVB) light therapy is the most common type for eczema, and it’s an effective treatment. But it may take a couple of months of regular UVB therapy to see results.

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How can you prevent eczema flares?

In addition to medication, there are other lifestyle changes and home remedies that may help your eczema. Here are a few strategies that can help reduce eczema flare-ups:

• Moisturize often: Moisturize at least twice a day, and apply it while your skin is still wet from bathing.

• Use a humidifier: This can also help add moisture to your skin. This is especially important when your environment is dry.

• Avoid irritants: Resist the urge to use harsh soaps, strong fragrances, or skin scrubs. All of these can irritate the skin.

• Try wet wraps: Wrapping the skin in moist cloths overnight after applying moisturizer can soothe the skin. It can also help keep moisture in the skin. 

• Learn your triggers: Once you identify your triggers, do your best to avoid them to limit your eczema flares. Triggers may include certain foods, chemicals, or allergens.