Eczema

Eczema, also known as atopic dermatitis, is a condition that makes the skin inflamed, dry, red, bumpy and itchy. It’s typically common in children but occurs at any age. Eczema is a chronic condition that is not contagious and flares up periodically throughout one’s life. There is no cure, but there are treatments to manage symptoms.

Signs and symptoms

Some common signs and symptoms of eczema include:

  • Dry skin
  • Itchy skin
  • Bumpy skin
  • Redness
  • Red rash-like patches
  • White patches
  • Scale-like patches of skin
  • Flaking and crusting of skin
  • Inflammation of skin

Some individuals have conditions alongside eczema (not causing it) including:

  • Allergies
  • Asthma
  • Anxiety
  • Stress
  • Depression
  • Sleep loss

Causes

Eczema is usually caused by a combination of genetics, immune system activation, stress and environmental triggers. 

Immune system: In individuals with eczema, the body’s immune system is overly stimulated by small allergens or irritants. This causes the skin to become red and inflamed.

Genetics: An individual’s genetics plays a huge role on whether or not they will have experienced eczema. If your family has a history of dermatitis, you are more likely to experience it as well. Some people are genetically predisposed to lacking a specific protein within the skin (filaggrin) that protects and keeps skin healthy by acting as a barrier. There is also a higher risk of developing eczema if your family has a history of asthma, hay fever, or other forms of allergies.

Environment: Cool, dry air can dry out the skin and cause itchiness to occur. Along with this, excessive sweating due to high heat and humidity can increase itchiness. Certain irritants within the environment may cause eczema to flare up. Some common examples of irritants in the environment are air pollutants, tobacco smoke, fragranced soaps or lotions, pollen, pet hair, and certain foods like peanuts, milk, soy, wheat, fish and eggs.

Stress: Increased stress levels cause a rise in cortisol which can make the skin excessively oily, provoking an eczema outbreak. Rising cortisol levels from stress and anxiety also causes the body’s immune system to be suppressed, causing an inflammatory response like eczema.

Risk factors

Eczema usually first occurs during childhood, but someone of any age can get it. High risk individuals are:

  • Female
  • African American
  • Have been diagnosed with asthma
  • Have been diagnosed with hay fever
  • Have family members with history of asthma or hay fever
  • Have family members with history of any kind of dermatitis

Treatment

Treating eczema is difficult when the cause is genetic. When eczema is caused by environmental factors or stress, it can be easier to avoid these triggers. The main goal for eczema treatment is to reduce discomfort and itching and prevent more flare-ups. Some treatments ideas:

  • Moisturize skin with creams and ointments several times a day
  • Use a humidifier to avoid dry air
  • Use soaps that are fragrance free or hypoallergenic (for sensitive skin)
  • Use products that include ceramide to replace skin barriers
  • Use cortisone (OTC steroid) cream or ointment to control redness and itching
  • Take OTC antihistamines for itching
  • Take prescription medications such as steroid creams, pills, or injections
  • Utilize phototherapy: UV light waves in sunlight and ultraviolet B lamps have been shown to decrease eczema
  • Avoid long, hot baths or showers. Use lukewarm water instead
  • Apply lotion or cream after bathing
  • Avoid laundry soaps with fragrance

When to seek care

Seek care by a dermatologist or other healthcare provider if symptoms of eczema arise and persist. Seek medical assistance if you notice any signs of skin infection including redness, raised skin that looks like boils, drainage, increased itchiness and/or pain.

Prevention

  • Establish a skincare routine and listen to your healthcare provider’s recommendations
  • Use mild soap and avoid scrubbing areas with irritation. Pat to dry
  • Apply cream or ointment two to three times a day
  • Take lukewarm baths and showers instead of using hot water
  • Drink plenty of water
  • Wear loose, cotton clothing
  • Avoid fragranced lotions and laundry detergents
  • Limit exposure to known allergens or irritants
  • Avoid scratching patches of eczema
  • Find ways to minimize stress levels
  • Avoid sudden temperature changes

Campus resources

The Nebraska Medicine University Health Center offers dermatology services to evaluate and treat dermatologic concerns. The dermatologist is available Mondays by appointment only. A doctor's referral is required. Call 402.472.5000.