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Eczema: Symptoms, Causes, and Treatment

Eczema is a common skin condition that causes itchiness, rashes, dry patches, and infection. It's a type of dermatitis, which is a group of conditions that can inflame or irritate your skin. The most common type is atopic dermatitis or atopic eczema. “Atopic” means that you're more likely to get allergic conditions such as asthma and hay fever.

Eczema looks different for everyone. And your flare-ups won’t always happen in the same area.

No matter which part of your skin eczema affects, it's almost always itchy. The itching sometimes starts before the rash. Your skin may also be:

• Red
• Dry and cracked
• Itchy
• Swollen with a rash (color varies depending on skin color)
• Bumpy (on brown or Black skin)
• Thick and leathery
• Oozing and crusting
• Raw from scratching

Eczema rash

One of the first signs of eczema is a rash that looks different on different individuals. For those with darker skin, the rash can be purple, brown, or gray. If you have a light skin tone, the rash can look pink, red, or purple.

Symptoms in infants

In infants, the itchy rash can lead to an oozing, crusting condition, mainly on the face and scalp. It can also appear on their arms, legs, back, and chest. Newborn babies can show symptoms within the first few weeks or months after birth.

Symptoms in children

Children and teens usually have a rash in the bends of their elbows, behind their knees, or on their necks, wrists, or ankles. The rash turns scaly and dry.

Symptoms in adults

The rash usually happens on your face, the backs of your knees, wrists, hands, or feet.

Your treatment plan may need adjustments

In studying dyshidrotic eczema, dermatologists have found that the following can be effective.

Treatment for excessive sweating: If you sweat profusely where you have blisters, treatment that helps to control the sweating can be effective. To treat the excessive sweating, your dermatologist may prescribe:

• A prescription antiperspirant that you apply to the area
• Injections of botulinum toxin where you have dyshidrotic eczema

Studies suggest that excessive sweating may trigger dyshidrotic eczema. By reducing the profuse sweating, some people are able to reduce flare-ups. If your dermatologist recommends botulinum toxin, protect your health by seeing a board-certified dermatologist for this treatment.

Stronger medication: People who have dyshidrotic eczema likely have a hypersensitivity. It’s believed that this hypersensitivity causes the blisters. Applying corticosteroids to your skin can help lessen this hypersensitivity, but some patients need stronger (or different) medication.

Studies show these medications can effectively treat dyshidrotic eczema. They can be prescribed for a few weeks. If you need long-term treatment, your dermatologist can explain how to use these medications as needed to control flares.

Light treatments: This may be an option when stronger treatment is required. If this is an option, you will need to go to your dermatologist’s office or a hospital for treatment. Often a patient needs five treatments a week for three weeks. Do not try to self-treat by spending time outdoors without sun protection or using a tanning bed, as this can damage your skin and increase your risk of getting skin cancer.

Change in diet: Nickel and cobalt are metals found in many foods. If you have a hypersensitivity to either of these metals, a change in diet may help reduce flares-ups.

How do dermatologists treat dyshidrotic eczema?

Your dermatologist will create a treatment plan for you to follow at home. This treatment plan will be tailored to your individual needs and may include the following:

Soaks and cool compresses: Medicated soaks and cool compresses can be very effective for drying blisters. You will apply these two to four times a day for 15 minutes at a time.

Corticosteroid that you apply to your skin: After each soak or cool compress, you’ll likely need to apply a medicated cream or ointment, such as a prescription corticosteroid. This helps to reduce the inflammation and clear the blisters.

Anti-itch medicine: An antihistamine pill or other anti-itch medicine can reduce your discomfort. Anything you can do to reduce scratching is helpful because scratching tends to worsen dyshidrotic eczema. One anti-itch medication that dermatologists frequently include in a treatment plan is pramoxine (pra mox’ een). Available as a cream or lotion, this medication helps to relieve itch and pain.

Moisturizer or a barrier repair cream: Dyshidrotic eczema can make your skin extremely dry. To reduce dryness and decrease flare-ups, your dermatologist will recommend a moisturizer or barrier repair cream.

Be sure to use the moisturizer or barrier repair cream that your dermatologist recommends

You want to apply it when your skin is still damp after every:

Medication to treat an infection: Skin with dyshidrotic eczema can be very itchy. Scratching often causes an infection. To clear the infection, your dermatologist will first determine what type of infection you have and then prescribe medication to treat it.

Types of Eczema

Eczema includes conditions such as:

Atopic dermatitis

This is what people usually mean when they say “eczema.” This is the most common form, and it affects more than 7% of American adults. Other allergic disorders, such as asthma and hay fever, can trigger it. It often starts in childhood.

This is a less common but more challenging form of eczema. It causes outbreaks of tiny blisters on the palms of the hands, soles of the feet, and sides of the fingers. Sweat or irritants such as metals may trigger it.

Neurodermatitis

Nummular eczema

This coin-shaped eczema often appears after a skin injury such as a burn or insect bite. You’re more likely to get nummular eczema if you or your family members have atopic dermatitis, allergies, or asthma.

Seborrheic dermatitis

Stasis dermatitis

This type happens in people who have poor blood flow, usually in their lower legs. Unlike some other types of eczema, these plaques don't mean you have abnormal genes. Some lifestyle habits raise the risk too, such as being overweight or not getting enough physical activity.

Read more about the different types of eczema .