Eczema Symptoms

When people talk about eczema, they usually mean atopic dermatitis, its most common form. But eczema is actually the name for a group of skin conditions. They all cause red, itchy, and often cracked skin, but there are also different symptoms for each type.

Atopic Dermatitis

This form of eczema starts with an intense itch. Once you give in to the urge to scratch, the telltale rashy (and even itchier) outbreak begins. When skin is very irritated, it can crack and bleed or ooze clear fluid.

The main symptoms are the same for almost everyone, but how often they happen, and how severe they are, vary from person to person. There are also some key differences, depending on your age.

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Symptoms in babies:

  • Eczema appears mostly on the scalp and cheeks
  • Dry, itchy skin
  • Scales
  • Lesions that may ooze
  • Fussiness and trouble sleeping because of itching

A skin infection may develop if your baby rubs the affected area.

Symptoms in children:

  • Eczema appears most often inside the elbows and behind the knees. It can also be on the neck, wrists, or ankles, or the area between the buttocks and the creases at the top of the thighs.
  • Rash that feels warm to the touch
  • Raised patches that look scaly and may crust over

Skin may become swollen, change color, and thicken over time.

Symptoms in adults:

  • Eczema is often on hands, on eyelids, and under the eyes
  • Severely dry skin that is easily irritated and cracked

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Skin may get thick and leathery over time.

Some adults get eczema only on their hands. Symptoms often follow this pattern:

  • Skin looks chapped, red or brown, and irritated.
  • Skin feels hot or burning and may itch.
  • Patches of scaly and inflamed skin develop.
  • Itchy, painful blisters may appear.
  • Skin may crack and bleed or ooze and crust over.

Contact Dermatitis

This form of eczema is irritation or an allergic reaction to something that comes into contact with your skin, especially your hands or face. Symptoms may include:

  • An intense itch and then a rash
  • Skin that feels tender and may be painful
  • An outbreak of hives or of blisters that ooze and crust over

Skin can become thick, leathery, and cracked after repeated contact with your triggers.

Dyshidrotic Eczema

This eczema is named after the term that means “disordered sweat.” It was once thought to be a problem with sweat glands. Signs appear only on the palms of the hands, the sides of the fingers, and sometimes the soles of the feet. When you have an outbreak, symptoms often follow this pattern:

  • Severe itchiness and possibly pain or tingling, followed by tiny, itchy blisters
  • Groups of blisters that may join together into bigger blisters
  • Obvious sweat on blistered areas
  • Peeling skin after the blisters go away

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Over time, skin looks inflamed and scaly and gets cracks. Your nails may change color, thicken, and be ridged or pitted.

Nummular Eczema

Nummular means “coin-like.” This form of eczema gets its name from the shape of the patches it creates, most often on your legs, forearms, or hands. Symptoms include:

  • Tiny bumps that form after a skin injury, get crusty, and merge to make scaly coin shapes
  • Intense itching, burning, or stinging that gets worse when sitting still or sleeping
  • Dry skin between the patches
  • Darkening of your regular skin color as the patches go away

Seborrheic Dermatitis

This form of dermatitis often affects the scalp, especially in infants, and other areas rich in oil (or sebaceous) glands. It may go away in childhood but return in the teen years (especially in boys) and in adulthood. Unlike many other forms of eczema, it’s not always itchy.

Symptoms in babies include scaly and greasy patches on the scalp. It may affect the buttocks. It’s usually limited to infancy.

Symptoms in teens and adults:

  • Scaly, greasy, flaky patches on the scalp, on the eyebrows, and around the nostrils, possibly on the chest, back, underarms, and groin
  • Inflammation, redness, and swelling
  • Flares that may be triggered by things like dry, cold weather and stress

Stasis Dermatitis

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This form of eczema is linked to blood flow problems like varicose veins. It tends to happen in the lower legs and around the ankles. Symptoms include:

  • Dry, discolored skin over the problem veins
  • Itchiness that often spreads to the top of the foot
  • Swelling and discomfort in the leg or ankle that gets worse during the day and better when you sleep

Stasis dermatitis can lead to:

  • Skin that darkens and becomes tough and scaly from the calf to the foot
  • Very itchy and painful skin
  • Sores that easily bleed

Neurodermatitis

This is an unusual form of eczema that usually causes just one or two patches on a specific area, like the nape of the neck, the scalp, the eyelids, or the arms. Patches can even appear around the genitals or anus. Symptoms include:

  • An intense itch that worsens as you scratch or rub it
  • Itching that gets worse with stress or while sleeping
  • Pain from scratching

Once a raised patch develops, it may:

  • Look scaly, thick, and leathery
  • Change color to red or violet from scratching
  • Develop sores that bleed
  • Become even itchier

When to Call Your Doctor About Eczema

No matter what type of eczema you might have, schedule a visit if:

  • You get an itchy rash and have a family history of eczema or asthma.
  • The inflammation doesn't respond within a week to treatment with over-the-counter hydrocortisone creams. You may need stronger forms of treatment.
  • You get yellowish to light brown crust or pus-filled blisters over patches of eczema, especially if you’ve been scratching. You could have a bacterial infection that should be treated with an antibiotic. In fact, you’re also more likely to get viral and fungal skin infections.
  • During a flare-up of eczema, you have contact with anyone with a viral skin disease such as cold sores or genital herpes. Having eczema puts you at higher risk of catching the herpes simplex virus.
  • You get many painful, small, fluid-filled blisters in the areas of eczema. You may have eczema herpeticum, a rare but potentially serious complication caused by the herpes simplex virus.

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