Eczema is a common skin condition causing irritation and inflammation. While managing flare-ups is important, eczema can leave persistent marks on the skin. These discolorations, often called “eczema scars,” can be a concern. This article explores strategies and treatments to fade these marks and improve skin appearance.
Understanding Eczema Scars
Eczema does not cause deep, fibrous scars like those from injuries. Instead, eczema marks are changes in skin pigmentation or texture resulting from the skin’s healing process after inflammation and scratching. These changes can persist for weeks, months, or years.
The most common mark is post-inflammatory hyperpigmentation (PIH), appearing as darker spots where eczema lesions healed. Inflammation stimulates melanocytes to produce excess melanin, leading to these dark patches. PIH is often more intense in individuals with darker skin tones.
Some individuals may experience post-inflammatory hypopigmentation, characterized by lighter patches. This occurs when inflammation disrupts melanin production, causing temporary pigment loss. These lighter spots are more apparent in darker skin tones due to contrast. Beyond pigment changes, chronic scratching can lead to lichenification, where the skin becomes thickened and leathery.
At-Home and Over-the-Counter Fading Methods
At-home care and over-the-counter (OTC) products can significantly improve the appearance of discolored areas. These ingredients reduce hyperpigmentation and support skin health.
Niacinamide, a form of vitamin B3, helps fade dark spots by reducing inflammation and improving skin barrier function. Vitamin C brightens skin by inhibiting melanin production and protecting against environmental damage. Alpha arbutin suppresses excess melanin formation, making it effective for fading hyperpigmentation.
Azelaic acid targets hyperpigmentation by inhibiting tyrosinase activity and offers anti-inflammatory benefits. Bakuchiol is a gentler, plant-derived alternative to retinol. It provides skin-renewing and brightening benefits, including reducing hyperpigmentation and stimulating collagen, without the irritation of traditional retinols, making it suitable for eczema-prone skin. While retinol promotes cell turnover, it can cause dryness and irritation, so introduce it slowly.
Moisturization supports skin repair and helps scars fade. Moisturizers rich in ceramides, shea butter, glycerin, and petrolatum strengthen the skin’s protective layer, lock in moisture, and promote healing. Applying emollients regularly helps trap water in the skin, aiding scar improvement.
Sun protection prevents existing hyperpigmented scars from darkening. Ultraviolet (UV) exposure stimulates melanin production, making dark spots more prominent and slowing fading. Daily use of a broad-spectrum sunscreen with an SPF of at least 30 is recommended. For textural scars, medical-grade silicone sheets or gels can help flatten and soften scar tissue over time.
Professional Treatments for Eczema Scars
When at-home methods are insufficient, professional treatments from dermatologists offer targeted solutions. These procedures address discoloration or textural changes.
Laser therapy uses different types of lasers for specific concerns. Pulsed dye lasers target residual redness by constricting blood vessels. Fractional lasers create microscopic channels in the skin, stimulating collagen production and promoting turnover of pigmented cells to improve texture and color.
Chemical peels involve applying a chemical solution to exfoliate top skin layers, encouraging new, less pigmented skin. Superficial peels are less aggressive and suitable for sensitive, eczema-prone skin. Microneedling uses fine needles to create controlled micro-injuries, stimulating collagen and elastin production. This process improves skin texture and tone, effective for atrophic (indented) scars and fading hyperpigmentation.
For hyperpigmentation, a dermatologist might prescribe stronger topical agents. These include higher concentrations of retinoids or hydroquinone, which reduces melanin production. Prescription-strength treatments require medical supervision due to their potency and potential side effects. A dermatologist can recommend the most appropriate treatment plan.
Preventing New Eczema Scars
Preventing new eczema scars involves controlling flare-ups and minimizing skin damage. Managing underlying eczema is important, as reducing inflammation lessens the likelihood of post-inflammatory pigment changes.
Adhering to prescribed treatments helps keep eczema symptoms under control, preventing inflammation that leads to discoloration. A gentle skincare routine also supports skin health. Using cleansers and moisturizers helps maintain the skin’s barrier, reducing irritation and flare-ups.
Avoiding scratching is a preventative measure. Keeping fingernails short and smooth minimizes skin trauma. Techniques like wet wraps provide a physical barrier against scratching while delivering moisture. Using anti-itch creams at the first sign of itching can help break the itch-scratch cycle.
Regular moisturization is key to prevention. Consistent moisturizing reduces dryness and inflammation, making the skin less susceptible to damage and scarring. This approach supports the skin’s healing and minimizes new marks.