Eczema: Types, Symptoms, Causes & Treatment

Often referred to as atopic dermatitis, eczema is a common, noncontagious skin condition that causes patches of uncomfortable dryness, itchiness, and inflammation. It affects more than 31 million Americans—many of them infants and children—although adults may also develop eczema. This condition is a chronic (lifelong) problem that can trigger flareups throughout adulthood, but proper management of eczema can minimize symptoms and significantly reduce the number and severity of flare-ups.

Types of Eczema

“Atopic dermatitis” and “eczema” are often used interchangeably, but atopic dermatitis actually refers to the most common type of eczema. This type causes skin to become dry, scaly, bumpy, or cracked. People with light skin may experience red rashes that come and go, while rashes on people with darker skin may appear purple, brown, or gray.

Other types of eczema include:

  • Contact dermatitis – Skin irritation caused by contact with an allergen, such as poison ivy.
  • Neurodermatitis – Patches of intense itchiness that may be linked to emotional distress.
  • Nummular eczema – Raised, round patches on skin that may itch, ooze fluid, or crust.
  • Dyshidrotic eczema – Areas of dryness or small blisters that usually occur on the feet, hands, or fingers.
  • Seborrheic dermatitis (dandruff) – Skin flaking on the scalp, along with areas of itchiness, redness, or greasiness.
  • Stasis dermatitis – Skin irritation on the lower leg that’s usually related to circulatory problems.

Eczema Causes

The precise causes of eczema aren’t clear, although most researchers and physicians believe eczema results from an overactive immune system. A combination of genetics and environmental factors can trigger this immune response, including:

  • Irritants found in soaps, shampoos, lotions, detergents, and other cleaning products.
  • Allergens such as pollen, dust mites, pet dander, and mold.
  • Scratchy fabrics like wool and polyester.
  • Changes in weather, including very hot or cold temperatures and high humidity levels that can lead to excess perspiration and skin irritation.
  • Certain types of bacterial, viral, and fungal infections.
  • Stress, anxiety, and other types of emotional distress.
  • Changes in hormone levels due to menstruation, pregnancy, or menopause.
  • Food allergies, such as milk, eggs and nuts (when food is a trigger, it occurs much more commonly in infants and very young children, rather than older children or adults).

These environmental factors may play a direct role in the development of eczema or simply make flare-ups worse. Additionally, a child is more likely to experience eczema if one or both parents have this condition. Research also shows that some people with eczema don’t produce enough of a protein that helps skin stay moisturized (filaggrin, or filament aggregating protein).

Eczema Symptoms

Just as the causes of eczema can vary, so can its symptoms. The signs of eczema will depend on the person’s age and the type of eczema present.

Generally speaking, infants and young children under the age of two may develop:

  • Itchy rashes that can interfere with sleeping
  • Patches of irritation on the cheeks or scalp
  • Rashes that may swell and leak fluid

In older children, the signs of eczema may involve:

  • Rashes that appear bumpy or become lighter or darker
  • Rashes that develop on the ankles, wrists, or neck, or on the creases of the knees, elbows, or buttocks
  • Areas of skin thickening, known as lichenification

Adults with eczema may experience:

  • Rashes that cover large areas of the body
  • Rashes that are notably scaly, dry, or itchy
  • Rashes that develop on the nape of the neck or behind the elbows or knees
  • Infected eczema, which occurs when bacteria or a virus enters a blister, sore, or cracked skin

Many people experience itchiness that worsens at night. While rashes often appear red in people with lighter skin tones, those with darker skin may develop a brown or gray rash. Patches of dark or light skin can also occur after eczema flare-ups subside—a condition known as hyperpigmentation and depigmentation.

It’s important to promptly consult with your physician if your eczema symptoms:

  • Stop responding to over-the-counter treatments
  • Involve thickening, peeling, or blistering skin
  • Keep you awake at night or prevent you from functioning normally

Treatment/Medications for Eczema

The mainstay of treating atopic dermatitis is moisturizing with a thick cream, rather than a lotion, two or more times a day, especially after bathing.  Topical steroid cream is usually the first medication used for flares, but other prescription topical non-steroid medications are also prescribed at times.  A relatively new injectable treatment called Dupixent can be prescribed for severe or resistant atopic dermatitis.  In addition, individuals with atopic dermatitis appear to be more prone to skin infections and therefore may require additional treatment such as oral or topical antibiotics.

Lifestyle Changes

Avoiding individual triggers and minimizing exposure to irritants and allergens are critical components of eczema treatment. Prioritizing mental health is also helpful for many people with eczema, as stress and anxiety tend to exacerbate symptoms. A few simple ways to combat worrisome feelings include:

  • Practicing deep breathing exercises
  • Staying physically active
  • Relaxation techniques such as meditation, journaling, and yoga
  • Going to bed early and getting as much sleep as possible

Find Relief From Eczema

A full scope of diagnostics and treatment for eczema is available at Florida Medical Clinic’s Department of Allergy, Asthma & Immunology. Our team includes Dr. Daniel Reichmuth—a board-certified allergist-immunologist who helps patients effectively manage eczema symptoms and achieve their best health. You can schedule an appointment with Dr. Reichmuth by visiting our website or calling (813) 779-8194. Telemedicine appointments are also currently available.

Meet Daniel A. Reichmuth, MD, FAAAAI, FACAAI

Dr. Daniel Reichmuth is an award-winning allergist-immunologist who practices at Florida Medical Clinic’s locations in Land O’Lakes, Wiregrass, and WaterGrass. A graduate of the Indiana University School of Medicine, Dr. Reichmuth has published several medical articles and is trusted to educate other professionals in his field. When he’s not helping patients at FMC, Dr. Reichmuth enjoys spending time outdoors with his wife and three children.

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Allergy, Asthma & Immunology • Uncategorized

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