Eczema, also known as atopic dermatitis, is a common inflammatory skin condition resulting in dry, itchy, and inflamed skin. This chronic condition affects people of all ages, though it is most prevalent in young children. While there is no cure, various treatments can help manage its symptoms.
Acute Presentation
An acute eczema flare-up typically presents with intense skin symptoms. The affected skin often appears red, swollen, and can develop small, fluid-filled blisters that may ooze clear fluid and then form crusts. Severe, relentless itching is the primary symptom during this phase.
Scratching these areas can further irritate the skin, potentially leading to bleeding or infection. Common triggers include irritants like harsh soaps or fragrances, certain fabrics, environmental allergens such as dust mites or pollen, stress, or temperature changes. The skin during an acute episode feels raw and sensitive.
Chronic Presentation
Chronic eczema develops from prolonged or repeated skin inflammation. Over time, continuous scratching and rubbing lead to distinct changes in skin texture and appearance. The skin often becomes noticeably thicker and leathery, a condition known as lichenification.
Affected areas may also become dry, scaly, and exhibit changes in pigmentation, appearing darker (hyperpigmentation) or, less commonly, lighter (hypopigmentation). Chronic itching persists, contributing to the cycle of skin damage and further thickening.
Severity Levels
Eczema is classified into different levels of severity based on the extent of skin involvement and its impact on daily life. Mild eczema typically involves small, localized patches of dry, itchy skin with minimal inflammation, causing little interference with daily activities or sleep. Managing mild eczema often involves regular moisturizing.
Moderate eczema covers larger body areas, characterized by more frequent itching and regular flare-ups. The skin may show scaling, thickening, or cracking, and the condition can disrupt sleep and daily tasks. Severe eczema involves extensive skin involvement and constant, intense itching. It leads to debilitating flares and significantly affects quality of life, sleep, and social interactions. In severe cases, the skin may bleed or develop secondary infections.
Eczema’s Progression Across Ages
Eczema can manifest differently depending on age. In infants, eczema commonly appears on the cheeks, scalp, and extensor surfaces of the arms and legs, such as the outside of the elbows and knees. These rashes are often red, oozing, and crusty, causing significant itchiness that interferes with sleep.
As children grow older, particularly between ages 2 and puberty, eczema tends to shift its typical locations. It frequently appears in the flexural creases, such as behind the elbows and knees, on the neck, wrists, and ankles. The skin in these areas often becomes drier, thicker, and more lichenified compared to infantile eczema.
In adults, eczema can affect various body parts, including the hands, feet, eyelids, neck, and face, or it can be more generalized. Adult eczema is frequently chronic, characterized by dry, intensely itchy skin. It may present with scaly patches that can be purple, brown, or gray on darker skin tones, or pink to red on lighter skin tones.