Eczema is a general term for a group of conditions that cause skin inflammation, swelling, discoloration, dryness, and itch.
There are seven different types of eczema: atopic dermatitis, dyshidrotic eczema, contact dermatitis, discoid eczema, neurodermatitis, seborrheic dermatitis, and stasis dermatitis.
Some are more common than others, but on the whole, eczema affects almost 32 million people in the United States, roughly 10% of all Americans.
Different forms of eczema have different symptoms that require their own treatment plan, and you can suffer from more than one type of eczema at a time.
Patients with more common types of eczema may experience:
- Dry, itchy patches of skin
- Skin that is thick or leathery
- Skin that is discolored or rashy
- Skin that is oozing or leaking fluid
- Skin that crusts over or looks scaly
Researchers still don’t know what causes eczema, but it is not contagious.
It seems to be related to family history, the immune system, and environmental factors.
Eczema affects people of all ages, including infants and young children, and often occurs along with seasonal allergies like hay fever, food allergies, and asthma.
It can get better over time but can sometimes be a life-long ailment.
There is no cure for eczema, but patients can manage symptoms with proper medical care and an effective treatment plan.
If you have discolored, itchy, scaly patches of skin, a rash that doesn’t go away, or dry, uncomfortable skin that doesn’t resolve with regular moisturizing, make an appointment with your primary care provider or a dermatologist.
They can evaluate your symptoms, determine what you might be suffering from, and recommend different treatments to help contain and soothe your irritated skin.
In this article, I’ll discuss each of the seven types of eczema, how they’re diagnosed, and treatment options.
I’ll also talk about how you can prevent eczema flare-ups, and when you should talk to a doctor about your eczema symptoms.
Atopic dermatitis (AD) is the most common form of eczema, impacting more than 26 million Americans every year.
It is a long-term condition that often begins in infancy.
AD can exist on its own or along with other types of eczema. Some people with this form of eczema experience fewer symptom flare-ups as they grow.
Others have symptoms that affect them on and off for a lifetime.
When people have atopic dermatitis, their immune system is easily triggered into a reaction that leads to skin inflammation.
Over time, that reaction damages the normal barrier function of the skin, leading to symptoms like:
- Itchy skin
- Dry skin
- Skin redness
- Purple, brown, or gray skin
- Thick, leathery, or scaly skin
- Weeping, oozing, or crusty skin
- Infection-prone skin
- Cracking skin
- Skin pain
Patients with atopic dermatitis may also experience asthma, allergies, depression, ADHD, and anxiety, as well as sleep problems when their symptoms flare.
Adults with severe AD are also at higher risk for diabetes, high blood pressure, autoimmune disorders, eye-related problems, and respiratory infections.
But many people have isolated atopic dermatitis without any of those other conditions.
Doctors still don’t know what causes atopic dermatitis.
They believe it’s a combination of genetics and exposure to environmental triggers.
Common triggers include:
- Household detergents, cleaning chemicals, shampoos, or soaps
- Mold, pet dander, dust mites, or tree pollen
- Food allergies
- Wool, polyester, or nylon
- Sudden changes in hormones
- If you have atopic dermatitis, tracking your triggers can help you identify ways to prevent flare-ups.
Dyshidrotic eczema (dyshidrosis) is another common type of eczema.
It primarily affects adults between 20 and 40 years of age and often appears on individuals who already suffer from other forms of eczema, or from seasonal allergies.
Dyshidrotic eczema affects the palms of the hands, sides of the fingers, and soles of the feet.
Symptoms often occur regularly for months or years at a time.
These symptoms include:
- Fluid-filled pustules or small blisters that appear in clusters or merge
- Intensely itchy, painful, or burning skin
- Scaly or red skin around the blisters as they dry out
- Dry skin
- Cracking skin
- Abnormally thick skin in the areas where blisters once were
The blisters that develop from dyshidrotic eczema tend to last about 2-3 weeks before they dry out and flake off.
Patients often develop new blisters before their old ones heal.
Researchers aren’t sure what causes dyshidrotic eczema.
Because it so often affects people with other eczema types, they believe there may be a genetic component to the disease.
Other risk factors include:
- Exposure to hot temperatures or high humidity
- Exposure to metals like nickel or cobalt
- Emotional or physical stress
If you have an itchy rash that you believe might be related to dyshidrotic eczema, contact a healthcare provider to learn how to manage and contain your condition.
Patients with contact dermatitis experience symptoms when their skin comes into direct contact with a substance or material that causes a rash.
Unlike other forms of eczema, contact dermatitis doesn’t have a relationship with hay fever or seasonal allergies.
In addition, researchers do not believe that genetics predispose some individuals to experience contact dermatitis over others.
Contact dermatitis is a common skin condition that often affects people who regularly touch chemicals, allergens, or irritants—like hairstylists and health care workers.
Contact dermatitis can be caused through contact with an allergen like poison ivy.
It is not contagious, but it can be uncomfortable.
- Mild to severe itch
- Red skin
- Dry or cracked skin
- Painful, swollen, or tender skin
- Bumpy rash
There are two kinds of contact dermatitis: irritant contact dermatitis and allergic contact dermatitis.
Irritant contact dermatitis is far more common, comprising 80% of cases.
Irritant contact dermatitis occurs when someone comes into regular contact with an irritating substance or material that damages the skin over time.
These irritants can include:
Harsh soaps and detergents
- Hair dyes
- NIckel or cobalt
- Zippers, belt buckles, fasteners, and snaps
Some patients can also develop irritant contact dermatitis from overwashing their hands in hot water.
Allergic contact dermatitis is an allergic condition that occurs when a patient comes into contact with something that triggers an immune response.
- Certain fragrances
- Preservatives found in topical medicines
- Poison ivy, poison sumac, and poison oak
Once someone is exposed to an allergen, they usually develop symptoms of allergic contact dermatitis after a few days.
Discoid eczema or nummular eczema, is a chronic medical condition characterized by round or coin-shaped patches of inflamed or blistered skin.
On people with light complexions, these patches will appear red.
People with darker complexions may develop brown or pale patches instead.
Discoid eczema can sometimes be mistaken for other skin diseases like ringworm, psoriasis, or fungal infection.
Discoid eczema is more prevalent among men, and tends to become worse during cold winter months.
It can occur with other types of eczema or appear on its own.
Discoid eczema can appear anywhere on the body but most often develops on the arms, legs, and torso.
Patients can have a single patch of discoid eczema, but typically develop more than one at a time.
- Small round, oval, or coin-shaped patches of red skin that merge into larger patches of inflammation
- Patches of skin that ooze fluid or crust over
- Itchy or burning skin
- Scaly or inflamed skin that appears around the blisters
- A ring of discolored skin with a clear center
Eczema should not cause fever, malaise, or hot, tender, or painful skin.
If you experience any of those symptoms, you may be suffering from a skin infection that requires medical treatment.
Make an appointment with your provider or go to an urgent care or emergency room.
Doctors don’t know the specific cause of nummular dermatitis but believe that some factors may contribute to its development.
- Very dry or sensitive skin
- Insect bites
- Traumatic scrapes
- Chemical burns
- Frequent bathing
- Rough clothing
- Harsh soaps, detergents, and certain fabric softeners
When discoid eczema appears on the lower legs, it is sometimes attributable to poor circulation.
Neurodermatitis is a common condition that affects up to 12% of the population.
It often begins with a chronic itch, usually when patients go through a stressful or difficult emotional period.
Unlike other forms of eczema, neurodermatitis does not appear in multiple areas across the body, but stays limited to one or two areas of affected skin.
Patients with neurodermatitis can develop symptoms on their feet, ankles, hands, wrists, shoulders, neck, face, scalp, or genitals.
These symptoms include:
- An intense urge to itch or itching until you bleed
- Pronounced skin lines
- Scaly skin
- Discolored skin
- Dry, leathery, or thick skin
- Scabs, scarring, and hair loss
People who suffer from neurodermatitis can also experience sleep challenges like insomnia and sexual dysfunction due to the itching associated with their condition.
Research has still not determined the exact cause of eczema, but specific individuals are more prone to developing neurodermatitis than others:
- People with depression, anxiety, or obsessive-compulsive disorder
- People under stress
- People between the ages of 30-50 years old
- People of African and Asian descent
- People with contact dermatitis, atopic dermatitis, or psoriasis
- People who have experienced nerve injuries or insect bites
- People with dehydrated skin, allergies, or poor blood flow
- People who are exposed to traffic exhaust, heat, or humidity
- Children rarely experience neurodermatitis, though some pediatric patients with atopic dermatitis can develop symptoms.
Seborrheic dermatitis is a common type of eczema that affects oil-producing areas of the skin, including your scalp, nose, and upper back. In adults, it is sometimes called seborrheic eczema.
In infants, the condition is known as cradle cap.
Symptoms of seborrheic dermatitis most commonly affect infants, as well as people 30-60 years old.
In adults, the condition comes and goes, often flaring when individuals are under stress or experiencing cold weather. In infants, the condition usually clears with time and doesn’t return.
Infants with this type of eczema can have what’s called a “cradle cap,” a greasy, scaly patch on the scalp.
They may also have dermatitis on their bottoms, where it can be mistaken for diaper rash.
Adults with seborrheic dermatitis experience:
- Flaky, dry skin on the face, scalp, eyebrows, chest, back, groin, or armpits
- Greasy skin covered in white or yellow scales
- Red, itchy skin
Dermatologists believe seborrheic dermatitis may be caused by the hyperreaction of the immune system to an overgrowth of yeast that naturally occurs on human skin.
People who have certain chronic ailments are more likely to develop seborrheic dermatitis.
Diseases that put you at higher risk include:
- Heart attack
- Parkinson’s disease
People who experience hormonal changes, cold weather, high stress, or use harsh detergents and other cleaning chemicals are also at higher risk of developing seborrheic dermatitis.
Stasis dermatitis occurs when patients have poor circulation, or blood flow, in their legs.
Sometimes, due to advanced age or another health condition, veins cannot efficiently pump blood out of the legs and back toward the heart.
When that happens, fluid leaks and pools in the feet, ankles, and legs below the knees.
The swelling causes discomfort, itch, and other symptoms.
Stasis dermatitis is sometimes called gravitational dermatitis, varicose eczema, or venous eczema, and it is widespread among people of advanced age.
It may affect up to 20 million people over 50 in the United States alone.
Patients with stasis dermatitis experience a cascade of symptoms as their circulation declines.
Early signs include small spots of discoloration, but as the condition worsens, patients develop:
- A heavy ache in the legs, particularly after sitting or standing for an extended period
- Dry skin
- Hair loss on the ankles or legs
- Itchy or scaly skin
- Large ulcers that bleed or ooze fluid
- Red, brown, purple, or gray skin discoloration on their legs
- Shiny skin
- Thick, dark, scarred, or bumpy skin
- Stasis dermatitis can affect one or both legs at a time. It rarely affects other parts of the body.
Stasis dermatitis is closely associated with poor circulation and tends to affect women more often than men.
Other risk factors include:
- Blood clot
- Heart failure
- High blood pressure
- History of a leg injury
- Kidney failure
- Multiple pregnancies
- Varicose veins or other vein-related health conditions
People who sit or stand still for long periods are at higher risk of developing stasis dermatitis.
If you believe you might have eczema, seek medical advice from a healthcare provider with experience evaluating skin conditions.
A primary care provider, dermatologist or eczema specialist can give you an accurate diagnosis and recommend a treatment plan that will help soothe your itch and manage any other symptoms.
During your exam, your provider will examine your skin, note where your rash is located, and observe any other characteristics that might help identify the ailment.
They will ask you about your health history and family history, the symptoms you are experiencing, and what kind of cleaning agents or other household chemicals you use.
If they still need more information, they may perform a patch test or biopsy for closer examination.
Once they determine a diagnosis, your provider will recommend prescription or over-the-counter medications for you to try.
In addition, they may recommend self-care measures that you can take to soothe your symptoms, and suggest a skin care regimen that will lessen inflammation over time.
There is no cure for eczema, but patients can contain their condition with medication and lifestyle changes. Treatment options for eczema vary depending on an individual’s diagnosis.
Atopic Dermatitis: Experts often recommend that patients use topical corticosteroids like hydrocortisone cream, a prescription cream such as a calcineurin inhibitor, and moisturizers to keep the skin healthy and reduce swelling. They may also suggest that patients make bathing and dietary changes, take antihistamines, and use bandages or wet wraps to help heal the skin’s natural barrier.
Dyshidrotic eczema: Treatment includes topical steroid ointments or calcineurin inhibitor creams to treat symptoms and manage itch. They may also recommend draining large blisters or treating skin with ultraviolet light to help reduce swelling and pain.
Contact Dermatitis: Providers will prescribe topical steroids or recommend other moisturizing ointments to soothe the affected area and heal skin rash. They may also suggest that patients take an oral corticosteroid or antihistamine.
Discoid Eczema: Treatment may include topical steroids and antihistamines to treat the round patches on their skin. Your doctor may also suggest gentle soap products and recommend short, lukewarm baths or showers, which can help protect the skin barrier.
Neurodermatitis: Doctors may suggest that patients apply a moisturizer, cool compress, coal tar, or topical steroid to the skin to reduce their inclination to itch. They may also recommend that patients soak in a bath treatment to soothe their skin. Oral antihistamines can help decrease itching.
Seborrheic Dermatitis: Your provider may recommend a shampoo, ointment, or cream applied to the scalp to reduce swelling and discomfort. They may also prescribe an anti-fungal pill, medicated lotion, or shampoo to decrease yeast on the skin that can trigger this condition. Infants with cradle cap will only need a gentle baby shampoo.
Stasis Dermatitis: Doctors treat stasis dermatitis by working with patients to reduce the vein issues that cause it. They may recommend compression socks or keeping your legs elevated for a certain amount of time every day. They might suggest that you take vitamin C or other supplements to help increase blood flow. And they may prescribe a topical corticosteroid or antibiotic to treat inflammation and infection.
Getting an accurate diagnosis and following your healthcare provider’s recommendations will help you prevent eczema symptoms.
Take any medication exactly as prescribed, make the lifestyle changes that your provider suggests, and reduce your exposure to the environments, experiences, substances, materials, and other conditions that tend to exacerbate your condition.
Avoiding triggers and gently treating your inflamed skin will help your immune system and skin rest, recover, and heal.
Other lifestyle habits that you can implement to help avoid symptom flare-ups include:
- Using fragrance- and dye-free soaps, detergents, and other cleaning products
- Cleaning your house regularly to avoid environmental exposure to mold, pollen, or dander
- Exercising regularly
- Eating a healthy diet
- Drinking plenty of water
- Avoiding tobacco smoke
- Wearing 100% cotton clothing
- Avoiding stress
Article By Terez Malka, MD Khealth.com/learn/eczema/types/