Suffering From Eczema? Here's What You Need to Know
The following scenario is all too familiar to many: you experience a sudden, intense itch. That itch turns into an angry, scaly red rash, and then that begins to spread. No, it's not poison ivy nor chickenpox. You have atopic dermatitis, better known as eczema.
According to the National Eczema Association, more than 31 million people in the United States alone experience this genetic skin condition. Everyone from Adele to Kate Middleton has dealt with it and recently, it gained media attention thanks to the 2023 documentary "Under My Skin: Untold Stories of Life with Eczema," as well as the 2016 HBO series "The Night Of," in which John Turturro's character, John Stone, suffers from an intense case of eczema. While his flare-ups famously landed him in the hospital, the common ailment can typically be managed with some simple tips.
To better understand eczema and what causes it, we spoke with Craig Austin, MD, New York City dermatologist and founder of Cane + Austin, to get the lowdown. Keep reading for everything you need to know.
What is Eczema and What Causes It?
Eczema is a common, chronic inflammatory skin condition where an overactive immune system leads to an impaired skin barrier that can cause dry, itchy skin and even skin infections. "Medically, it's called atopic dermatitis," says Dr. Austin. "It's usually an itch that rashes rather than a rash that itches."
What makes the skin condition more complicated, however, is that it manifests itself differently for everyone. It can appear as early as infancy and usually shows up on the face, elbows, and knees. From there, it can eventually spread to other parts of the body and can be quite painful if left untreated. Dermatologists typically diagnose eczema by its appearance and occasionally by biopsies to exclude any other issues.
What Triggers Eczema?
The tricky part about this skin condition is that there are many potential causes that can trigger flare-ups, such as genetics, your environment, stress, or even allergies. "Once your skin is dry, it breaks down easily to form a rash," Dr. Austin says.
Environmental factors like cold, dry air, overexposure to water, air pollutants, low humidity, smoking, irritating soaps or perfumes, stress, and diet can all contribute to eczema. Because the condition is genetic, if someone in your family has eczema, you're more likely to develop it at some point during your life.
Common Areas Prone to Eczema
Again, though eczema rashes can occur anywhere on the body, Dr. Austin says that it's more common on flexural areas (elbows, backs of knees, etc.) and arms and legs. "It probably occurs on the extremities more due to the lack of circulation to these areas, thus resulting in drier skin."
How Severe Can Eczema Become?
Unfortunately, eczema can go beyond seriously intense itching; sufferers are more at risk for skin infections. "A person with eczema who develops a cold sore due to herpes simplex virus is more susceptible to having it spread all over the skin," says Dr. Austin. Those with this condition are also vulnerable to erythroderma, an inflammatory disease that causes much of the body to become red. This will lead to loss of bodily fluids and electrolytes.
"These are serious issues which all need to be regulated in a hospital under supervision of doctors," he says.
What Products Can Help Treat Eczema?
The best course of action when treating any serious skin condition, but especially severe eczema, is with a dermatologist's help. They can equip you with prescription-strength steroids to alleviate rashes quickly. Another option is over-the-counter hydrocortisone cream, but make sure you don't use it for longer than five days to a week.
Otherwise, gentle exfoliation and deep hydration are essential when dealing with these rashes; exfoliate to remove the dull, dry skin, then moisturize the tender skin underneath with a rich cream. Over-the-counter formulas containing lactic acid, like the fragrance-free AmLactin Moisturizing Lotion 12 Percent ($20, originally $25), do double duty. (You can read our full review of the product here.) There's also the Peach & Lily KP Bump Boss Microderm Body Scrub ($29) that contains both lactic acid and another alpha-hydroxy acid, glycolic acid, to slough off dead skin cells.
"It's a great home treatment for eczema if you're aiming to avoid a trip to the dermatologist and application of steroids and antibiotics," he says. Again, in more intense cases, Dr. Austin prescribes topical prescription moisturizers, steroid creams, and antibiotics for deeper treatment.
Tips to Managing Eczema at Home
- Avoid drying out your skin. This sounds obvious, but everything from excessive swimming and overwashing hands to long, hot showers can strip skin of moisture.
- Add extra hydration back into your skin. Make sure you drink plenty of water and moisturize religiously. Dr. Austin also suggests using a humidifier in Winter to prevent skin from getting too parched.
- Follow an anti-inflammatory diet. Processed foods, sugars, simple carbohydrates, and alcohol increase cortisol and insulin production, which cause inflammation (your body's immune system response). "Eat foods containing omega-3 fatty acids such as salmon, walnuts, and sardines, which help decrease inflammation and dryness in skin," says Dr. Austin.
- Skip perfumed soaps, lotions, and other beauty products. Scented items can irritate sensitive skin. Dr. Austin likes Neutrogena's and Cetaphil's fragrance-free formulas as they are extremely gentle.
- Don't stress. Stress also triggers cortisol production and thus inflammation in your body, which will lead to itching and eczema flare-ups. Consider a tropical vacation during Winter to help you unwind. "It might clear your eczema due to decreased stress and increased [skin] hydration from the humid environment," says Dr. Austin.