Eczema is one of the most common dermatological conditions out there, affecting roughly 10 percent of all Americans, according to the National Eczema Association. This chronic inflammatory condition “causes the skin to become dry, itchy, red, and inflamed,” Dr. Debra Jaliman, MD, a dermatologist, tells SheKnows. It’s a concern she frequently sees in patients in her New York City practice.
In mild cases, eczema rashes can be uncomfortable or make you slightly self-conscious. But when a flare-up is in full force? That telltale itchiness can become downright unbearable. It can keep you up at night, cause emotional distress, and even lead to painful, weeping sores or skin infections.
Despite its relatively high prevalence, eczema is a complex condition that can be triggered by a range of things, from irritants in your environment, to your mental and emotional state, and to fluctuations in your hormone levels. That’s why it’s so important to seek treatment from a professional. “Tailored guidance that may include over-the-counter products or prescriptions from a dermatology provider is critical in helping to manage symptoms,” Renata Block, MMS, PA-C, a physician assistant specializing in dermatology, tells SheKnows.
Luckily, there are plenty of products out there to treat acute flare-ups. You can also take proactive steps to prevent outbreaks. Below, find an overview of everything you need to know about eczema, including what it is, common triggers, and how to prevent and treat flare-ups.
What is eczema?
Eczema is a form of dermatitis, or inflammation of the skin, that causes visible, itchy rashes. “It can be seen on any part of the body and can show up as red, scaly spots that sometimes ooze and blister,” Dr. Alexandra Flamm, MD, a dermatologist with NYU Langone, tells SheKnows. On brown or Black skin, it can present as small, raised, itchy bumps. There are different forms of eczema too, atopic dermatitis being the most common.
Across the board, eczema isn’t contagious, and it’s usually not painful. It often comes and goes throughout a person’s life. Eczema can be connected to your environment, genetic factors, and anything that causes increased inflammation in your body; however, it’s not considered an autoimmune disorder.
Though it often shows up first in childhood, eczema can affect anyone at any age. It can even appear later in life in adults who never had symptoms previously. In fact, “adult women are more likely to have persistent or adult-onset eczema,” Jaliman says. Since women disproportionately shoulder the burden of household cleaning, they’re also more likely to suffer from hand eczema.
If your doctor suspects that you have eczema, they may perform allergy tests or bloodwork to rule out other skin conditions that mimic it. Once you’ve been diagnosed, they’ll equip you with tools to manage symptoms. That may include prescription-strength creams or ointments, oral antihistamines, or gentle lotions that you can purchase OTC.
Common eczema triggers and how they can affect you
When it comes to eczema management, “it’s important to understand what your triggers are and try to avoid them,” Flamm says. Otherwise, it could lead to a flare-up. That’s when symptoms worsen noticeably — a rash may appear or spread, and you’ll typically notice increased itchiness and discomfort. You might even start oozing or bleeding, which can be a sign of a severe flare-up or infection, Jaliman says.
Triggers vary widely. Some are preventable; others involve natural fluctuations in your body and can’t always be prevented, only addressed.
Fragrance
Fragrance is a very common trigger. If you have eczema, you can prevent flare-ups by using fragrance-free makeup, skincare products, body products, laundry detergents, and other household cleaning products. (Read the labels closely — you’d be surprised at how many products contain fragrances!) Flamm also recommends looking for moisturizers that are “geared towards people with eczema-prone skin or contain ceramides, which are important building blocks for skin health.”
Fluctuations in temperature or humidity
Extreme hot or cold weather or the changing of the seasons can trigger flare-ups. So can prolonged exposure to water, like swimming all day or taking long, hot showers. Many patients also report that their symptoms get worse in the winter, when temps are cooler and the air is drier. Jaliman’s advice? Take shorter showers, and avoid using scalding-hot water. Be sure to keep your skin adequately moisturized, and use gentle products that won’t aggravate it.
Irritating fabrics
Many eczema patients find wool, mohair, and certain synthetic fabrics irritating to the touch, which can lead to flare-ups. Generally, Jaliman recommends that her patients wear gentle, breathable fabrics made of natural materials, such as cotton. (A pro tip from yours truly, who’s dealt with eczema for years: Layer a cotton t-shirt underneath your wool sweater to create a barrier.)
Allergic reactions
Per Cleveland Clinic, the connection between allergies and eczema isn’t entirely clear, but anecdotal reports indicate that allergic reactions can lead to flare-ups. Basically, “anything that promotes an inflammatory environment can trigger it,” Block says. If you’re allergic to any common allergens — like certain foods, pet dander, or dust mites — you’ll want to steer clear of them. This will both prevent allergic reactions, which can be life-threatening, and help keep your eczema at bay.
Fluctuations in your hormone levels or stress
“Hormonal fluctuations affect eczema,” Jaliman says, which is key for women and people with uteruses. At certain points in your menstrual cycle, you may notice that you’re more prone to flare-ups. The same logic applies to people who are pregnant and going through perimenopause or menopause.
Like most inflammatory conditions, eczema is also connected to your mental health. Surges in stress, anxiety, or depression can trigger inflammation in the body too, triggering flare-ups.
If any of that applies to you, it’s extra important to stay on top of your eczema management protocol. Avoid known triggers, do what you can to manage stress, and keep your skin moisturized with gentle, eczema-friendly products.
How to manage eczema flare-ups
Think you’re experiencing an eczema flare-up? First things first, reach out to a dermatology provider. They’ll be able to confirm that eczema is the culprit, identify potential triggers, and go over your treatment options. These vary depending on the location and severity of the outbreak.
If the rash is mild or near your eyes, your doctor may prescribe you a non-steroid cream or recommend a non-prescription anti-itch lotion. They may also suggest that you take an oral antihistamine to reduce your body’s immune response. However, if it’s more severe or in a less-sensitive area, you might go home with an Rx for a topical corticosteroid. These powerful ointments work quickly to reduce inflammation and alleviate itchiness, allowing the rash to heal. (As a note, corticosteroids are not safe for long-term use and should only be used “no more than twice a day to flared areas,” Flamm says.)
You’ll also want to monitor the area for infection, Jaliman adds. “Signs include yellow crusting, weeping, swelling, or pain.” If your doctor suspects that your rash has become infected, they’ll likely send you home with a topical or oral antibiotic to nip it in the bud.
As a rule of thumb, avoid scratching at any rashes. “The more you scratch, the worse it gets,” Block explains, “as the scratching triggers an inflammatory response, which worsens the condition.” Instead, focus on reducing inflammation and keeping your skin lightly moisturized.
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