Eczema is a general term for inflammatory skin conditions that cause redness, dryness, itching, and sometimes cracking or oozing.

One of the most common types is atopic dermatitis.

Atopic dermatitis often begins in childhood, but it can also affect adults. The condition may flare up periodically and require long-term follow-up.

Eczema is not contagious. Appropriate treatment and consistent skincare can help keep symptoms well controlled.

What Causes Eczema?

A weakened skin barrier and an inflammatory immune response play important roles in eczema.

The skin barrier normally prevents moisture loss and protects against environmental substances. In atopic dermatitis, this barrier may not function properly.

Factors that may contribute include:

• Genetic predisposition
• An impaired skin barrier
• An excessive inflammatory immune response
• Soaps, detergents, and irritating substances
• Cold, dry weather
• Sweating and excessive heat
• Certain allergens

However, not all eczema is caused by allergies. Routine allergy testing is therefore not necessary for every patient.

What Are the Symptoms of Eczema?

Itching is the main symptom of eczema.

Other symptoms may include:

• Dry, scaly skin
• Redness or changes in skin color
• Itchy bumps
• Cracks and sometimes oozing
• Thickened skin from prolonged scratching
• Itching that worsens at night and disrupts sleep

In infants, eczema commonly affects the cheeks, scalp, and outer surfaces of the arms and legs.

In older children, the inner elbows and backs of the knees are frequently affected.

Adults may develop eczema on the hands, face, eyelids, neck, and other areas of the body.

What Are the Different Types of Eczema?

Atopic Dermatitis

A recurring inflammatory skin condition typically associated with dry skin and intense itching.

Contact Dermatitis

This develops after the skin comes into contact with irritants or allergens. Detergents, cosmetics, metals, and certain workplace substances may be involved.

Hand Eczema

Hand eczema may be associated with frequent handwashing, detergent exposure, glove use, occupational exposures, or a predisposition to atopic conditions.

Seborrheic Dermatitis

This can cause redness and flaking in areas with many oil glands, such as the scalp, eyebrows, sides of the nose, and chest.

An accurate diagnosis is important because these conditions may require different treatments.

How Is Eczema Diagnosed?

Eczema is usually diagnosed through a dermatologic examination and a review of the patient’s medical history.

The assessment considers the location of the rash, the pattern of itching, when symptoms began, and possible triggers.

Patch testing may be needed when allergic contact dermatitis is suspected.

There is no single blood test that everyone needs to diagnose atopic dermatitis.

Current Eczema Treatment Options

Treatment aims to relieve itching, reduce inflammation, repair the skin barrier, and help prevent further flare-ups.

The plan depends on the type and severity of eczema, the patient’s age, and the areas affected.

1. Moisturizers and Skin Barrier Care

Regular moisturizing is a foundation of atopic dermatitis treatment.

Suitable moisturizers support the skin barrier, reduce water loss, and help relieve itching associated with dryness.

Moisturizers should be used during flare-ups and when the condition is calm.

2. Topical Corticosteroids

Corticosteroid creams or ointments may be used during flare-ups to reduce redness and inflammation.

A dermatologist should determine the medication’s strength, where it should be applied, and how long it should be used.

These medications are effective when used appropriately, but prolonged use without medical supervision can cause side effects.

3. Nonsteroidal Topical Treatments

Calcineurin inhibitors such as tacrolimus and pimecrolimus may be suitable for sensitive areas, including the face, eyelids, and skin folds.

In selected patients, they may also be used intermittently to help prevent flare-ups.

4. Newer Topical Treatments

New topical medications targeting inflammatory pathways in atopic dermatitis have been developed in recent years.

These include topical JAK inhibitors, PDE-4 inhibitors, and medications that act on the aryl hydrocarbon receptor.

Active ingredients such as ruxolitinib, roflumilast, and tapinarof have been studied in specific patient groups and approved in some countries.

Their suitability and availability in Türkiye require separate assessment.

5. Phototherapy

Narrowband UVB (NB-UVB) phototherapy may be used in suitable patients.

It is an option particularly for widespread atopic dermatitis that has not responded adequately to other treatments.

6. Biologic Treatments

Treatment options for moderate to severe atopic dermatitis have expanded significantly in recent years.

Biologic medications such as dupilumab, tralokinumab, and lebrikizumab target specific immune signals involved in inflammation.

Nemolizumab is a newer treatment that targets the IL-31 signaling pathway, which is closely associated with itching.

A dermatologist may consider these treatments for suitable patients when standard care is insufficient.

7. JAK Inhibitors

JAK inhibitors such as upadacitinib, abrocitinib, and baricitinib are effective systemic treatment options for some patients with moderate to severe atopic dermatitis.

However, the risk of infections and other significant side effects means these medications require careful patient selection, appropriate testing, and regular monitoring.

They are not suitable for everyone.

Can Eczema Go Away Completely?

Eczema may become much milder as some children grow older. In others, it can persist into adulthood.

No single treatment provides a complete, permanent cure for every patient with atopic dermatitis.

However, current treatments can help keep the condition under control for extended periods.

Daily Skincare Tips for Eczema-Prone Skin

Daily skincare is an essential part of treatment.

• Take short showers with lukewarm water.
• Avoid harsh soaps and cleansers that produce excessive lather.
• Apply moisturizer after showering while the skin is still slightly damp.
• Choose fragrance-free products that your skin tolerates well.
• Use moisturizer at least twice a day or as needed.
• Manage individual triggers such as sweating and excessive heat.
• Keep your nails short to reduce skin damage from scratching.
• Use prescribed medications for the duration recommended by your physician.

Herbal mixtures, essential oils, or irritating products should not be used indiscriminately to treat eczema.

Does Diet Matter in Eczema?

Food allergies can coexist with atopic dermatitis, but not everyone with eczema has a food allergy.

Eliminating staple foods such as milk, eggs, or wheat without medical advice can lead to nutritional problems, particularly in children.

Dietary restrictions should be based on an appropriate clinical assessment.

When Should You See a Dermatologist?

A dermatologic evaluation is recommended if eczema recurs frequently, causes severe itching, disrupts sleep, or affects daily life.

Yellow crusting, pus, worsening pain, fever, or rapidly spreading redness requires assessment for a possible infection.

Painful clusters of fluid-filled blisters or rapidly spreading skin lesions may require urgent medical evaluation.

Dermatologic Evaluation and Follow-Up

Eczema care aims to reduce the existing rash, support the skin’s protective barrier, and help prevent further flare-ups.

At Dr. Armin Müştak’s private dermatology practice, patients with eczema receive a dermatologic examination. A treatment and follow-up plan is developed based on the type and severity of eczema, possible triggers, and previous treatments.

Accurate diagnosis, regular moisturizing, and appropriate anti-inflammatory treatment are central to long-term eczema control.