Frequently Asked Questions about Eczema (Atopic Dermatitis)
Browse through some common questions about eczema:
- What is eczema (atopic dermatitis)?
- What is the most common form of eczema?
- What are the signs and symptoms of eczema?
- How do I know if what my child or I have is eczema or some other skin problem?
- Why does eczema affect some people and not others?
- Is eczema contagious?
- What causes eczema?
- Can stress cause eczema?
- Who is more likely to have eczema?
- Can you have eczema for the first time as an adult?
- What is the link between eczema and asthma, hay fever, and allergies?
- Once you get eczema, can you get it again?
- Is there a cure for eczema?
- How serious is eczema?
- What are the treatment options for eczema?
Eczema (atopic dermatitis) is a chronic, recurring inflammatory skin disease that is most common in people with a family history of an atopic disorder: asthma, hay fever, or atopic dermatitis. Eczema is characterized by patchy, dry, itchy and scaly areas of skin. In severe cases of eczema, the skin can weep, bleed, and crust over.
2. What is the most common form of eczema?
The most common form of eczema is atopic dermatitis.
3. What are the signs and symptoms of eczema?
The signs and symptoms of eczema (atopic dermatitis) vary from person to person. Most commonly, the affected skin becomes very dry, itchy, red and swollen; sometimes it’s cracked, crusty and scaly.
- Babies may have patchy rashes on their face, elbows and knees
- Older children usually get the eczema rash behind the knees, inside the elbows, on the sides of the neck, and on the wrists, ankles and hands
- In adults, eczema usually shows up as rashes on the arms, legs, hands and neck, but any location can be involved
4. How do I know if what my child or I have is eczema or some other skin problem?
Your healthcare provider is your best source of information and diagnosis. While eczema (atopic dermatitis) is very common, it can sometimes mimic other skin diseases, such as seborrheic dermatitis (dandruff), psoriasis, or contact dermatitis.
5. Why does eczema affect some people and not others?
Over 34.8 million Americans have symptoms of eczema (atopic dermatitis), but scientists don’t really know what causes it. Many experts think that eczema occurs when you have an inherited tendency for the disease, and the disease is “triggered.” Triggers can vary widely, and some examples are stress, or sensitivity and exposure to some soaps, fabrics or foods.
No, eczema is not contagious.
No one really knows what causes eczema (atopic dermatitis). We do know that certain things can cause eczema to get worse. When eczema gets worse, it is called a flare-up. A flare-up occurs when the immune system in people’s skin overreacts to environmental or emotional triggers. This reaction results in symptoms such as itching.
People with eczema may have different triggers. Some of the common things that can trigger an eczema flare-up include:
- Changes in temperature or humidity
- Chemical irritants, such as pesticides, paint strippers, alcohol, astringents, perfumes, harsh soaps, detergents, and household cleaners
- Physical irritants, such as clothes made of rough or scratchy fabrics, like wool or burlap
- Allergies (to dust, pollen, mold, animal dander, etc.)
- Intense emotion or stress
- Infections of any kind
People with eczema must work closely with their healthcare providers to figure out what triggers their eczema flare-ups. Then they can take steps to avoid these triggers.
Stress doesn’t actually cause eczema (atopic dermatitis), but it can trigger a flare-up, or make the condition worse. Feelings like anger and frustration can also aggravate eczema.
Because emotional stress can aggravate the condition, patients with eczema (atopic dermatitis) may find that techniques in stress management and relaxation can decrease their chances of having flare-ups.
9. Who is more likely to have eczema?
Many people have eczema (atopic dermatitis). It is a very common problem in the United States. In fact, eczema is the most common skin problem in children under the age of 12. Children with a parent, grandparent, brother, sister, aunt, or uncle who have or have had eczema, asthma, or hay fever often have eczema themselves. But even people who don’t have these conditions in their families can develop eczema too.
Eczema appears most often in early childhood. Nine out of 10 people who have eczema get it before they are 5 years old. People who have it as children may always have dry or extra-sensitive skin, even as adults.
About two thirds of eczema cases begin in babies under the age of 1 year. It starts usually in babies between the ages of 6 and 12 weeks. The eczema may clear up but then may come back from time to time.
10. Can you have eczema for the first time as an adult?
It is not common for someone to have eczema for the first time as an adult, but it can happen.
11. What is the link between eczema and asthma, hay fever, and allergies?
Many people with eczema also have asthma or hay fever as children or adults. Children with eczema often have allergies to such things as food or pollen.
12. Once you get eczema, can you get it again?
Eczema (atopic dermatitis) is a chronic, recurring skin condition which can come and go for months and even years. In most people, there are times when eczema gets worse-called “flares” or “flare-ups”-followed by times when it gets better, or even seems to disappear. These are called “remissions.”
Although eczema tends to first occur in babies and children, many children with eczema will seem to grow out of it-they’ll have a permanent remission, although their skin may stay dry and easily irritated. People who had eczema as a child often have sensitive, dry skin in adulthood, especially on the hands.
13. Is there a cure for eczema?
While there is no cure for eczema (atopic dermatitis), there are treatments and techniques that can help. Your healthcare professional is your best source of advice when eczema flares up. Experts say that these steps help to control the problem:
- Moisturize daily
- Try to keep from scratching or rubbing
- Protect the skin from irritating substances, including rough clothing
- Keep the temperature cool and stable; avoid extremes
- Keep humidity levels stable; avoid extremes
- Avoid contact with things that you may be allergic to, such as pollen and animal dander
- Try to limit emotional stress
While eczema is not life-threatening, it can have a serious effect on daily life. For those who have eczema (atopic dermatitis), the skin can get so dry that the outer layer loses its ability to protect the deeper layers of skin and even cracks may form. That can make the skin prone to infections, such as warts and or bacterial skin infection (i.e., impetigo). And, the rash and itching can affect sleep and work or school performance.
15. What are the treatment options for eczema?
Aside from the itching and redness, eczema can disrupt sleep, dictate how you dress, and lead to infection if not treated. Fortunately there are several prescription eczema treatment options available when avoiding triggers and using moisturizers aren�t enough to control your eczema. While there is no cure for eczema, these eczema treatment options can help manage the itching, redness, and other symptoms that can occur when eczema is left untreated. Here is some information on eczema treatment options you may be using:
Antihistamines can be used to reduce the itching of an eczema flare-up, but they often cause drowsiness. Some oral antihistamines are:
Benadryl® | Zyrtec® |
TIMs or topical immunomodulators can help reduce the itching and redness of eczema. TIMs are the newest class of drugs in over 40 years to treat eczema, and they do not contain steroids. TIMs include:
Elidel® | Protopic® |
Corticosteroids (steroids) can also be effective in reducing itching and redness associated with eczema. Some such steroids are:
Aclovate® | Diprolene® | Psorcon® |
Aristocort® | Diprosone® | Synalar® |
Cormax® | Elocon® | Temovate® |
Cutivate® | Halog® | Topicort® |
Cyclocort® | Hytone® | Tridesilon® |
Decadron® | Kenalog® | Ultravate® |
Dermatop® | Lidex® | Valisone® |
DesOwen® | Locoid® | Westcort® |
Cold compresses can help relieve itching.
Antibiotics are used to treat skin affected by eczema that has become infected. They kill the bacteria causing the infection.
Be sure to use any prescription products properly. Use them only as often and as long as your healthcare provider instructs.
Revision date: June 21, 2011
Last revised: by Andrew G. Epstein, M.D.