Eczema (Atopic Dermatitis)
A chronic inflammatory skin condition causing dry, itchy, red, and inflamed patches of skin that can significantly impact quality of life.
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Statistics & Prevalence
Eczema (atopic dermatitis) is one of the most common skin conditions, affecting approximately 31 million Americans. It typically begins in childhood - 60% of cases start in the first year of life, and 90% start before age 5. About 10-20% of children and 1-3% of adults have eczema. The prevalence has increased 2-3 fold in industrialized countries over the past few decades. About 50% of children with moderate-to-severe eczema will develop [asthma](/condition/asthma) and/or allergic rhinitis - this is called the "atopic march." Eczema significantly impacts quality of life, causing sleep disruption, [anxiety](/condition/anxiety), and reduced productivity. The economic burden in the US is estimated at $5.3 billion annually.
What is Eczema (Atopic Dermatitis)?
Common Age
Often starts in childhood (before age 5), but can occur at any age
Prevalence
10-20% of children, 1-3% of adults worldwide, ~31 million Americans
Duration
Chronic condition with flares and remissions; many children outgrow it
Why Eczema (Atopic Dermatitis) Happens
Common Symptoms
- Intense itching, often worse at night
- Dry, scaly skin
- Red, inflamed patches
- Small raised bumps that may leak fluid when scratched
- Thickened, cracked skin (from chronic scratching)
- Raw, sensitive skin from scratching
- Darkened or discolored skin in affected areas
- Patches typically in creases of elbows, knees, wrists
- Face and scalp involvement (especially in infants)
- Sleep disruption from itching
Possible Causes
- Genetic predisposition (filaggrin gene mutations)
- Family history of eczema, asthma, or allergies
- Skin barrier dysfunction (moisture loss, allergen penetration)
- Overactive immune response
- Environmental triggers (irritants, allergens)
- Stress and emotional factors
- Climate and weather changes
- Bacterial colonization of skin (Staph aureus)
Note: These are potential causes. A healthcare provider can help determine the specific cause in your case.
Quick Self-Care Tips
- 1Moisturize within 3 minutes of bathing to lock in moisture
- 2Use thick creams or ointments, not thin lotions
- 3Take lukewarm (not hot) baths or showers
- 4Pat skin dry gently, don't rub
- 5Wear cotton gloves at night if you scratch in sleep
- 6Use fragrance-free products for everything
- 7Apply cold compresses to reduce itch
- 8Keep nails short and smooth
- 9Identify and avoid your personal triggers
Disclaimer: These are general wellness suggestions, not medical treatment recommendations. They may help manage symptoms but should not replace professional medical care.
Home Remedies & Natural Solutions
Colloidal Oatmeal Baths
Finely ground oatmeal has anti-inflammatory and moisturizing properties. Add to lukewarm bath water and soak for 10-15 minutes. Available in commercial products or make your own by grinding regular oatmeal.
Coconut Oil
Virgin coconut oil has moisturizing and antimicrobial properties. Apply to damp skin after bathing. Studies show it reduces Staph colonization. Not for everyone - do a patch test first.
Wet Wrap Therapy
Apply moisturizer (and medication if prescribed) to affected areas, cover with damp bandage or clothing, then dry layer on top. Leave on for hours or overnight. Very effective for severe flares.
Dilute Bleach Baths
Adding 1/4-1/2 cup of regular bleach to a full bathtub reduces Staph bacteria on skin. Soak 5-10 minutes, 2-3 times per week. Rinse and moisturize after. Doctor-recommended for frequent infections.
Cold Compresses
Apply cold, damp cloths to itchy areas for 10-15 minutes to reduce itch and inflammation. Especially helpful for acute flares. Do not use ice directly on skin.
Sunflower Seed Oil
Contains linoleic acid which helps skin barrier function. Apply to slightly damp skin. Studies show it improves skin hydration and barrier in eczema. Avoid if sunflower allergy.
Note: Home remedies may help relieve symptoms but are not substitutes for medical treatment. Consult a healthcare provider before trying any new remedy, especially if you have underlying health conditions.
Evidence-Based Treatment
FDA-Approved Medications
Important: The medications listed below are FDA-approved treatments. Always consult with a healthcare provider before starting any medication. This information is for educational purposes only.
Dupilumab (Dupixent)
FDA-approved biologic for moderate-to-severe atopic dermatitis. Injection every 2 weeks. Blocks IL-4 and IL-13 inflammation. Very effective - 50% of patients achieve clear or almost clear skin.
Warning: Injection site reactions common. Eye problems (conjunctivitis) in some patients. Do not use with live vaccines. Cost is significant without insurance.
Crisaborole (Eucrisa)
FDA-approved topical PDE4 inhibitor for mild-to-moderate eczema. Non-steroidal option. Apply twice daily to affected areas. Approved for ages 3 months and up.
Warning: May cause burning or stinging at application site (usually temporary). Not as strong as steroids for moderate-severe eczema.
Tacrolimus (Protopic) / Pimecrolimus (Elidel)
Topical calcineurin inhibitors. Non-steroidal, good for face and skin folds where steroids can thin skin. Apply twice daily during flares.
Warning: Box warning about theoretical cancer risk (not proven in studies). May burn initially. Avoid with active skin infections. Can use long-term without steroid side effects.
Upadacitinib (Rinvoq) / Abrocitinib (Cibinqo)
Oral JAK inhibitors for moderate-to-severe eczema. Daily pill. Very effective for patients not responding to other treatments.
Warning: Increased risk of serious infections, blood clots, and cardiovascular events. Requires monitoring. Not first-line treatment. Discuss risks/benefits with doctor.
Lifestyle Changes
- ✓Moisturize at least twice daily and after every hand washing/bathing
- ✓Use lukewarm water for bathing (hot water worsens dryness)
- ✓Choose fragrance-free soaps, detergents, and skincare products
- ✓Wear soft, breathable cotton clothing; avoid wool and synthetic fabrics
- ✓Keep home humidity at 45-55% - use humidifier in dry seasons
- ✓Identify and avoid personal triggers (keep a diary)
- ✓Manage [stress](/condition/stress) through relaxation, exercise, or therapy
- ✓Keep fingernails short and smooth to minimize scratch damage
- ✓Wash new clothes before wearing to remove irritants
- ✓Vacuum and dust regularly to reduce dust mites
Detailed Treatment & Solutions
1Establish daily moisturizing routine (at least twice daily)
2Use prescription medications as directed during flares
3Identify and eliminate triggers through diary keeping
4Consider allergy testing if food triggers suspected
5Use wet wrap therapy for severe flares
6Practice stress management techniques
7Get adequate sleep (use antihistamines if needed for nighttime itch)
8Work with dermatologist for treatment plan optimization
Important: Always consult a healthcare professional before starting any treatment regimen. The solutions above are for educational purposes and may not be suitable for everyone.
Risk Factors
- Family history of eczema, asthma, or hay fever
- Personal history of asthma or allergies
- Living in urban areas or developed countries
- Dry climate
- Exposure to irritants (occupational)
- Stress
- Food allergies in young children
Prevention
- Moisturize skin daily, especially after bathing
- Use gentle, fragrance-free soaps and detergents
- Avoid known triggers and irritants
- Keep home humidity at comfortable level (45-55%)
- Wear soft, breathable fabrics (cotton)
- Manage stress effectively
- Keep fingernails short to minimize scratch damage
- Early treatment of flares prevents worsening
When to See a Doctor
Consult a healthcare provider if you experience any of the following:
- Eczema affecting daily activities or sleep
- Signs of skin infection (oozing, yellow crusts, increased pain)
- Not responding to over-the-counter treatments
- Eczema spreading or worsening
- Fever with eczema flare
- Painful skin
- Need for prescription-strength treatments
- Considering newer biologic medications
Talk to a Healthcare Provider
If your symptoms are persistent, severe, or concerning, please consult with a qualified healthcare professional for proper evaluation and personalized advice.
Frequently Asked Questions about Eczema (Atopic Dermatitis)
Click on a question to see the answer.
[Eczema](/condition/eczema) and [psoriasis](/condition/psoriasis) can look similar but have key differences. Eczema is intensely itchy and appears in skin folds (elbows, behind knees); it's associated with allergies and often starts in childhood. Psoriasis causes thick, silvery scales, typically on outer elbows, knees, and scalp; itching is usually milder. Psoriasis is autoimmune while eczema involves barrier dysfunction. A dermatologist can distinguish them.
Currently there is no cure for eczema, but it can be effectively managed. Many children (about 50%) outgrow eczema by adolescence. For those who continue to have it, consistent skin care and appropriate treatments can keep symptoms well controlled. New biologic medications have been game-changers for severe eczema that didn't respond to other treatments.
No, eczema is not contagious. You cannot catch it from or give it to another person. However, people with eczema are more prone to skin infections (bacterial, viral), and these infections can be contagious. If eczema looks infected (oozing, crusting, spreading rapidly), see a doctor.
Food triggers are more common in children than adults, and most people with eczema do NOT have food triggers. Common culprits when present include milk, eggs, peanuts, soy, wheat, and fish. Elimination diets should only be done under medical supervision. In adults, [stress](/condition/stress), irritants, and environmental factors are usually more significant triggers than food.
Several factors make eczema itch worse at night: body temperature rises during sleep, there are no daytime distractions, and cortisol (which reduces inflammation) naturally drops at night. To help: keep bedroom cool, use cotton sheets, moisturize before bed, consider sedating antihistamines for severe nighttime itch, and treat flares aggressively.
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References & Sources
This information is based on peer-reviewed research and official health resources:
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Medical Disclaimer
The information on this page is for educational purposes only and is not intended as medical advice. It should not be used for self-diagnosis or self-treatment. Always seek the guidance of a qualified healthcare professional with any questions you have regarding a medical condition. If you are experiencing a medical emergency, call your local emergency services immediately.
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