Eczema: Symptoms, Causes, Treatment

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, like 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 by the two types of contact dermatitis:

• 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 like 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.

Eczema Causes

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

• An immune system 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

Who gets eczema?

• You're more likely to get eczema if someone in your family has it. It's not entirely genetic, but genes increase the chances.
• Eczema shows up most before you turn 5, and 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 age 50.
• Atopic dermatitis is more common in children, while forms like nummular eczema are more typical in adults.

Eczema Triggers

Some people have flare-ups of the itchy rash in response to things like:

• Rough or coarse fabric or clothing
• Feeling too hot or cold
• Household products like soap or detergent
• Dander from animal hair or fur
• Infections or colds
• Stress
• Sweat

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 about 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 of time 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

Eczema Treatment

The aim of eczema treatment is easing and preventing 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 over the age of 2. It should not be used in kids under age 2.

Hydrocortisone creams and antihistamines. Over-the-counter products like 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.

Colloidal oatmeal. Add this finely ground oatmeal to a lukewarm bath. It contains starches that seal in moisture to keep your skin hydrated and help to block irritants.  

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, or about 11% of each gender. The condition is more common among non-Hispanic Black children than with any other race. For example, 2021 data from the CDC reports around 14% of Black kids under 17 had eczema, compared to 9% for 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 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 Asians. 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. With that said, 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

It's also important to keep in mind that allergies are highly individual. It may take time to learn your specific allergy triggers. Some foods, like dairy, can cause inflammation even if you're not allergic and can eat them without troublesome symptoms. In time, you can find the right diet for you, whether it's paleo, Mediterranean, gluten-free, or something else.

It's also important to drink plenty of water. Water helps keep your skin from drying out, which can cause flare-ups. 

Managing eczema

There are several things you can do to ease itchiness, the main symptom of 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, like grass or carpet.
• Moisturize during the day with a product containing ceramides.

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. 

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 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, like meds, 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 where they last weeks. There may also be long periods of time 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. 

Eczema Flare-Up Prevention

A few tips can help you prevent outbreaks or keep them from getting worse:

• Moisturize your skin often.
• Avoid sudden changes in temperature or humidity.
• Try not to sweat or get too hot. Keeping cool and keeping your home comfortable can reduce itching.
• Manage stress, and take time for yourself to relax. 
• Get regular exercise. It can help to control stress and increase circulation.
• Avoid scratchy materials such as wool.
• Don’t use harsh soaps, detergents, or solvents.
• Pay attention to foods that might trigger symptoms, and try to avoid them.
• Use a humidifier in rooms where you spend the most time.
• If your baby is more likely to have eczema because of a family history, it’s best to breastfeed them exclusively for the first 3 months of life, or longer if possible. Doctors advise continuing breast milk for at least up to 6 months (preferably 1 year) as you introduce your baby to solid food. Babies should also be protected from such potential allergens as pet hair, mites, and molds.

Takeaways

You can manage your eczema by living a healthy and well-balanced lifestyle. Avoid triggers like 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.