When you think of eczema, itchy, red, dry, scaly, or thickened skin may come to mind.
While that’s true for those with medium to darker skin tones, it may not be as obvious and can appear brown, purple, and ashen. Those with brown and Black skin also more commonly develop small bumps on the torso, arms, and legs.
Eczema is sometimes called atopic dermatitis, which is the most common form. “Atopic” refers to an allergy. People with eczema often have allergies or asthma along with itchy, red, or hyperpigmented skin.
Eczema comes in a few other forms, too. Each eczema type has its own set of symptoms and triggers.
There are also some common symptoms for all types of eczema:
dry, scaly skin
redness
hyperpigmentation
itching, which may be intense
In this blog, we will cover:
What are the causes of eczema?
Many factors can contribute to eczema, including an interaction between your environment and your genes. When an irritant or an allergen from outside or inside the body “switches on” the immune system, it produces inflammation, or a flare-up, on the surface of the skin. This inflammation causes the symptoms common to most types of eczema. Creases of the skin, especially the flexural areas behind the knees, elbows, lower legs and other areas of skin that rub against each other can lead to irritation.
There is also a potential genetic component to eczema that includes a protein called “filaggrin” that helps maintain moisture in your skin; a filaggrin deficiency can lead to drier, itchier skin. If you have family members with atopic dermatitis and certain other types of eczema, you may be at an increased risk.
Along with having a family history of eczema, many common household items are also potential environmental irritants and can cause allergic reactions leading to an eczema flare. Additional common triggers of eczema may include:
extended exposure to dry air, extreme heat or cold
some types of soap, shampoos that cause dander, bubble bath products, body wash, and facial cleansers
laundry detergents and fabric softeners with chemical additives
certain fabrics like wool or polyester in clothing and sheets
surface cleaners and disinfectants
natural liquids like the juice from fruit, vegetables and meats
fragrances in candles
metals, especially nickel, in jewelry or utensils
formaldehyde, which is found in household disinfectants, some vaccines, glues and adhesives
isothiazolinone, an antibacterial found in personal care products like baby wipes
cocamidopropyl betaine, which is used to thicken shampoos and lotions
paraphenylene-diamine, which is used in leather dyes and temporary tattoos
dust mites and living in dirty spaces
7 types of eczema:
1. Atopic dermatitis
Atopic dermatitis is the most common form of eczema. It usually starts in childhood, and often gets milder or goes away by adulthood.
Atopic dermatitis is part of what healthcare professionals call the atopic triad. “Triad” means three. The other two diseases in the triad are asthma and hay fever. Many people with atopic dermatitis have all three conditions.
Symptoms
In atopic dermatitis:
The rash often forms in the creases of your elbows or knees.
The skin in areas where the rash appears may turn lighter or darker or get thicker.
Small bumps may appear and leak fluid if you scratch them.
Babies will often get the rash on their scalp and cheeks.
Your skin can get infected if you scratch it.
Causes
Atopic dermatitis happens when your skin’s natural barrier against the elements is weakened. This means your skin is less able to protect you from irritants and allergens.
Atopic dermatitis is likely caused by a combination of factors, such as:
genes
dry skin
an immune system problem
triggers in the environment
2. Contact dermatitis
If you have red, irritated skin, thick scaly region that’s caused by a reaction to substances you touch, you may have contact dermatitis.
It comes in two types: Allergic contact dermatitis is an immune system reaction to an irritant, like latex or metal. Irritant contact dermatitis starts when a chemical or other substance irritates your skin.
Symptoms
In contact dermatitis:
You skin itches, turns red, is hyperpigmented or pink, magenta, burns, and stings.
Itchy bumps called hives may appear on your skin.
Fluid-filled blisters can form that may ooze and crust over.
Over time, the skin may thicken and feel scaly or leathery.
Causes
Contact dermatitis happens when you touch a substance that irritates your skin or causes an allergic reaction. The most common causes are:
detergents
bleach
jewelry
latex
nickel
paint
poison ivy and other poisonous plants
skin care products, including makeup
soaps and perfumes
solvents
tobacco smoke
3. Dyshidrotic eczema
Dyshidrotic eczema causes small blisters to form on your hands and feet. It’s more common in women than men.
Symptoms
In dyshidrotic eczema:
Fluid-filled blisters form on your fingers, toes, palms, and the soles of your feet.
These blisters may itch or hurt.
Your skin can scale, crack, and flake.
Causes
Dyshidrotic eczema can be caused by:
allergies
damp hands and feet
exposure to substances, such as nickel, cobalt, or chromium salt
stress
smoking tobacco products
4. Hand eczema
Eczema that only affects your hands is called hand eczema. You may get this type if you work a job, like hairdressing or cleaning, where you regularly use chemicals that irritate the skin.
Symptoms
In hand eczema:
Your hands get red, hyperpigmented, itchy, and dry.
They may form cracks or blisters.
Causes
Hand eczema is triggered by exposure to chemicals. People are more likely to get this form if they work in jobs that expose them to irritants, such as:
cleaning
hairdressing
healthcare
laundry or dry cleaning
5. Neurodermatitis
Neurodermatitis is similar to atopic dermatitis. It causes thick, scaly patches to appear on your skin.
Symptoms
In neurodermatitis:
Thick, scaly patches form on your arms, legs, back of your neck, scalp, bottoms of your feet, backs of your hands, or genitals.
The patches can be very itchy, especially when you’re relaxed or asleep.
The patches can bleed and get infected if you scratch them.
Causes
Neurodermatitis usually starts in people who have other types of eczema or psoriasis. Doctors don’t know exactly what causes it, but stress can be a trigger.
6. Nummular eczema
This type of eczema causes round, coin-shaped spots to form on your skin. The word “nummular” means coin in Latin.
Nummular eczema looks very different from other types of eczema, and it can itch a lot.
Symptoms
In nummular eczema:
Round, coin-shaped spots form on your skin.
The spots may itch or become scaly.
Causes
Nummular eczema can be triggered by a reaction to an insect bite or an allergic reaction to metals or chemicals. Dry skin can also cause it.
You’re more likely to get this form if you have another type of eczema, such as atopic dermatitis.
7. Stasis dermatitis
Stasis dermatitis happens when fluid leaks out of weakened veins into your skin.
This fluid causes:
swelling
redness in lighter skin tones
brown, purple, gray or ashen color in darker skin tones
itching
pain
Symptoms
In stasis dermatitis:
The lower part of your legs may swell, especially during the day when you’ve been walking.
Your legs may ache or feel heavy.
You’ll likely also have varicose veins, which are thick, ropey damaged veins in your legs.
The skin over those varicose veins will be dry and itchy.
You may develop open sores on your lower legs and on the tops of your feet.
Causes
Stasis dermatitis happens in people who have blood flow problems in their lower legs. If the valves that normally push blood up through your legs toward your heart malfunction, blood can pool in your legs.
Your legs can swell up and varicose veins can form.
Tips for reducing outbreaks
Here are a few ways to prevent eczema flare-ups and manage symptoms:
Apply cool compresses to your skin or take a colloidal oatmeal or baking soda bath to relieve the itch.
Moisturize your skin daily with a rich, oil-based cream or ointment to form a protective barrier against the elements. Apply the cream right after you get out of the shower or bath to seal in moisture.
During eczema flare-ups, you may also use organic moisturizer with herbs that help in soothing inflammation and itchiness
After you bathe, gently pat your skin with a soft towel. Never rub.
Avoid scratching. You could cause an infection.
Use fragrance-free detergents, cleansers, makeup, and other skin care products. Go for natural and organic skin care products made specially for dry and sensitive skin.
Wear gloves and protective clothing whenever you handle chemicals.
Wear loose-fitting clothes made from soft fibers, like cotton.
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