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Eczema

Information about the skin condition eczema, as well as guidance about what support is available from Changing Faces and other organisations.

What is eczema?

Eczema, also known as dermatitis, causes the skin to become dry, cracked and itchy. Eczema is usually a long-term condition although it often comes and goes.

There are lots of different types of eczema. The most common type is called “atopic eczema”, which affects one in five children and one in 10 adults. Atopic eczema tends to develop in children but can also appear for the first time in adults. Seborrheic eczema is also common, affecting 4% of the population.

There is no cure for eczema but there are a range of treatments to help manage the condition.

For some people, the effects of eczema on their appearance can affect their mental health and self-confidence. On this page, we look at the different kinds of eczema, some of its causes, treatments available – and the support which is available to help you manage the impact of living with a visible difference.

I have struggled with eczema all my life. When I was younger, my parents wrapped me in bandages to stop me itching. During the early years of school, eczema on my hands would make it difficult to write as I simply couldn’t stop itching and teachers had to encourage me not to itch!

Sabira, who has eczema

Types of eczema

Although each type of eczema can cause dry, cracked and itchy skin, they also differ in various ways – including the body parts affected and the age at which they tend to occur. In this section we look at some of the most common types of eczema including symptoms and treatment options.

The causes of eczema are not well understood so below we generally talk about suspected triggers for different types of eczema. The question of triggers is a complex area, and some people will never identify all or any of their triggers. In some cases (including seborrheic eczema and varicose eczema), possible underlying causes have been identified and we discuss these below.

Please note that we have listed typical forms of treatment which medical professionals may recommend. Please speak to your doctor before beginning any treatment.

Atopic eczema

Atopic eczema is the most common type of eczema. It tends to develop in childhood – often in the first year of life – but can also occur for the first time in adulthood. It affects up to a fifth of children and one tenth of adults.

Atopic eczema causes dry, cracked and sore skin. It can occur in small patches or large areas of the body. It can occur anywhere on the body and affects everyone differently.

It may appear differently on different skin tones:

  • Darker skin tends to appear darker brown, purple or grey. It may be less visible on darker skin than lighter skin. However, eczema can change the pigmentation of the skin so may cause lighter patches too.
  • Lighter skin tends to become red.

What can trigger atopic eczema?

“Atopic” describes conditions which occur in people who are prone to allergies. Atopic eczema often develops alongside conditions such as asthma and hay fever. It often seems to run in families.

Flare ups can be triggered by:

  • Things in the environment, such as heat, dust, animal dander (skin flakes) or hair, soaps and detergents (for example, washing up liquid or washing powder), and food allergens.
  • Bacterial and viral infections, for example, common cold, staphylococcus, cold sore virus (herpes simplex).
  • Dryness of the skin.
  • Teething in babies.
  • Stress.
  • Weather.

Atopic eczema treatments

The main treatments for atopic eczema are:

  • Emollients (moisturisers) to stop the skin becoming dry.
  • Topical corticosteroids – creams and ointments which reduce swelling and redness.

Other treatments may be prescribed if the main treatments are not effective. These include topical pimecrolimus or tacrolimus.

Contact dermatitis

Contact dermatitis causes itchy, blistered, dry and cracked skin, usually on the hands and face.

It may appear differently on different skin tones:

  • Darker skin tends to become dark brown, purple or grey.
  • Lighter skin tends to become red.

What can trigger contact dermatitis?

As the name suggests, contact dermatitis is triggered when particular substances (irritants or allergens) come into contact with the skin. Triggers include:

  • Soaps and detergents
  • Solvents, for example, white spirit or nail polish remover
  • Regular contact with water

Contact dermatitis treatment

Contact dermatitis is usually treated with emollients to reduce dry skin and prevented by avoiding the substances which cause it to occur.

A young girl who has eczema wears a black coat and smiles at the camera. She is outside.

Sabira’s story: “The feeling of being understood overwhelmed me”

Opening up helped Sabira feel more confident about her eczema and showed her the importance of discussing visible differences.

Read Sabira's story

Discoid eczema

Discoid eczema causes one or more circular or oval patches to form on the skin. Patches tend to begin as a group of small spots which join together to form larger round patches. Affected areas can be very itchy and may become swollen, blistered and may ooze fluid. Over time, patches may become dry, crusty, cracked and flaky.

Discoid eczema may appear differently on different skin colours:

  • Darker skin can become dark brown or paler than the surrounding skin.
  • Lighter skin can become pink or red.

What can trigger discoid eczema?

There are a number of possible triggers:

  • Dryness may mean that the skin does not provide an effective barrier against substances it comes into contact with.
  • Skin injuries can trigger discoid eczema.

Discoid eczema treatment

The main treatments for discoid eczema are the same as for atopic eczema:

  • Emollients (moisturisers) to stop the skin getting too dry.
  • Topical corticosteroids – creams and ointments to reduce swelling and redness.

Other treatments, such as topical pimecrolimus or tacrolimus, may be prescribed if emollients and topical corticosteroids aren’t effective.

Dyshidrotic eczema (pompholyx)

Dyshidrotic eczema, also known as pompholyx, causes small blisters to develop across the palms of the hands and sometimes the soles of the feet. These come and go, typically lasting between two and three weeks at a time. An early symptom may be a burning or prickling sensation.

What can trigger dyshidrotic eczema?

The causes of dyshidrotic eczema are not well understood but it may be triggered by substances, getting your hands too wet, being too hot or getting sweaty.

Dyshidrotic eczema treatment

Treatments for dyshidrotic eczema is similar to other forms of eczema. Prescriptions typically include emollients and steroid creams and ointments.

Seborrheic eczema

Seborrheic eczema causes red, scaly patches to develop on the nose, eyebrows, eyelid margins (edges), ears and scalp. On darker skin, it may cause dark brown patches. It is one cause of dandruff. It tends to start after puberty.

It is very common, affecting 4% of the population. Dandruff – which may be mild seborrheic eczema of the scalp – affects half of adults.

What causes seborrheic eczema?

“Seborrheic” means that the condition affects greasy (“sebaceous”) areas of the skin. The underlying cause is believed to be a harmless yeast, or an immune response to the yeast, called Malassezia which lives on the skin.

Seborrheic eczema treatment

Treatment is dependent on whereabouts on the body the eczema occurs, including:

  • If eczema occurs on the scalp, anti-dandruff or antifungal shampoos may be used.
  • For eczema on the body, anti-yeast creams can be used.
  • If the eyelids are affected, careful cleaning between the eyelashes may help.
  • Medicated eardrops can be used if the ear canal is affected.

Varicose eczema

Varicose eczema affects the lower legs, causing skin problems, swelling and sometimes blood flow issues. Skin tends to become dry and flaky, scaly or crusty. It is also known as venous, gravitational or stasis eczema.

It can appear differently on different skin colours:

  • Darker skin may become dark brown, purple, grey and the eczema may be less visible.
  • Lighter skin tends to become red or brown.

Varicose eczema tends to be long term and possible complications include leg ulcers.

What causes varicose eczema?

Varicose eczema tends to be caused by increased pressure in the legs, which causes blood to leak backwards instead of pushing against gravity.

Varicose eczema treatment

Treatments focus on improving circulation to reduce the causes of varicose eczema, for example, by raising the legs or, if possible, doing more physical activity. Compression stockings can also be used.

Dryness and skin discomfort is treated in much the same way as other forms of eczema, with emollients and topical corticosteroids.

Is eczema genetic?

Anyone can develop eczema, even if no one in your family has it. However, you are more likely to develop eczema if family-members have it.

A 2015 study suggested that the chance of inheriting atopic eczema was 75%.

Environmental factors – things in the world around us that may influence our health – have a key role to play in whether you develop eczema. Environmental factors include diet, pollutants, irritants and allergens, exercise, infections and climate. If you have a genetic disposition towards eczema, you may only develop eczema if it is triggered by one or more environmental factors. Alternatively, you may develop it regardless of environmental factors – or you may not develop it at all.

How is eczema diagnosed?

Eczema is usually diagnosed by a physical examination. Your GP will look at the affected skin and ask questions about your lifestyle and medical history.

Eczema and my appearance

Eczema can change your appearance. Some people find that this impacts their self-confidence and mental health. The way you view your own body (body image) can be affected after you develop eczema.

If you have eczema, you may become self-conscious about your appearance and be aware of other people looking at you. You may find it particularly difficult if others ask questions or make comments about the way you look.

If I had not started to be open with my friends about how it affected me, I would not be able to have such easy conversations with them now about my skin, as well as their own. I would not have had any of the conversations I have had this year if this breakthrough hadn’t happened.

Sabira, who has eczema

What eczema support can we offer?

At Changing Faces, we can help you if you’re struggling with the psychological impacts of living with eczema.

We provide counselling and wellbeing support to help you manage the social, emotional and psychological effects of living with a visible difference. Our trained practitioners can offer a listening ear and provide support and guidance to help you cope with the challenges you may be facing. Take a look at our page.

We also have a wide selection of self-help guides. These cover practical guidance on a range of topics – from self-esteem and mental health to other people’s reactions, work, and dating and relationships. We also have a dedicated section for young people which covers subjects such as school, making friends, social media and body image. We have advice specifically for parents and carers as well.

There are a number of other ways we support people with eczema here at Changing Faces:

  • Online Community: An online forum administered and moderated by Changing Faces staff, where you can talk with others affected by visible differences.
  • Peer Group Chat Service: An online support group of up to eight participants and facilitated by Changing Faces staff, taking place on Zoom or via an internet chatroom.
  • Workshops for children and young people and their parents: An opportunity to meet others and learn tools, tips and techniques for managing challenges with your visible difference.
  • Real stories: Read stories by other people living with skin conditions such as eczema.

Please contact our Support and Information Line to find out more about using our services. Our friendly team can connect you to our services and also offer support calls in which you can talk about the impact of eczema on your life.

Other organisations

Eczema Outreach Society logo

Eczema Outreach Support

Eczema Outreach Support provides support to children with eczema and their families. They understand that eczema is different for everyone and tailor their support to each family’s needs. They offer one-to-one support on the phone, a range of specialist resources, children's clubs and opportunities for families to connect with each other.

National Eczema Society logo

National Eczema Society

Eczema Outreach Support provides tailored support to children with eczema and their families. They offer one-to-one support, specialist resources, children's clubs and opportunities for families to connect. They also raise awareness about the impact eczema and support eczema-related research.

Outlook logo

Outlook

A national, highly specialist psychological service based at North Bristol NHS Trust, supporting adults (16+) with appearance-related distress. They can provide face-to-face and remote support via NHS Attend AnyWhere. Please speak to your GP or healthcare professional to discuss a referral.

Hands typing on a MacBook keyboard

NHS

Please have a look at the NHS conditions page for official guidance on eczema, information on when to see a GP, and advice about treatments available on the NHS. You will also find information about the current impact of coronavirus (COVID-19) on NHS services. (Links to atopic eczema - other pages available.)