eczema

Overview
Eczema, also known as atopic dermatitis, is a chronic inflammatory skin condition that causes the skin to become dry, itchy, red, and cracked. It’s not contagious but results from a complex interaction between genetics, the immune system, and environmental triggers. Eczema can vary in severity and may flare up periodically, especially in response to stress, allergens, or irritants. While it is most common in children, it can affect people of all ages and often persists into adulthood.

Why It’s Important
Eczema can have a major impact on quality of life, especially when itching and irritation interfere with sleep or daily activities. Persistent scratching can lead to skin infections, scarring, and even psychological distress such as low self-esteem or anxiety. Early treatment and proper skin care are crucial to manage symptoms and prevent complications.

Quick Facts

  • Affects 10–20% of children and 1–3% of adults globally

  • More common in individuals with a family history of allergies, asthma, or hay fever

  • Typically a chronic condition with recurrent flare-ups

  • Multiple types, including:

    • Atopic dermatitis (most common)

    • Contact dermatitis

    • Dyshidrotic eczema

    • Nummular eczema

    • Seborrheic dermatitis

What Happens in the Body
In people with eczema, the skin barrier is weakened, making it more susceptible to moisture loss and the entry of irritants, allergens, and microbes. This triggers an overactive immune response, leading to inflammation and the hallmark symptoms of redness, swelling, and itching.

Common Signs and Symptoms

  • Dry, scaly patches of skin

  • Intense itching, especially at night

  • Redness, inflammation, and swelling

  • Cracks, oozing, or crusting in more severe cases

  • Thickened or leathery skin with long-term scratching (lichenification)

  • Commonly affects face, hands, feet, inner elbows, and behind the knees

Diagnosis

  • Diagnosed primarily through physical examination and patient history

  • No single test, but allergy testing or skin biopsies may help rule out other conditions

  • Should see a doctor if:

    • Symptoms are severe or worsening

    • Skin is oozing, crusted, or infected

    • Over-the-counter treatments are ineffective

Treatment and Management

  • No cure, but symptoms can be managed

  • First-line treatment includes moisturizers and topical corticosteroids

  • Other treatments may include:

    • Topical calcineurin inhibitors (e.g., tacrolimus)

    • Oral antihistamines to reduce itching

    • Phototherapy (light therapy)

    • Biologic medications (e.g., dupilumab) for severe cases

  • Lifestyle management includes avoiding triggers (e.g., soaps, fragrances), keeping skin hydrated, and using gentle skincare routines

Risks and Complications

  • Secondary skin infections from scratching (e.g., staph or herpes)

  • Sleep disturbances

  • Increased risk of asthma, food allergies, and hay fever in children (known as the "atopic triad")

  • Potential for psychological effects, including anxiety or depression

Who Is at Risk

  • Children, especially those with a family history of eczema or allergies

  • People with asthma or allergic rhinitis

  • Living in urban or dry climates

  • Use of harsh soaps, frequent bathing, or exposure to allergens

Related Conditions

  • Asthma

  • Allergic rhinitis (hay fever)

  • Contact dermatitis

  • Food allergies, especially in children

When to See a Doctor

  • If eczema is not controlled with basic skincare

  • If signs of infection develop (yellow crusting, pus, fever)

  • If itching is severe enough to disrupt sleep or daily activities

  • If large areas of skin are affected or symptoms worsen over time

Last Updated: June 21, 2025