Eczema: Symptoms, Causes, and Treatment

Your skin will probably be very dry, thick, or scaly. In fair-skinned people, these areas may appear reddish at the start and then turn brown. In darker-skinned people, eczema can affect skin pigments, making the affected area lighter or darker.

Types of Eczema

Eczema includes conditions such as:

Atopic dermatitis

This is what people usually mean when they say “eczema.” This is the most common form, and it affects more than 7% of American adults. Other allergic disorders, such as asthma and hay fever, can trigger it. It often starts in childhood.

Contact dermatitis

Nearly everyone gets this at some point in their lives. It happens when your skin comes into contact with something that causes a rash. The trigger can cause irritation or an allergic reaction. Triggers are unique to each person and vary depending on the type of contact dermatitis. Contact dermatitis has two main types:

• Irritant dermatitis is the more common kind and is more closely linked to people with atopic dermatitis. Triggers may include skin care products, soaps and detergents, jewelry made with nickel, and industrial chemicals such as solvents and cement.
• Allergic dermatitis flares when your skin comes into contact with something you’re allergic to. Common allergens include poison ivy, nickel and other metals, fragrances and beauty products with fragrances, rubber, latex, and the preservative thimerosal. For some people, it takes sunlight to cause a reaction.

Dyshidrotic eczema

This is a less common but more challenging form of eczema. It causes outbreaks of tiny blisters on the palms of the hands, soles of the feet, and sides of the fingers. Sweat or irritants such as metals may trigger it.

Eczema Causes

Experts aren’t sure what exactly causes eczema. Things that may make it more likely include:

• An immune response to something irritating
• Problems in your skin’s barrier that let moisture out and germs in
• A family history of other allergies or asthma

Is eczema contagious?

No. You can’t catch eczema from someone or pass it on to others.

Eczema risk factors

Stress and genes are among the most common risk factors for getting eczema. But there are more, including:

• Having very dry skin
• Using hair care or skin products with certain allergens
• Food allergies
• Living in cold, damp areas or swampy, hot areas
• Having someone in your family who has eczema

Your age may affect whether you get eczema or not:

• Eczema shows up most often before you turn 5. Most children will outgrow eczema.
• If you get eczema as an adult, you're more likely to get it either in your 20s or over the age of 50.
• Atopic dermatitis is more common in children, while forms such as nummular eczema are more typical in adults.

Eczema Flare-Ups

When your immune system responds to something unusual going on inside or outside of the body, it causes inflammation. Inflammation causes the itchy, painful symptoms of eczema. Different people react to different substances, experiences, and triggers. Some people may react to more than one thing.

What causes eczema flare-ups?

There are many causes, and they’re different for each person. These may include one or more of the following:

• Genes and family history
• Overreactive immune system
• Extremely dry skin
• Stress
• Environment — pollen from different blooming plants, cold and damp or hot and humid weather
• Allergens — substances that may cause allergic reactions, such as those in certain household or grooming products, and foods

Recent studies suggest that living near factories, major roadways, or wildfires can increase the risk of developing eczema. So can exposure to household materials such as paint, plastics, and cigarette smoke or synthetic fabrics such as spandex, nylon, and polyester.

Eczema triggers

Some people have flare-ups in response to specific things, such as:

• Pollen
• Rough or coarse fabrics or clothing (such as wool)
• Feeling too hot or cold
• Household products such as soap or detergent
• Dander from animal hair or fur
• Dust mites or mold
• Infections or colds (including skin infections)
• Stress
• Heat and sweat
• Cold and dry air
• Fragrances or tobacco smoke
• Irritating chemicals
• Certain foods (including peanuts, dairy, and eggs)

Eczema and mental health

There’s a strong link between eczema and emotion. While stress, anxiety, and depression don’t cause eczema, they can set off a physical reaction that includes inflammation. This can make flare-ups worse.

It works the other way as well. Having eczema can make it more likely that you’ll have issues with mental health. One study found that more than 30% of adults with eczema also have a diagnosis of depression, anxiety, or both. Kids who have the condition are two to six times more likely to also have anxiety, depression, or attention deficit hyperactivity disorder (ADHD) than those who don’t. If they have other atopic conditions such as asthma, their risk goes up.

There are many things you can do to help yourself manage your mental health when you have eczema. Meditation, spending time outside, and exercise are some things that can help you handle stress and feel calmer.

If you have symptoms of depression for 2 weeks or more, talk to your doctor right away. They may suggest that you join a support group or start therapy with a mental health professional. Signs of depression to watch for include: 

• Feeling sad, empty, or hopeless
• Being unable to concentrate
• Low energy
• Loss of interest in hobbies or activities you usually enjoy
• Thoughts of suicide

Eczema Diagnosis

No one test can spot eczema. Your doctor will probably diagnose it by looking at your skin and asking a few questions.

Because many people with eczema also have allergies, your doctor may order some allergy tests to look for irritants or triggers. Children with eczema are especially likely to have allergy tests.

If your doctor diagnoses you with eczema, you might want to ask them:

• What’s the best way to add moisture to my skin? Can I use over-the-counter products, or do you need to prescribe something?
• Do I need to buy special soaps, lotions, and laundry detergent? Do fragrance-free or sensitive-skin products help?
• Are there foods that I should avoid to keep flares at bay?
• Are there fabrics that I shouldn't wear? What fabrics should I wear?
• Do pets make symptoms worse?
• If sweating makes things worse, can I still exercise?
• What’s next if my symptoms don’t improve or I get an infection from scratching my skin?
• Does stress lead to flare-ups?
• Are long periods without symptoms common?
• Are there ways I can treat my skin to reduce my chances of another flare-up?

Know more about how eczema is diagnosed .

Psoriasis vs. eczema

It can be difficult to tell the difference between the two. Psoriasis and eczema look the same and have similar symptoms. Both can cause a rash that appears in the same places, such as the hands or scalp. Neither condition is contagious, but both types of rashes can become infected.

Psoriasis is an autoimmune disease. This means that the person’s immune system doesn’t work right, and their skin cells grow too fast. Those cells show up on top of the skin as a white, scaly patch. Risk factors can include a person’s genes (family background) or exposure to something in the environment — or both.

How can you tell them apart? Here are a few things that your dermatologist will consider when making a diagnosis:

Itchiness. Psoriasis causes milder itching and, sometimes, a burning sensation. Eczema itches so much that some individuals scratch until it bleeds.

Location. Both can show up anywhere on your body, but they tend to develop in certain areas. Psoriasis typically appears on the scalp, elbows, knees, buttocks, and face. Eczema often occurs on the back of the knees or inside of the elbows.

Eczema Treatment

Eczema treatment aims to ease and prevent itching, which can lead to infection.

Medications

Your doctor may also prescribe creams and ointments with corticosteroids to ease inflammation. If the area becomes infected, you’ll probably need antibiotics.

Other options include tar treatments (chemicals that reduce itching), phototherapy (using ultraviolet light), and the drug cyclosporine.

The FDA has approved two medications called topical immunomodulators (TIMs) for mild to moderate eczema. Elidel cream and Protopic ointment work by changing your immune system response to prevent flare-ups. They can reduce inflammation and itching.

The FDA has warned doctors to use caution with Elidel and Protopic because of concerns over a cancer risk. The two products also carry the FDA's “black box” warning on their packaging to alert doctors and patients to these potential risks. The warning advises doctors to prescribe Elidel and Protopic for only a short time after other eczema treatments have failed in adults and children older than 2 years. It should not be used in kids younger than 2 years.

Baby eczema treatment

Daily bathing with a mild cleanser and warm water is key. Be sure to rinse completely, pat your baby dry, and apply a fragrance-free moisturizing lotion or cream while the skin is still damp. Moisturize at least twice a day (test products on a small patch of skin first). Avoid itchy fabrics and extreme temperatures. To help avoid scratching, trim your baby’s nails or put on cotton mittens.

Contact your medical provider if your baby’s rash is purple, crusty, watery or has blisters, or if your baby has both a rash and a fever.

Eczema Health Disparities

Research shows that 1 in 10 Americans will get eczema during their lifetime. But adult women are more likely to get it than men.

In the U.S., boys and girls are equally likely to have eczema, with about 11% of each gender affected. The condition is more common among non-Hispanic Black children than among children of any other race. For example, 2021 data from the CDC reports around 14% of Black kids under 17 had eczema, compared to 9% of non-Hispanic Asian children.

Among adults, multiracial and White people have the highest incidence. One reason may be that they’re more likely than people of other races to see a doctor for a diagnosis. At the same time, Black children and adults are more likely to have a more serious and persistent form of eczema. That may be due to a lack of insurance, reliable transportation, and other barriers to seeking care.

Physical differences also may explain some of the disparities. For example, researchers believe that Black people tend to have drier skin compared to Asian people. And people with eczema lose their skin moisture more quickly.

Eczema Complications

Eczema can lead to skin infections from scratching or cracking. That can break down your skin’s barrier against bacteria and other germs. Complications with eczema can include some or all of the following:

• Asthma or hay fever. Either of these can happen before or after diagnosis.
• Food allergies. These can cause hives.
• Darker or lighter skin areas. This is more common in people with a darker skin color.
• Skin infections. If you get a skin infection, it can be life-threatening. So, watch out for these and tell your doctor right away.
• Sleep problems. Eczema can cause these because of the itchiness.

Living With Eczema

Eczema can lead to many complications, but there are ways to manage your daily life and routine if you have the condition. These tips may help you avoid flare-ups and reduce costs.

Eczema diet

Since eczema is linked to allergens in food, there's no one specific diet you should stick to if you have eczema. But it's good to focus on anti-inflammatory foods that are less likely to lead to an allergic reaction. Foods that can often be inflammatory include:

• Red meat
• Processed meats (lunch meats, hot dogs, bacon)
• Fried foods
• Foods and drinks with added sugar
• Trans fats
• Refined carbs (white bread, pastries)
• Snack foods, such as cookies, chips, and crackers

Products with glycerin, lactic acid, and urea may also help because they help pull water into your skin. You’ll use these when your skin is damp, such as after bathing, to help hold in moisture.

Hydrocortisone creams and antihistamines. Over-the-counter products such as hydrocortisone cream and antihistamines can also help. Hydrocortisone is a steroid that helps keep redness, itching, and swelling at bay. You can buy low-strength creams and lotions at the store. If those don’t help, your doctor may prescribe something stronger.

It’s safe to put hydrocortisone on most body parts as many as four times a day for up to 7 days — as long as you’re not pregnant or breastfeeding. Keep it away from your eyes and private parts.

Some people have a severe reaction to hydrocortisone. If you have trouble breathing or swallowing or notice a skin rash after you use it, call 911.

Over-the-counter allergy meds may not work well for itchy skin caused by eczema. But antihistamines that are known to cause drowsiness can help you sleep if you take them before bed.

Relaxation techniques. There’s a strong link between stress and your skin. Plus, you’re likely to scratch more when your emotions are running high.

Use a humidifier. Hot, dry indoor air can worsen itching and flaking. A home humidifier will add moisture to the air inside your home.

Managing eczema

There are several things you can do to ease itchiness, which is the main symptom of eczema. You can:

• Use a cold compress at the itch site.
• Softly pat the itchy skin. Don't scratch it.
• Take an apple cider vinegar bath.
• Make sure your clothing is soft and breathable.
• Try to avoid sitting on rough things, such as grass or carpet.
• Moisturize during the day with a product containing ceramides.

Eczema costs

The average out-of-pocket cost for living with eczema is about $600 per year, but it can be as high as around $5,000 per year, depending on how much care you need and how serious your condition is.

Eczema Prognosis

Because experts are unsure of the exact causes of eczema, it's best to treat the symptoms and reduce triggers for flare-ups. Speak with your doctor or dermatologist about what the root cause of your eczema might be and how to best manage it. Treatments tend to include a mixture of medications and home remedies.

Can eczema be cured?

There is currently no cure for eczema. But with the right treatments, such as medications, ointments, over-the-counter drugs, and home remedies, you can control and manage the symptoms.

What to expect with eczema

Almost 50% of children will outgrow their eczema as they get older and reach puberty. For others, it could last a lifetime. If you have eczema, there are ways to treat it, but it may take some time to find the right treatment for you. There will be times when flare-ups only last days and other times when they last weeks. There may also be long periods when you don't have any flare-ups. Just keep in mind that this doesn't mean the eczema has gone away. Stay away from inflammatory foods and triggers such as stress.

Takeaways

You can manage your eczema by living a healthy and well-balanced lifestyle. Avoid triggers such as stress, harsh soaps, and rough or scratchy clothing. Keep your skin well-moisturized. This can help you prevent flare-ups and cut down on itchiness. If you feel your eczema is getting worse, let your doctor or dermatologist know right away.

Eczema FAQs

Will eczema go away?

There is no cure. It may go away and then come back. But treatments are very effective in reducing symptoms.

Why is my eczema flared up?

Different people react to different substances, experiences, and other triggers. Some people have reactions to more than one thing.

How do you calm down eczema?

• Use a cold compress at the itch site.
• Softly pat the itchy skin. Don't scratch it.
• Take an apple cider vinegar bath.
• Make sure your clothing is soft and breathable.
• Try to avoid sitting on rough things, such as grass or carpet.
• Moisturize during the day with a product containing ceramides.

Can you cure eczema permanently?

There is no cure, but there are treatments that can soothe flare-ups.

What is the difference between eczema and psoriasis?

They have similar symptoms and risk factors, but psoriasis is an autoimmune disorder. The itch resulting from psoriasis is milder than that from eczema. Psoriasis is often located on the scalp, elbows, knees, buttocks, and face, while eczema often occurs on the back of the knees or inside of the elbows. More children have eczema. Sunshine is good for psoriasis but can irritate eczema.