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Understanding Eczema (Atopic Dermatitis): Symptoms and Management

Medically reviewed by Anna Heck, PA-C, MPAS, CAQ-Derm · 4 min read

Eczema — also called atopic dermatitis — is a chronic inflammatory skin condition that causes dry, itchy, and inflamed skin. It affects about 31 million Americans, including many adults who never outgrow it.

What Is Eczema?

Eczema occurs when the skin's protective barrier is weakened, allowing moisture to escape and irritants or allergens to enter. This triggers an immune response that causes inflammation and the characteristic symptoms.

Eczema is not contagious. It often occurs alongside asthma and hay fever — this trio is known as the "atopic triad," and it has a strong genetic component.

Common Symptoms

  • Dry, sensitive skin
  • Intense itching (often worse at night)
  • Red or brownish-gray patches
  • Small, raised bumps that may weep fluid when scratched
  • Thickened, cracked, or scaly skin
  • Raw, swollen skin from scratching

Eczema commonly appears on the hands, feet, ankles, wrists, neck, upper chest, eyelids, and inside the bend of the elbows and knees.

Common Triggers

Eczema flares are often triggered by:

  • Dry skin — the single most common trigger
  • Sweating — exercise or heat
  • Soaps, detergents, and cleaning products
  • Stress
  • Allergens — pollen, pet dander, dust mites
  • Certain fabrics — wool or synthetic materials
  • Food allergens — dairy, eggs, nuts (especially in children)
  • Low humidity — common in air-conditioned environments

Management Strategies

While there's no cure for eczema, consistent management can dramatically reduce symptoms:

Moisturize religiously. Apply a thick, fragrance-free moisturizer (cream or ointment, not lotion) within 3 minutes of bathing to lock in moisture. Do this daily, not just during flares.

Use gentle cleansers. Avoid soaps with fragrances, sulfates, or alcohol. Look for cleansers labeled for sensitive or eczema-prone skin.

Keep baths lukewarm. Hot water strips the skin's natural oils.

Identify and avoid your triggers. Keeping a simple diary of flares and potential triggers can reveal patterns.

Manage stress. Stress is a major trigger for many people. Exercise, sleep, and mindfulness can help.

Treatment Options

  • Topical corticosteroids — the most common prescription treatment for flares
  • Topical calcineurin inhibitors — non-steroidal options like tacrolimus or pimecrolimus
  • Biologics — for moderate-to-severe cases, dupilumab (Dupixent) has been a game-changer
  • Antihistamines — can help with itching at night
  • Wet wrap therapy — for severe flares, especially in children

When to See a Dermatology Professional

If your eczema is interfering with sleep, causing open sores from scratching, or not responding to over-the-counter treatments, see a dermatology professional. Prescription treatments are highly effective, and a dermatology professional can help you find the right combination for your skin.

Ready for a Skin Exam?

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