Eczema is a common inflammatory skin condition. Otherwise known as atopic dermatitis, this disease is often nicknamed the “itch that rashes.” Anyone who has had eczema can confirm the dryness and itchiness it causes.
Eczema produces a distinctive appearance on the skin, such as patches of dry and scaly skin in different body parts. It’s also possible for this dry, itchy skin to produce clear fluid when scratched.
While eczema is sometimes confused with a disease caused by poor hygiene—this isn’t the case. Atopic dermatitis is the result of a dysfunction in the skin barrier.
Eczema is a chronic skin condition, meaning it can last for a long time. Although most associated with children, adults also experience their fair share.
When identifying the types of eczema, the age at which the condition first appears is the prime consideration.
When children from birth to age two develop eczema, they will likely experience early-onset atopic dermatitis. It is the most common type of eczema. Around 60% of eczema cases begin at the age of one.
On the plus side, 60% of early-onset cases will usually be resolved by the age of 12.
If a person first experiences eczema in their teens, it’s likely a case of late-onset atopic dermatitis. This form of eczema appears after reaching puberty.
It’s possible to develop eczema in adulthood. When people over 60 are affected by eczema for the first time, this is known as senile-onset atopic dermatitis. However, this is a less common form of eczema.
Eczema is a worldwide condition affecting about 2.4% of the global population¹.
Atopic eczema is commonly a young people’s disease. From 10% to 30% of children will contract atopic dermatitis at some point. In the United States, 24% of children from birth to age five receive eczema treatment. Other countries like Sweden report a 20% rate of eczema in children.
In developed countries around the world, 2%–10% of adults live with eczema.
Studies have placed the number of adults affected in Japan at 2.1%. About 4.9% of the US adult population live with eczema.
Eczema is often mistaken for other conditions like psoriasis, scabies, or rabies. There are, however, tell-tale signs of eczema that set it apart. When a person contracts eczema, their skin may appear red and itchy.
This itching can become so unbearable that it affects their quality of life. A person with eczema could develop blisters that leak liquid.
When examining a baby for eczema, there are a few common areas to check first. This condition will often appear on the cheeks, arms, and legs. Other areas to monitor are the belly, back, and chest.
Older children, teenagers, and adults may notice eczema on the backs of their knees, in the crooks of their elbows, and on the back of their necks. Also affected are the palms and soles of the feet. The face tends to be free of eczema in older children and adults.
People with eczema can experience bouts of flare-ups when it suddenly appears, disappears, or improves.
Atopic dermatitis is a persistent challenge. Over time, people with this disease may find their skin appears dry and cracked. It may also thicken, taking on a leathery look.
Environmental factors and genetic changes are key factors responsible for eczema.
Atomic dermatitis is usually found where the skin barrier is damaged. The outer layer of the skin—the part we can see and touch—usually offers protection against dirt and other harmful elements.
When the skin barrier offers weak protection, this can spark an inflammatory reaction within the body. This inflammation causes further damage to the skin barrier, limiting its protective function.
A person can experience eczema if they do not produce enough ceramides. Ceramides help to build up the skin’s barrier. They also prevent excessive water loss and can protect against environmental irritants.
Eczema may also stem from a genetic mutation. In particular, this condition can erupt from changes to the Fillagrin gene. This gene helps to form the protective layer of the skin. When Fillagrin mutates, the change can affect how skin cells are arranged.
This mutation may cause a dysfunctional, leaky skin barrier.
Atopic dermatitis can also form when the skin lacks the right amount of defense peptides. These defense mechanisms protect against bacteria, viruses, and fungi. In particular, Staphylococcus aureus—a key cause of eczema—thrives when the body has poor defense systems against it.
Because eczema is an inflammatory response, certain conditions increase the risk of this disease. Anyone that experiences allergies after exposure to pollen, dust, or other triggers has a higher chance of eczema.
Likewise, around 50% of children¹ with eczema will eventually develop asthma or rhinitis (a stuffy or runny nose).
Not every case of itching or sensitive skin is caused by eczema. Several other skin conditions produce similar symptoms. Other conditions related to eczema include:
Allergic contact dermatitis
Because eczema is a chronic condition, it is managed rather than treated. Controlling eczema involves moisturizing the skin to limit water loss. Make sure to also check possible irritants that may be causing eczema.
The following skin-care options can help to regulate eczema flare-ups:
The skin can benefit from products that restore moisture. Eczema can be maintained by applying moisturizers or emollients to the skin at least twice daily.
These products have the benefit of relieving the itching caused by eczema. They can also offer protection against certain environmental irritants.
Moisturizers increase the skin’s water content. They help to prevent water loss and heal damaged skin.
Regular soaps can strip the skin of necessary moisture. Soaps and other cleansers that do not dry out the skin are leading choices to prevent eczema flare-ups.
Itching is a well-known result of eczema. To get this symptom under control, steroids are often recommended. This is because steroid creams have anti-inflammatory effects, which help to soothe the itching.
Steroid creams may be applied once or twice weekly to ease itching and inflammation.
Special care is necessary when eczema appears on the face, neck, or sensitive areas like the genitals. Pimecrolimus and tacrolimus are non-steroidal agents that offer relief against eczema.
These two options are recommended when steroids prove ineffective against eczema. They are also advisable if a patient cannot tolerate steroidal treatments. Depending on professional recommendations, pimecrolimus and tacrolimus may be used once or twice a week.
While effective, these measures are not suitable for children under two.
Wet wrap therapy is a popular treatment for eczema. Parents are advised to bathe their children in lukewarm water three times a day while applying medications to the skin. Moisturizers like petroleum jelly come next, with a wrap of wet gauze applied last.
Experts recommend this treatment to bring eczema under control.
If moisturizers, anti-inflammatory treatments, or protection against irritants don't get eczema under control, light or phototherapy can be a suitable treatment. This eczema treatment targets ultraviolet (UV) light on affected areas of the skin. The UV light prevents an inflammatory response in the skin, limiting flare-ups.
This process is carried out by professionals. Phototherapy sessions take place in a hospital or dermatologist’s office.
It is important to act fast to reduce or suppress eczema triggers. Repeated bacterial infections can worsen eczema and may require diluted bleach baths to get skin bacteria under control.
Patients with eczema also have a higher chance of developing viral infections. A more severe form of the condition — eczema herpeticum — is a medical emergency that produces symptoms like blisters, fever, and fatigue. This virus can lead to serious illnesses like meningitis and sepsis if left untreated.
Likewise, eczema coxsackium could result from atopic dermatitis. This complication can cause widespread blisters and erosions in areas previously affected by eczema.
Atopic dermatitis commonly appears as a genetic disease, so people with eczema often have a family history. This makes it difficult to prevent eczema, although there are some preventative methods that you can try. It’s important to note that these methods are still up for debate. Seek the opinion of a specialist before taking protective measures.
Early exposure to allergens could give a boost to eczema resistance. This theory supposes that children are placed around allergens/triggers as the immune system develops. This can build up their tolerance against potentially harmful effects of their environment.
Making a habit of using moisturizers can prevent eczema from worsening. When creams and emollients are a regular part of skincare, this can limit skin dryness. If the skin is given constant moisture, it can prevent more eczema from forming.
Another possible preventative measure is breastfeeding as a way to manage eczema in children. There’s also a chance that supplements with probiotic bacteria work against eczema.
October is set aside for celebrating friends and family members managing eczema. Throughout the month, organizations like the Asthma and Allergy Foundation of America¹ raise awareness about the disease.
Outside of October, seeking out and sharing information about living with and managing atopic dermatitis is important.
Eczema isn’t just hard on the skin, it can also take a toll on your bank account. Ideally, eczema treatment should be covered by health insurance. However, not every insurance package covers full treatment costs.
Sometimes, compromises like step first are suggested. The insurance company may require a cheaper treatment measure to fail before moving to more expensive alternatives. Drawbacks like prior authorizations can also cause delays in eczema treatment.
In a recent survey, the National Eczema Association asked members about out-of-pocket expenses. Around 42% of US participants reported spending $1,000 yearly on eczema treatment. 8.5% of participants placed their annual fees at around $5,000.
To reduce the cost of eczema treatment, patients can take advantage of financial aid for prescription medication. Generic treatment options, as well as patient assistance programs, can keep eczema care affordable.
When itchiness, scaling, and other symptoms appear, it’s best to see a dermatologist. These professionals have expert knowledge of the skin and conditions that affect it.
Allergy specialists and pediatricians can also make up the eczema care team.
Because eczema damages the skin’s protective layer, the condition can raise the risk of other infections. The skin becomes more easily exposed to harmful irritants.
Eczema is also a precursor to conditions such as asthma and allergies.
These diseases can be managed, but another illness — eczema herpeticum may appear. This disease, like sepsis and meningitis, can be life-threatening.
While eczema in itself isn't life-threatening, complications arising from the condition can be severe, even fatal. It’s important to seek help as soon as you notice symptoms appear.
When eczema isn’t properly managed, it can spread to other parts of the body. However, this is usually the limit of its transfer. Eczema is a non-contagious disease, so it doesn't spread from person to person.
To diagnose eczema, doctors carry out a physical examination. This is usually after a patient reports a rash that shows common signs of eczema.
Doctors will conduct tests and examinations to rule out other possible reasons for the symptoms.
Specific tests will be carried out when eczema has a possible link to allergies. Doctors diagnose eczema caused by an allergic reaction using a blood or skin-prick test.
Eczema may result from exposure to allergens like dust mites. Other common triggers include perfume, soaps, and detergents.