What is eczema? What does it look and feel like?
Eczema (also called atopic dermatitis) is a condition that causes your skin to become dry, red, itchy and bumpy. It’s one of many types of dermatitis. Eczema damages the skin barrier function (the "glue" of your skin). This loss of barrier function makes your skin more sensitive and more prone to infection and dryness.
Eczema doesn’t harm your body. It doesn’t mean that your skin is dirty or infected, and it’s not contagious. There are treatments that can help manage your symptoms.
In the word “dermatitis,” “derm” means “skin” and “itis” means “inflammation.” The word as a whole means “inflammation of the skin.” “Eczema” originates from the Greek word “ekzein” which means to “boil over” or “break out.”
How common is eczema (atopic dermatitis)?
Eczema affects up to 15 million Americans. Infants are prone to eczema and 10% to 20% will have it. However, nearly half outgrow the condition or have significant improvement as they get older.
Eczema affects males and females equally and is more common in people who have a personal or family history of asthma, environmental allergies and/or food allergies.
How does eczema start?
The first signs of eczema are itchiness and redness.
Where does eczema most commonly occur?
Eczema can show up anywhere on your skin. In teens and adults, it’s typically found on your hands, neck, inner elbows, ankles, knees, feet and around your eyes.
Who is at risk of getting eczema?
Eczema (atopic dermatitis) usually begins in childhood, but anyone at any age can get it. You’re high risk if you are:
- African American.
- Diagnosed with hay fever or asthma.
- Part of a family with a history of dermatitis, hay fever or asthma.
Is eczema (atopic dermatitis) contagious? Can it spread?
No. No type of dermatitis is contagious. It can’t be spread to anyone else.
Does eczema hurt? Does it burn?
Although some types of dermatitis are painful (contact dermatitis, for example) or cause a burning sensation, eczema is usually itchy.
Can eczema hurt the rest of my body, or kill me?
Eczema and other types of dermatitis are not harmful to the rest of your body. The condition is not deadly.
What’s the difference between dermatitis and psoriasis?
Psoriasis and dermatitis can appear similar. Both cause patches of red skin. However, in psoriasis, the scales are thick and the edges of those scales are well-defined.
Discuss with your healthcare provider your questions about which type of skin condition you have. You can have more than one skin condition at a time. Treatments for one may not work for the other.
Symptoms and Causes
What causes eczema?
Eczema (atopic dermatitis) is caused by a combination of immune system activation, genetics, environmental triggers and stress.
- Your immune system. If you have eczema, your immune system overreacts to small irritants or allergens. This overreaction can inflame your skin.
- Your genetics. You’re more likely to have eczema if there is a history of dermatitis in your family. You’re also at a higher risk if there’s a history of asthma, hay fever and/or allergens. Allergens are substances like pollen, pet hair or foods that trigger an allergic reaction. Also, there might be a change in your genes that control a protein that helps your body maintain healthy skin. Without normal levels of that protein, your skin will not be completely healthy.
- Your environment. There is a lot in your environment that can irritate your skin. Some examples include exposure to tobacco smoke, air pollutants, harsh soaps, fabrics such as wool and some skin products. Low humidity (dry air) can cause your skin to become dry and itchy. Heat and high humidity can cause sweating and that can make the itchiness even worse.
- Your stress. Your stress levels can cause or worsen your eczema. There are mental/emotional signs of stress and physical signs of stress. They include:
- Difficulty relaxing.
- Use of alcohol, tobacco, or illegal drugs to relax.
- A negative opinion of yourself (low self-esteem).
- Anxiety, constant worry.
- Feeling overwhelmed.
- Difficulty with concentration.
- Irritability, mood swings, or a short temper.
- Nausea and dizziness.
- Not wanting to have sex.
- Sleeping too much.
- Sleeping too little.
- Muscle tension.
- Aches and pains.
What are the signs and symptoms of eczema?
Eczema (atopic dermatitis) symptoms include:
- Dry skin.
- Itchy skin.
- Red rashes.
- Bumps on the skin.
- Scaly, leathery patches of skin.
- Crusting skin.
If you have eczema, you might also have another condition that doesn’t cause it, but is often found alongside it:
- Sleep loss.
Notice that diabetes is not included in this list.
Does the weather make eczema worse?
Low humidity (dry air) can dry out your skin, and sweating caused by high heat can make the itchiness worse.
How long does eczema (atopic dermatitis) last?
Eczema can be lifelong, but symptoms can be managed with at-home remedies, over-the-counter medications and prescribed medications.
Diagnosis and Tests
How is eczema (atopic dermatitis) diagnosed? What tests are done?
Your healthcare provider will take a close look at your skin. They will look for classic signs of eczema such as a redness and dryness. They will ask about the symptoms you’re experiencing.
Usually your healthcare provider will be able to diagnose eczema based on examining your skin. However, when there is doubt, they may perform the following tests:
- An allergy skin test.
- Blood tests to check for causes of the rash that might be unrelated to dermatitis.
- A skin biopsy to distinguish one type of dermatitis from another.
What questions might my healthcare provider ask to diagnose eczema?
The conversation with your healthcare provider will need to cover a lot of information. Be sure to be specific about your symptoms.
- Where is your eczema located?
- What have you used to try to treat your eczema?
- What medical conditions do you have? Allergies? Asthma?
- Is there a history of eczema in your family?
- How long have you had symptoms of eczema?
- Do you take hot showers?
- Is there anything that makes your symptoms worse?
- Have you noticed that something triggers or worsens your eczema? Soaps? Detergents? Cigarette smoke?
- Is there so much itchiness that you have trouble sleeping? Working? Living your normal life?
Management and Treatment
How is eczema treated? What medications are used?
Treating eczema (atopic dermatitis) can be difficult if the cause is something you can’t control, like genetics. Fortunately, you may have some influence over your environment and stress levels. Do your best to figure out what triggers or worsens your eczema, and then avoid it. The goal is to reduce itching and discomfort and prevent infection and additional flare-ups.
Consider these treatment tips:
- Use a humidifier if dry air makes your skin dry.
- See a psychiatrist for medication and a therapist for counseling if you’re experiencing symptoms of poor mental/emotional health.
- Moisturize your skin using a cream or ointment. Lotions don’t work as well. Apply several times a day, including after you bathe or shower. Use lukewarm water in the tub or shower instead of hot.
- Use mild soaps and other products that are free of perfumes, dyes and alcohol. Look for products labeled “fragrance free,” “hypoallergenic” and “for sensitive skin.”
- Use skin products that contain ceramide. These moisturizers replace some of the “glue” (the barrier) missing from your skin.
- Apply cortisone creams and ointments. Cortisone is an over-the-counter steroid found in hydrocortisone (Cortisone 10®) and hydrocortisone acetate (Cort-Aid®). They may help control the itching and redness.
- Take over-the-counter antihistamines for severe itching.
- Take prescription medications. Your healthcare provider may prescribe steroid creams, pills and/or shots. Long-term risks include side effects like high blood pressure, weight gain and thinning of the skin. There are newer medications, called topical immunomodulators (TIMs) that show progress in treating patients who do not respond to other treatments. They change the body’s immune response to allergens and have fewer side effects.
- Phototherapy: The ultraviolet light waves found in sunlight have been shown to help certain skin disorders, including eczema. Phototherapy uses ultraviolet light, usually ultraviolet B (UVB), from special lamps.
If your child has skin problems, such as eczema, you can:
- Avoid long, hot baths, which can dry the skin. Use lukewarm water instead and give your child sponge baths.
- Apply lotion immediately after bathing while the skin is still moist. This will help trap moisture in the skin.
- Keep the room temperature as regular as possible. Changes in room temperature and humidity can dry the skin.
- Keep your child dressed in cotton. Wool, silk and manmade fabrics such as polyester can irritate the skin.
- Use mild laundry soap and make sure that clothes are well rinsed.
- Watch for skin infections. Contact your healthcare provider if you notice an infection.
- Help them avoid rubbing or scratching the rash.
- Use moisturizers several times daily. In infants with eczema, moisturizing on a regular basis (with each diaper change for example) is extremely helpful.
Is there a cure for eczema (atopic dermatitis)?
No. There are treatments, but no treatment can claim to eliminate the symptoms of dermatitis 100% of the time.
Should I see a dermatologist for my eczema?
Yes, if your usual healthcare provider is unable to help with your eczema symptoms. Dermatologists specialize in skin conditions.
How can I reduce my risk of eczema (atopic dermatitis)?
There are steps you can take that may prevent eczema outbreaks:
- Establish a skin care routine, and follow your healthcare professional’s recommendations for keeping your skin healthy.
- Wear gloves for jobs where you have to put your hands in water. Wear cotton gloves under plastic gloves to absorb sweat, and wear gloves outside, especially during the winter months.
- Use mild soap for your bath or shower, and pat your skin dry instead of rubbing. Apply a moisturizing cream or ointment immediately after drying your skin to help seal in the moisture. Reapply cream or ointment two to three times a day.
- Take baths or showers with tepid (lukewarm) rather than hot.
- Drink at least eight glasses of water each day. Water helps to keep your skin moist.
- Try to avoid getting too hot and sweaty.
- Wear loose clothes made of cotton and other natural materials. Wash new clothing before wearing. Avoid wool.
- Avoid sudden changes in temperature and humidity.
- Learn to recognize stress in your life and how to manage it. Regular aerobic exercise, hobbies and stress-management techniques, such as meditation or yoga, might help.
- Limit your exposure to known irritants and allergens.
- Avoid scratching or rubbing itchy areas of skin.
What foods should I eat or avoid to reduce my risk of eczema?
The connection between eczema and food allergies is unclear. If you have food allergies, then one of the reasons why you must avoid that food is that it may cause or worsen dermatitis. Examples of common allergies include peanuts, dairy, eggs, sugar, alcohol and gluten. Pay attention to what you eat. If your eczema flares up after you eat a certain food, then you might have an allergy to it.
If you don’t have a food allergy then there are no foods, including chicken, that will cause or worsen your eczema.
Outlook / Prognosis
What can I expect if I’ve been diagnosed with eczema (atopic dermatitis)?
Nearly half of children with eczema will outgrow the condition or experience great improvement by the time they reach puberty. Others will continue to have some form of the disease. For adults with eczema, the disease can be generally well-managed with good skin care and treatment, although flare-ups of symptoms can occur throughout life.
How long will I have eczema?
Eczema can be with you lifelong. It can start in infancy and continue through adulthood. It can start in the teenage years and disappear by young adulthood. Each possibility depends on the person.
Can eczema (atopic dermatitis) be cured?
Eczema is a chronic condition, which means that it cannot be cured. Treatments, however, are very effective in reducing the symptoms of itchy, dry skin.
What is it like living with eczema?
Many people live with eczema (atopic dermatitis). As many as 15 million Americans may have this skin condition. Living with it can be challenging.
There may be times when your eczema disappears. This is known as a “remission” period. Other times you may have a “flare-up,” which is when it gets worse. The goal of treatment is to prevent such flare-ups, preventing your symptoms from getting worse. Be sure to avoid triggers, moisturize, take your medicine and do anything else your healthcare provider recommends.
How do I take care of myself?
Reducing your stress is very important. Try these tips:
- Count to ten as you take a deep breath.
- Exercise daily.
- Try not to drink as much caffeine and alcohol.
- Sleep eight hours a night.
- Eat healthy.
- Try to have a positive attitude.
- Journal every day.
- Talk about your life with friends, family and a therapist.
When should I see my healthcare provider?
See your dermatologist or other healthcare provider as soon as you notice symptoms. Get treatment right away.
What questions should I ask my healthcare provider about eczema (atopic dermatitis)?
- How can you tell that I have eczema?
- If I don’t have eczema, what other skin condition might I have?
- Is there a specific brand of moisturizer that you recommend?
- Is there a prescription cream that you can prescribe?
- How often should I see a dermatologist regarding my eczema?
- What soaps, lotions, makeup, etc. should I avoid?
- What medications do you recommend?
- What at-home treatments do you recommend?
A note from Cleveland Clinic
Eczema (atopic dermatitis) is very normal, very common, and very, very uncomfortable. It can affect your quality of life. At its worse it can keep you from sleeping, distract you and make you feel self-conscious in public. See your dermatologist or other healthcare provider as soon as you start to see signs of it. Explore at-home remedies and prescribed treatments.
You’re not alone! 15% to 20% of people experience eczema or another type of dermatitis at some point in their lives.
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