Eczema is not a specific disease, but rather a term that describes a group of inflammatory skin conditions that produce rash-like symptoms, such as irritated, itchy patches on the skin.
It's also known as dermatitis (skin inflammation), atopic eczema ("atopic" means a genetic tendency toward allergic hypersensitivity), or simply atopic dermatitis.
What’s the Difference Between Eczema and Atopic Dermatitis?
The word "eczema" is often used interchangeably with "atopic dermatitis,” though clinically speaking, atopic dermatitis is the most common type of eczema.
Atopic dermatitis is the most severe and chronic (long-lasting) form of eczema. It's characterized by inflamed skin that may crack and release a clear fluid when scratched (an effect known as weeping).
Common Questions & Answers
Pictures of Different Types of Eczema
Contact Eczema (Contact Dermatitis)
Compared to other types of eczema, nummular eczema appears differently: as itchy, coin-shaped spots on the skin.
This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.
Easing Eczema During COVID-19
Signs and Symptoms of Eczema
People with eczema have very dry, itchy skin and rashes on various parts of the body — particularly the face, hands, feet, insides of the elbows, and behind the knees.
In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth.
For most people, the main symptom of eczema is itching, which can lead to scratching and rubbing that further irritates the skin. This can, in turn, lead to the “itch-scratch cycle” or increased itching and scratching that worsens eczema symptoms.
Other skin symptoms associated with eczema include:
- Rough, leathery patches of skin
- Discolored, raised bumps (hives)
- Increased skin creases on the palms of the hands
- Small, rough bumps on the face, upper arms, and thighs
- Scaly skin patches
- Swollen, sore skin
- Skin color changes
Causes and Risk Factors of Eczema
Skin affected by eczema is unable to retain moisture well, possibly because of low production of fats and oils. It is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes it to become dry and lose its protective properties.
It's not clear what causes certain people to develop eczema, specifically atopic dermatitis.
Children are more likely to develop eczema if other allergic diseases — such as hay fever and asthma — run in the family, which suggests that there may be a genetic component to the condition. Read more about conditions related to eczema below.
Though dermatologists don’t necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.
In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema.
- Soaps, detergents, shampoos, and dishwashing liquids
- Bubble bath liquids
- Dust or sand
- Cigarette smoke
- Perfumes, and skin-care products that contain fragrances or alcohol
- Wool or synthetic fabrics
- Chemicals, solvents, and mineral oils
- Pet dander
- Allergenic foods (such as peanuts, soy, and eggs)
- Dust mites
- A hot or dry climate
- High or low humidity
- Bacterial, viral, or fungal infections
How Much Do You Know About Eczema?
How Is Eczema Diagnosed?
To diagnose eczema, your doctor will first conduct a physical examination to look at the state of your skin and see if you have the characteristic rash of the illness.
Prognosis of Eczema
But about one-half of adults with atopic dermatitis had it as a child.
Duration of Eczema
Atopic dermatitis in adults often lasts a long time and there is no way to determine if it will go away or last a lifetime. But the frequency and severity of symptoms usually decrease over time, and you can control atopic dermatitis through treatment, moisturizing, and by avoiding irritants that cause flare-ups.
Treatment and Medication Options for Eczema
There is no cure for eczema, and the goal of treatment is to reduce eczema symptoms, heal the skin, and prevent skin damage and flare-ups.
Medication, moisturizers, and at-home skin-care routines make up an effective treatment plan for many people who live with eczema.
- Corticosteroids (ointments, creams, or lotions) that include drugs such as 0.1 percent fluocinonide cream (Vanos), and come in varying degrees of strength
- Calcineurin inhibitors (TCIs), like tacrolimus (Protopic) and pimecrolimus (Elidel)
- The PDE4 inhibitor crisaborole (Eucrisa)
- The JAK inhibitor ruxolitinib (Opzelura)
For moderate and severe disease, treatments include:
- Biologics, including the self-administered injectable drugs dupilumab (Dupixent) and tralokinumab-ldrm (Adbry)
- Oral immunosuppressants, like cyclosporine (Neoral, Sandimmune, or Restasis), methotrexate (Trexall or Rasuvo), or mycophenolate (CellCept)
- The oral JAK inhibitors upadacitinib (Rinvoq) and abrocitinib (Cibinqo)
- Wet wrap therapy, which combines topical medicines and moisturizers with a wet gauze wrap.
Alternative and Complementary Therapies
Prevention of Eczema
There is no proven way to prevent getting eczema. Nonetheless, research suggests children who are breastfed until they’re 4 months old may be less likely to get it. Alternatively, partially hydrolyzed formula, which contains processed cow milk protein, may also reduce a child's chance of developing atopic dermatitis.
- Follow a healthy skin-care routine, including using moisturizing cream or ointment two to three times a day.
- Use gloves when needed, such as when you’re at risk of coming in contact with irritants. That means while working outside or if you have to put your hands underwater (to absorb sweat, wear cotton gloves under plastic gloves).
- Bathe smart, such as by using only mild soap and lukewarm water for your bath or shower, and patting your skin dry instead of rubbing it.
- Stay cool by drinking lots of water, and avoiding getting hot and sweaty.
- Wear loose clothes — that is, those that are made of cotton and other natural materials.
- Keep your body temperature steady by avoiding sudden changes in temperature and humidity.
- Tame stress by recognizing the signs and taking steps to manage it.
- Limit exposure to known irritants and allergens as best you can.
- Don't itch affected skin areas.
Complications of Eczema
People with eczema are at risk of developing infections if they scratch themselves so much that they break the skin.
Research and Statistics: Who Has Eczema? How Many People Have Eczema?
Eczema can occur at any age, but it typically begins in infancy and early childhood.
National survey data suggest the one-year prevalence of atopic dermatitis among American adults was 10.2 percent in 2010 and 7.2 percent in 2012. But the surveys used different questions: The former referred to "dermatitis, eczema, or any other red, inflamed skin rash" and the latter to "eczema or skin allergy."
Furthermore, skin infections due to a compromised skin barrier may affect people with eczema. They include:
BIPOC and Eczema
- White: 11 percent
- African American or Black: 10 percent
- Asian or Pacific Islander: 13 percent
- Native American: 13 percent
The authors of the review also noted that African American children are 1.7 times more likely to develop atopic dermatitis compared with European American children, even when adjusting for household income, parental education level, metropolitan versus rural environment, and health insurance coverage status.
Another finding detailed in the review: African American children are 3 times more likely to be diagnosed with atopic dermatitis during a dermatologist visit than European American children, even though they are significantly less likely to seek dermatological care, while Asian American kids are 7 times more likely compared with white kids.
The itching due to eczema has been shown to have a greater impact on Black patients, who also tend to have more severe disease, per the NEA.
Eczema can lead to skin discoloration, as can scratching itchy areas. Darkened patches (hyperpigmentation) or lightened ones (hypopigmentation) can be a particular concern for people of color.
Although skin tone eventually evens out on its own, the discoloration can linger for weeks, months, or longer, according to the Skin of Color Society.
Changes in skin color can be improved with appropriate treatment for the underlying eczema and inflammation.
Eczema Resources We Love
Favorite Orgs for Essential Info About Eczema (Atopic Dermatitis)
The NEA is the most prominent U.S. organization devoted solely to education, research, patient support, and advocacy related to atopic dermatitis and other forms of eczema. We love their eczema fact sheets, glossary of skin-care terms, and informative webinars. Plus, they have a yearly family-friendly Eczema Expo each summer at a vacation destination.
This society is one of the most visible resources in the United Kingdom to educate people about eczema, provide help for people with the disease, and support research. Perhaps their most unique resource is a confidential telephone and email hotline that people in the United Kingdom can call Monday through Friday, 8 a.m. to 8 p.m. local time.
Favorite Orgs for Essential Info About Skin and Allergic Diseases, Including Eczema
The AAD says it is the largest professional dermatologic association, with more than 20,500 physicians as members worldwide. They publish information about a variety of skin conditions, and we recommend checking out the robust resource center with information about childhood and adult eczema.
Because allergens can trigger eczema flareups, it makes sense to stay on top of information about managing allergies. The AAFA’s site has a wealth of information about allergies, for both adults and kids.
Favorite Annual Meetings for Eczema Patients
The NEA’s annual expo provides a vacation retreat for people and families affected by eczema. The four-day event includes activities; educational seminars; camps for infants, children, and teens; and hotel accommodations that are as free of potential allergens as possible. The next Eczema Expo is June 25 through 28, 2020, in Orlando, Florida. The organization offers a limited amount of needs-based scholarships to help people attend.
Favorite Alternative Medicine Resource
Favorite Online Support Networks
Filling out a lengthy form indicating your areas of interest will give you free access to an online forum that includes discussion threads on eczema-related topics. Each time you log in you will see a stream of blog posts with daily news and the latest discussion threads.
We recommend this NEA-hosted forum for sharing support and advice about living with eczema. After registering for free, members post questions or comments in freewheeling discussions and receive written replies, or reactions via “Support,” “Thanks,” and “Useful” buttons.
Favorite Sites for Eczema Relief Products
Find household products that are certified “Asthma & Allergy Friendly,” and therefore less likely to trigger eczema flare-ups, through the Asthma and Allergy Foundation of America’s online store.
The National Eczema Association has an online store of sensitive skin–friendly products that bear the NEA Seal of Acceptance, meaning they are intended for people with moderate to severe skin conditions. Get moisturizers, cleansers, detergents, and other items designed to protect and not irritate your skin.
Favorite Resource for Diet Advice
Avoiding food allergy triggers may help you manage eczema, but sometimes you need help identifying precisely what the triggers are. This is where an elimination diet may help. This approach involves omitting a food you think is problematic and then reintroducing it to see what happens. We love this article with information from the dermatologist Peter Lio, MD, which delves into some of the misconceptions about the diet, as well as the link between eczema and what you eat.
Favorite Resource for Becoming an Advocate
We love that the NEA has made it so easy to advocate for better healthcare policies. Their Advocacy Action Center enables people to browse legislation related to eczema in various states. If you wish to “take action,” you can click on a button and fill out an online form to send a message to your local lawmaker.
Favorite Eczema Tracking App
Information is power when it comes to managing eczema symptoms and flare-ups. Eczema Tracker allows you to take a photo of flare-ups and monitor your condition, as well as track and analyze a wealth of information concerning your triggers, allergies, and skin. The app even provides local pollen, weather, mold, and humidity information to help you manage your symptoms. It uses your data to find trends that may lead to flare-ups. Eczema Tracker is available only for iOS in the Apple Store. It is a free app.
Favorite Eczema Spa Retreat
Participants in the 2019 NEA Eczema Expo were able to enjoy spa treatments at a local day spa in consultation with a dermatologist who could help them to choose the best treatments for their skin condition. We hope they will do this again in 2020!
Editorial Sources and Fact-Checking
- Atopic Dermatitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. July 31, 2016.
- Eczema. National Eczema Association.
- Eczema Causes and Triggers. National Eczema Association.
- McPherson T. Current Understanding in Pathogenesis of Atopic Dermatitis. Indian Journal of Dermatology. November–December 2016.
- Types of Eczema. National Eczema Association.
- Hand Eczema. National Eczema Association.
- Atopic Dermatitis. MedlinePlus. October 24, 2016.
- Eczema: Diagnosis and Tests. National Jewish Health. July 1, 2015.
- Atopic Dermatitis Treatment. American Academy of Dermatology.
- Darsow U, Wollenberg A, Simon D, et al. Difficult to Control Atopic Dermatitis. World Allergy Organization Journal. March 2013.
- Prescription Topical Treatment. National Eczema Association.
- Topicals, Oral Medicines, and Phototherapy: An Overview of Eczema Treatments. National Eczema Association.
- Phototherapy. National Eczema Association.
- Eczema (Atopic Dermatitis) Treatment. National Institute of Allergy and Infectious Diseases. May 24, 2017.
- Everything You Need to Know About Eczema and Food Allergies. National Eczema Association. December 13, 2018.
- Eczema: Can Eliminating Particular Foods Help? InformedHealth.org. February 23, 2017.
- Eczema and Bathing. National Eczema Association.
- Complementary and Alternative Treatments. National Eczema Association.
- Eczema (Atopic Dermatitis) Complications. National Institute of Allergy and Infectious Disease. August 28, 2015.
- Eczema Herpeticum. National Eczema Association.
- Eczema and Emotional Wellness. National Eczema Association.
- Eczema Facts. National Eczema Association.
- Lee HH, Patel KR, Singam V, et al. A Systematic Review and Meta-Analysis of the Prevalence and Phenotype of Adult-Onset Atopic Dermatitis. Journal of the American Academy of Dermatology. June 2019.
- Conditions Related to Eczema. National Eczema Association.
- Food Allergy and Children With Eczema. National Eczema Association.
- Traditional Smallpox Vaccines and Atopic Dermatitis Frequently Asked Questions. National Eczema Association.
- Eczema. Cleveland Clinic. October 28, 2020.
- Eczema: Prevention. Cleveland Clinic. October 28, 2020.
- Ask the Ecz-perts: What Can Be Done About Dark Spots Left by Eczema? National Eczema Association. June 9, 2021.
- Hewett L. Eczema in Skin of Color: What You Need to Know. National Eczema Association. February 15, 2018.
- Kathuria P, Kundu RV. Eczema. Skin of Color Society.
- Brunner PM, Guttman-Yassky, E. Racial Differences in Atopic Dermatitis. Annals of Allergy, Asthma, and Immunology. November 19, 2018.