Eczema has been called "the itch that rashes" because the itching usually occurs first. This group of skin rashes may first appear in babies and toddlers, becoming a drier, flaky rash in older children. Adults may see scaly, leathery patches or a stubborn hand eczema. Atopic dermatitis is a common, often inherited form, but there are other types, as well as many treatment options.
Eczema SymptomsItching is the defining symptom. Once you start scratching, the skin becomes inflamed -- and even itchier. The appearance can vary greatly and may include:
- Red, scaly areas
- Small, rough bumps
- Thick, leathery patches
- Bumps that leak fluid and crust over
Eczema in BabiesInfants who are just 6 to12 weeks old can develop atopic dermatitis as a patchy facial rash. It can progress, becoming red and scaly, and may appear on the forehead or scalp. Moisture from drooling worsens the rash. In some cases, the condition goes away by age 2. But about half of people who had atopic dermatitis as a child will have the condition as an adult.
Atopic Dermatitis or Cradle Cap?"Cradle cap" in babies is actually a condition known as seborrheic eczema or seborrheic dermatitis. It appears as yellow, oily, scaly patches on the scalp and will usually clear up without treatment at 8 to 12 months of age. In contrast, atopic dermatitis (AD) in infants usually appears as a red rash. It's more often found on the cheeks, but AD can also affect the scalp.
Eczema in ChildrenChildren may develop the rash on the inside of their elbows or behind the knees, around their mouths, on the sides of their necks, or on wrists, arms, and hands. Those with atopic dermatitis are more likely to have food allergies, including allergies to peanuts, milk, or other nuts. However, experts say you shouldn't restrict foods unless there is a confirmed food sensitivity. Reassure children that it isn't contagious.
Eczema in AdultsAdults typically notice itchy patches on the hands, elbows, and in the "bending" areas of the body, such as the inside of the elbows and back of the knees. But eczema can appear anywhere, including the neck, chest, even the eye lids. Those who had atopic dermatitis as a child may see drier, scaly rashes as adults. The skin may be discolored or thickened.
Diagnosing EczemaIf a rash persists, causes significant discomfort, or develops a crust or pus-filled blister, you may want to see your health care provider. A diagnosis of eczema is usually based on a detailed medical history, symptoms, measurable physical signs, and a family history of allergic conditions. Your doctor may also order allergy tests or a microscopic exam of a skin scraping (seen here) to rule out infections.
Who Gets Eczema?There's a link between atopic dermatitis and hay fever or asthma. If a parent has hay fever or asthma, their children are more likely to have the skin condition. And about half of children with atopic dermatitis will go on to develop hay fever or asthma.
Eczema and AllergiesThe substances that bring on an allergy attack -- dust mites, pollen, animal dander, mold -- can cause some people with atopic dermatitis to break out in a rash. Food allergies also can trigger a flare-up. These allergens cause the immune system to overreact, activating cells that produce inflammation in the skin.
Other Eczema TriggersIrritants can cause inflammation and itching, bringing on a bout of eczema. Touching harsh chemicals can cause a nasty rash in anyone, but people with eczema may be sensitive to mild irritants, such as wool, detergents, astringents, or fragrances. Emotional stress can trigger a flare-up, as can sweating and frequent wetting and drying of the skin -- even everyday hand-washing.
Eczema and Dry SkinThe outer layer of our skin normally acts as a barrier, protecting inner layers from irritants and infection. People with atopic dermatitis have very dry skin that isn't as protective. If you have eczema, use mild cleansers and apply a moisturizing cream or ointment after washing. A dry climate or the low humidity of winter can cause the condition to flare up. People with atopic dermatitis are also more likely to get skin infections.