Eczema is the broad name for a group of conditions that make your skin itchy and red. It may look like a rash. The most common type is atopic dermatitis (AD). More than 31 million Americans have some type of eczema. It affects both adults and children.
Many of the complications of eczema are related to itching. Scratching itchy skin damages its surface. Eczema also causes skin changes you can’t see that increase your risk of infections.
Bacterial Infections
Signs that your eczema is infected include:
- Fever or feeling sick overall
- Oozing
- Swelling and soreness
- Yellow crust
- Yellow or white spots within your eczema
Your doctor may prescribe an antibiotic. If you have a boil, the doctor may need to open it and drain it.
Cellulitis
A bacterial infection that gets deep into your skin is called cellulitis. Symptoms include:
- Fever
- Redness
- Swelling
- Warm and tender skin
You’ll need an antibiotic to clear up the infection. If it’s serious, your doctor may admit you to the hospital to get medicine through an IV.
Viral Infections
Sometimes a virus causes an infection.
Eczema herpeticum
Eczema herpeticum is caused by the same virus behind cold sores (herpes simplex 1). Less often it’s caused by the virus involved in genital herpes (herpes simplex 2).
Symptoms include painful blisters that break open and form crusts. You might also have a fever and swollen lymph nodes. You treat it with antiviral drugs.
This viral infection is caused by a poxvirus. You get white or flesh-colored lesions on your skin when you have it. These spots might have a pit in the center. They may itch and swell.
Doctors sometimes suggest letting your body clear this condition on its own. But when you have eczema, treatment might be the best course.
Among the options are:
- Cryotherapy (freezing it)
- Curettage (cutting it out)
- Pulsed-dye laser (burning it)
- Treatments you spread on your skin, including acids and cantharidin
Infection prevention
These steps can help you prevent both bacterial and viral infections:
- Always wash your hands before you apply creams to your skin.
- Don’t dip your fingers into a tub of ointment or cream -- you might contaminate it. Instead, use a spoon you can wash each time.
- If your eczema is infected, don’t share towels, bedding, or clothes.
- Avoid close contact with anyone who has a cold sore. Don’t share dishes, lip balm, or anything that has touched that person’s mouth.
Neurodermatitis
This condition, also called lichen simplex chronicus, is a result of the itch-scratch cycle and can be brought on by eczema. It happens when you scratch a certain place so often that the skin becomes thick, dry, and leathery. The spot might turn red, brown, or gray.
It can happen anywhere, but common places include:
To treat neurodermatitis, your doctor will want to help your skin heal and stop the cycle of itching and scratching. Options include:
Scars
Eczema can scar your skin, particularly in spots that have been infected and then healed. Scarring can be especially visible if you have darker skin.
Many scars will fade over time. But when they don’t, your doctor may recommend an ointment. You could have a procedure to smooth away the damaged skin. Plastic surgery is another possibility.
Scalp Problems
Seborrheic dermatitis is a separate type of eczema that mostly affects the scalp. You can have it in addition to atopic dermatitis. A fungus called malassezia yeast that lives on the surface of your skin may be the culprit that causes inflammation.
In adults, it often causes dandruff. In severe cases, you might scratch your scalp so much that you damage the hair follicles, which can cause hair loss.
It can also affect the sides of your nose, forehead, chest, armpits, and groin. In babies, the pattern on the scalp is sometimes called cradle cap.
Your doctor will probably recommend an antifungal cream or medicated shampoo to treat the condition. If your case is more severe, you might take a steroid or other type of medication.
Sleep Problems
Trouble sleeping is common among people with eczema. Researchers don’t fully understand why, but itching that wakes people up is one reason.
When your eczema is under control, you sleep better. You can take other actions to help improve sleep too, such as:
- Keep a regular bedtime.
- Limit caffeine in the evenings.
- Turn off screens well before bed.
- Sleep in a dark, quiet bedroom.
Your doctor also might recommend you take an antihistamine or a melatonin supplement.
Mental Health Effects
Research suggests that eczema can increase your risk of developing depression and anxiety. This can create a difficult cycle because your body’s physical reactions to stress can trigger eczema flares.
If you feel anxious or depressed, here are some steps to take:
- Exercise or find other ways to relax.
- Find a support group.
- Talk to your doctor about it.