Scratch Attack: Common Forms of Eczema and the Best Forms of Treatment

Around 10 to 20 percent of babies experience atopic dermatitis, a common form of eczema (more on that in a second).

Symptoms may appear anywhere on the body, but the most commonly affected areas are the face and joints.

Symptoms

• redness and swelling
• thickened, leathery skin
• darkened skin around the eyes
• changes to skin around eyes, ears, and mouth
• small raised bumps and blisters

While the exact cause is unknown, eczema is often hereditary. If a parent had eczema as a child, their baby is more likely to have it.

Babies also have a much weaker skin barrier than adults, which allows more moisture and germs to penetrate the skin, leading to eczema.

What makes it worse

• Dry skin. Low humidity, particularly in the winter months, can make a baby itchier.
• Irritants. Scratchy wool blankets or clothing, and scented soaps or detergents can trigger eczema in babies.
• Stress. Babies and young children can pick up on environmental stress. Illness can also be a form of stress to the body. Both may lead to skin flushing and eczema.
• Food allergens. Foods like peanuts, eggs, cow’s milk, and some fruits may trigger eczema. If a mother eats these foods and is breastfeeding, the baby is exposed too.

Outlook

Most children will outgrow eczema. In the meantime, there are some affordable home remedies to comfort your baby.

Home remedies

• Switch to fragrance-free and hypoallergenic soaps and detergents.
• Dress your little one in loose clothing to ease possible skin irritation.
• Give your baby a lukewarm bath (hot water dehydrates the skin).
• Use a nourishing bath treatment.
• Apply an irritant-free lotion. For more troublesome skin areas, use a thicker cream.

It’s time to visit the pediatrician if:

• a yellowish crust or pus-filled blisters appear on the skin (or other signs of infection)
• your baby has been around anyone with cold sores or an infection
• you’ve not had your baby tested for food allergies (around 30 percent of children with eczema also have food allergies)

Atopic dermatitis is the most common term for eczema in general. While babies and children are most commonly affected, adults who live in congested areas or in dry climates are more likely than other adults to experience symptoms.

People with atopic dermatitis have more sensitive skin than most and must take extra care of their skin. They’re also more likely to have asthma and hay fever.

It’s more common in those with a family history of eczema. Some children who develop atopic dermatitis may experience improvement as they get older.

Symptoms

• rashes on the face, behind the knees, hands, feet, or in skin folds (especially under the arm)
• dry, cracking, and red skin
• clear fluid on the rash
• thick, scaling skin

Factors that may trigger flare-ups

• dry skin
• genes
• environmental triggers
• abnormal immune system
• stress

Treatment

• corticosteroid creams
• antibacterial creams for open, bleeding wounds
• good skin care, including liberal use of hypoallergenic creams or Vaseline
• oral antihistamines can help relieve the itch
• topical calcineurin inhibitors
• dupixent (FDA approved for certain ages)
• light treatments (NBUVB)

Allergic contact dermatitis is usually caused by direct exposure to an allergen. The itchy skin rash typically appears 48–72 hours following exposure to an allergen.

Symptoms

Allergic contact dermatitis is characterized by a burning itch. The affected skin may appear red, swollen, blistered, dry, and/or bumpy.

Causes

Skin contact with:

• nickel (often from jewelry)
• strong perfumes, soaps, and detergents
• plants, such as poison ivy

Treatment

• Removing the allergen or irritant. And getting patch tested for diagnosis and future prevention.
• Topical creams. Such assteroid creams or ointments. These are generally applied one or two times per day for two to four weeks.

Irritant contact dermatitis occurs when skin is injured by environmental triggers, such as extreme cold or friction. The hands are most commonly affected, since they’re frequently in contact with harsh cleaners and are often exposed to winter elements.

Symptoms

Irritant contact dermatitis usually appears as a well-defined red patch with a glazed surface. The skin will itch and appear swollen, blistered, or scaly.

Causes

Skin contact with:

• mild irritants like water and soap or detergent
• cold, dry air
• latex or rubber

Treatment

• for a chemical burn trigger, flush the area with the specific antidote for that chemical
• emollient creams (like Vaseline)
• latex or rubber
• antibiotics for a related infection

Similar to atopic dermatitis, neurodermatitis (also called lichen simplex) is characterized by intense itching that worsens the more it’s scratched.

The itching might be so intense that it wakes you from sleep. The condition is rare in children. Women between 30 and 50 are most commonly affected.

Symptoms

• thick, itchy patches on the arms, legs, neck, or genitals
• waking up from sleep due to itching
• intense urge to scratch

Causes

• eczema
• contact dermatitis
• psoriasis
• anxiety disorders (especially obsessive-compulsive disorder)
• periods of extreme stress and trauma

Treatment

• corticosteroid creams
• cold compress to prevent swelling

Nummular eczema looks very different from other types of eczema.

It appears as coin-shaped spots and has a similar appearance to ringworm except for the middle of the lesions do not have clearing, like that seen in ringworm.

Nummular eczema is a chronic condition that may never fully resolve. Luckily, symptom management is possible and most people see improvement within a year.

Symptoms

• coin-shaped lesions that may itch and appear scaly

Causes

• genes
• dry skin
• metal allergy
• damage to skin (scratches, wounds, and chemical burns)
• some medications

Treatment

• Cover affected area with moist bandages.
• Use antihistamines to relieve itching and discomfort.
• Use of corticosteroids.
• UV light treatment for diffuse involvement.
• Keep skin hydrated with an unscented moisturizer.

Varicose dermatitis is caused by leakage from weakened veins into the skin. It rarely occurs before the age of 40 and commonly develops in the lower legs and feet.

This is a long-term skin condition, most commonly affecting those with varicose veins. It’s also known as leg eczema and stasis dermatitis. If left untreated, you may develop ulcers.

Symptoms

• itchy, dry skin and varicose veins
• swelling in the feet and ankles
• thickened skin
• red, open sores (venous ulcers)

Causes

• sedentary lifestyle
• high blood pressure
• an underlying heart condition
• previous blood clots
• kidney failure
• obesity
• circulatory issues

Treatment

• exercise to improve blood flow
• maintain a healthy weight
• reduce high blood pressure
• wear loose-fitted clothing to reduce irritation
• elevate the legs above the heart for 15 minutes every 2 hours
• apply fragrance-free moisturizer
• wear compression stockings
• topical corticosteroids

If you’re experiencing stasis dermatitis it’s important to visit your doctor, as the condition is often linked to other potential health concerns.

This chronic form of eczema appears on oily areas of the body, such as the back, nose, and scalp.

While the exact cause is unknown, it’s linked to hormones. People of any age can develop this condition, but it most commonly affects infants under 3 months — hence its alias, “cradle cap” — and adults aged 30 to 60.

Men are more likely to have this condition.

Symptoms

• stubborn dandruff
• swollen, greasy skin
• pink, itchy patches

Triggers

• health changes
• autoimmune conditions
• HIV/AIDS
• harsh soaps and detergents
• cold, dry weather
• stress
• medications including lithium, interferon, and psoralen

Treatment

• Use body wash with 2% zinc pyrithione.
• Apply topical corticosteroids.
• Use an anti-dandruff shampoo.
• Moisturize after bathing and before bed.
• Apply an antifungal treatment (usually prescribed by a doctor).

This common form of eczema causes dry, itchy blisters on the hands and feet, and is commonly associated with seasonal allergies.

Women are twice as likely to have this condition as are men. There are several names for this type of eczema, including:

• palmoplantar eczema
• cheiropompholyx
• foot-and-hand eczema
• pompholyx
• vesicular eczema
• dyshidrosis

Symptoms:

• deep blisters on edges/sides of fingers and toes, or on palms and soles of feet
• itchy, red, scaling, or flaking skin
• painful skin patches

Triggers:

• pollen
• moist skin
• stress
• nickel in foods (commonly found in soy, oatmeal, nuts, legumes, chocolate, and canned foods)
• corrosive chemicals

Treatment:

• wear compression socks and/or gloves for 15 minutes, up to 4 times per day
• use a skin barrier repair cream
• avoid harsh soaps with chemicals like triclosan
• remove jewelry around affected areas
• avoid scratching
• avoid hot water and excess sweating

This type of eczema primarily affects those over the age of 60, when skin becomes drier. It’s characterized by abnormally pink or red, cracked skin. The lower legs are commonly affected.

Symptoms:

• dry, itchy skin
• red or pink irritated skin
• noticeable cracks on the skin (commonly referred to as “crazy paving”)

Causes:

• over-cleansing with strong soaps or irritants
• taking too many hot baths or showers
• living in a climate with low-humidity
• aging

Treatment:

• topical corticosteroids
• keep skin moisturized
• good skin care

If general prevention and at-home care doesn’t defeat your eczema symptoms, see your doctor.

To help your doctor determine the type of eczema, be prepared to explain:

• which detergents, perfumes, soaps, skin products, and makeup you use
• whether you’re frequently exposed to harsh chemicals
• whether you bathe/shower in hot water, and how long you’re immersed in water each day
• any stress triggers
• which parts of your body are affected by eczema
• any history of allergic reaction to products, such as jewelry
• any family history of eczema/atopic dermatitis
• any personal history of atopic dermatitis, asthma, or hay fever

If the cause is allergic contact dermatitis (including unknown food allergies), your doctor may have patch testing performed to detect the allergic substance.

This is a simple allergy test to determine if any specific substance is causing inflammation in your skin.

Eczema symptoms may come and go. Successful treatment is largely dependent on identifying triggers and diagnosing the type of eczema.

The most common treatments include:

• antihistamines and hydrocortisone creams to control the itch
• unscented moisturizers for sensitive skin
• gently patting affected areas dry with a clean cloth after bathing
• avoiding scratching when possible
• frequently applying moisturizer to hands, especially after washing them

Here are some tips for preventing eczema flare-ups and for managing related symptoms:

• Avoid soaking hands in hot, soapy water, which can cause the skin to crack.
• Stop using antibacterial sanitizers and soaps that dry out the skin.
• Take cooler showers.
• Apply moisturizers after bathing.
• Use allergen and fragrance-free detergents and soaps.
• Alternate between your normal body wash and shampoos and products that contain zinc pyrithione (which prevents flaking skin).

The good news is, you can’t “catch” eczema, and most cases will clear up in time.

While the exact cause is unknown, researchers believe it’s triggered by a combination of genetic and environmental factors, meaning the best way to treat eczema is to avoid triggers.

When the body considers something to be an allergen, the immune system responds by causing inflammation.