This article has been medically approved by Senior Pharmacist Melanie King, MPharm MRPharmS. - GPhC Reg No: 2063161
Eczema, also known as Dermatitis, is a common skin condition that causes dry, scaly skin, redness, and itching. While itís more common in children, adults can get it too. You may have heard of Atopic Eczema, but did you know there are 7 different types of eczema, each with their own set of symptoms and triggers? Read our article below for more information on the different types of eczema, as well as treatments and top tips to prevent flare ups.
1. Atopic Eczema
Atopic Eczema, or Atopic Dermatitis, is the most common form of eczema. It usually starts in childhood and gets milder or goes away completely in adulthood.
ĎAtopicí refers to an allergy, which is why Atopic Eczema is part of what doctors call the ĎAtopic triadí. ĎTriadí means three, and the other two conditions in this triad are asthma and hay fever. Many people with Atopic Eczema have all three of these conditions.
The most common symptoms of Atopic Eczema include:
- Itchy, dry, cracked, and sore skin
- A rash that forms in the crease of the elbows or knees
- Skin may turn lighter, darker or thicker in areas where the rash appears
- Babies may get a rash on their scalp or cheeks
Atopic Eczema happens when your skinís natural barrier is weakened, meaning it is less able to protect you from allergens and irritants. It is likely caused by a combination of factors such as:
- Dry skin
- An immune system problem
- Environmental triggers like dust, pollen, and pet fur
2. Contact Dermatitis
If your skin gets red and irritated after touching certain substances, you may have Contact Dermatitis, also called Contact Eczema. There are two types of Contact Dermatitis: allergic and irritant. Allergic Contact Dermatitis is an immune system response to a trigger like latex or metal, whereas Irritant Contact Dermatitis happens when a chemical or other substance irritates your skin.
The most common symptoms of Contact Dermatitis include:
- Skin itches, turns red, burns, and stings
- Hives (an itchy rash) may appear on the skin
- Fluid filled blisters may form Ė these can ooze and crust over
- Over time skin may become thicker or feel scaly or leathery
- Irritating plants like poison ivy
- Soap and perfume
- Tobacco smoke
3. Dyshidrotic Eczema
Dyshidrotic Eczema, sometimes called Pompholyx, causes small blisters to form on the hands and feet. Itís more common in women than men.
The most common symptoms of Dyshidrotic Eczema include:
- Fluid filled blisters on the fingers, toes, palms, and soles of the feet
- These blisters may itch or hurt
- The skin can become scaly or flaky and may crack
Dyshidrotic Eczema can be caused by:
- Damp hands and feet
- Exposure to substances like nickel, cobalt, or chromium salt
4. Seborrhoeic Eczema
Seborrhoeic Eczema cause redness, scaly patches and dandruff. It most commonly affects the scalp but can also appear in oily areas of the body like the face, upper chest, and back. Cradle cap is a form of Seborrhoeic Eczema.
The most common symptoms of Seborrhoeic Eczema include:
- The skin develops scaly patches that flake off
- These patches may be white or yellowish in colour
- Skin in the affected area is typically oily
- Skin may be red and itchy
- Hair loss may occur
The exact cause of Seborrhoeic Eczema isnít known, but itís thought to be caused by two main factors. The first factor is excess oil in the skin acting as an irritant. The second factor is a type of fungus that is naturally found in the skinís oils. This fungus can sometimes grow abnormally, causing the skin to secrete more oil than usual.
Alternatively, it may be caused aggravated by illness, psychological stress, fatigue, changes of season and a general deterioration of health. Those with an immunodeficiency (especially infection with HIV), heavy alcohol intake, and neurological disorders such as Parkinsonís disease and stroke are also particularly prone to developing Seborrhoeic Eczema.
Seborrhoeic Eczema is thought to develop in infants due to hormonal changes that occur in the mother during pregnancy. These fluctuating hormones are believed to stimulate the infantís oil glands, causing them to over produce.
Neurodermatitis, also known as Lichen Simplex Chronicus or LSC, is similar to Atopic Eczema. It causes itchy patches of skin that only become itchier when scratched, This cycle causes skin to become thick and leathery.
The most common symptoms of Neurodermatitis include:
- Thick, scaly patches form on the arms, legs, back of the neck, scalp, bottoms of the feet, backs of the hands, or genitals
- These patches can be itchy, especially when relaxed or asleep
- The patches may bleed or become infected if scratched
Neurodermatitis usually starts in people who already have another form of Eczema or Psoriasis. Doctors donít know exactly what causes it, but stress and over scratching can be triggers.
Other common causes include insect bites, scars (eg, traumatic, or due to shingles), and venous insufficiency (where the venous walls and/or valves in the leg veins are not working as well as they should).
6. Discoid Eczema
Discoid Eczema, sometimes called Nummular Eczema, causes round coin shaped spots to form on the skin. Discoid eczema looks very different to other forms of eczema.
It usually first appears as a group of small spots or bumps which quickly join up to form larger patches. These larger patches can range from a few millimetres to several centimetres in diameter. On lighter skin these patches will be pink or red, wheres on darker skin they can be either dark brown or paler than the skin around them.
Initially, these patches can be swollen, blistered, and may ooze fluid. They are also usually very itchy, especially at night.
Over time, these patches may become dry, crusty, cracked, or flaky. Additionally, the centre of the patches may clear up, leaving a ring of discoloured skin that can be mistaken for ringworm.
Similarly to Neurodermatitis, youíre more likely to develop Nummular Eczema if you have another type of Eczema. It can be triggered by a reaction to an insect bite or allergic reaction to metals or chemicals. Dry skin can also cause Nummular Eczema.
7. Varicose Eczema
Varicose Eczema, also known as Venous, Gravitational, or Stasis Eczema, happens when fluid leaks out of weakened veins into your skin. This fluid leak causes swelling, redness, itching, and pain.
The most common symptoms of Varicose Eczema include:
- The lower portion of your legs may swell up, particularly during the day when youíve been walking
- Your legs may ache or feel heavy
- You may have varicose veins
- The skin over varicose veins will be dry and itchy
- You may also develop open sores on your lower legs and tops of your feet
Varicose Eczema happens in people who have poor blood flow in their lower legs. If the valves that normally carry blood up your legs towards your heart stop working as well as they should, blood can pool in your legs. This can cause your legs to swell up and varicose veins can form.
Eczema often comes and goes. During a flare up, you may need to try different medicines and treatments to treat the rash.
- Emollients can help to stop the skin becoming dry
- Antihistamines can help to control the itching
- Corticosteroid cream or ointment, like hydrocortisone, can also help to reduce the itch
- Calcineurin inhibitors, such as topical pimecrolimus or tacrolimus, help to reduce the immune response that causes red, itchy skin
- Light therapy can help to heal rashes
- For Varicose Eczema, raise your legs when you're resting (ideally above the level of your heart) to reduce swelling
- Keep physically active
- For Varicose Eczema, wear compression stockings
If the itching and redness doesnít go away or is affecting your quality of life you should visit your doctor. They will work with you to help you to understand what is causing your eczema.
You may find it helpful to begin tracking what you eat and drink, what skin products you use, what activities you do, how long you spend in the bath or shower, and when youíre feeling stressed. Then, you can find connections between these activities and your eczema flare ups.
You may be referred to a specialist like an immunologist, dermatologist, or paediatrician to explore your eczema further.
Top Tips for Reducing Flare Ups
There are some ways that you can help to prevent eczema flare ups and manage symptoms:
- Apply cool compresses to your skin to reduce the itch
- Moisturise your skin every day with an emollient or rich moisturiser
- After washing, blot skin with a towel rather than rubbing
- Avoid scratching skin even if it is itchy
- Use fragrance free products and avoid products you know cause irritation
- Wear gloves and other protective clothing whenever youíre handling chemicals
- Wear lose fitting clothes made from soft fibres like cotton
- Avoid any known triggers