Eczema is a common, non-contagious skin condition that causes inflammation. It affects people of all ages, from infancy into adulthood. The condition weakens the skin’s barrier function, making it prone to dryness and irritation.
Eczema is characterized by periods of flare-ups, where symptoms worsen, and periods of remission, where symptoms improve. Common symptoms include dry, itchy, and red patches of skin. The skin may also appear swollen, bumpy, or thickened.
Eczema and Skin Marks
Eczema typically does not lead to true, permanent scarring in the way a deep cut or burn might. It rarely causes raised, thickened scars such as hypertrophic scars or keloids unless there is a severe secondary infection or significant skin damage from intense, prolonged scratching. Instead, eczema commonly leaves behind various types of temporary skin marks.
One common mark is post-inflammatory hyperpigmentation (PIH), which appears as darker patches on the skin where inflammation has subsided. These patches can be brown, gray, or purple, and are especially noticeable in individuals with darker skin tones. PIH occurs due to an overproduction of melanin, the pigment that gives skin its color, in response to the skin’s inflammatory healing process.
Less common, but also possible, is post-inflammatory hypopigmentation, where the skin appears lighter than the surrounding areas. This occurs when inflammation temporarily reduces melanin production in the affected skin. Both hyperpigmentation and hypopigmentation are usually temporary and tend to fade over time, though it can take months or even years for the skin tone to normalize.
Another common textural change associated with chronic eczema is lichenification. This refers to the skin becoming thick, leathery, and often ridged due to repeated scratching and rubbing over an extended period. While it alters the skin’s texture, lichenification is a result of the skin’s protective response to irritation, rather than a permanent scar.
Preventing Eczema Marks
Preventing eczema marks primarily involves managing the underlying inflammation and protecting the skin from further damage. Consistent management of eczema flare-ups is crucial, as inflammation is the root cause of these skin changes. This often includes the regular use of emollients and topical corticosteroids as prescribed by a healthcare professional to keep symptoms under control.
Minimizing scratching is another important step, as it can worsen inflammation and lead to skin damage or infection, increasing the risk of marks. Strategies to prevent scratching include keeping nails short, wearing soft gloves, or using wet wraps during severe flares. Applying anti-itch creams can also help reduce the urge to scratch.
Regular moisturizing is essential for maintaining the skin barrier’s integrity, which helps reduce dryness and irritation. A well-hydrated skin barrier is less susceptible to triggers and can heal more effectively. Identifying and avoiding known eczema triggers, such as certain allergens or irritants, also plays a significant role in preventing flares and subsequent marks.
Protecting affected areas from sun exposure is also advisable, as ultraviolet (UV) radiation can worsen post-inflammatory hyperpigmentation, making dark spots more pronounced and longer-lasting. Using sunscreen or protective clothing can help mitigate this effect.
Treating Eczema Marks
Patience is a key aspect of treating eczema marks, as many hyperpigmented or hypopigmented areas will naturally fade over several months to a few years as the skin regenerates. However, continued control of active eczema is the most important first step, because new marks will continue to form if flares are not managed effectively.
For existing post-inflammatory hyperpigmentation, several topical treatments can help accelerate fading. Over-the-counter options include ingredients like Niacinamide, Vitamin C, Azelaic Acid, or Alpha Arbutin, which work to reduce melanin production or break down existing pigment. For more stubborn marks, prescription treatments such as retinoids or hydroquinone may be recommended by a dermatologist, but these require medical supervision due to potential side effects.
Gentle exfoliation can sometimes assist in the fading process by promoting skin cell turnover, but harsh scrubbing should be avoided as it can irritate the skin and worsen inflammation. Professional treatments offered by dermatologists, such as chemical peels or various laser therapies, can be considered for persistent marks. These advanced treatments should only be pursued after consultation with a dermatologist to determine suitability and minimize risks.
Managing lichenification involves consistent moisturizing to soften the thickened skin and continued effort to control the underlying itch. Reducing the urge to scratch allows the skin to gradually return to a smoother texture over time. While the leathery texture may persist for a while, ongoing care helps improve its appearance.