Eczema

Eczema is a chronic inflammatory skin condition that disrupts the skin’s natural barrier function. The term “eczema” is often used interchangeably with atopic dermatitis, though it can also describe other forms of dermatitis.

The skin in people with eczema is unable to retain moisture properly, making it more vulnerable to irritants, allergens, and environmental triggers. The result is red, dry, and itchy skin that can become cracked, thickened, or infected if left untreated.

Eczema is believed to result from a combination of genetic and environmental factors. Patients with a family history of eczema, asthma, or allergies are at greater risk of developing the condition.

In addition to genetic predisposition, several environmental factors can trigger or worsen eczema symptoms, including:

• Exposure to allergens such as dust mites, pet dander, or pollen
• Harsh soaps, detergents, and fragrances
• Changes in temperature or humidity
• Stress or emotional anxiety
• Sweating or prolonged heat exposure
• Certain fabrics such as wool or synthetic materials
• Food allergens (particularly in children), including dairy, eggs, soy, or nuts

Understanding these triggers is key to developing an effective eczema management plan tailored to the individual’s lifestyle and skin type.

Symptoms of eczema vary depending on the individual and the severity of the condition, but they generally include:

• Persistent itching, which can be intense and often worse at night
• Dry, scaly, or rough patches of skin
• Redness and inflammation
• Thickened or leathery skin from chronic scratching
• Crusting, oozing, or clear fluid discharge in more acute flares
• Darker or lighter patches of skin after healing (post-inflammatory pigment changes), especially in individuals with deeper skin tones

Eczema commonly appears on the face, hands, elbows, behind the knees, and the neck, although it can affect any part of the body. In infants, it is often seen on the cheeks and scalp. In adults, it may be more localized or show up as more chronic, dry, and itchy patches.

Diagnosis of eczema is based on a patient’s history and physical examination. A board-certified dermatologist like Dr. Neely Khan can typically identify eczema based on the appearance and location of the rash, as well as a discussion of the patient’s symptoms and any contributing factors.

Accurate diagnosis is essential, as eczema can resemble other skin conditions such as psoriasis, seborrheic dermatitis, fungal infections, or scabies. Sometimes additional tests may be recommended to rule out other conditions or confirm a diagnosis:

• Patch testing may be used to evaluate for allergic contact dermatitis if a specific allergen is suspected.
• Skin swabs may be taken to check for infection, particularly if the eczema appears to be oozing or crusted.
• Blood tests are rarely necessary but may be used to check for elevated IgE levels in cases of suspected atopic dermatitis linked with other allergic conditions.