Eczema is a chronic skin condition affecting about 10 percent of the U.S. population.

Eczema, also called atopic dermatitis, is a group of inflammatory skin conditions that cause swelling, dryness, itchiness, and rashes. It commonly affects the face, elbows, knees, hands, and feet.

The term “eczema” originates from the Greek word meaning “to boil” and refers to red, dry, and itchy skin.

Eczema affects about 10 percent of the U.S. population.

What Are the Symptoms of Eczema?

While not contagious, eczema varies from person to person and can appear on different areas of the body. Common symptoms include dry, itchy, scaly, or rough patches that can lead to intense itching and scratching, sometimes causing the skin to bleed.

It often results in inflammation or swelling, and in some cases, oozing or crusting of the affected areas.

Skin discoloration is also common, varying by skin tone and appearing as pink, red, purple, brown, or gray.

Symptoms specific to atopic dermatitis—the most common form of eczema—include thickened skin with light or dark patches, a condition known as lichenification, resulting from repeated scratching or rubbing that makes the skin appear leathery.

The distribution of atopic dermatitis rashes varies with age:

• Infants often experience widespread, dry, red, and scaly rashes, especially on the face and cheeks.
• In older children, rashes typically appear on the wrists, elbows, ankles, and knees.
• In school-aged children and adults, eczema commonly affects the folds of the elbows and knees.

Additional symptoms may include blisters and sores, which can become infected with bacteria or viruses.

What Causes Eczema?

Although its exact cause is not fully understood, atopic eczema is believed to be caused by a combination of factors, including:

Genetics

A family history of eczema, asthma, or allergies increases the risk. Certain genes, such as the filaggrin gene, play a key role in maintaining the skin barrier. Mutations in these genes can make the skin more sensitive to irritants. Other genes related to skin barrier function, lipid production, and immune system response may also contribute to the condition.

Environmental Factors

People with atopic eczema have a weakened skin barrier, making their skin prone to dryness and irritation.

Common triggers that can cause flare-ups and worsen symptoms include:

• Soaps
• Detergents
• Dust mites
• Pet dander
• Certain foods, such as eggs, milk, and peanuts
• Stress
• Weather changes
• Hormonal changes, such as those during pregnancy
• Skin infections, such as staph
• Sweat
• Scratchy clothing

Immune System Overactivation

Atopic eczema is also linked to an overactive immune system, in which the body responds too strongly to environmental triggers, leading to inflammation and, in turn, itchy, painful skin symptoms. However, atopic eczema is not an autoimmune disorder.

Other risk factors for atopic eczema include:

• Age: Atopic dermatitis can develop at any age, but it most commonly begins in childhood, typically within the first six months of life. Approximately 65 percent of cases develop before age 1, and about 90 percent occur before age 5.
• Allergies: People with eczema often also have asthma and allergies such as allergic rhinitis (hay fever). These conditions, known as “atopic” conditions, occur in people who are highly sensitive to environmental allergens.
• Race: Non-Hispanic black children are at a higher risk for atopic dermatitis than other populations.
• Obesity: Excess fat tissue releases pro-inflammatory cytokines, which can disrupt the immune balance in the skin, making it prone to the exaggerated immune response that characterizes eczema.
• Vitamin or nutrient deficiency: Deficiencies in nutrients such as zinc—which has anti-inflammatory properties—may contribute to eczema by increasing the production of pro-inflammatory mediators.
• Urban living: Air pollutants can affect both local and systemic immune responses, potentially skewing the immune system towards eczema. Research has shown a link between higher levels of particulate matter and an increased risk and severity of eczema.
• Climate with low humidity: Low humidity increases the risk and severity of eczema by drying out the skin, compromising the skin barrier, and making it more susceptible to irritants and allergens.

What Are the Types of Eczema?

Atopic dermatitis, also known as atopic eczema, is the most common type of eczema. Atopic dermatitis is the most prevalent chronic inflammatory skin disease and what people usually refer to as “eczema.” Atopic dermatitis has three subtypes based on age of onset:

Early-Onset Atopic Dermatitis (Birth to Age 2)

Early-onset atopic dermatitis is the most common form affecting approximately 10 percent to 30 percent of children and 2 percent to 10 percent of adults in developed countries, with its prevalence increasing two- to threefold in recent decades. About 60 percent of affected children see their symptoms resolve by age 12. However, some people continue to experience symptoms throughout life.

Late-Onset Atopic Dermatitis

Symptoms of late-onset atopic dermatitis first appear after puberty.

Senile-Onset Atopic Dermatitis

Senile-onset atopic dermatitis is a rare subtype and begins after age 60.

Atopic dermatitis may also worsen with age. Even after symptoms subside, the skin can remain sensitive and prone to irritation. People who had eczema as a child may struggle with jobs involving frequent hand washing, such as nursing, because the skin can become raw, cracked, and irritated—sometimes resulting in bleeding.

In addition to atopic dermatitis, there are at least six other types of eczema. Each has distinct causes, symptoms, and treatments:

Contact Dermatitis

Contact dermatitis occurs when skin comes into direct contact with irritants or allergens. There are two main types:

1. Allergic contact dermatitis involves an immune-based, delayed reaction.
2. Irritant contact dermatitis causes a nonimmune, immediate response.

Common triggers include metals, fragrances, medications, and workplace chemicals. Symptoms can range from mild redness to severe blistering. Management includes avoiding triggers, regular moisturizing, and topical corticosteroids.

Dyshidrotic Eczema

Also called pompholyx, dyshidrotic eczema is a chronic condition causing small, painful blisters primarily on palms, soles of the feet, and sides of the fingers. Blisters typically last 3 to 4 weeks and heal with dryness and peeling. Common triggers include nickel exposure, stress, excess moisture, and seasonal allergies. Treatment may involve topical corticosteroids, antifungal medications, and cool compresses.

Neurodermatitis

Also known as lichen simplex chronicus, neurodermatitis affects about 12 percent of the population. It involves thickened, leathery skin patches with severe itching that worsens during periods of rest. Neurodermatitis is driven by an itch-scratch cycle and rarely resolves without treatment. Common therapies include corticosteroids, nonsteroidal topicals, and strategies to reduce scratching.

Nummular Eczema

Nummular eczema produces distinctive, coin-shaped, itchy patches on the arms, hands, and legs. Patches may ooze, crust, and resemble ringworm. Although the cause is unclear, winter dryness, skin trauma, and stress are contributing factors. Most cases improve within 3 to 4 weeks when treated with emollients, topical medications, and wet-wrap therapy.

Seborrheic Dermatitis

Seborrheic dermatitis affects oily areas such as the scalp, where it’s known as dandruff in adults and cradle cap in infants, face, and chest. It causes red, greasy skin with white or yellow scales and often worsens in winter and is likely triggered by an inflammatory reaction to the Malassezia yeast, which naturally lives on the skin. Seborrheic dermatitis affects 3 to 5 percent of the population and can be treated with antifungal products, medicated shampoos, and moisturizers.

Stasis Dermatitis

Also called varicose eczema, stasis dermatitis primarily affects the lower legs of people with poor circulation, causing swelling, discoloration, and characteristic “cayenne pepper spots” from burst blood vessels. Stasis dermatitis results from blood pooling in the legs due to weakened vein valves—a condition known as venous insufficiency. Management includes leg elevation, regular exercise, emollients, and compression stockings. In severe cases, vein surgery may be required.

How Is Eczema Diagnosed?

Eczema is typically diagnosed based on a physical exam and a review of the patient’s medical history. A health care provider will look for common symptoms such as redness, dryness, itchiness, and skin thickening. The appearance and location of the rash—often found in the folds of the elbows or knees—can also help confirm the diagnosis. In most cases, no additional testing is needed.

However, if the diagnosis is unclear or if allergic triggers are suspected, a doctor may recommend further testing. While not routinely performed, these tests can help identify underlying allergies or rule out other skin conditions:

• Patch test: Small adhesive patches containing allergens are applied to the patient’s back and left in place for 48 hours to identify any that cause skin irritation.
• Skin prick test: Suspected allergens are placed on or just beneath the skin’s surface using small droplets to observe for a reaction.
• Blood test: A blood sample is analyzed to detect immunoglobulin E antibodies, which may be elevated in people with allergic conditions, including eczema.
• Oral food challenge: The patient eats small amounts of a suspected food allergen, gradually increasing the quantity, while a doctor monitors for any allergic reactions.
• Skin biopsy: A small skin sample is examined to help confirm a diagnosis or rule out other skin conditions.

What Are the Possible Complications of Eczema?

Eczema can lead to several complications, particularly if the skin barrier is severely compromised or if scratching causes breaks in the skin. These complications range from skin infections to serious viral conditions, and in some cases, they may require urgent medical attention.

Common and potential complications include:

• Eye problems: Eczema near the eyes can lead to conditions such as eyelid dermatitis, conjunctivitis (pink eye), blepharitis (inflammation of the eyelids), and, in rare cases, cataracts.
• Skin infections: Scratching and open sores can allow bacteria or viruses to enter the skin. Common infections include: impetigo (caused by bacteria), cold sores (caused by herpes simplex virus), and warts (caused by human papillomavirus).
• Hand dermatitis: A form of eczema that specifically affects the hands. It can become chronic and interfere with daily activities, particularly in jobs involving frequent handwashing or exposure to irritants.
• Eczema herpeticum: A potentially life-threatening infection caused by the herpes simplex virus. It presents as rapidly spreading, painful blisters and may require immediate antiviral treatment.
• Eczema coxsackium: A rare but serious infection caused by the coxsackievirus, also responsible for hand, foot, and mouth disease. It can cause widespread blistering in people with active eczema.

What Are the Treatments for Eczema?

There is no cure for atopic dermatitis, but a variety of treatments can help ease symptoms, reduce flare-ups, and improve the skin’s appearance and function. A consistent skincare routine and appropriate use of medications are central to managing the condition.

Skincare Routine

A regular skincare regimen is essential for managing eczema and may include bathing with a gentle, fragrance-free cleanser and moisturizing immediately afterward to help retain moisture and repair the skin barrier. Moisturizing helps prevent dryness, blocks irritants and allergens, and reduces the risk of flare-ups. Applying emollients (medical moisturizers) twice daily is recommended. Ointments such as petroleum jelly can also be helpful.

Medications 

Treatment plans may include a range of medications, depending on the severity and persistence of symptoms:

• Over-the-counter topicals: Mild corticosteroids such as hydrocortisone cream may be applied to reduce inflammation. These are usually used before applying emollients.
• Prescription oral corticosteroids: For severe flare-ups, doctors may prescribe oral corticosteroids such as prednisone or methylprednisolone. These are typically used for short-term relief due to potential side effects with long-term use.
• Immunosuppressants: In rare cases where symptoms do not improve with oral corticosteroids, drugs that suppress the immune system may be prescribed for adults.
• Antihistamines: Medications such as diphenhydramine can help reduce itchiness—particularly at night—by blocking histamine, a substance the body releases in response to irritants.
• Topical immunomodulators: These steroid-free medications, including tacrolimus and pimecrolimus, are used to reduce skin inflammation and are generally recommended when other treatments fail or for sensitive areas, such as the face.
• Other nonsteroidal topicals: May be used on sensitive areas where corticosteroids might be too harsh.

Light Therapy (Phototherapy)

Ultraviolet light treatment can help mild-to-moderate eczema in adults and children over 12. Phototherapy may be used alone or combined with a medication called psoralen, a treatment approach known as photochemotherapy.

Wet Wraps and Bandaging

Damp dressings—also known as wet wraps—can be used for short periods to rehydrate and calm the skin. Cotton bandages, or specially designed silk garments worn over creams, help lock in moisture and prevent scratching. Medicated paste bandages may also be used to soothe irritated skin and provide a protective barrier.

Bleach Baths

For those with frequent skin infections, particularly staph infections, a diluted bleach bath may help reduce bacteria on the skin and improve symptoms. Bleach treatments must be done carefully under medical supervision to avoid irritation.

How Does Mindset Affect Eczema?

Mindset can significantly affect eczema by influencing stress, emotional well-being, and self-care habits.

Stress and anxiety may trigger flare-ups by increasing inflammation, while negative emotions such as annoyance or frustration can lead to scratching, which worsens symptoms.

A positive mindset encourages proactive management of eczema, including sticking to treatment plans and avoiding known triggers.

Additionally, building mental resilience and practicing relaxation techniques can help reduce stress and improve immune function, potentially leading to fewer flare-ups.

What Are the Natural Approaches to Eczema?

Please consult your doctor before trying any of the following natural approaches to manage eczema symptoms.

1. Herbal Medicines and Products:

Some herbal products may help soothe eczema symptoms and improve skin health. While research is ongoing, the following remedies have shown promise:

• Topical aloe vera: Aloe vera gel naturally hydrates the skin and has antibacterial properties, making it a popular remedy for reducing dryness and irritation. A 2023 study found that aloe vera-based gels can help fight harmful bacteria and support skin healing.
• Xiao Feng San: A 2011 study found that the traditional Chinese herbal formula Xiao Feng San may improve symptoms in people with severe, persistent atopic dermatitis. Xiao Feng San’s ingredients include Angelica sinensis, Saposhnikovia divaricata, Schizonepeta tenuifolia, Sophora flavescens, and many other herbs.
• Witch hazel (Hamamelis virginiana) bark extract: Witch hazel bark extract has long been used to treat skin conditions such as atopic eczema. A 2022 study shows that it may help alleviate itching and improve skin barrier function.
• St. John’s wort (Hypericum perforatum) cream: Research suggests that St. John’s wort cream can significantly improve subacute atopic dermatitis and reduce skin colonization by staph bacteria.

2. Dietary Supplements:

Certain dietary supplements may offer anti-inflammatory benefits that support eczema management. However, results can vary, and more research is needed to determine optimal dosing.

• Omega-3 fatty acids: A 2024 study found that supplementing with omega-3 fatty acids may be a safe and effective way to reduce the severity of atopic dermatitis in children.
• Vitamin D: According to a 2023 meta-analysis, vitamin D supplementation may improve eczema severity in children. However, the ideal dose and duration of supplementation remain unclear.
• Flavonoids: A type of antioxidant found in various plants, flavonoids possess anti-inflammatory properties. A 2023 study suggested that flavonoids may offer future therapeutic potential for treating skin conditions, including atopic eczema.

3. Hypnotherapy

Medical hypnotherapy uses a trance-like state to access unconscious memories and aspects of the psyche, as well as influence physiological control beyond normal waking awareness. It can also help modify harmful behaviors, such as excessive scratching. Hypnotherapy may help people become more aware of their scratching habits and replace them with less damaging responses to the itch. It may also aim to reduce the psychological sensation of itching.

4. Acupuncture

Emerging evidence suggests that acupuncture may offer benefits for people with eczema. A 2022 meta-analysis of 14 studies found that acupuncture can be more effective at treating atopic eczema than standard medication, such as oral antihistamines. Certain acupuncture points are believed to help clear inflammation, ease redness, and promote healing of eczema lesions.

How Can I Prevent Eczema?

Since the causes of several types of eczema are not fully understood, there is no guaranteed way to prevent the condition. However, the following measures may help reduce your chance of developing eczema or minimize flare-ups if you already have it.

Mindset

Reducing stress, anxiety, nervousness, and depression may help prevent eczema flares. Mind-body techniques such as cognitive behavioral therapy and meditation may be useful in supporting emotional well-being and lowering inflammation.

Environmental Triggers

Identifying and avoiding personal triggers is essential for managing eczema effectively. Common triggers include:

• Environmental factors: Extremes or changes in weather, such as dry air, may worsen eczema. Using a humidifier indoors can help maintain skin moisture.
• Irritants: Everyday products like soaps, detergents, certain fabrics, and frequent handwashing can irritate the skin and trigger flare-ups.
• Inhaled allergens: Dust mites, pollen, animal dander, and mold spores can provoke allergic reactions that may exacerbate eczema symptoms.
• Microorganisms: Certain bacterial, viral, or fungal infections can trigger or worsen eczema.
• Food allergens: Common food triggers include eggs, milk, and peanuts.

Lifestyle Factors

Several lifestyle habits may also help lower the risk of developing eczema or reduce its severity:

• Avoid allergens and irritants: Limiting exposure to allergens, alcohol, and tobacco smoke can help prevent flare-ups.
• Manage stress: Emotional stress can trigger or worsen eczema. Practicing stress management techniques such as mindfulness, meditation, or therapy may help protect skin health.
• Breastfeed infants: Babies who are exclusively breastfed for at least four months have a lower risk of developing atopic dermatitis and cow’s milk allergy during their first two years, compared with those fed regular cow’s milk formula.
• Take probiotics during pregnancy: A 2002 study suggests that pregnant and breastfeeding mothers who take probiotics may lower the risk of atopic eczema in their children. However, probiotics should only be used under a health care provider’s supervision, as they may increase the risk of preeclampsia.
• Keep a pet cat: A 2020 study suggests that having a cat at home may decrease the chance of children developing atopic eczema.

Important Notice: This article was originally published at www.theepochtimes.com by Mercura Wang, where all credits are due. Medically reviewed by Jimmy Almond, M.D.