Severe Eczema (Atopic Dermatitis): What It Is and How It’s Treated

At best, eczema can be uncomfortable. But this chronic skin condition marked by dry, itchy skin and rashes may become severe in some cases. It’s considered severe based on:

• The intensity of symptoms

• How much of the skin the symptoms are covering

• And/or the degree to which symptoms are affecting your quality of life

How does eczema become severe?

Severe eczema may happen if you are repeatedly scratching at your rashes. Eczema can also become severe if you’re continuously exposed to a trigger for flares without realizing it, according to Nkem Ugonabo, MD, Dermatologist in New York City.

What does severe eczema look like? 

In addition to dry, itchy skin, here are some of the other symptoms of severe eczema to look out for:

• Weeping fluid

• Crusty skin

• Bleeding

• Thickened, leathery skin

• Frequent skin infections

Severe eczema is also likely to affect your mental health and self-esteem, according to Dr. Ugonabo. 

“Not only can you see it, but other people can see it as well,” she says. “Over time, a lot of my patients start to feel self-conscious about going out in public.”

It may be helpful to see a mental health professional to deal with your feelings about severe eczema.

How is severe eczema treated?

Moisturizing, good skincare habits, and avoiding triggers play a role in treating eczema at any stage, whether mild or severe. People with severe eczema may need additional treatments, however.

Some treatments that may help you with your severe eczema might include:

• Phototherapy: This treatment uses ultraviolet (UV) light, which will help reduce inflammation in your skin and reduce your urge to scratch.

• Immunosuppressants: These medications, which are prescribed by a doctor, helps reduce the activity of your immune system and suppress some of your itchiness.

• Biologic therapy: These injectable medications, also prescribed by a doctor, act on specific parts of the immune system that fuel eczema activity.

Outcomes for these treatments can vary from patient to patient. However, many people find that they help reduce their severe eczema symptoms. This in turn may help give them more confidence and a better quality of life.