They call this skin condition the “itch that rashes.”
Most people associate eczema with rashes that itch, but dermatologists flip that on its head: They describe eczema as an “itch that rashes.” In other words, the itchiness of eczema itself can bring on a rash, especially if you scratch (and scratch and scratch).
Eczema—which comes from the Greek word for “to boil over”—is not contagious. Doctors don’t know exactly what causes eczema, though it does tend to run in families and is more common among people who have allergies and asthma. Eczema makes the skin feel dry, itchy, and flaky. It can appear as redness, small bumps, flaked skin, and inflamed rashes. Learn more about eczema symptoms here.
The most common areas that eczema affects are the neck, elbow creases, and the backs of the knees. You may also see it on the face, hands, forearms, and wrists in adults. Eczema can range from mild to moderate to quite severe; more serious cases can have a major impact on patients’ quality of life. For all cases of eczema, basic skin care rules can go a long way toward managing symptoms. Dermatologist Suzanne Friedler, MD, recommends that eczema patients take shorter showers, use lukewarm water instead of very hot water, use soap and other products made for sensitive skin, and moisturize their skin frequently. (Here’s how to pick the right moisturizer for eczema.)
If tweaking your skin care regimen doesn’t control your eczema symptoms, the next step in treatment is usually topical steroid creams or calcineurin inhibitors, which a dermatologist would prescribe. These reduce inflammation and itching in the skin. More severe cases of eczema may need other treatments that act directly on the immune system to relieve symptoms, including immunosuppressive drugs and biologics.
Eczema is a chronic condition, which means that symptoms can improve and then flare periodically. Most patient with atopic dermatitis, the most common kind of eczema, see their first symptoms prior to age five. About half of patients who are diagnosed with eczema during childhood see their symptoms become milder during adulthood, according to the American Academy of Dermatology.
There’s no actual test to diagnose eczema. Dermatologists can tell if you have it by looking at your skin and asking questions about when you experience symptoms.
Dr. Friedler is a dermatologist and clinical instructor at The Mount Sinai Hospital and St. John's Episcopal Hospital.
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Eczema is a skin condition that
makes your skin itchy and flaky.
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That means you have sensitive skin, and
your skin needs extra special care.
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It may need gentler treatment
than the average person.
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The main symptoms of eczema
include intense itching, redness,
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small bumps or skin that flakes off.
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Doctors don't know exactly
what causes eczema,
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but it often happens in people
who have allergies and asthma.
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Eczema can run in families too.
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Eczema can range from mild to moderate,
to very severe cases,
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which can have a big impact
on patients' quality of life.
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The main thing I talk to my patients
about is how to care for their skin.
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Taking shorter showers, not using hot
water, using a soap for sensitive skin,
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and moisturizing frequently with a creamer
and ointment rather than a lotion.
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Once you've done those basic things
if your eczema is still flaring up,
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the next step is topical steroids and
topical calcineurin inhibitors.
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Both work by reducing inflammation and
itching in the skin.
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Severe cases of eczema may
need other medications or
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treatments that help calm down the immune
system, including immunosuppressive drugs,
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biologics, or phototherapy.
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Eczema's a chronic condition.
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It tends to improve and
then flare periodically.
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Some people flare in the winter
when the air gets dry,
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some people flare in the summer when
heat and sweat can irritate their skin.
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Most people with atopic dermatitis,
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which is the most common kind of eczema,
have their first symptoms as children.
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This can sometimes persist into
adulthood and sometimes it resolves.
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Other kinds of eczema can
show up at any age and
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may be related to your environment.
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Someone who starts taking
a lot of hot showers or
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who starts using a stronger soap can
get eczema just from these behaviors.
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There's no actual test to
know if you have eczema.
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Dermatologists can tell by looking at your
skin and by asking the right questions.
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When we examine a patient's skin, we'll
often see redness and scaling, especially
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in places like the folds of your elbow or
behind the knees or in the neck area.
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Sometimes we'll find dryness all over
the body, some patients are more prone to
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eczema if they're missing
a certain protein in the skin,
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and they'll often have fish-like scales on
their skin, especially on the lower legs.
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Another key part of dealing with eczema,
is managing itching without scratching.
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When you scratch, bacteria can
get introduced into the skin, and
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eczema can become infected.
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Sometimes we add things
like bleach baths and
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antibacterial soaps into an eczema
regimen to prevent those infections.
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Atopic dermatitis: Signs and symptoms. Schaumburg, IL: American Academy of Dermatology. (Accessed on December 30, 2020 at https://www.aad.org/public/diseases/eczema/atopic-dermatitis#symptoms.)Eczema. Schaumburg, IL: American Academy of Dermatology. (Accessed on December 30, 2020 at https://www.aad.org/media/stats/conditions/eczema.) Students with eczema have lowered self-esteem due to bullying. San Rafael, CA: National Eczema Association. (Accessed on August 24, 2017 at https://nationaleczema.org/students-with-eczema-lowered-self-esteem/.) What is eczema? San Rafael, CA: National Eczema Association. (Accessed on December 30, 2020 at https://nationaleczema.org/eczema/.)