Symptoms of eczema (atopic dermatitis)

Symptoms of eczema (atopic dermatitis) include dry, red, itchy and scaly skin. Although eczema can occur anywhere on the body, it is most common on the back of the knee and in the crease of the elbow. Other symptoms may also occur, including skin discoloration and crusting.Eczema symptoms may depend in part on the severity and stage of the disease.

As a chronic relapsing disease, eczema requires ongoing management to treat and prevent acute flare-ups. (The only exceptions are young children, many of whom will grow up.)

How is eczema and psoriasis different

common symptoms

Eczema usually starts with itching. A rash occurs when the skin is scratched. The most common symptoms of eczema are:

  • red, itchy rash
  • dry, rough, or scaly skin
  • small fluid-filled blisters
  • cracked or broken areas of skin
  • oozing, crying, or crusting

Eczema symptoms can ebb and flow with periods of worsening symptoms (called flares) and periods of improvement (called remissions).

Although doctors primarily use symptoms to diagnose diseases, they are not always sufficient to distinguish eczema from other skin conditions, such as psoriasis. As the condition progresses, the appearance of eczema can also change.

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Eczema Stages

Initially, eczema develops into small fluid-filled bumps (blisters) that ooze or peel when scratched. This is called the acute phase, during which the skin is often very itchy, red and inflamed.

The rash will progress to a subacute stage as the skin begins to heal. Here, instead of blistering like blisters, the rash looks dry, flaky, and scaly. It also tends to be less itchy.

Over time, with continued scratching, the skin becomes mossy, which means it gets thick and tough with a hyperpigmented (darkened) look. Lichenification is most likely to occur in a chronic phase in which episodes recur frequently and tend to get progressively worse.

Stages of atopic dermatitis

rash location

Eczema can appear anywhere on the body, but certain areas are more common, depending on a person’s age.

In infants and very young children, eczema is most common on the face, chest, and back of the scalp (because these are the areas young children scratch). Eczema rarely occurs in the diaper area.

In older children and adults, eczema usually involves the bend of the elbow or the back of the knee. Eczema is also common on the face, eyelids, hands, and feet, especially in adults.

How Age Affects Eczema

rare symptoms

The appearance of eczema can vary depending on the type involved. The most common forms, atopic dermatitis and seborrheic dermatitis (dandruff), can be exacerbated but tend to be easier to control than the other types.

More serious and difficult to treat is numbing eczema (also called discoid eczema), a condition characterized by itchy, coin-shaped spots that ooze and become infected. Open lesions sometimes result in permanent scarring.

Numb eczema is relatively rare. Although atopic dermatitis affects 15% to 20% of children and 1% to 3% of adults globally, Numb eczema affects only about 2 in 1,000 people.

Venous eczema (also called gravity dermatitis or stasis dermatitis) occurs when blood pressure in the veins (usually the lower extremities) causes fluid to leak from the skin. Infections are common, including a potentially serious type called cellulitis. In some cases, venous eczema can cause skin ulcers that don’t heal.

Hyperhidrotic eczema is characterized by the formation of tiny, itchy blisters on the edges of the fingers, toes, palms, and soles. When these blisters coalesce, they can cause severe flaking, oozing, and cracking.


People with atopic dermatitis are prone to skin infections. This is partly due to the reduced barrier function of the skin. Cracks and scales expose the epidermis and dermis to various pathogenic organisms (pathogens). Scratching only makes things worse by creating breaches through which bacteria, viruses, and fungi can get through.

Atopic dermatitis is thought to be associated with reduced immune function, which means the body is less able to fight off pathogens.

Evidence is mounting that genetic defects in the innate immune system — the body’s first line of defense against infection — contribute to the development and severity of eczema.

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No complete frontline defender against infections, pathogens Easier to colonize.

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Bacterial infections

bacterial infection by Staphylococcus aureus It can cause a variety of problems in people with atopic dermatitis. Not only can it cause impetigo (characterized by honey-crusted sores), but it also produces toxins that can trigger allergy symptoms. This can further complicate eczema outbreaks, prolonging them, while increasing the itching, redness, and blistering of the skin.

fungal infection

Fungal infections, such as tinea corporis (ringworm) and tinea capitis (scalp infection), are also common in people with atopic dermatitis. This may be due in part to the use of topical steroids, which suppress the immune system and allow common fungi to colonize and proliferate.

This may also be due to a lack of infection-fighting cytokines in patients with atopic dermatitis. The loss of these proteins, which elicit an immune response, renders the body incapable of defending against relatively harmless pathogens, such as fungi.

Viral infection

Viral infections are also common in patients with atopic dermatitis. These tend to affect specific areas of the body, such as the lips with herpes simplex virus (HSV) infection or the genitals with molluscum contagiosum. In rare cases, it can involve the entire body, a condition known as herpes eczema.

Herpes eczema is especially worrying because if it spreads to the brain, lungs, or liver, it can cause permanent scarring, vision damage, organ failure, and even death.

when to see a doctor

There are many skin conditions that can cause an itchy red rash, some of which are indistinguishable even among medical professionals. If you or your child develops a rash and suspects eczema is the cause, the only way to be sure is to see a doctor called a dermatologist.

If you have been diagnosed with eczema, you should still see your doctor if your symptoms change in any way. E.g:

  • Despite the treatment of eczema is getting worse
  • The rash is spreading or affecting new areas of skin
  • more frequent or more severe flares
  • itching that interferes with daily activities or sleep
  • Severely cracked or oozing skin

You should also seek care if there are signs of a skin infection, including:

  • increased redness and swelling
  • persistent or increased pain and tenderness
  • hot skin temperature
  • Draining pus or fluid from the skin
  • fever
  • feeling of discomfort

When to call 911

If you experience any of the following, please call 911 or seek emergency care. Such symptoms can be a sign of cellulitis, a condition that requires 5 to 14 days of antibiotic treatment and, in some cases, hospitalization.

  • rapidly expanding areas of hot, red, and swollen skin
  • high fever or chills
  • nausea and vomiting
  • increased pain
  • swollen tissue numbness
  • Blisters on the affected skin

Frequently Asked Questions

  • How is eczema treated?

    Eczema is usually treated with home remedies and a combination of over-the-counter and prescription medications. It is important to keep the area hydrated with lotion. Hydrocortisone cream and antihistamines can relieve itching. To heal the rash, prescription medications, such as topical or oral steroids or antibiotics, are often required. Special procedures that may help include light therapy, immunotherapy, and wet wraps.

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    How to Treat Eczema

  • How is eczema different from psoriasis?

    Psoriasis usually causes only mild itching and thick, clear lines on the knees and elbows, but can also appear elsewhere in children, while eczema usually occurs in the crevices of the knees and elbows and causes severe itching .

  • How common is eczema?

    Eczema is common, affecting approximately 15 million Americans.

  • Can eczema cause dandruff?

    If possible. Eczema on the scalp, called seborrheic dermatitis, can cause flaking of the skin associated with dandruff.