skin disorders

What Causes Eczema and What Type Do I Have?

Wondering if you have eczema? Check out this article to find out if your symptoms fit the bill and what the cause may be. You’ll be surprised by how many varieties of this skin condition exist!

In This Article:

Eczema (also known as atopic dermatitis) is a general term that refers to a group of skin disorders. Though the severity can vary from person to person, most who suffer from eczema experience a variety of skin rashes, ranging from small sections of skin that are slightly dry and irritated to chronically inflamed, oozing, crusted areas covering the entire body and accompanied by incessant itching. [1] Eczema is a tricky skin condition to diagnose because it can look and feel dramatically different from person to person.

If you think you have eczema, it’s important that you’re diagnosed by a physician so you can be certain what you’re dealing with.

Let’s delve into the causes and types of eczema—as well as their common triggers—so you can avoid the things that make it worse and know how to choose your best treatment options…


What Causes Eczema

One of the predominant theories is that someone with eczema has a short-circuited immune response, which means their skin reacts abnormally when a substance comes in contact with it. [2] The trigger can be anything from clothing, detergents, soaps, grass, food products, allergens (including dust mites) to a lack of humidity, or a combination of elements. Even more frustrating is that the reaction can be intermittent with no real rhyme or reason for why or when.

There also appears to be a hereditary component to eczema. [3]For example, children whose parents suffer from eczema are two to three times more likely to develop it themselves. [3,4]

Further, in both children and adults, stressful situations tend to trigger, prolong, or worsen eczema flare-ups. [5]

Regardless of the source, eczematous skin reacts to a substance or substances or to environmental conditions by spinning out of control and generating mild to severe inflammation, which leads to itching and subsequent scratching that damages skin’s critical barrier function.


Types of Eczema

There are several types—and varying degrees of eczema—that, as you can imagine, makes diagnosis and developing a treatment plan challenging.

Though it can develop anywhere on the body, the most common areas for eczema to occur are in the folds of the arms and legs, the back of the neck, back of the hands, tops of feet, and the wrists. The following are the most common types of eczema—keep in mind you can have more than one type on different parts of your body.

Atopic eczema (also referred to as atopic dermatitis): Perhaps the most pernicious and painful type of eczema, it’s characterized by its severity and the intolerable sensation of itching and irritation, leaving skin raw, fissured, and vulnerable to infection. This is the type of eczema that many infants experience between the ages of two and six months. In infants, symptoms appear on the face, scalp, feet, and hands; in older children and into adulthood, symptoms appear in the fold of the arm and behind the knees, though particularly bad outbreaks can appear anywhere on the body. [1,4]

Allergic contact dermatitis: This specific form of eczema often stems from a subset known as irritant contact dermatitis. It occurs when a specific substance comes in contact with the skin and causes the immune system to overreact. The result is inflamed and sensitized skin. Most typically, allergic contact dermatitis is caused by fragrance, nickel, detergents, wool, grass, citrus, household cleaning products, and vinegar. [5] Once you’ve identified the specific substance, avoiding it often solves the problem.

A subset of allergic contact dermatitis is eyelid dermatitis. Typically mild to moderate redness is present, as well as scaling, flaking, and swollen skin. This is common among women—especially those who have already developed eczema at some point in their life—and is often triggered due to their use of hairstyling products, makeup, and wet or dry nail polish (when manicured nails come in contact with the eye area). The best way to solve the problem is to stop using the offending product(s) and experiment to find options that don’t trigger a reaction. [7]

Infantile seborrheic eczema: Better known as cradle cap, this form of eczema generally affects babies and children. The crusty, thick, sometimes reddened lesions may look problematic, but this disorder is rarely itchy or even felt by the child. If you want to treat this, and success is limited, consider a 1% hydrocortisone or a 2% topical ketoconazole cream, which are available from your infant’s pediatrician. [8,9]

Adult seborrhoeic eczema: This shows up for most people between the ages of 20 and 40, and is estimated to affect 5% of adults. It’s usually seen on the scalp as mild dandruff, but can spread to the face, ears, and chest, where the skin becomes flaky, red and inflamed. It’s believed to be caused by yeast, but its precise cause remains unclear; stress may be a factor. If the area becomes infected, treatment with an antifungal cream, topical steroid creams, or immunomodulators may be necessary. Topical gamma linolenic acid, a fatty acid found naturally in borage seed and evening primrose oils, may also be helpful and is absolutely worth trying. [10]

Nummular eczema: Typically localized on the legs, nummular eczema is characterized by coin-shaped patches of pink to red skin that may take on an orange cast if crusting or scaling is present. Left untreated, the dry, scaly spots typically darken and thicken. This type of eczema is most common in adolescent girls and in women between the ages of 30 and 60, and the condition tends to occur in winter. [11]

References Cited:

  1. Peate I. Eczema: causes; symptoms and treatment in the community. Br J Community Nurs. 2011;16(7):324;326-31.
  2. Mao W, Mao J, Zhang J, Wang L, Cao D, Qu Y. Atopic eczema: a disease modulated by gene and environment. Front Biosci (Landmark Ed). 2014;19:707-17. 3.
  3. Brown S, McLean W. Eczema genetics: current state of knowledge and future goals. J Invest Dermatol. 2009;129(3):543-52.
  4. Biagini JMB, Hershey GKK. Eczema in early life: Genetics, the skin barrier, and lessons learned from birth cohort studies. J Pediatr. 2010;157(5):704-714.
  5. Suarez AL, Feramisco JD, Koo J, Steinhoff M. Psychoneuroimmunology of Psychological Stress and Atopic Dermatitis: Pathophysiologic and Therapeutic Updates. Acta Derm Venereol. 2012 Jan; 92(1): 7–15.
  6. Nosbaum A, Vocanson M, Rozieres A, Hennino A, Nicolas J. Allergic and irritant contact dermatitis. Eur J Dermatol. 19(4):325-32. 2009;19(4):325-32.
  7. Amin KA, Belsito DV. The aetiology of eyelid dermatitis: a 10-year retrospective analysis. Contact Dermatitis. 2006 Nov;55(5):280-5.
  8. Williams J, Eichenfield L, Burke B, Barnes-Eley M, Friedlander S. Prevalence of scalp scaling in prepubertal children. Pediatrics. 2005;115(1):e1-6.
  9. Wannanukul S, Chiabunkana J. Comparative study of 2% ketoconazole cream and 1% hydrocortisone cream in the treatment of infantile seborrheic dermatitis. J Med Assoc Thai. 2004;87(S2):S68-71.
  10. Bukvic M, Kralj M, Basta-Juzbasic A, LakosJukic I. Seborrheic dermatitis: an update. Acta Dermatovenerol Croat. 2012;20(2):98-104.
  11. Bonamonte D, Foti C, Vestita M, Ranieri L. Nummular eczema and contact allergy: a retrospective study. Dermatitis. 2012;23(4):153-7.
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