Eczema: Types, Symptoms, and Treatment

What is eczema?

Eczema is a general term for a group of inflammatory skin diseases characterized by redness, dryness, scaling, itching, and sometimes cracking or weeping of the skin.

Therefore, "eczema" is not a single disease. Atopic dermatitis, contact dermatitis, hand eczema, seborrheic dermatitis, and some other conditions can be considered within this broad group.

Briefly, what you need to know

Eczema is not contagious.

Not all cases of eczema have the same cause.

Damage to the skin barrier is important in many types of eczema.

Itching is common, but it alone does not diagnose eczema.

Treatment varies depending on the type and severity of eczema.

Moisturizing is a fundamental part of care for most types of eczema. Current guidelines from the American Academy of Dermatology (AAD) strongly support the use of moisturizers in the treatment of atopic dermatitis.

What does eczema look like?

Eczema doesn't look the same in everyone.

Skin:

dry and rough,

red,

itchy,

scaly,

crack,

sometimes watery or crusty

it could be.

Prolonged scratching and inflammation can also lead to thickening of the skin.

What are the different types of eczema?

Atopic dermatitis

Atopic dermatitis is one of the best-known types of eczema. Although it is common in childhood, it can persist or develop in adulthood.

Skin dryness, itching, and recurrent flare-ups are typical. It can be associated with allergic diseases, but it is not accurate to explain atopic dermatitis solely as "allergy.".

Contact dermatitis

It can develop due to a substance that comes into contact with the skin.

Irritant contact dermatitis can be triggered by irritants such as soap, detergents, frequent hand washing, or chemicals.

Allergic contact dermatitis is a delayed-type immune reaction that develops against a specific substance.

Hand eczema

Hand eczema is not caused by a single factor.

Frequent hand washing, disinfectants, detergents, occupational exposures, atopic predisposition, and contact allergy can all play a role.

Seborrheic dermatitis

It can appear as redness and scaling in areas with a high concentration of sebaceous glands, such as the scalp, around the eyebrows, the sides of the nose, and around the ears.

This condition is not the same as classic atopic eczema and should be evaluated separately.

What causes eczema?

There isn't just one reason.

Depending on the type of eczema;

genetic predisposition,

disruption of the skin barrier,

immune system response,

irritants,

allergens,

environmental conditions

can play a role.

Therefore, giving all eczema sufferers the same list of "avoid this, definitely don't eat this" is not scientifically sound.

Is eczema contagious?

No.

Eczema is not an infection and is not contagious.

However, secondary bacterial or viral infections can develop in eczematous skin due to impaired skin barrier function. This does not mean that eczema itself is contagious.

Is eczema an allergy?

Not always.

A relationship can be found, particularly between atopic dermatitis and allergic diseases. In allergic contact dermatitis, there is an immune reaction to a specific substance.

However, it is not necessary to perform extensive allergy tests on all eczema patients. Targeted evaluation is done if there is clinical suspicion.

How is eczema diagnosed?

Often, the diagnosis is:

patient history,

appearance of lesions,

distribution in the body,

exposures

It is determined after evaluation.

If allergic contact dermatitis is suspected, a patch test may be necessary.

Biopsies or other tests are only used in selected cases.

How is eczema treated?

Treatment varies depending on the type of eczema.

To repair the skin barrier.

Moisturizers are a key component of treatment for most types of eczema. Regular use can reduce dryness and lengthen the time between flare-ups.

Topical corticosteroids

It is among the primary treatments for many inflammatory eczemas, including atopic dermatitis.

Strength, area to be treated, and duration of use should be determined by a dermatologist on a case-by-case basis.

Topical calcineurin inhibitors

Options like tacrolimus and pimecrolimus may be used particularly in specific anatomical regions or as a long-term treatment strategy. The AAD strongly recommends them for adult atopic dermatitis.

New topical options

The AAD's 2025 focus update added newer topical options like tapinarof and roflumilast to the list of strong recommendations for adult atopic dermatitis.

More severe atopic dermatitis

In suitable patients with moderate to severe disease, systemic options such as phototherapy, biological therapies, or JAK inhibitors may be considered.

Current AAD guidelines consider dupilumab, tralokinumab, and some JAK inhibitors among the strong recommendations; the 2025 update added newer options such as lebrikizumab and nemolizumab.

However, current AAD guidelines oppose the routine long-term use of systemic corticosteroids.

What precautions should be taken at home?

Avoid long showers with very hot water.

Using a gentle cleanser

Moisturize regularly after showering.

Reduce irritating products.

Limit scratching as much as possible.

Reduce known personal triggers.

It is important.

There is no single "eczema diet" that works for everyone with eczema.

When should eczema be seen by a dermatologist?

Especially:

if it happens frequently,

if it itches so much that it disrupts your sleep at night,

If the skin cracks and bleeds,

If yellow crusting or discharge develops,

If there is involvement of the face, the area around the eyes, or the genital area,

if it doesn't improve despite using the products

A dermatological evaluation would be appropriate.

Frequently Asked Questions

Does eczema completely go away? It depends on the type. Some contact dermatitis can completely resolve when the trigger is removed. Atopic dermatitis, however, can be a chronic disease with flare-ups.

Does stress worsen eczema? In some patients, stress can increase flare-ups; however, stress is not the only cause of eczema.

Is applying cortisone to eczema harmful? Topical corticosteroids, when used at the correct strength, in the correct area, and for the appropriate duration, are among the basic medications for eczema treatment. The problem is uncontrolled and incorrect use.

Can moisturizer be applied to eczema? Yes. Regular moisturizing is a key part of treatment, especially for atopic dermatitis.

Can eczema be confused with fungal infections? Yes. Some fungal infections can resemble eczema. Therefore, differential diagnosis is important, especially in unilateral, treatment-resistant, or atypical lesions.

Clinical Note by Dr. Utkan Kızıltaç

“A diagnosis of "eczema" alone is often insufficient. For me, the real question is which type of eczema we are dealing with. The treatment approach for hand eczema is not the same as for atopic dermatitis, contact dermatitis, or seborrheic dermatitis. Correct classification significantly facilitates treatment.