What does an eczema rash look like. How can you identify different types of eczema. What are the most effective treatments for managing eczema symptoms. Who is most at risk for developing atopic dermatitis. How can you prevent eczema flare-ups.

Understanding Eczema: The Basics of Atopic Dermatitis

Eczema, also known as atopic dermatitis, is a common skin condition characterized by itchy, inflamed patches of skin. Often referred to as “the itch that rashes,” eczema typically begins with intense itching followed by the appearance of a rash. This chronic condition affects people of all ages, from infants to adults, and can significantly impact quality of life.

Eczema is not contagious, but it can be hereditary. If a parent has hay fever or asthma, their children are more likely to develop atopic dermatitis. Interestingly, many children with eczema may later develop hay fever or asthma, highlighting the complex relationship between these conditions.

Key Characteristics of Eczema

• Intense itching
• Red or darkened patches of skin
• Dry, scaly areas
• Small, rough bumps
• Thick, leathery patches
• Oozing or crusting lesions

Identifying Eczema: Appearance and Symptoms Across Different Age Groups

The appearance of eczema can vary depending on age, skin tone, and the severity of the condition. Understanding these differences is crucial for proper identification and treatment.

Eczema in Infants

In babies, eczema often appears as a patchy facial rash, typically beginning between 6-12 weeks of age. The condition can be exacerbated by drooling, which increases skin moisture. It’s important to note that in some cases, eczema may resolve by age 2, but for about half of affected children, it persists into adulthood.

Eczema in Children

For children, eczema commonly appears in specific areas:

• Inside of elbows
• Behind knees
• On the face
• Back of the neck
• Wrists and forearms

Eczema in Adults

Adults with eczema may experience drier, scaly rashes. The skin may appear discolored or thickened, particularly in areas prone to frequent scratching. Common sites for adult eczema include:

• Hands
• Elbows
• Neck
• Chest
• Eyelids

Differentiating Eczema from Other Skin Conditions

Distinguishing eczema from other skin conditions is crucial for proper treatment. One condition often confused with eczema in infants is cradle cap, medically known as seborrheic dermatitis.

Cradle Cap vs. Eczema

While both conditions affect infants, there are key differences:

• Location: Cradle cap primarily affects the scalp, while eczema is more common on the cheeks
• Appearance: Cradle cap appears as oily, scaly patches, whereas eczema is typically dry and red
• Itching: Cradle cap is usually not itchy, unlike eczema
• Duration: Cradle cap often clears up without treatment in a few weeks or months

The Science Behind Eczema: Causes and Triggers

The exact cause of atopic dermatitis remains unknown, but researchers believe it involves a combination of genetic and environmental factors. Understanding these factors can help in managing the condition effectively.

Genetic Factors

Eczema tends to run in families, suggesting a strong genetic component. Individuals with a family history of atopic conditions (eczema, asthma, or hay fever) are at higher risk of developing eczema.

Immune System Dysfunction

An overactive immune system may play a role in eczema development. This hyperactivity can lead to inflammation in the skin, resulting in the characteristic symptoms of eczema.

Environmental Triggers

Various environmental factors can trigger or exacerbate eczema symptoms:

• Allergens (pollen, animal dander, dust mites)
• Irritants (harsh chemicals, soaps, detergents)
• Stress or anxiety
• Extreme temperatures
• Excessive sweating
• Frequent hand washing or bathing

Diagnosing Eczema: When to See a Doctor

While mild cases of eczema can often be managed at home, certain situations warrant professional medical attention. Consulting a healthcare provider is crucial for accurate diagnosis and appropriate treatment.

When Should You Seek Medical Advice for Eczema?

• When the rash persists despite home treatments
• If the rash is causing significant discomfort or interfering with daily activities
• When there are signs of infection (crusting, pus, or increased redness)
• If you suspect the rash might be caused by an allergy

The Diagnostic Process

When diagnosing eczema, a healthcare provider will typically:

1. Review your medical history
2. Discuss your symptoms and potential triggers
3. Inquire about any family history of allergies or atopic conditions
4. Perform a physical examination of the affected skin

In some cases, additional tests may be necessary:

• Allergy tests to identify potential triggers
• Skin scraping or biopsy to rule out other skin conditions or infections

Managing Eczema: Effective Treatment Strategies

While there is no cure for eczema, various treatment options can help manage symptoms and prevent flare-ups. A comprehensive treatment plan often involves a combination of approaches.

Topical Treatments

Topical medications are often the first line of treatment for eczema:

• Over-the-counter hydrocortisone creams for mild cases
• Prescription corticosteroid creams or ointments for moderate to severe eczema
• Non-steroidal anti-inflammatory creams

It’s important to use these medications as directed by a healthcare provider, as long-term use of strong corticosteroids can lead to side effects such as skin thinning or stretch marks.

Systemic Treatments

For severe cases of eczema, systemic treatments may be necessary:

• Oral corticosteroids
• Immunosuppressant drugs
• Biologic injections

Antihistamines

Oral antihistamines may provide relief from itching and help improve sleep quality for some individuals with eczema. However, they should be used with caution, as they can cause drowsiness.

Living with Eczema: Lifestyle Modifications and Self-Care

Managing eczema extends beyond medical treatments. Implementing certain lifestyle changes and self-care practices can significantly improve symptoms and prevent flare-ups.

Skin Care Routine

Proper skin care is crucial for managing eczema:

• Use mild, fragrance-free cleansers
• Apply moisturizer immediately after bathing to lock in hydration
• Avoid hot showers or baths, opting for lukewarm water instead
• Limit bathing time to prevent excessive drying of the skin

Avoiding Triggers

Identifying and avoiding personal triggers can help prevent eczema flare-ups:

• Choose clothing made from soft, breathable fabrics like cotton
• Avoid known allergens and irritants
• Manage stress through relaxation techniques or counseling
• Maintain a consistent temperature and humidity level in your home

Itch Management

Resisting the urge to scratch is crucial but challenging. Try these strategies to manage itching:

• Apply cold compresses to soothe itchy skin
• Use distraction techniques, especially for children
• Keep nails short to minimize damage from scratching
• Wear gloves at night if nighttime scratching is an issue

By understanding the nature of eczema, recognizing its symptoms, and implementing appropriate treatment and management strategies, individuals with this condition can significantly improve their quality of life. Remember, while eczema is a chronic condition, with proper care and management, many people can achieve long periods of symptom-free skin.

What an Eczema Rash Looks Like

Medically Reviewed by Brunilda Nazario, MD on March 25, 2021

It’s sometimes called “the itch that rashes,” because the itching usually comes first. This group of skin rashes is very common in babies and toddlers. Adults can have it too, often as scaly, leathery patches or on their hands. Atopic dermatitis is a common, often inherited form of eczema, but there are other types and many treatments.

Itching is the main one. Scratching makes your skin inflamed and itchier, and it can look different. You may notice:  

• Affected areas may be red (light skin) or darker brown, purple, or ash gray (brown skin).
• Dry, scaly areas
• Warmth, possibly also with some swelling
• Small, rough bumps
• Thick leathery patches
• Bumps that leak and crust over
• After healing, the affected area might look lighter or darker than the rest of your skin.

Infants who are 6-12 weeks old can get atopic dermatitis as a patchy facial rash. Moisture from drooling makes it worse. In some cases, the condition goes away by age 2. But about half of people who had atopic dermatitis as a child will have it as an adult.

“Cradle cap” in babies is a condition that doctors call seborrheic eczema or seborrheic dermatitis. It appears as oily, scaly patches on the scalp. In contrast, atopic dermatitis is more often found on the cheeks, though it can also affect the scalp. Also unlike eczema, cradle cap typically isn’t itchy. Usually cradle cap clears up without treatment in a few weeks or months.

Kids can get eczema in a lot of different places: the inside of their elbows, behind the knees, on the face, on the back of their necks, or on wrists and forearms. You can’t “catch” eczema — it’s not contagious.

You might notice itchy patches on the hands, elbows, and in the “bending” areas of the body, such as the inside of the elbows and back of the knees. But eczema can appear anywhere, including the neck, chest, and eyelids. People who had atopic dermatitis as a child may see drier, scaly rashes as adults. The skin may be discolored or thickened.

If a rash won’t go away, is uncomfortable, or gets a crust or pus-filled blister, see your doctor. They will check your medical history, symptoms, and ask you about any allergies that run in your family. You may also get allergy tests or a microscopic exam of a skin scraping (seen here) to rule out infections.

There’s a connection between those two conditions and atopic dermatitis. If a parent has hay fever or asthma, their children are more likely to have the skin condition. And many children with atopic dermatitis will go on to get hay fever and/or asthma.

Triggers that bring on an allergy attack — such as pollen, animal dander, and dust mites — can cause some people with atopic dermatitis to break out in a rash. These allergens cause the immune system to overreact, leading to skin inflammation.

Irritants can cause inflammation and itching, bringing on eczema. Harsh chemicals can cause a rash in anyone, but people with eczema may be sensitive to mild irritants, such as wool and synthetic fabrics, detergents, soaps, perfumes, and cosmetics. Stress or anxiety can cause a flare-up, too. So can sweating, along with wetting and drying your skin a lot, such as when you wash your hands. Cold, dry environments can also cause a flare.

Your skin’s outer layer protects the inner layers from irritants and infections. People with atopic dermatitis have dry skin that isn’t as protective. If you have eczema, use mild cleansers and a moisturizer after you wash. And don’t take hot showers or baths, or linger too long while showering or bathing.

Doctors don’t know exactly what causes atopic dermatitis, the most common form of eczema. Genes likely play a role. An immune system problem could create inflammation in the skin. Emotional problems aren’t a cause, but stress can make symptoms worse.

It’s easier said than done, of course. Eczema is very itchy. But scratching worsens the rash and can make an infection more likely. Use a cold compress to soothe the skin. Try to distract children with activities. Moisturizers are soothing, and some medicated creams or ointments may help, too.

Over-the-counter hydrocortisone or nonsteroidal prescription creams may ease mild to moderate eczema. Ask your doctor before using corticosteroids on children under 2. Don’t use them for more than 7 days. Sometimes, stronger corticosteroids are needed to control inflammation. Side effects, like thinning skin, infections, and stretch marks, are more likely with long-term use. You have to be careful using steroids on the face, especially around the eyes. For severe eczema, your doctor may recommend steroid shots or pills, or biological injections.

There’s some evidence that these medicines may bring relief from the cycle of itching and scratching for some people with atopic dermatitis. When taken by mouth, they can make you drowsy, so that you fall asleep more easily and hopefully scratch less when you’re asleep. Many over-the-counter and prescription-only options are available, each with slightly different dosing and side effects. Check with your doctor for a recommendation.

Prescription skin meds that calm an overactive immune system can treat eczema from atopic dermatitis. Doctors generally prescribe them only for short-term use in people who’ve tried other treatments that haven’t helped. They have a “black box” warning due to a higher cancer risk. So ask your doctor about the pros and cons. A biologic medication called Dupixent, given as a shot, works on the immune system to treat atopic dermatitis.

Alitretinoin, a relative of vitamin A, may improve or even clear up this condition when other treatments don’t work. It hasn’t yet been approved by the FDA for this use. It can give you headaches or dry, flushing, or sun-sensitive skin. Alitretinoin can cause severe birth defects, so you shouldn’t take it when you’re planning to get pregnant.

UV light affects the immune system. In some people, it can improve moderate to severe cases of eczema from atopic dermatitis or contact dermatitis. Usually, these treatments use UVB light. “PUVA” is a UV treatment combined with a drug called psoralen. But it doesn’t work for everyone, and it makes some people’s eczema worse. Too much UV light is bad for your skin. So you should talk to your doctor about the risks and benefits.

If your child has eczema, keep their fingernails short and their skin moisturized. Dress them in loose-fitting clothes and make sure they don’t get overheated. Depending on how severe their eczema is, your doctor may recommend wet wraps, a diluted bleach bath, over-the-counter or prescription medications, and/or light therapy to help.

A small amount of household bleach in the bath may help tame inflammation, though recent research shows it may not help prevent infections. Talk to a dermatologist or other doctor first. These baths use a specific amount of bleach, greatly diluted. Never put bleach directly onto skin!  

Some research shows that coconut oil, sunflower oil, and vitamin B12 skin creams may help. So can massage and other things that lower your stress level, since stress can make eczema worse. Herbs and supplements can have side effects, so talk to your doctor first.

These can look a lot alike. You’ll want to make sure that it really is eczema, and not an infection. Tell your doctor about symptoms of an infection, such as honey-colored crusts, pus- or fluid-filled blisters, scaly patches, swelling, or a fever.

Even when the eczema eases up, your skin may still be dry. Take short daily baths in warm water. Pat your skin partially dry and use a thick moisturizer, as well as any medication, right after your bath. Moisturize throughout the day and stick to mild soaps or cleansers. Look for fragrance-free products to help prevent a reaction. Remember, “unscented” may just mean the product has another ingredient to mask the scent.

Does your child feel self-conscious about his rashes? Help him avoid triggers, set up a routine for bathing and moisturizing, and stick to your treatment plan. Adults with the condition may also need to take a look at their routines to avoid exposure to some chemicals in cleaning products, perfumes, and cosmetics, as well as cigarette smoke.

IMAGES PROVIDED BY:

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SOURCES:

American Academy of Dermatology: “A new understanding of itch and eczema,” “Eczema/Atopic Dermatitis,” “Seborrheic Dermatitis,” “Is that eczema or an infection on my child’s skin?”

National Institute of Arthritis and Musculoskeletal & Skin Diseases: “Atopic Dermatitis,” “Is there a test for atopic dermatitis?”

National Eczema Association, “Understanding Your Child’s Eczema,” “Eczema in skin of color: What you need to know,” “Prescription Topical Treatment,” “Dupixent for Atopic Dermatitis FAQ. ”

Mayo Clinic: “Cradle cap.”

American College of Allergy, Asthma & Immunology: “Eczema in Children.”

UpToDate: “Patient education: Eczema (atopic dermatitis) (Beyond the Basics).”   

National Institute of Allergy and Infectious Diseases: “Eczema (Atopic Dermatitis) Treatment.”

Asthma and Allergy Foundation of America: “Atopic Eczema (Atopic Dermatitis).”

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Images, types, body parts, and more

Several types of eczema, including contact dermatitis and discoid eczema, affect certain age groups and body areas. They also present differently across skin tones. People with lighter skin tones may develop skin redness, and on darker-skinned individuals, these areas may appear purple or gray.

This article looks at the different types of eczema affecting certain body parts. We also examine eczema in adults and children and provide slideshows of the types of eczema on different skin tones and bodies.

There are different types of eczema, including:

• Atopic dermatitis: Atopic refers to a collection of allergic conditions, such as asthma and hay fever, and the word dermatitis refers to skin inflammation. This condition’s general symptoms tend to include itching and dry, scaly patches. Foods, environmental allergens, and genetics may trigger this type of eczema. However, atopic dermatitis does not present with a patterned rash, which occurs with contact dermatitis. This is how doctors differentiate the two conditions.
• Contact dermatitis: This skin condition occurs when a person receives contact with certain substances that trigger an allergic reaction. The rash usually appears in a pattern that follows the shape of the allergen, such as a wedding band. Symptoms include:
  • itchy skin
  • crusting or scaly skin
  • lesions in affected areas
• Dyshidrotic eczema: This type causes water-filled blisters on the affected body area. It may cause accompanying symptoms, including extreme itching and a burning sensation. Factors that can aggravate this condition include:
  • stress
  • sensitivity to specific compounds
  • extreme temperatures
  • sweating
• Discoid eczema: This condition results in coin-shaped plaques with raised spots and scaling. It tends to be more common in older adults and those with extremely dry skin, such as during winter.
• Varicose eczema: This skin condition causes swelling and itchy discolored skin. It usually occurs on the lower legs when circulation issues lead to varicose veins.
• Asteatotic eczema: Doctors characterize this type of eczema as dry, cracked skin, scaling, and itching that results from dry and colder climates.

Skin tones

On lighter skin tones, eczema tends to cause skin reddening if people scratch itchy eczema patches. Conversely, the condition can cause darker brown, purple, or gray areas on darker skin.

Find out more about eczema on the skin of color.

The following slides show pictures of the types of eczema. To see all the images on one screen, click “view all.”

These different types of eczema may occur on specific body parts more than others, including the:

• scalp
• face
• ear
• neck
• fingers and hands
• legs, which doctors call varicose and asteatotic eczema
• feet

The images in the slideshow below show some of the different areas of the body that eczema may affect.

Adults can develop any type of eczema. If a person has had the condition for years, the skin may appear thick, rougher, and darker than the surrounding skin.

Specific types of eczema are more common in older adults. For example, varicose eczema tends to affect people over 50 years of age.

Additionally, asteatotic eczema affects those over 60 years, possibly due to drier skin occurring with older age.

Varicose eczema is quite common, affecting approximately 70% of people over the age of 70 years.

Adults also usually develop eczema on different parts of their bodies compared with children. Adult eczema may form in one or more of the following areas:

• the backs of the knees
• the creases of the elbows
• the back of the neck
• the face

To see all the pictures, click “view all.”

Eczema can appear on any area of the skin at any age. However, at certain ages, it is more likely to develop in some regions of the body.

Babies

In babies, eczema may occur on the scalp and face, particularly the cheeks. However, they rarely develop AD in the diaper area, as the skin stays too moist for AD. A rash in the diaper area usually indicates diaper rash.

Eczema often appears as a dry, raw, scaly rash. Itching may come and go, and any lesions may weep fluid in some cases.

Children

When eczema develops after the age of 2 years, it usually occurs as itchy and scaly patches in areas such as:

• the creases of the elbows and knees
• neck
• wrists
• ankles
• the crease between the buttocks and legs

Over time, the skin may change in appearance, causing it to become bumpy, discolored, and thicker, resulting in the skin becoming persistently itchy.

Read more about eczema in children.

In the following slides, find examples of the areas that eczema affects in children.

There are several risk factors can trigger eczema, including:

• stress
• a family history of this condition
• environmental allergens
• extremely dry skin
• contact with allergic substances in shampoo or cleansers
• certain food allergies
• hay fever
• cold or damp environments
• warm and humid environments
• immune system issues
• COVID-19
• metal compounds
• chemical compounds

Learn more about what causes eczema to flare.

There is no cure for eczema, but there are many treatments available. These may include over-the-counter (OTC) or prescription medications or lifestyle changes depending on the type of eczema.

• OTC treatments include topical and oral medications, such as antihistamines and hydrocortisone, to relieve itching. Other OTC remedies can help prevent flares and assist with sleep when nighttime itching occurs.
• prescription topical medications include:
  • topical Janus kinase (JAK) inhibitors
  • topical calcineurin inhibitors such as tacrolimus
  • topical PDE4 inhibitors
  • topical steroids
• prescription injectable medications, such as biologics
• prescription oral medications:
  • immunosuppressants
  • JAK inhibitors
  • systemic medication
  • steroids
• prescription phototherapy

Several types of eczema can cause symptoms ranging from itching, dry skin, and scaling. These may present in different body areas, varying by age and skin tone. There is no cure for any type of eczema, but treatments are available to relieve symptoms.

causes and treatment in St. Petersburg

The author of the article: Skosareva Marina Yuryevna

Chief physician of the clinic. Dermatovenereologist, cosmetologist, physiotherapist, trichologist, health and public health specialist

Social network profile: Instagram

Time to read: 12 min

Publication date: 05/11/22

Effective treatments for eczema

Cryotherapy

NeoGen procedure

Plasma therapy

One of the most common skin diseases is eczema. It is an inflammation, accompanied by redness, itching and the appearance of tiny bubbles with liquid. It is the latter that explains the name of the disease: such bubbles resemble the boiling of water, from the Greek eczeo means “boil”.

According to statistics, eczema affects up to 2% of the world’s population. And in the practice of dermatologists, such a pathology occurs in almost 40% of all skin diseases. Most often, patients turn to the problem of the appearance of foci of inflammation on the arms, legs, body and head. Rashes go through several stages of development, over time from simple redness developing into weeping erosion and severe peeling. Against the background of such a pathology, secondary purulent infections often develop. If left untreated, visible cosmetic defects remain on the skin that do not disappear with time.

Let’s figure out why eczema occurs, how to suspect its development and how such a pathology is treated.

Causes of disease

Until now, doctors cannot unequivocally answer the question about the causes of eczema in adults and children. Most experts agree that the disease develops as a result of a complex effect of endogenous factors (for example, genetic predisposition) and exogenous factors (professional, etc.). Simply put, external factors most often include various allergens that affect the body constantly or for a long time. To internal, endogenous – genetic predisposition. It has been proven that if there is a person with eczema in the family, the risk of disease in relatives increases significantly. If one of the parents (mainly the mother) is ill, the risk of eczema in a child is approximately 40%, if both parents are ill, it is almost 60%

The most common triggers for eczema are:

• chronic allergies;
• disruption of the endocrine system;
• psychoemotional triggers.

Also, additional factors are isolated that can weaken the body’s immunity and thereby provoke the development of eczema. This is:

• chronic inflammatory processes;
• secondary immunodeficiencies;
• diseases of the digestive system;
• foci of chronic infection in the body.

Among the possible causes of eczema are called psychosomatics: we are talking about constant stress, various disorders of the autonomic system, anxiety and depression. Patients often show functional changes in the activity of the central nervous system, the predominance of the activity of unconditioned reflexes over the activity of conditioned ones, as well as an imbalance between the activity of the sympathetic and parasympathetic divisions of the autonomic nervous system.

Types of eczema

Specialists distinguish the following types of pathology:

• True, or idiopathic. The patient has symmetrical foci of inflammation and pigmentation, symptoms appear on open areas of the skin. Over time, erosion develops, on which exudate accumulates. As it heals, skin peeling occurs.
• Microbial. This form of pathology develops against the background of traumatic injuries, fungal, viral and bacterial infections. Infiltrate often accumulates under the skin. Failure to comply with the rules of personal hygiene provokes an accelerated spread of lesions throughout the body.
• Seborrheic. This pathology is characterized by damage to areas of the skin on the scalp. The affected areas have typical redness, peeling and itching. In some cases, the course of the disease is complicated by swelling and weeping cracks.
• Professional. It occurs due to the constant contact of the patient with various allergens: dust, chemicals, cleaning products, etc. Very often, small vesicles appear on various parts of the body.
• Weeping. At the beginning of such a disease, pink spots of various shapes and sizes appear on the skin, swelling and the formation of subcutaneous exudate are also observed. Then the cortical stage and exfoliation begin. The main feature is the presence of a rash at all stages of the disease.
• Dyshidrotic. This pathology affects the sweat glands of the feet and hands, is characterized by the formation of serous vesicles and seasonal exacerbation. As a rule, there are pronounced vesicles with a dense shell. There is severe itching and peeling.
• Allergic. It occurs as a result of hypersensitivity of the body to external and internal stimuli. Accompanied by rashes, itching and dry skin. In place of the opening bubbles, large crusts form, sometimes the process is accompanied by a burning sensation.

Disease stages

If we talk about the features of the course of the disease, then usually there are three stages of its development:

• Acute. It is characterized by the appearance of vesicles on edematous skin, punctate erosions with weeping, serous crusts, etc. The rashes are multiple.
• Subacute. This stage is characterized by erythema, redness, and scaling.
• Chronic. It is characterized by infiltration and increased “skin pattern”, the appearance of pigmentation.

Symptoms of eczema

Depending on the cause of the disease and the location of the inflammation, the symptoms can vary significantly. The most common manifestations of skin eczema in patients are:

• At the erythematous stage, red inflammatory spots appear, which gradually merge with each other.
• At the papular stage – bright red nodules with clear boundaries are formed.
• At the vesicular stage – vesicles appear with transparent contents.
• At the stage of wetting – the bubbles open, point erosions are formed with the release of exudate.
• At the cortical stage, grayish-gray crusts are found, under which the skin heals.
• At the stage of peeling – the removal of crusts and scales from the surface of the skin.

Symptoms of the disease go away with the elimination of provoking factors. However, the healed area of ​​the skin has an uneven color and dense texture.

What other symptoms may indicate the development of eczema:

• Scaly layer on the border of the scalp. Develops with seborrheic eczema. At the initial stage, it manifests itself as single yellowish nodules that grow rapidly. In the future, a scaly layer is formed along the border of the hair.
• Round eruptions on the arms. Appear in almost 80% of cases of eczema. At the initial stage, they have a rounded shape, but over time they lose it.
• Eruptions with sharp edges. Most often found on the legs. They can be seen with varicose veins, the rashes have a rounded shape and pronounced borders.
• Symmetrical eruptions on the body. Are located on all body, often are shelled. At the initial stages, they look typical – they are vesicles with liquid, later areas of thickened skin with severe peeling appear.
• Callous eruptions on the palms. Such formations, especially in places atypical for corns, also indicate eczema. Bubbles form, but due to the dense skin, they may not open.
• Vesicles in the axillary region with a hair in the center. A rash with a hair in the center is a sign of sycosis – damage to the hair follicles. As a rule, such rashes are accompanied by itching and redness.
• Bumps on the face and hands. Such formations do not have wetting and crusts, often appear on the face.
• Itching redness on the arms and legs. Indicate true or microbial eczema. Accompanied by multiple vesicles.
• Suppuration around wounds. With the development of microbial pathology, purulent crusts and hyperemia of the skin appear.

In its signs, eczema is often similar to atopic dermatitis. However, it should be understood that pathologies have significant differences. Dermatitis, as a rule, occurs in childhood, while eczema is found in adults and even elderly patients. Another difference is that the first pathology is most often localized on the elbow and knee bends, neck and face, while eczema can be located on any area, but more often on the hands and shins. Dermatitis occurs suddenly and often also disappears. Eczema appears regularly and is often the immediate result of exposure to a particular allergen.

Diagnosis of eczema

The diagnosis is made on the basis of examination and questioning of the patient. In some cases, additional studies may be prescribed to differentiate eczema from other skin diseases. With true eczema, the clinical picture of the disease is typical. In other cases, the symptoms may be similar to atopic dermatitis, toxidermia and allergic contact dermatitis.

The diagnostic process may include:

• general blood analysis;
• tissue scraping for examination under a microscope;
• allergy tests to identify the source of the allergy;
• histological examination of tissues.

Treatment is prescribed only after confirming the diagnosis and determining the existing type of pathology.

Features of treatment

A key task in the treatment of eczema is to identify and minimize provoking factors. In addition, systemic or local therapy is prescribed, as well as various physiotherapy procedures:

• Systemic therapy. It is based on taking antihistamines, which can prevent an acute allergic reaction. Sedatives, glucocorticosteroids and a number of hormonal drugs are also used.
• local therapy. May include the use of retinol ointment, anti-inflammatory and antiseptic agents. Therapy is selected taking into account the identified form of eczema and the causes of its occurrence. For example, a virus or fungal infection may need to be treated.
• Physiotherapy. As a rule, it includes ozone therapy, magnetotherapy and laser therapy. In difficult cases, it is possible to treat foci of eczema with the help of cryotherapy. Often prescribed therapeutic and mud baths, exposure to ultraviolet radiation, etc.

Preventive measures

Diet and lifestyle play an important role in preventing the development of new exacerbations. The diet should exclude any foods that can provoke allergic reactions. Typically this is:

• red berries;
• citrus;
• Fish and seafood;
• chocolate;
• dairy products.

Patients are also advised to avoid alcohol and smoking.

Personal hygiene is also important. With the development of eczema of the feet, legs, hands and face, it is recommended to refuse flavored soaps. Water-based creams can be used to moisturize the skin.

And most importantly, improper treatment of skin diseases can provoke eczema. So, you should not self-medicate. If any rashes and redness appear, do not postpone a visit to a dermatologist, because this can be the key to a quick and successful recovery.

If you are faced with symptoms of eczema and do not know how to get rid of such an ailment, then the dermatologists of our KallistoMed clinic are ready to help in this matter. We will be waiting for you at the reception – sign up using the website or by phone!

Information sources

1. Federal clinical guidelines for the management of patients with eczema. – M.: 2013.
2. Olisova O.Yu., Belousova T.A., Kail-Goryachkina M.V. Strategy and tactics of treatment of patients with infectious and inflammatory skin diseases. Dermatology. – 2017; No. 1. – pp. 42–47.

Eczema ☝ What are Eczema data 2023

• What is eczema
• General symptoms of eczema
• Atopic dermatitis
• Dyshidrotic eczema
• Contact dermatitis
• Discoid eczema
• Neurodermatitis
• Seborrheic dermatitis
• Varicose eczema
• Diagnosis of eczema
• Eczema Treatment Options
• Prevention of exacerbations
• When to see a doctor
• Frequently Asked Questions
• Sources

What is eczema

Eczema is a general term for a group of conditions that cause skin inflammation, swelling, discoloration, dryness and itching.

There are seven different types of eczema: atopic dermatitis, dyshidrotic eczema, contact dermatitis, discoid eczema, neurodermatitis, seborrheic dermatitis, and stasis dermatitis.

Eczema is a type of dermatitis. Dermatitis is a group of conditions that cause skin inflammation.

General symptoms of eczema

Different forms of eczema have different symptoms.

Patients with the most common types of eczema may experience:

• Dry and itchy skin
• Mark skin thickening
• Skin depigmentation or discoloration
• Skin rash
• Appearance of areas of weeping
• Skin crusting and scales

The development of eczema is associated with family history, the immune system and environmental factors.

Eczema affects people of all ages, including infants and young children, and often occurs in association with seasonal allergies such as hay fever, food allergies, and asthma.

Over time, the symptoms of the disease may improve, but more often the disease is permanent, with periods of exacerbation and remission

There is no cure for eczema, but patients can manage the symptoms with proper medical care and an effective treatment plan.

If you have discolored, itchy, flaky skin, a rash that doesn’t go away, or dry, uncomfortable skin that doesn’t go away with regular moisturizing, make an appointment with your doctor or dermatologist.

They can evaluate your symptoms, determine what you may be suffering from, and recommend a variety of treatments to help contain and soothe your irritated skin.

In this article, I will discuss each of the seven types of eczema, how to diagnose them, and treatment options.

I will also talk about how you can prevent flare-ups of eczema and when you should talk to your doctor about eczema symptoms.

Atopic dermatitis

Atopic dermatitis (AD) is the most common form of eczema.

This is a long term condition that often begins in infancy.

Atopic may exist alone or together with other types of eczema. Some patients with this form of eczema experience fewer flare-ups and fewer symptoms as they get older.

Symptoms of atopic dermatitis

• Itchy skin
• Dry skin
• Skin redness
• Violet, brown or gray skin in areas of inflammation
• Thick, wrinkled or scaly skin
• Moist, crusty skin
• Infection prone skin
• Cracked leather
• Pain at sites of inflammation

Childhood atopic dermatitis, infant face, source https://dermnetnz. org/

Patients with atopic dermatitis may also develop diseases such as:

• asthma
• allergy
• depression
• anxiety disorders
• sleep problems

Adults with severe atopic dermatitis are also at higher risk for diabetes, high blood pressure, autoimmune disease, vision problems, and chronic respiratory infections.

Atopic dermatitis, body, source https://dermnetnz.org/

Causes of atopic dermatitis

Doctors still don’t know what causes atopic dermatitis.

They think it’s a combination of genetics and environmental factors.

Common triggers include:

• Household detergents, cleaning chemicals, shampoos or soaps
• Mold, pet dander, dust mites or tree pollen
• Food allergens
• Wool, polyester or nylon
• Chronic stress
• Sudden hormonal changes

Dyshidrotic eczema

Dyshidrotic eczema (dyshidrosis) is another common type of eczema.

It primarily affects adults in their 20s and 40s and often occurs in people who already suffer from other forms of eczema or seasonal allergies.

Dyshidrotic eczema, finger skin, source https://dermnetnz.org/

Symptoms of dyshidrotic eczema

Dyshidrotic eczema affects the palms of the hands, the sides of the fingers and the soles of the feet.

Symptoms often occur regularly for months or years.

These symptoms include:

• Fluid-filled pustules or small blisters that appear in clusters or coalesce
• Severe itching of the skin, soreness or burning of the skin
• Scaly or red skin around blisters as they dry out
• Dry skin
• Cracks in the skin
• Abnormally thick skin where there were once blisters.

The blisters that develop due to dyshidrotic eczema usually last about 2-3 weeks before they dry up and peel off.

Patients often develop new blisters before old ones heal.

Dyshidrotic eczema, foot skin, source https://dermnetnz.org/

Causes of dyshidrotic eczema

Since this type of eczema often affects people with other types of eczema, it has been suggested that the disease may have a genetic component.

Other risk factors include:

• Exposure to high temperatures or high humidity
• Exposure to metals such as nickel or cobalt
• Emotional or physical stress

Contact dermatitis

Patients with contact dermatitis experience symptoms when their skin comes into direct contact with a substance or material that causes skin damage.

Unlike other forms of eczema, contact dermatitis is not associated with hay fever or seasonal allergies.

Contact dermatitis, sourced from https://dermnetnz.org/

Symptoms of contact dermatitis

Contact dermatitis is a common skin condition that often affects people who regularly come into contact with chemicals, allergens or irritants, such as hairdressers and medical workers.

Contact dermatitis can be caused by contact with an allergen such as poison ivy.

Symptoms of dermatitis:

• Mild, moderate or severe itching
• Skin redness
• Dry or cracked skin
• Painful, swollen skin
• Blistering

Contact dermatitis, sourced at https://dermnetnz.org/

Causes of contact dermatitis

There are two types of contact dermatitis: contact dermatitis and allergic dermatitis.

Contact dermatitis is much more common, accounting for 80% of cases.

Irritant contact dermatitis occurs when someone comes into regular contact with an irritating substance or material that damages the skin over time.

These irritants may include:

• Harsh soaps and detergents
• Hair dyes
• nickel or cobalt
• Make-up, put up
• Zippers, belt buckles, snaps and snaps
• Wool

Some patients may also develop irritant contact dermatitis due to excessive hand washing with hot water.

Allergic contact dermatitis is an allergic condition that occurs when a patient comes into contact with something that triggers an immune response in the body.

Triggers include:

• Plant allergens: any plant, its sap, pollen, airborne oils, etc.
• Cosmetics: decorative cosmetics, skin care products, masks, materials from which napkins, brushes, sponges are made.
• Household chemicals: powders, solvents, paints, detergents, soap, glue.
• Fabrics: any constituents of natural and synthetic fabrics may be allergens.
• Industrial chemistry: if at work you come across various chemical solutions, compounds and preparations, all this can be an allergen.
• Jewelry: here the allergen can be jewelry coatings, substances that treat metals.
• Medicines for external use

Discoid eczema

Discoid eczema or nummular eczema is a chronic disease characterized by round or coin-shaped patches of inflamed skin or blisters.

In people with fair skin, these spots will be red. Patients with darker skin color may develop brown or pale spots.

Discoid eczema can sometimes be confused with other skin conditions such as ringworm, psoriasis, or a fungal infection.

Discoid eczema is more common in men and tends to get worse during the cold winter months.

It may occur with other types of eczema or appear on its own.

Discoid eczema, sourced from https://dermnetnz.org/

Symptoms of discoid eczema

Discoid eczema can appear anywhere on the body, but most commonly occurs on the arms, legs and trunk.

Patients may have one patch of discoid eczema, but usually develop more than one patch at a time.

Symptoms include:

• Small round, oval, or coin-shaped patches of red skin that coalesce into larger inflammatory lesions.
• Moist skin areas
• Itching or burning of the skin
• Scaly or inflamed skin around blisters
• Bleached leather ring with clear center

Discoid eczema should not cause fever or malaise.

Discoid eczema on the lower leg, source https://dermnetnz.org/

Causes of discoid eczema

Doctors do not know the specific cause of nummular eczema, but believe that some factors may contribute to its development.

They include:

• Insect bites
• Traumatic scratches
• Chemical burns
• Frequent bathing
• Rough clothes
• Harsh soaps, detergents and some fabric softeners

Neurodermatitis

Neurodermatitis is a common disease affecting up to 12% of the population.

Neurodermatitis often begins with chronic itching, usually when patients are going through a stressful or difficult emotional period.

Unlike other forms of eczema, neurodermatitis does not appear in several areas of the body, but is limited to one or two areas of the affected skin.

Neurodermatitis, sourced at https://dermnetnz.org/

Symptoms of neurodermatitis

Patients with neurodermatitis may develop symptoms on the feet, ankles, hands, wrists, shoulders, neck, face, scalp, or genitals.

These symptoms include:

• Violent itching,
• Skin scratching to bleeding
• Skin scaling
• Skin discoloration
• Dryness, thickening of the skin
• Skin scabs, scarring and hair loss

People with neurodermatitis may also experience sleep problems such as insomnia and sexual dysfunction due to the itching associated with their condition.

Neurodermatitis, https://dermnetnz.org/

Causes of neurodermatitis

Research has not yet determined the exact cause of neurodermatitis, but certain people are more likely to develop neurodermatitis than others:

• People with depression, anxiety, or obsessive-compulsive disorder
• People under stress
• People aged 30-50
• Women
• People of African and Asian origin
• People with contact dermatitis, atopic dermatitis or psoriasis
• People who have suffered nerve injuries or insect bites
• People who are exposed to exhaust fumes, heat or humidity

Children rarely have neurodermatitis, although some children with atopic dermatitis may develop symptoms of neurodermatitis.

Seborrheic dermatitis

Seborrheic dermatitis is a common type of eczema that affects areas of the skin that produce sebum, including the scalp, nose, and upper back. In adults, it is sometimes called seborrheic eczema.

Seborrheic dermatitis eyelid and eye area, https://dermnetnz.org/

Seborrheic dermatitis symptoms

Seborrheic dermatitis symptoms most commonly affect infants and people aged 30-60.

Babies with this type of eczema may have what is called “lullaby dermatitis” or “gneiss” – greasy scales on the scalp.

Gneiss in an infant, source https://dermnetnz.org/

They may also have dermatitis on the buttocks, which can be mistaken for diaper rash.

Adults with seborrheic dermatitis experience:

• Flaky, dry skin on the face, scalp, eyebrows, chest, back, groin, or armpits
• Greasy skin covered with white or yellow scales
• Red, itchy skin

Seborrheic Dermatitis, sourced at https://dermnetnz. org/

Causes of Seborrheic Dermatitis

Dermatologists believe that seborrheic dermatitis may be caused by an overreaction of the immune system to the yeast overgrowth that naturally occurs on human skin.

People with certain chronic conditions are more likely to develop seborrheic dermatitis.

Diseases that put you at higher risk include:

• Acne
• Alcoholism
• Cancer
• Depression
• HIV
• Parkinson’s disease
• Psoriasis
• Rosacea

People who experience hormonal changes, cold weather, severe stress, or use harsh detergents and other cleaning products are also at a higher risk of developing seborrheic dermatitis.

Varicose eczema

Venous, gravitational or congestive eczema is a chronic skin disease that affects the legs. This is common in people with varicose veins.

Stasis dermatitis occurs when patients have poor circulation or blood flow to the legs. Sometimes, due to advanced age or other health conditions, the veins cannot effectively pump blood from the legs and back to the heart.

When this happens, fluid accumulates in the feet, ankles, and legs below the knees. The swelling causes discomfort, itching, and other symptoms.

Stasis dermatitis is sometimes called gravitational dermatitis, varicose eczema, or venous eczema, and is common among the elderly.

Varicose eczema, sourced from https://dermnetnz.org/

Symptoms of varicose eczema

Early signs include small patches of discoloration, but as the condition worsens, patients develop:

• Severe pain in the legs, especially after prolonged sitting or standing.
• Dry skin of legs
• Loss of hair on ankles or legs
• Itching or peeling of the skin
• Weeping and ulceration
• Red, brown, purple or gray discoloration of the skin on the legs
• Shiny shin leather
• Thick, dark, scarred or uneven skin

Stasis dermatitis can affect one or both legs at the same time. Rarely affects other parts of the body.

Varicose eczema, sourced from https://dermnetnz.org/

Causes of stasis dermatitis

Stasis dermatitis is closely related to poor circulation and affects women more often than men.

Other risk factors include:

• Extremity vein thrombosis
• Heart failure
• High blood pressure
• Renal failure
• Multiple pregnancy
• Obesity
• Varicose veins

People who sit or stand still for long periods of time are at a higher risk of developing stasis dermatitis.

Eczema Diagnosis

If you think you may have eczema, seek medical advice from a dermatologist.

A dermatologist will be able to give you an accurate diagnosis and recommend a treatment plan that will help soothe itching and manage any other symptoms of eczema.

During your appointment, the provider will examine your skin, note where the rash is, and check for any other symptoms.

Once diagnosed, your doctor will recommend prescription or over-the-counter medications.

In addition, your doctor will recommend skin care measures that can help relieve symptoms of eczema and reduce inflammation over time.

Eczema Treatment Options

There is no cure for eczema, but patients can manage their condition with medication and lifestyle changes. Eczema treatment options include:

• Atopic dermatitis : Experts often recommend that patients use topical corticosteroids such as hydrocortisone cream, a prescription cream such as a calcineurin inhibitor, and moisturizers to keep skin healthy and reduce swelling. They may also suggest that patients take baths and diet changes, take antihistamines, and use bandages or wet wraps to help restore the natural skin barrier.
• Dyshidrotic eczema : Treatment includes topical calcineurin inhibitor steroid ointments or creams to treat symptoms and reduce itching. They may also recommend draining large blisters or treating the skin with ultraviolet light to reduce swelling and pain.
• Contact dermatitis : Health care providers will prescribe topical steroids or other moisturizing ointments to soothe the affected area and heal the skin rash. They may also suggest that patients take oral corticosteroids or antihistamines.
• Discoid eczema : Treatment may include topical steroids and antihistamines to treat round spots on the skin. Your doctor may also recommend mild soap products and recommend short, warm baths or showers, which can help protect the skin barrier.
• Neurodermatitis . Doctors may suggest that patients apply a moisturizer, cool compress, coal tar, or topical steroid to the skin to reduce the tendency to itch. They may also recommend that patients take a bath to soothe their skin. Oral antihistamines may help relieve itching.
• Seborrheic dermatitis : Your doctor may recommend a scalp shampoo, ointment, or cream to reduce swelling and discomfort. They may also prescribe antifungal tablets, a medicated lotion, or shampoo to reduce the amount of yeast on the skin that can cause this condition. Lullaby babies will only need a mild baby shampoo.
• Stasis Dermatitis : Physicians treat stasis dermatitis by working with patients to reduce the vein problems that cause it. They may recommend wearing compression socks or keeping your legs elevated for a certain amount of time each day. They may suggest that you take vitamin C or other supplements to increase blood flow. And they may prescribe a topical corticosteroid or antibiotic to treat inflammation and infection.

Atopic dermatitis and secondary infection

Prevention of flare-ups

Accurate diagnosis and following your doctor’s recommendations will help you prevent the symptoms of eczema.

Take any medication exactly as prescribed, make lifestyle changes your healthcare provider suggests, and reduce exposure to environments, experiences, substances, materials, and other conditions that tend to aggravate your condition.

Avoid triggers and gently treat inflamed skin to allow your immune system and skin to rest, regenerate and heal.

Other lifestyle habits you can adopt to help avoid flare-ups of symptoms include:

• Use of soaps, detergents, and other cleaning products that are free from fragrances and dyes.
• Regular house cleaning to avoid mold exposure.
• Meditation, psychotherapy
• Regular exercise
• Healthy eating
• Drink plenty of water
• Smoking cessation
• 100% cotton clothing
• Stress avoidance

When to See a Doctor

Any skin symptoms that seem severe, unusual, or interfere with your sleep, work, or daily life deserve medical attention.

If you or your child has a rash or other skin condition that doesn’t go away or gets worse even with over-the-counter medications, make an appointment with the Profderm clinic doctor for an assessment.

If you have itchy, painful, or tender skin with red streaks, scabs, or an infection of the skin that secretes pus, or if you develop a fever, call your doctor right away.

These may be signs of an infection that can become life-threatening if left untreated.

Frequently Asked Questions

What are the seven different types of eczema?

There are seven different types of eczema:

• atopic dermatitis
• dyshidrotic eczema
• contact dermatitis
• discoid eczema
• neurodermatitis
• seborrheic dermatitis
• stasis dermatitis.

Each has its own symptoms and requires a unique treatment plan.

What causes eczema?

Researchers are still not sure what causes eczema, but they believe the most common types are caused by a combination of genetics and environmental factors.