Eczema: Types, Symptoms, Causes, Diagnosis, Treatment, Outlook and Tips for reducing outbreaks


Eczema is a reaction pattern that the skin produces in a number of diseases. It begins as red, raised tiny blisters containing a clear fluid atop red, elevated plaques.

June 5, 2018

Eczema: Types, Symptoms, Causes, Diagnosis, Treatment, Outlook and Tips for reducing outbreaks

Eczema is a reaction pattern that the skin produces in a number of diseases. It begins as red, raised tiny blisters containing a clear fluid atop red, elevated plaques. When the blisters break, the affected skin will weep and ooze. It is not a single health condition. Atopic dermatitis is a most common causes of eczema.
People with eczema often have allergies or asthma along with itchy, red skin. Tiny blisters that can weep and ooze, eventually producing crusted, thickened plaques of skin are the symptoms of eczema. It is almost always itchy which which may be intense in severe cases.
This skin condition is very common in children, however people of any age can get it too. There are several types of eczema and each type has its own set of symptoms and triggers. As the treatment option differs for each type, it is important to distinguish the different causes of eczema. For example, if eczema is produced by skin exposure to a specific substance, it can be helpful to avoid it. Keeping the skin healthy and moisturized can prevent certain kinds of eczema.

Different Types of Eczema:

There are several distinct types of skin conditions that produce eczema. It is important to distinguish them to choose an effective treatment plan which is often not easy. The different type of conditions are:

Atopic dermatitis:

Atopic dermatitis is the most common form of eczema which is has a genetic basis. Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. It is chronic and tends to flare periodically and then clears up for a time, even for several years. It may be accompanied by asthma or hay fever.

Symptoms of Atopic dermatitis:

Signs and symptoms of atopic dermatitis vary widely from person to person and include:

  • Dry skin
  • Itching, which may be severe, especially at night
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Thickened, cracked, scaly skin
  • Raw, sensitive, swollen skin from scratching
  • Your skin can get infected if you scratch it

Causes of Atopic dermatitis:

Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is related to a gene variation that affects the skin's ability to provide this protection as your skin's natural barrier against the elements is weakened. As a result of this your skin gets easily affected by environmental factors, irritants and allergens. It is likely caused by a combination of factors such as genes, dry skin, an immune system problem and triggers in the environment.
Food allergies may also be a cause of eczema in some children.

Contact Dermatitis:

Contact dermatitis is a result of a reaction to substances you touch producing red, irritated skin. There are two types of contact dermatitis. Allergic contact dermatitis is an immune system reaction to an irritant like latex or metal and Irritant contact dermatitis occurs when the skin is repeatedly exposed to excessive washing or toxic substances.

Symptoms of Contact Dermatitis:

In contact dermatitis:

  • your skin itches, turns red, burns, and stings
  • itchy bumps called hives may pop up on your skin
  • fluid-filled blisters can form that may ooze and crust over
  • over time, the skin may thicken and feel scaly or leathery

Causes of Contact Dermatitis:

Contact dermatitis happens when you touch a substance that irritates your skin or causes an allergic reaction. The most common causes are:

  • detergents
  • bleach
  • jewelry
  • latex
  • nickel
  • paint
  • poison ivy and other poisonous plants
  • skin care products, including makeup
  • soaps and perfumes
  • solvents
  • tobacco smoke

Dyshidrotic eczema:

Dyshidrotic eczema causes small blisters to form on your hands and feet. It is more common in women than men.

Symptoms of Dyshidrotic eczema:

In dyshidrotic eczema:

  • fluid-filled blisters form on your fingers, toes, palms, and soles of your feet
  • these blisters may itch or hurt
  • the skin can scale, crack, and flake

Causes of Dyshidrotic eczema:

Dyshidrotic eczema can be caused by:

  • allergies
  • damp hands and feet
  • exposure to substances such as nickel, cobalt, or chromium salt
  • stress

Hand eczema:

Eczema that affects only your hands is called hand eczema. The possibility of getting this type of eczma is more if you work in a job like hairdressing or cleaning, where you regularly use chemicals that irritate the skin.

Symptoms of Hand eczema:

In hand eczema:

  • your hands get red, itchy, and dry
  • they may form cracks or blisters

Causes of Hand eczema:

Hand eczema is triggered by exposure to chemicals. People who work in jobs that expose them to irritants are more likely to get this form, such as:

  • cleaning
  • hairdressing
  • healthcare
  • laundry or dry cleaning

Neurodermatitis:

Neurodermatitis is similar to atopic dermatitis which causes thick, scaly patches to pop up on your skin.

Symptoms of Neurodermatitis:

Symptoms of neurodermatitis include:

  • thick, scaly patches on your arms, legs, back of your neck, scalp, bottoms of your feet, backs of your hands, or genitals
  • these patches can be very itchy, especially when you are relaxed or asleep
  • they can bleed and get infected if you scratch the patches

Causes of Neurodermatitis:

Neurodermatitis usually occurs in people who have other types of eczema or psoriasis. The exact causes of this condition is unknown, although stress can be a trigger.

Nummular eczema:

This type of eczema causes round, coin-shaped plaques of scaling skin most often on the lower legs of older individuals. The word nummular means coin in Latin. Nummular eczema looks very different from other types of eczema which can make it distinguishable from other types, and it can itch a lot.

Symptoms of Nummular eczema:

Symptoms of nummular eczema include:

  • round, coin-shaped spots on your skin
  • the spots may itch or become scaly

Causes of Nummular eczema:

Nummular eczema can be triggered by a reaction to an insect bite, or by an allergic reaction to metals or chemicals. Dry skin can also cause it. People are more likely to get this form if they have another type of eczema, such as atopic dermatitis.

Stasis dermatitis:

Stasis dermatitis occurs when fluid leaks out of weakened veins into your skin. This fluid causes swelling, redness, itching, and pain.   

Symptoms of Stasis dermatitis:

Symptoms of stasis dermatitis include:

  • the lower part of your legs may swell up, especially during the day when you’ve been walking
  • your legs may ache or feel heavy
  • you will likely also have varicose veins, which are thick, ropey damaged veins in your legs
  • the skin over those varicose veins will be dry and itchy
  • you may develop open sores on your lower legs and on the tops of your feet

Causes of Stasis dermatitis:

Stasis dermatitis happens in people who have poor circulation in the veins of the legs. If the valves that normally push blood up through your legs toward your heart does not function properly, blood can pool in your legs. Your legs can swell up and varicose veins can form.

Xerotic or dry skin eczema:

The skin will crack and ooze if dryness becomes excessive.

Seborrheic dermatitis:

It produces a rash on the scalp, face, ears, and occasionally the mid-chest in adults. It can produce a weepy, oozy rash behind the ears in infants and can be quite extensive, involving the entire body.

Fungal infections:

This can produce a pattern identical to many other types of eczema. Fungal infections occur when an invading fungus takes over an area of the body and is too much for the immune system to handle. The fungus can be visualized and identified with a scraping under the microscope or grown in culture.
For all type of eczema, the most common symptom is itching. Since the appearance of most types of eczema is similar that is elevated plaques of red, bumpy skin, the location of the eczema can be helpful in distinguishing one type from another. For example, stasis dermatitis occurs most often on the lower leg while atopic dermatitis occurs in the front of the elbow and behind the knee.

Diagnosis of Eczma:

If the itching and redness you are experiencing doesn't go away on its own, or if it interferes with your life and daily activities, do visit a skin doctor called a dermatologist who can diagnose and treat eczema. It may be helpful to keep a note to identify your eczema triggers to help your doctor understand your condition. The note should be about

  • the kind of food you eat and drink
  • the skin products, chemicals, soaps, makeup, and detergents you use
  • the activities you do, such as taking a walk outside in the woods or swimming in a chlorinated pool
  • how long you spend in the bath or shower, and the temperature of the water
  • when you are under stress

You should try to notice and understand the connections between your activities and your eczema flare-ups which help your doctor to pinpoint your triggers.
A patch test can be done to find out the substances that trigger your eczema, so that you can avoid them . In this test a small amounts of irritating substances is placed on patches that are applied to your skin. The patches stay on your skin for 20 to 30 minutes to see if you have a reaction.
A sample of skin or biopsy may be sent for examination in a laboratory to confirm the diagnosis. It is important to rule out curable conditions caused by infectious organisms. An examination of the entire skin surface and a health history is required for an accurate diagnosis.

Treatment of Eczma:

Treatment options are different for different types of eczma. These include:
Repeated cycles of application of dilute solutions of vinegar or tap water in the form of a compress followed by evaporation is required where there is significant weeping and oozing. The affected body part will then be placed in front of a fan after the compress. Topical steroid such as triamcinolone cream applications can be an effective treatment once the acute weeping has diminished.
Cool compresses applied before you rub on the corticosteroid cream can help the medicine get into your skin more easily and therefore will be more effective.
Treatment of skin infections include antibiotics. Other medication used for reducing the symptoms of eczma include:

  • Antihistamines such as diphenhydramine or Benadryl can control the itch.
  • Corticosteroid cream or ointment can reduce the itch. For a more severe reaction, you can take steroids like prednisone orally or by injection to control swelling.
  • Calcineurin inhibitors such as tacrolimus and pimecrolimus can reduce the immune response that causes red, itchy skin.
  • Light therapy exposes your skin to ultraviolet light to heal your rash.
  • If an allergic reaction results in a flare-up of your eczema, you should avoid the substance that is causing the triggers.
  • Use of moisturizing creams or ointments can be an effective treatment for many people in preventing certain types of eczema.

Outlook of Eczma:

Mostly the patients of eczema do quite well under the care of a dermatologist after an accurate diagnosis. The flares may come and go. Atopic dermatitis is usually worst in childhood and improves with age. Other forms of eczema may stay with you throughout your life. However, you have treatment options to reduce your symptoms. When eczema can become infected by microorganisms, such a staphylococci or herpes simplex virus, the infection could be contagious and require antibiotics treatment. This happens when the normal barrier function of the skin has been damaged by the inflammatory condition. The development of fever and pustules, pain at the site of the rash are significant sign of this condition.

Tips for reducing outbreaks:

You should also avoid any known triggers to prevent eczema flare-ups.
Here are a few ways to prevent eczema flare-ups and manage symptoms:

  • Apply cool compresses to your skin, or take a colloidal oatmeal or baking soda bath to relieve the itch.
  • Moisturize your skin daily with a rich, oil-based cream or ointment to form a protective barrier against the elements. Apply the cream right after you get out of the shower or bath to seal in moisture.
  • Gently blot your skin with a soft towel after bath. Never rub your skin.
  • Avoid scratching to prevent an infection.
  • Wear loose-fitting clothes made from soft fibers, like cotton.
  • Use fragrance-free detergents, cleansers, makeup, and other skin care products.
  • Wear gloves and protective clothing whenever you handle chemicals.