Eczema 101: Everything You Need to Know, From Causes to Treatment
If your skin feels constantly dry, itchy, or irritated, you might be dealing with eczema. This common skin condition affects millions of people across the world, both children and adults.
Eczema, also known as atopic dermatitis, is an inflammatory condition that causes the skin to become red, itchy, and cracked. In some cases, it can even lead to bleeding or infection.
Although eczema can be uncomfortable and difficult to live with, understanding the condition can help you manage and treat it more effectively.
We spoke to leading board-certified dermatologists—Dr. Melanie Palm, Dr. Jeremy Brauer, and Dr. Lauren Penzi—to break down everything you need to know about eczema.
What Is Eczema?
Eczema is a chronic skin disorder that causes inflammation. It often shows up as dry, itchy patches that may become red, cracked, or scaly. It can appear anywhere on the body.
Eczema is actually a term that includes several types of dermatitis, though atopic dermatitis is the most common form. Other types include contact dermatitis, dyshidrotic eczema, and nummular eczema.
In short, eczema results from a combination of factors: a compromised skin barrier, a sensitive immune system, and environmental or lifestyle triggers.
What Causes Eczema?
Experts agree that there isn’t just one cause of eczema. It’s a multifactorial condition, meaning several things can contribute to its development and flare-ups.
1. Genetics
If you have a family history of eczema, asthma, or hay fever, you’re more likely to develop eczema. This hereditary link increases your susceptibility to allergic skin reactions.
2. Skin Barrier Dysfunction
Your skin acts as a protective barrier. When that barrier is damaged or weak, it loses moisture easily. This makes the skin vulnerable to irritants, allergens, and bacteria.
A compromised skin barrier is a key factor in eczema. It’s why people with eczema often experience excessive dryness, flaking, and inflammation.
3. Environmental Triggers
External factors like cold weather, pollution, or pollen can irritate your skin. People living in dry or cold climates may be more prone to flare-ups, especially in winter.
Even indoor triggers like dust mites, mold, or pet dander can spark symptoms. In cities with high pollution levels, eczema tends to be more common and severe.
4. Allergens and Irritants
Common household items like soaps, detergents, fragrances, and cleaning products can all irritate the skin. Even natural substances, such as essential oils, may cause a reaction.
Textiles like wool or rough fabrics can also aggravate eczema. Stick to soft, breathable materials like cotton whenever possible.
5. Food Sensitivities
Certain foods can trigger eczema in sensitive individuals. Common culprits include dairy, gluten, peanuts, eggs, and soy. An elimination diet may help identify triggers.
Not everyone with eczema is food-sensitive, but it’s more common in children than adults. Always consult a doctor before cutting out major food groups.
6. Hormonal Changes
Fluctuating hormone levels can worsen eczema. Many women report flare-ups during menstruation, pregnancy, breastfeeding, or menopause due to hormonal shifts.
7. Stress
Stress doesn’t cause eczema, but it can definitely make it worse. Emotional stress affects your immune system and can lead to a worsening of symptoms or a new flare.
Dr. Palm advises using mindfulness, breathing techniques, or exercise to manage stress and keep symptoms under control.
Who Gets Eczema?
Eczema affects people of all ages, races, and backgrounds. However, it’s especially common in babies and young children, often appearing in the first six months of life.
Many kids outgrow eczema, but some continue to have symptoms into adulthood. For others, it may develop later in life due to lifestyle, stress, or health changes.
People with allergies, asthma, or a family history of skin disorders are more likely to have eczema. However, even people without any known risk factors can develop it.
Common Symptoms of Eczema
Eczema symptoms can range from mild to severe. They often vary from person to person and may change over time.
Here are some of the most common signs:
Dry, scaly, or rough skin
Intense itching, especially at night
Red or inflamed patches
Oozing or crusting in severe cases
Thickened or leathery skin due to chronic scratching
Sensitivity to clothing or skincare products
In babies, eczema often appears on the cheeks, scalp, or legs. In older kids and adults, it may affect the hands, elbows, knees, or behind the ears.
How Is Eczema Diagnosed?
Doctors typically diagnose eczema based on your symptoms and medical history. No lab test is required, though they may perform an allergy test or skin biopsy if needed.
A dermatologist can help determine whether you have eczema or another condition like psoriasis, fungal infections, or allergic contact dermatitis.
How to Treat Eczema
While there is no permanent cure for eczema, many effective treatments are available. A good skincare routine, medications, and lifestyle adjustments can keep symptoms in check.
1. Moisturizing Is Essential
Keeping the skin hydrated is the first step in treating eczema. Use fragrance-free, hypoallergenic moisturizers multiple times a day, especially after bathing.
Ointments and thick creams are better than lotions. Look for ingredients like ceramides, glycerin, or colloidal oatmeal, which support the skin’s barrier.
2. Use Gentle Cleansers
Avoid soaps that are harsh, drying, or heavily scented. Use mild, non-soap cleansers designed for sensitive skin. Hot water should also be avoided—use lukewarm instead.
3. Topical Steroids
Corticosteroid creams or ointments help reduce inflammation and itching. These are often prescribed for short-term use during flares and come in various strengths.
Overuse can thin the skin, so always follow your doctor’s instructions carefully.
4. Prescription Treatments
For moderate to severe eczema, dermatologists may prescribe:
Topical calcineurin inhibitors (like tacrolimus)
Oral steroids for short-term use
Injectable biologics such as Dupixent or Tralokinumab
JAK inhibitors like abrocitinib for systemic inflammation
These medications target the immune response driving the eczema.
5. Light Therapy
Narrowband UVB phototherapy is a special kind of light treatment that can help reduce symptoms in stubborn cases. It must be administered in a clinical setting.
This therapy is safe and effective but may require multiple sessions weekly over several months.
Lifestyle Tips to Manage Eczema
Along with medical treatments, small changes in your daily routine can make a big difference in managing symptoms.
1. Identify and Avoid Triggers
Keep a symptom diary to track what causes flare-ups. Whether it’s a detergent, pet, pollen, or food, identifying triggers can help reduce future episodes.
Dr. Palm recommends avoiding all scented products—air fresheners, dryer sheets, and even some candles.
2. Minimize Stress
Stress can be a powerful eczema trigger. Try yoga, meditation, journaling, or even a daily walk to relieve stress and support your mental health.
3. Dress for Comfort
Avoid wearing scratchy fabrics like wool. Opt for soft, breathable clothes made from cotton or bamboo, and avoid tight-fitting garments.
4. Use a Humidifier
If your home has dry air—especially in winter—use a humidifier. This adds moisture back into the air and prevents your skin from drying out.
5. Bathe Smart
Don’t bathe too often, and avoid long, hot showers. Keep baths under 10 minutes and always moisturize immediately afterward to lock in hydration.
When to See a Dermatologist
If your eczema is painful, interferes with sleep, or doesn’t improve with over-the-counter treatments, it’s time to consult a dermatologist.
They can offer stronger treatment options, evaluate for other skin conditions, and help you build a long-term care plan that works for your skin.
According to Dr. Palm, “A board-certified dermatologist or allergist can help confirm the diagnosis with tests, such as patch testing or skin biopsies.”
Final Thoughts
Eczema is a complex, chronic skin condition that can impact both physical comfort and emotional well-being. The good news is that with the right care, it’s manageable.
Whether you’re newly diagnosed or have struggled with eczema for years, understanding your triggers and sticking to a consistent routine can help prevent flares.
While there’s no cure, modern treatments and lifestyle changes offer real relief. Talk to your doctor or dermatologist to find the best plan for your unique skin.