Whether you’ve just been diagnosed or worry that you could have eczema, you’re probably nervous, confused, or just plain uncomfortable. That’s normal, and everyone featured on HealthCentral with this condition felt like you do now. You know what they say, though: knowledge is power. On this page alone, you’ll discover the realities and challenges of the condition, but also the best treatments, helpful lifestyle changes, where to find your eczema community, and all the crucial information to help you not just manage—but thrive. We’re sure you’ve got a lot of questions...and we’re here to answer them.
We went to some of the nation's top experts in eczema to bring you the most up-to-date information possible. Look who's on your side:
Cheryl Bayart, M.D.Dermatologist
Lawrence Eichenfield, M.D.Chief of Pediatric and Adolescent Dermatology at Rady Children's Hospital and Vice Chair of the Department of Dermatology and Professor of Dermatology and Pediatrics
Emma Guttman, M.D., Ph.D.Director of the Center for Excellence in Eczema
What Is Eczema, Exactly?
Let’s start with the 30-second trailer version: Eczema—a chronic inflammatory skin condition—is red, raw, and itchy. In some cases, ridiculously so; it’s an itch that begs to be scratched. Maybe you’ve scratched until your skin swelled. Or bled. Or maybe your child is the one suffering and itching. Odds are strong on the latter as eczema is more likely to impact infants and young kids. In fact, nine million children in the U.S. have it.
And like a movie sequel that nobody wanted, the condition can return. Eczema affects more than seven percent of adults, according to the National Eczema Society. And one in four people report adult-onset of symptoms, having never experienced them as a child.
Experts say the prevalence of eczema is like a U-shaped curve: high in children and teens, low in young and middle-aged adults, and high again in those in their 70s, per a recent study published in the Annals of Internal Medicine.
Eczema is frequently referred to as atopic dermatitis, the most common form that starts in children. It often goes away in adulthood. “Eczema” and “atopic dermatitis” are used interchangeably by physicians.
But there are six other types of eczema:
Contact dermatitis: A red, itchy skin reaction to something you touch: say, nickel in jewelry or laundry detergent.
Dyshidrotic eczema: More common in women, this type forms small blisters and bumps on hands and feet.
Hand eczema: Just what it sounds like—this version only affects the hands.
Neurodermatitis: Like atopic dermatitis, this forms scaly patches on skin. Only difference is that the patches here are noticeably thicker.
Nummular eczema: With this type, round coin-sized spots pop up on skin, and they itch even more than other types of eczema.
Stasis dermatitis: This appears when fluid seeps out of veins into skin, leading to painful swelling.
While there is no cure for eczema, there are periods when symptoms worsen (flares), and periods where they disappear entirely (remission).
What Causes Eczema in the First Place?
Researchers don’t know the exact cause of eczema, but they know what drives it—a getaway car-combo of genes and environmental factors. If you have a family history of eczema, you’re more likely to develop the condition. One study published in Nature Genetics found that some people with eczema lack the proper proteins to build a strong barrier on the outermost layer of the skin, the epidermis.
This allows critical moisture to escape and rolls out a welcome mat for allergens, aka triggers. When people with eczema are exposed to these allergens (be it certain soaps or emotional stress), their bodies produce inflammatory signals to their immune system. Enter: flares.
If you have been diagnosed with eczema, then your symptoms can worsen if you’re exposed to triggers, including:
Too-cold or too-dry environments. These can strip your skin of moisture, causing it to become brittle and scaly and leading to an eczema flare. But there can also be the wrong kind of moisture....
Excessive sweating. This can irritate your skin, especially when you’re in the middle of a flare and in areas where sweat can get trapped, like in the crooks of your elbows, knees, and neck.
Stress or anxiety. When you’re tense, your nervous system takes the pilot’s seat (hello, “fight or flight”), instructing your body to shield itself by pumping out stress hormones, including cortisol. Cortisol regulates the immune system, but when it whooshes out during stressful situations, an imbalance occurs—inflammation-promoting cells and allergic antibodies produce at a rapid clip. Plus, when we’re in freak-out mode, white blood cells release itch-inducing histamines and our blood vessels dilate, adding a little more histamine to the mix. In a nutshell: A bad, no-good party.
Airborne allergens. Allergens and allergies are not one in the same and eczema is not an allergy. Allergens are essentially triggers, and eczema flares when those triggers—dust mites, pollen, and pet dander—enter the skin and your immune system plays defense. You might itch, swell, or get hives. Again, this is not an “allergic” reaction; it is an immune system response. What about food allergies and eczema? There’s still plenty of research to be done, but the general consensus is that kids—less so for adults—with eczema are more likely to be allergic to foods (peanuts, milk, and eggs are the big ones), but food allergies don’t necessarily cause eczema or flares. In other words, a food allergy might make an eczema symptom worse, but it’s not likely going to directly make you flare like an airborne allergen can. That said, because eczema is an inflammatory condition, many people find relief when they monitor their diets and eat anti-inflammatory foods like fish and vegetables.
Other irritants. Exposure to certain chemicals, including fragrance and sulfates found in soaps, detergents, perfumes, and cosmetics, can irritate already sensitive skin, opening the door for an inflammatory response. Look for the National Eczema Association seal on everything from lotion to laundry detergent labels.
Do I Have Eczema Symptoms?
Tell us your date of birth and we’ll take it from there.
Babies tend to get eczema on places they can reach and scratch like their cheeks, belly or scalp.
Young kids, as they become more mobile, get it in areas of the body that come into contact with surfaces.
Adults are more likely than kids to develop a ring of eczema around their eyes when they’re exposed to allergens or irritants, or in the nooks and crannies of their bodies, such as the back of their knees and elbows. If you’ve had eczema for many years, your skin can also be thicker, more leathery and darker, due to longtime scratching.
No matter the age, many eczema sufferers experience intense itching. Unfortunately, this can cause something known as the “itch-scratch cycle,” where the itching leads to scratching, resulting in the release of more inflammatory chemicals that worsen eczema by drying out the skin. If you don’t treat it, and keep scratching, you can get a bacterial skin infection.
Other symptoms of eczema include:
Thick, scaly skin
Plugged hair follicles that cause small bumps on your face, upper arms, and thighs
A darkening of the skin around your eyes. You may also see an extra fold of skin under them.
Self-care is critical. If you have eczema—any kind—get yourself a ceramide-rich moisturizer. We can’t underscore this enough. It’s a thirst trap for eczema, creating a barrier that helps prevent water loss and keeps out germs that could infect raw, inflamed skin, and it also replenishes lost moisture. Apply it immediately after a bath or shower.
Speaking of that shower, as amazing as hot water feels (it might even temporarily quell some of the itching), you want to stick with lukewarm water (too hot and you’ll dry out skin) and bathe for under 15 minutes. Use a gentle, unscented cleanser, not a sudsy bar of soap. The National Eczema Society also recommends either a ten-minute bleach bath—yes, bleach! Use a half-cup of household bleach for a full tub of water to kill bacteria and reduce the risk of infections or inflammation. Another expert-approved way to indulge your skin is to use a store-bought oatmeal bath product two to three times a week to help with the itching.
How Do Doctors Diagnose Eczema?
There’s no gold standard test. (Sorry, we hate when people tell us that too.) But a dermatologist can diagnosis by carefully examining your skin and reviewing your medical history. Besides the rash, other signs that can tip off your doctor that you have eczema include:
You’ve also got itching. And we mean uncontrollable itching. Saying that eczema is itchy is like saying that a hurricane is windy.
The rash has come and gone since childhood, leaving behind scarring or skin discoloration.
You have a personal or family history of eczema and/or allergies and asthma. More than twenty percent of adults with eczema also have hay fever and/or allergic asthma, per the National Eczema Foundation.
The rash flares up after exposure to certain triggers, like during hay fever season or when seasons change.
If you’ve never been diagnosed with eczema, it’s important to get any eczema-like rash checked out rather than try to treat it yourself with over-the-counter remedies. It could be psoriasis or even a very rare form of cancer called cutaneous T-cell lymphoma that’s often accompanied by swollen lymph nodes and/or some hair loss. If there’s any question, your doctor can always do a biopsy to make sure.
What Is the Best Treatment for Eczema?
There’s no magical medication that will—poof!—cure eczema. While research has shown that nearly 75% of kids are free of eczema by the time they turn 16, it’s a chronic condition with no guarantee that you will grow out of it. For decades, the main treatment was over-the-counter and prescription steroid creams, which, if used for long periods of time (more than a year), could cause side effects including skin thinning, cataracts and glaucoma.
But in the last decade, more treatments have become available, especially for severe, hard-to-treat cases. Here’s what works:
If you’ve got mild eczema in just a few spots on your body (moderate covers large areas like hands, knees, or back; severe eczema covers more than half the body), your dermatologist can prescribe a topical corticosteroid, which reduces skin inflammation. They come in varying strengths and are applied once or twice a day whenever you have a flare. But they’re not recommended for long term use (more than two weeks at a time) since they can thin your skin.
In some cases, steroid creams can’t control your eczema. Or if your eczema is on your face, your doctor can prescribe either tacrolimus (Protopic) or pimecrolimus (Elidel). These two drugs are topical calcineurin inhibitors (TCIs), anti-inflammatories that shut off the triggering part of your immune system. Since they don’t contain steroids, you can use them for as long as necessary. Another option is Eucrisa, a medication approved in 2016. It’s a type of drug known as a phosphodiesterase 4 (PDE4) inhibitor, and blocks the PDE4 enzyme, which in turn reduces skin inflammation. Researchers have found that this treatment shows significant results after 28 days and there aren’t any known side effects if used longer.
If you’ve got moderate to severe eczema that hasn’t responded to topicals, try dupilumab (Dupixent), which was FDA approved in 2017. This injectable drug is a biologic, which means it is a treatment developed from part of a living substance. Biologics block two proteins, interleukin-4 and interleukin-13, that can cause eczema. More than half of people who used it for 16 weeks found that their eczema symptoms improved by 75%, according to a 2016 study published in the New England Journal of Medicine. There are two potential downsides to this medication: 1) the price, as it costs more than $30,000 a year without insurance; some insurances will pay, but not completely. And 2) you must give yourself one to two shots in your belly or thigh every other week. If needles aren’t your thing, this isn’t the best option, as you can’t take it as a pill because your digestive tract would break the proteins down.
In extremely severe cases where eczema covers much of the body and there is a lot of inflammation (redness and itching), your dermatologist can prescribe an immunosuppressant drug to help control your immune system. This in turn will slow down eczema symptoms. The three most common drugs are azathioprine, cyclosporine, and methotrexate. These are all hardcore medications that are either used in transplant patients to prevent their bodies from rejecting an organ, or for chemotherapy, so they’re seen as an absolute last resort. You’ll have to be monitored very carefully with regular blood tests by your doctor when you’re on them, since they can upset your GI tract, cause kidney or liver damage, and make you more likely to get an infection.
Does Eczema Have Serious Complications?
When we talk about eczema, we talk about the surface—raw, itchy, inflamed skin. But eczema’s impact can reach deep into the bones—literally. Some of the risks:
Staph infections: Since your skin may lack infection-fighting proteins, you’re more at risk of bacterial infections like staph. If the areas of eczema on your skin begin to appear swollen and red, or on dark skin, appear swollen and grey, call your doctor right away.
Bone fractures: Recent research has also linked severe eczema to a higher risk of fractures—hip, back, and spine. Experts say this is in part due to chronic inflammation linked to eczema.
Heart disease: People with severe eczema have up to a 50 percent greater risk of heart attack and death from heart disease than those without the condition, according to a May 2018 study published in the British Medical Journal. Researchers don’t yet know if the conditions are directly linked, or if eczema treatments might play a role. But if you have severe eczema it’s yet another good reason to get screened for heart disease and its risk factors like hypertension and high cholesterol.
What's Life Like for People With Eczema?
Is it a life-threatening disease? In most cases, no. Is it a life-restricting disease? If not treated or controlled, yes. Adults with eczema are up to three times more likely to experience depression or anxiety than those who don’t have the disease, with about half going undiagnosed, perhaps because these emotions are new and not immediately connected to skin. And there are other ways eczema can dampen a person’s life:
Social life/dating: Almost a fifth of those with even just mild eczema say they avoid socializing because of it, while almost a quarter of eczema patients limit anything that might involve face-to-face interactions, according to a September 2018 study published in the Annals of Allergy, Asthma & Immunology.
Work: Eczema is not career-friendly: 20 percent of people say it’s hard to hold down a job because of it, with some saying that they’ve actually switched careers so they didn’t have to interface with people.
Sleep: Nearly half people with the condition say that their zzz time has been negatively impacted by their eczema. If you’re really itchy, you may have trouble sleeping, which can impact your mood and also make it harder for you to concentrate during the day.
Sex: An October 2017 French study discovered that more than 80 percent of people living with the condition found it hurt their libido. Eczema’s physical manifestations—red, itchy rash—may be hard to ignore. And if that rash appears in creases around your genital region, under breasts, or the folds between the backs of thighs and bum, sex may actually be an unpleasant experience.
Even if your libido is fine, your sex life may suffer due to your self-consciousness about your eczema. The best way to deal with this is to be up front. Let your partner know that you have eczema and that it’s not contagious. That simple exchange can help relieve your or someone else’s anxiety. And if you feel confident, but the act itself is uncomfortable, talk to your partner about possible tweaks to make you feel better physically—if sweat during sex is an issue, crack a window; if your skin is thin and sensitive in spots from treatments point them out to your S.O; or switch up positions to avoid skin-irritating chaffing.
Follow because: She’s a Sweden-based Certified Holistic Health Coach who turns to nature’s cleanest and greenest grub to treat her chronic condition. Her and before-and-after shots speak for themselves and make you want to try every recipe and meal she posts on her feed (warning: her feed will make you hungry). She shares every step of her healing process while providing insight about what does and doesn’t work—all served with a smile.
Follow because: She’s a self-proclaimed #eczemawarrior, but she’s really kind of a #lifewarrior. Not only does she fight eczema with natural healing (read: a “clean” skincare line), but she’s also CEO for a jewelry company (that helps save baby sea turtles!) and a social media agency, and is an actual in-the-ring fighter. Dive into her story highlights for the 101 on her journey with eczema, including product and treatment reviews, recipes, and more.
Follow because: One-hundred-percent realness here. She posts up close and personal videos about what it’s like to wake up with eczema, date with eczema, and how to speak UP about eczema. Ashley has no shame about wearing a bedazzled face mask to her brother’s wedding to hide a flare while looking fab. She is the epitome of #unbothered.
Follow because: Tara’s feed is super clean—and that’s not just her posted recipes. Her feed is simple and bright; you just want to double-tap it all. She posts appetizing layouts of various fruits and meals that are all save-worthy.
Follow because: If you’re not a patient with eczema, you’re likely a parent of eczema—just like Karen. She watched as her baby develop eczema and absolutely did not sit back while it took over her family’s lives. With her knowledge of nutritional biochemistry (she’s a certified nutritionist!), she designed The Eczema Diet and a supplement to help not only her daughter, but so many other people living with eczema. Her feed is a mini reel of her many books, all surrounding diets, detoxes, and family life with eczema.
Follow because: She’s not just an author because The Beauty of Eczema is not really just a book — it’s a journal, a cookbook, a place of affirmation, and a movement. Her best-selling debut book is about living a life beyond eczema, one that feeds your mind, body, and soul.
Top Eczema-Related Podcasts
The Eczema Podcast. Hosted by a holistic nutritionist, this podcast takes you inside the best strategies to heal eczema naturally (Chinese medicine, CBD oil, probiotics) with some of the top experts in the field (naturopaths, nurse practitioners, and dermatologists).
The Healthy Skin Show. Jennifer Fugo, Clinical Nutritionist, sprinkles this podcast with alternative solutions for stopping chronic rashes and then helps you to rebuild your healthy skin. Her goal is to go beyond the exam room and talk about everything you want to know that isn’t covered in a quickie appointment.
Top Eczema Support Groups and Non-Profits
National Eczema Association (NEA). Need to find a provider who specializes in eczema? NEA. Want to connect with others who live with or care for those with eczema as a sounding board? NEA. Need product reviews that are tailored specifically for eczema? N. E. A! This nonprofit is here to support you, your eczema, your family, and the future care of eczema.
International Topical Steroid Addiction Network (ITSAN). If you’re new to eczema—yes, topical steroid cream addiction is real. If you’ve been around the eczema block, you know this, but you might not know that there’s a place for support. This is it. Get photos, stories, and reviews on topic steroids for Red Skin Syndrome (RSS), a debilitating condition that can arise from the use of topical steroid creams.
It’s an Itchy Little World. Through trial and error, Jennifer Roberge, mom of two, came up with various methods to help her young son, then just two-years-old, with his raging itching from eczema. She shares all about what works (and what doesn’t) on her blog, and then helps other parents of kids with eczema cope in her Facebook group.
International Eczema Council. This global nonprofit not only provides general information about eczema, but also the latest information about next-gen treatments—including how to find a clinical trial near you.
Frequently Asked QuestionsEczema
Is eczema contagious?
That would be a hard NO—and don’t let anyone tell you otherwise. Eczema is a skin condition...not a cold. You can’t give it to others and your co-worker can’t give it to you.
Why does eczema feel so good when I scratch it?
It creates a short-term pain response that makes your brain temporarily forget about your itch. But the scratching damages the top layer of skin and causes your body to release pain-relieving chemicals like serotonin, which make you even itchier.
Is it safe to swim with eczema?
Yes, but you should take some precautions. Since chlorine or saltwater can irritate your skin if left to dry, you should rinse off immediately après swim, pat dry and apply a moisturizer to your entire body. This will help prevent a flare.
What’s a good home remedy for eczema?
Coconut oil! Not only is it incredibly moisturizing, it has antibacterial effects, which can help get rid of nasty bugs on your skin that make eczema worse.
Comorbidities and Eczema:British Medical Journal. (2018). “Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study.” bmj.com/content/361/bmj.k1786