Rick was exhausted. Increased stress at school, home, and work had made him extremely tired. It also made his skin act up. Not again, he thought — not another eczema flare-up!

Eczema is a common skin problem. If you have eczema or think you might have it, here's how to deal with it.

Some Skin Facts

Your skin — which protects your organs, muscles, and bones and regulates your body temperature — can run into plenty of trouble, like acne when pores become clogged. But zits aren't the only skin problem you may encounter. Have you ever tried a new type of soap and developed an itchy rash? That reaction may just be eczema in action.

What Is Eczema?

Eczema (pronounced: ek-zeh-ma) is a group of skin conditions that cause skin to become red, irritated, itchy, and sometimes develop small, fluid-filled bumps that become moist and ooze.

There are many forms of eczema, but atopic (pronounced: ay-tah-pik) eczema is one of the most common and severe. Doctors don't know exactly what causes atopic eczema, also called atopic dermatitis (pronounced: der-muh-tie-tis), but they think it could be a difference in the way a person's immune system reacts to things. Skin allergies may be involved in some forms of eczema.

If you have eczema, you're probably not the only person you know who has it. Eczema isn't contagious like a cold, but most people with eczema have family members with the condition. Researchers think it's inherited or passed through the genes. In general, eczema is fairly common — approximately 1 in 10 people in the world will be affected by it at some point in their lives.

People with eczema also may have asthma and certain allergies, such as hay fever. For some, food allergies (such as allergies to cow's milk, soy, eggs, fish, or wheat) may bring on or worsen eczema. Allergies to animal dander, rough fabrics, and dust can also trigger the condition in some people.

Signs and Symptoms

It can be difficult to avoid all the triggers, or irritants, that may cause or worsen eczema flare-ups. In many people, the itchy patches of eczema usually appear where the elbow bends; on the backs of the knees, ankles, and wrists; and on the face, neck, and upper chest — although any part of the body can be affected.

In an eczema flare-up, skin may feel hot and itchy at first. Then, if the person scratches, the skin may become red, inflamed, or blistered. Some people who have eczema scratch their skin so much it becomes almost leathery in texture. Others find that their skin becomes extremely dry and scaly. Even though many people have eczema, the symptoms can vary quite a bit from person to person.

What Do Doctors Do?

If you think you have eczema, your best bet is to visit your doctor, who may refer you to a dermatologist (a doctor who specializes in treating skin). Diagnosing atopic eczema can be difficult because it may be confused with other skin conditions. For example, eczema can easily be confused with a skin condition called contact dermatitis, which happens when the skin comes in contact with an irritating substance, like the perfume in a certain detergent.

In addition to a physical examination, a doctor will take your medical history by asking about any concerns and symptoms you have, your past health, your family's health, any medications you're taking, any allergies you may have, and other issues.

Your doctor can also help identify things in your environment that may be contributing to your skin irritation. For example, if you started using a new shower gel or body lotion before the symptoms appeared, mention this to your doctor because a substance in the cream or lotion might be irritating your skin.

Emotional stress can also lead to eczema flare-ups, so your doctor might also ask you about any stress you're feeling at home, school, or work.

If you're diagnosed with eczema, your doctor might:

• prescribe medications to soothe the redness and irritation, such as creams or ointments that contain corticosteroids, or antihistamine pills
• recommend other medications to take internally if the eczema is really bad or you get it a lot

For some people with severe eczema, ultraviolet light therapy can help clear up the condition. Newer medications that change the way the skin's immune system reacts also may help.

If eczema doesn't respond to normal treatment, your doctor might do allergy testing to see if something else is triggering the condition, especially if you have asthma or seasonal allergies.

If you're tested for food allergies, you may be given certain foods (such as eggs, milk, soy, or nuts) and observed to see if the food causes an eczema flare-up. Food allergy testing also can be done by pricking the skin with an extract of the food substance and observing the reaction. But sometimes allergy testing can be misleading because someone may have an allergic reaction to a food that is not responsible for the eczema flare-up.

If you're tested for allergy to dyes or fragrances, a patch of the substance will be placed against your skin and you'll be monitored to see if skin irritation develops.

Can I Prevent Eczema?

Eczema can't be cured, but you can do plenty of things to prevent a flare-up. For facial eczema, wash gently with a nondrying facial cleanser or soap substitute, use a facial moisturizer that says noncomedogenic/oil-free, and apply only hypoallergenic makeup and sunscreens.

In addition, these tips may help:

• Avoid substances that stress your skin. Besides your known triggers, some things you may want to avoid include household cleaners, drying soaps, detergents, and scented lotions.
• Try to avoid hot water. Too much exposure to hot water or overuse of soaps or cleansers can dry out your skin, so take short warm — not hot — showers and baths and wear gloves if your hands will be in water for long periods of time. Be sure to gently and thoroughly pat your skin dry, as rubbing with a coarse towel will irritate the eczema. Also, it isn't the water that causes your skin to react; it's the water evaporating that's not captured in the skin.
• Say yes to cotton. Clothes made of scratchy fabric like wool can irritate your skin. Cotton clothes are a better bet.
• Moisturize! A fragrance-free moisturizer such as petroleum jelly will prevent your skin from becoming irritated and cracked.
• Don't scratch that itch. Even though it's difficult to resist, scratching your itch can worsen eczema and make it more difficult for the skin to heal because you can break the skin and bacteria can get in, causing an infection.
• Keep your cool. Sudden changes in temperature, sweating, and becoming overheated may cause your eczema to kick in.
• Take your meds. Follow your doctor's or dermatologist's directions and take your medication as directed.
• Unwind. Stress can aggravate eczema, so try to relax.

Dealing With Eczema

There's good news if you have eczema — it usually clears up before the age of 25. Until then, you can learn to tune in to what triggers eczema and manage the condition. For example, if you have eczema and can't wear certain types of makeup, find brands that are free of fragrances and dyes. Your dermatologist may be able to recommend some brands that are less likely to irritate your skin.

Your self-esteem doesn't have to suffer just because you have eczema, and neither does your social life! Getting involved in your school and extracurricular activities can be a great way to get your mind off the itch. If certain activities aggravate your eczema, such as playing soccer in the grass, suggest activities to your friends that won't harm your skin.

Even if sweat tends to aggravate your skin, it's still a good idea to exercise. Exercise is a great way to blow off stress — just try walking, bike riding, or another sport that keeps your skin cool and dry while you work out.

Reviewed by: Patrice Hyde, MD
Date reviewed: May 2012