Eczema

Eczema is a common skin condition that affects millions of people. It causes dry, itchy, irritated skin and can flare up at any age. Although eczema is not contagious, it can make you feel uncomfortable and self-conscious. 

At Banner Health, we understand how frustrating eczema can be. Our experts are here to help you learn what’s causing your symptoms and find relief with a treatment plan that works for you.   

What is eczema?

Eczema is a chronic or long-term skin condition that can come and go over time. It causes red, itchy skin that can crack or bleed. 

More than 30 million Americans live with eczema and it often begins in childhood. Some people outgrow it, while others continue to have symptoms into adulthood. 

Eczema is not contagious, so you can’t spread it to others. But it can be uncomfortable and affect your quality of life if not managed.

What does eczema look and feel like?

Eczema symptoms can vary from person to person. You may have:

• Dry, sensitive skin 
• Red or inflamed patches
• Itching, sometimes severe
• Rough, scaly or thickened skin
• Cracked or bleeding skin
• Oozing or crusting during flares

Eczema often affects the hands, elbows, knees, neck or face. In babies, it may appear on the cheeks or scalp. In older children, it may show up in the folds of the elbows, behind the knees or the neck, wrists or ankles. On darker skin tones, eczema may look gray, purple or brown instead of red.

Symptoms may come and go, and flare-ups can range from mild to severe.

What causes eczema?

Eczema happens when your skin’s natural barrier doesn’t work well. This makes it harder to keep moisture in and protect against outside elements.

The exact cause is unknown but experts believe it’s caused by a mix of different factors, including:

• Genes: Eczema can run in families. If a parent or sibling has eczema, asthma or allergies, you may also be more likely to have it.
• Environmental factors: Things in your surroundings - like weather, pollution or household products - can dry out your skin or cause irritation.
• Immune system: If your immune system overreacts to certain triggers, it can cause inflammation in your skin. Eczema is often linked to allergies, asthma or hay fever.

Common eczema triggers include:

• Soaps, detergents or shampoos 
• Perfumes or fragrances
• Metals including nickel 
• Stress or anxiety
• Sweating or overheating 
• Cold, dry weather
• Dust mites, pollen or pet dander
• Insect bites or stings
• Certain foods (like eggs, dairy or nuts)
• Fabrics like wool, latex or synthetic blends

Types of eczema

Eczema is most often associated with atopic dermatitis (which usually starts in childhood). However, sometimes the term ‘eczema’ is also used for skin rashes and symptoms associated with other causes of dermatitis (inflammation in the skin), not just atopic dermatitis.   

They can look different and may have different triggers, but they all cause irritated, itchy skin. 

The most common types:

• Atopic dermatitis: This is the most common type of eczema. It often starts in childhood and is linked to allergies, asthma and hay fever.
• Contact dermatitis: This type happens when your skin touches or is exposed to something that irritates it or causes an allergic reaction. It can cause burning, itching or blisters.
• Dyshidrotic eczema: This type causes small, itchy blisters on your hands, fingers or feet. It can be painful and is often caused by stress or sweating.
• Nummular eczema: Also called discoid eczema, this type causes round, coin-shaped patches that are dry, itchy and scaly. Often triggered by dry skin or injuries.
• Seborrheic dermatitis: This form of eczema affects areas with lots of oil glands, like your scalp, face or chest. It causes red, flaky patches and dandruff. In babies, it’s known as cradle cap.
• Stasis dermatitis: This type happens when there’s poor blood flow in your lower legs, usually from vein problems. It can cause swelling, redness, itching and open sores.

It’s possible to experience more than one type of eczema at the same time. 

Conditions that look like eczema but are not

Some skin conditions look like eczema but need different treatment. These include:

• Psoriasis 
• Ringworm
• Scabies

If you’re not sure what’s causing your symptoms, see your health care provider, allergist or dermatologist.

How is eczema diagnosed?

There is no single test for eczema. Your provider will examine your skin and ask about your symptoms. They may also perform patch tests or blood work to rule out other causes.   

Eczema treatment: How to find relief

There is no cure for eczema, but there are many treatments to help you feel better and prevent flare-ups. 

Your care plan will depend on your symptoms, age, triggers and lifestyle. Your health care provider will work with you to find what works best. 

Moisturize every day

Drink plenty of water every day. Keep your skin hydrated by using a thick cream or ointment at least twice a day, especially after bathing. Look for creams that are:

• Hypoallergenic 
• Free of fragrance and dyes
• Made for sensitive skin
• Rich in ceramides or lipids

Your provider may suggest the following:

• Vaseline or petroleum jelly
• Aquaphor ointment
• CeraVe cream
• Cetaphil cream
• Eucerin cream
• Vanicream

See a complete list of products approved by the National Eczema Foundation.

Try prescription creams

If over-the-counter (OTC) products don’t help, your provider may recommend:

• Barrier repair creams to strengthen your skin
• Topical steroids to reduce redness and swelling
• Calcineurin inhibitors to calm the immune system
• Topical JAK inhibtors to reduce inflammation and alleviate itch
• Phosphodiesterase-4 (PDE-4) inhibitors to lessen inflammation
• Topical aryl hydrocarbon receptor agonist to strengthen skin and improve inflammation symptoms

Take oral medications

For more severe eczema, medicines taken by mouth in the form of a pill may be needed. These include:

• Antihistamines to ease itching
• Corticosteroids for flare-ups 
• JAK inhibitors to reduce inflammation, itching and other symptoms
• Other oral medications that impact the immune system and inflammatory responses 

Ask about biologic therapy

If you've tried several treatments without relief, an injectable biologic may be recommended. 

A biologic called dupilumab (Dupixent) is the most widely used. It’s an injection that helps calm the body’s overactive immune response. Dupilumab is approved for patients aged six months and older. 

Consider light therapy

Also called phototherapy, this treatment uses controlled ultraviolet (UV) light to reduce inflammation. It’s often used when other treatments don’t work.

For a more detailed list of treatment options, visit the National Eczema Association.

Make daily skin care a habit

Small steps in your daily life can help prevent flare-ups and protect your skin:

• Take short, lukewarm showers or baths
• Use gentle, fragrance-free soaps and shampoos
• Moisturize twice a day
• Wear soft, breathable fabrics, like cotton
• Keep your nails trimmed so you don’t scratch and damage your skin
• Avoid scratching (tap or use a cold compress instead)
• Use a humidifier if the air is dry 

Manage your eczema triggers

Avoid things that may set off your eczema. Everyone’s triggers are different, but common ones include:

• Harsh soaps or detergents
• Sweat or overheating
• Stress or strong emotions
• Pollen, pet dander or dust
• Certain foods (like eggs or dairy)

Talk to your health care provider if you’re unsure what causes your flare-ups. You may need allergy testing or help tracking your symptoms. 

Take care of your mental health

At times, living with eczema can be stressful and affect how you feel about yourself. It’s okay to feel frustrated. Talk to a therapist or counselor, join a support group or practice stress-reducing activities like deep breathing or yoga to help your skin and overall well-being.

When to see a health care provider

You should see your provider if:

• Your symptoms keep coming back or get worse
• OTC treatment doesn’t help
• You have trouble sleeping because of itching
• Your skin is cracked and bleeding
• You get an infection, have a fever or experience severe pain

How Banner Health can help

At Banner Health, we care for the whole person and not just their skin condition. Our team of dermatologists, allergists and pediatric specialists work together to help you or your child find relief.

We offer:

• Personalized treatment plans
• Allergy testing and trigger management 
• Expert diagnosis for all types of eczema
• Advanced treatments like biologics and light therapy
• Support and education for daily skin care

Schedule an appointment today with Banner Health.