Causes and SymptomsEczema is the result of inflammation of the skin and your body’s inability to maintain an effective moisture barrier, which is a thin layer of oil that seals the skin and protects the body. It can occur any time in life but often presents itself during childhood. Flare-ups can be caused by factors in the environment that irritate the skin, and potential irritants can range from fragrances, soaps, lotions, and laundry detergents to plants, wind, dry air, and cold weather.
In children, eczema usually develops in the creases of the elbows, behind the knees and on the cheeks and eyelids. Adults, more typically, are affected on the arms, legs, back, or chest. Eczema flare-ups may start with just an itch and no visible sign of a rash. However, as you itch, a red, coarse, dry, or flaking rash typically presents itself. Eczema rashes often start red and turn brown in fair-skinned people and can affect the pigment in darker-skinned people, turning the skin lighter or darker.
Types of Eczema
- Atopic dermatitis is often synonymous with eczema. It is the most common and general form of eczema that can be found anywhere on the skin.
- Neurodermatitis is characterized by intense itching typically on one or two patches. As itching continues, it can turn darker or red depending on skin tone.
- Contact dermatitis is caused by direct contact between the skin and an irritant, causing an itchy rash. This is another common form of eczema that almost everyone experiences at some point.
- Dyshidrotic eczema occurs when blisters form on the feet and hands.
- Nummular eczema causes round, coin-shaped sores to form on the skin, often after some type of skin injury.
- Seborrheic dermatitis mainly affects high oil producing parts of the body, such as the scalp, upper back, chest, and face. It can cause red skin, scaly patches, and dandruff.
- Stasis dermatitis is inflammation, typically in the legs, caused by poor blood flow.
Treatment Options and Things to Consider
Eczema is a lifelong health condition, so treating symptoms and avoiding irritants are the best courses of action to curb flair-ups.
Hot showers may feel good in the cold weather, but they damage the skin’s moisture barrier and contribute to dryness and itching. Aim to keep your showers to 10 minutes or less and use cooler water. Pat dry with a towel.
Make it a habit to apply moisturizer to your skin at least once a day. Using fragrance-free, gentle lotion daily can help treat and prevent flare-ups by protecting your moisture barrier. There are many good skin moisturizers available over the counter; choose one that has no perfumes or dyes and feels good against your skin. Some options are petrolatum, Aquaphor, Eucerin®, Aveeno® Eczema Therapy, CeraVe®, ammonium lactate lotion for very flakey skin, and VanicreamTM for those with very sensitive skin. Applying over-the-counter hydrocortisone cream directly to the rash can also help reduce swelling and alleviate itching and redness. When using a steroid cream, such as hydrocortisone, avoid prolonged sun exposure to the areas that have been treated. If these over-the-counter treatments do not relieve symptoms, your provider may prescribe oral medication or topical ointments to help relieve your symptoms.
Taking a bleach bath can also provide relief for extremely itchy eczema flare-ups. It does so by killing bacteria on the skin. Bleach baths involve pouring 1/2 cup of liquid chlorine bleach into a full bath and soaking for at least 5-10 minutes from the neck down.
Stress aggravates eczema and can trigger flare-ups, so working on stress relief can also help alleviate the symptoms. Certain relaxation techniques, including meditation, deep breathing, exercise, and mindfulness, might also help make flare-ups easier to manage.
At bedtime, taking an antihistamine, like diphenhydramine (Benadryl®), can help relieve itchiness throughout the night. Be sure to read the instructions carefully, as some antihistamines may cause drowsiness during the day and have little direct effect on reducing the itch of eczema.
In the winter and colder months, a humidifier can add moisture to the air and reduce water loss from your skin. The units must be carefully maintained to prevent the overgrowth of molds, which can cause breathing problems in susceptible individuals.
Sweat can trigger eczema flares in the summer. Wear proper sports clothing designed to keep your skin cool and dry when exercising.
Eczema can be a frustrating condition, but with the right treatment and management, it does not need to affect daily life. Contact your Atrius Health provider if you have questions about your skin or if you start to see signs of infection.