Eczema is not a single disorder, but a collective name for various inflammatory conditions of the skin. These inflammations have various causes and can occur at any time in your life, from baby to adulthood. What all forms of eczema have in common is that they lead to inflamed, irritated skin that is often intensely itchy and looks red and damaged.

An important fact that reassures many people: eczema is not contagious. You can't transmit it to others through touch or proximity, nor can you contract it from someone else. It is a reaction of your own skin to internal or external factors, in which the skin's immune system plays a role.

The skin of people with eczema has an impaired barrier function. Imagine your skin as a wall that protects your body against external stimuli. In eczema, that wall is weakened: it has cracks and holes that lose moisture and make it easier for irritants to enter. This explains why people with eczema often have dry, sensitive skin that responds quickly to various stimuli.

Eczema can manifest itself in various ways, from mild dryness and slight redness to severe inflammation with blisters, chapping and thickening of the skin. The different forms each have their own pattern of origin and occurrence on specific parts of the body. Some people deal with one specific type of eczema, while others may experience different forms over the course of their lives.

The impact of eczema goes beyond the physical symptoms alone. The itching can interfere with your sleep, affecting your energy levels and concentration during the day. Visible eczema on your hands or face can affect your self-confidence. Many people with eczema also struggle with unpredictability: periods when the skin is calm alternate with revivals where the symptoms suddenly worsen for no apparent reason.

The development of eczema is complex and varies by type, but a disturbed skin barrier plays a central role in all forms. Your skin consists of different layers that work together to protect your body. The outer layer, the horny layer, functions as a protective shield. For people with eczema, this shield does not work optimally, making the skin more vulnerable to external stimuli.

Heredity plays an important role in various forms of eczema. If one or both parents have eczema, asthma, or hay fever, children are more likely to develop a form of eczema as well. This genetic predisposition does not mean that you will definitely get eczema, but it does mean that your skin is more susceptible to inflammatory reactions. The hereditary component is particularly strong in atopic eczema, the most common form.

In atopic eczema, there is a genetic defect in the production of certain proteins that keep the skin barrier strong. This naturally makes the skin drier and more permeable. The immune system in the skin also reacts differently: it shoots more quickly into ignition mode when in contact with normally innocent substances. This overactive immune response causes the redness, swelling, and itching that characterize eczema.

Contact eczema, both irritant and allergic, occurs due to external influences. In the case of irritant contact eczema, substances such as cleaning agents, solvents or even excessive water contact damage the skin barrier directly. The skin becomes irritated and inflamed due to this mechanical damage. Allergic contact eczema, on the other hand, is an immune response: your body has learned to recognize a certain substance such as nickel or perfume as foreign and reacts violently to repeated contact.

Seborrheic eczema, which mainly occurs on the scalp and other areas with many sebaceous glands, is related to a yeast that occurs naturally on the skin. In people with this type of eczema, the skin reacts too strongly to the normal presence of this yeast, leading to inflammation and scaling. Hormones, stress, and certain neurological disorders can enhance this response.

Nummular eczema, with its characteristic coin-shaped patches, often has no clearly detectable cause. Presumably, extreme dryness of the skin plays a role, combined with minor damage that serve as the starting point for the inflammatory response. This form is more common in people with dry skin or in the winter months when the humidity is low.

Various triggers can worsen existing eczema or cause new recurrences. Stress affects your immune system and can weaken the skin barrier. Weather changes, especially cold, dry air in winter, draw moisture away from the skin. Sweating, abrasive clothing, certain foods, dust mites, and even emotional factors can all contribute to the occurrence of eczema in people who are prone to it.

The most universal and annoying symptom of all forms of eczema is itching. This itching ranges from mild to unbearable and tends to worsen in the evening and night. The urge to scratch is often overwhelming, but scratching further damages the skin and worsens inflammation, leading to a vicious cycle of itching and scratching that is difficult to break.

Redness is another characteristic sign of active eczema. The skin looks inflamed due to increased blood flow to the affected area. On lighter skin tones, this redness is clearly visible as bright red spots. On darker skin tones, eczema can show up as dark brown, purple, or greyish discolorations that are less noticeable but feel just as irritating. These discolorations can remain visible for months after healing.

Dryness and flaking are almost always present. The skin feels rough and constantly loses small flakes. This is because the weakened skin barrier is unable to retain moisture properly. In some forms of eczema, such as seborrheic eczema, the flakes are oily and yellowish instead of dry and white. This peeling is not only cosmetically disturbing, but also indicates active inflammation and skin renewal that is not proceeding normally.

In acute phases, blisters can develop, especially in atopic eczema and contact eczema. These small, fluid-filled bumps itch intensely and can burst, making the skin wet and extra vulnerable to infections. When the blisters dry up, scabs form that mark the healing process but can also tear and bleed when moving.

In chronic eczema that has been around for a long time, the skin thickens and takes on a leathery appearance. This process is called lichenification and is a result of prolonged inflammation and repeated scratching. The skin lines become deeper and more prominent, and the skin feels stiffer. This thickening is most visible in areas that are often scribbled, such as the elbows, knees, and ankles.

Cracks and cracks in the skin are painful and occur mainly in areas where the skin moves, such as the hands, fingertips, and around joints. These cracks can be deep enough to bleed and make daily activities like washing hands, typing, or just moving around uncomfortable. They are also a gateway for bacteria, which increases the risk of infections.

The severity of symptoms varies greatly between people and over time. Some people only have mild symptoms with occasional dryness and mild itching. Others suffer from severe, extensive eczema that affects large parts of their bodies and severely restricts their daily lives. Even for the same person, quiet periods with hardly any symptoms can be alternated with episodes where the skin suddenly becomes severely inflamed again.

The locations where eczema appears depend a lot on the type of eczema and the age at which it occurs. In babies with atopic eczema, the first signs often appear on the cheeks, forehead, and scalp. These spots are highly visible and may cause concern to parents, but are characteristic of eczema at this early age. The skin there is thinner and more sensitive to stimuli.

As children get older, atopic eczema typically moves to the folds of the body. The elbow creases and popliteal cavities are classic locations where eczema settles and can remain into adulthood. The wrists, ankles and neck are also often affected. These folds collect moisture and heat, making the skin extra sensitive to inflammatory reactions.

In adults with atopic eczema, the hands may be prominently affected. Hand eczema is particularly annoying because your hands are constantly in contact with water, soap and other potentially irritating substances. It can be confined to the fingers and palms, or spread to the wrists and forearms. For people whose work requires frequent hand washing or contact with chemicals, this can be particularly problematic.

Seborrheic eczema has its own distinctive distribution pattern. It appears in places where there are many sebaceous glands: the scalp, where it is known as dandruff, eyebrows, wings of the nose, behind the ears, and sometimes the chest. In babies, we see them as yellow, oily scabs on the scalp, often called milk crusts. This shape can also affect the diaper area. Other forms of eczema also often take place in this area, such as contact eczema.

Nummular eczema favors the legs, especially the lower legs and shins. However, the coin-shaped patches can also appear on the arms, torso, and sometimes the face. They are sharply defined and clearly distinguishable from the surrounding healthy skin, making them easier to spot than other forms of eczema.

Contact eczema, both irritant and allergic, logically appears at the sites that come into contact with the causative substance. With nickel allergy, you often see it in places where jewelry touches the skin: earlobes, neck, wrists and fingers. In case of perfume allergy, eczema can appear where you put perfume on, but also in other places because allergens can spread through the air.

The symmetry of the skin condition can also be diagnostically valuable. Atopic eczema is often symmetrical: if your left knee cavity is affected, you will also see similar symptoms in your right knee cavity. This is because the underlying cause, your genetic predisposition and immune reactivity, affects both halves of the body equally. Contact eczema, on the other hand, is often asymmetric because exposure to the irritant or allergenic substance is usually not perfectly the same on both sides.

Treating eczema always starts with good basic skin care, no matter what type of eczema you have. Applying oily, emollient creams daily is fundamental. These creams restore the skin barrier, retain moisture and protect against external stimuli. It is best to apply them to slightly damp skin after showering or bathing, when the skin is most receptive. Repeat this several times a day, especially in dry weather.

Your doctor will prescribe an anti-inflammatory cream or ointment for active inflammation. The strength and duration of this treatment depends on the severity and location of your eczema. Milder preparations are often used for the face and folds, while thicker skin such as on the palms or soles can tolerate stronger treatment. The goal is to quickly control the inflammation so that the itching decreases and your skin can recover.

Treatment is usually phased out as soon as symptoms ease. You go from twice a day to once a day, and finally to a maintenance schedule where you apply the cream twice a week to sensitive areas, for example. This approach prevents new revivals and keeps your skin calmer. Even when your skin looks good, daily basic skin care with emollient creams remains essential.

For specific forms of eczema, there are targeted additional treatments. If there is contact eczema, identifying and avoiding the causative agent is crucial. Your doctor may refer you to a skin specialist for allergy tests, such as an adhesive test where different substances are applied to your back over a few days to detect allergies. Once identified, you can consciously avoid these substances.

For seborrheic eczema on the scalp, special shampoos are available that help control yeast and reduce flaking. These shampoos contain substances that inhibit yeast growth and reduce inflammation. Regular use, sometimes combined with a mild facial treatment, can manage symptoms well.

When topical treatments are not effective, systemic treatments are available. These are medications that you take or receive via injections that affect your entire immune system. These are reserved for moderate to severe eczema that does not respond to regular treatments. A skin specialist will discuss the pros and cons of these treatments with you.

Self-care measures reinforce any medical treatment. Take short, lukewarm showers instead of long, hot baths that dry out the skin. Use soft, fragrance-free soaps or soap substitutes such as shower oil. Wear soft, breathable clothing made from natural fibers such as cotton, and avoid abrasive fabrics such as wool directly on the skin. Wash new clothes before wearing them to remove production equipment and do not use fabric softener.

Get to know your triggers and avoid them where possible. Keep a journal where you write down when your eczema revived and what happened that day. Patterns can help identify whether certain foods, stress, weather changes, or other factors make your eczema worse. This knowledge enables you to act proactively instead of just responding to upheavals.

Itch management is a separate area of focus. Scratching damages the skin and worsens inflammation, but the urge is often overwhelming. Keep your nails short and consider wearing cotton gloves while sleeping to limit unconscious nighttime scratching. Cool compresses can provide temporary relief, and distracting activities help take your mind off the itch.

A common mistake is washing the skin excessively under the assumption that eczema has something to do with hygiene. Washing too often or showering for too long actually dries out the skin and further weakens the skin barrier. Water, especially hot water, removes moisture from your skin and washes away the natural protective oils. Limit your shower to five to ten minutes and use lukewarm water.

Using regular soaps, especially those containing perfume or other additives, is counterproductive. These products are often too aggressive for the sensitive skin of people with eczema and can increase the inflammatory response. Products that are marked as natural or organic can also contain irritants. Opt specifically for products designed for sensitive or atopic skin.

Many people try various home remedies or alternative treatments with no proven effectiveness. While some natural products can be soothing, others are downright harmful. Products containing citrus, essential oils, vinegar, or alcohol may further irritate inflamed skin. Be careful with Internet advice or well-intentioned tips from others, and always discuss new treatments with your doctor first.

The idea that you need to let eczema dry out to heal is a misconception. On the contrary, dry skin is weak skin that is actually more susceptible to new inflammations. Constantly hydrating and retaining moisture is essential for recovery. Even after healing, regular application remains necessary to keep your skin barrier strong and prevent relapse.

Ignoring early signs of a rebound in the hope that it will go away on its own often leads to more severe symptoms that last longer and are harder to treat. As soon as you notice redness, itching, or dryness that doesn't respond to your basic skin care within a few days, it's time to contact your doctor. Early intervention prevents a small upsurge from developing into a major inflammatory response.

Arbitrarily discontinuing prescribed treatment as soon as symptoms improve is a common pitfall. Eczema is a chronic condition where the underlying skin vulnerability persists even when you no longer see symptoms. Stopping treatment too early almost always leads to a rapid relapse. Always follow the reduction schedule prescribed by your doctor.

Ignoring or trivializing stress doesn't work either. Although stress does not cause eczema, it can trigger relapses and make existing symptoms worse. Developing stress management skills, getting enough sleep, and ensuring relaxation are important parts of a holistic approach to eczema.

Is Eczema contagious?

No, definitely not. Eczema is a reaction of your own skin and immune system, not an infectious disease. You can't transfer it to others by touching, sharing towels, or in any other way. So you can just have normal contact with others without putting them at risk.

Are you growing over eczema?

That depends on the type of eczema. Many children with atopic eczema see their symptoms decrease or even disappear completely in puberty or early adulthood. For some, however, it persists or comes back later. Other forms of eczema, such as contact eczema, usually disappear as soon as you avoid the causative agent. The underlying sensitivity often persists.

Can diet affect eczema?

In some people, especially young children with severe atopic eczema, certain foods may make symptoms worse. However, this is not the case for everyone. Elimination diets without medical supervision are not recommended because they can lead to deficiencies. If you suspect that diet plays a role, discuss this with your doctor who may be able to arrange allergy tests or a referral to a dietician.

When should I see a doctor with eczema?

Visit your doctor if you develop new symptoms similar to eczema, if existing eczema does not respond to your current treatment, or if symptoms affect your daily life. Even if the skin shows signs of infection such as increasing pain, warmth, swelling, yellow scabs or fever, medical advice is needed soon. Infections can seriously complicate eczema.

Does sunlight help with eczema?

Moderate sunlight can indeed be beneficial for some forms of eczema due to the anti-inflammatory effects of UV radiation. Please note: too much sun damages the skin and can actually make eczema worse. Always use sunscreen that is suitable for sensitive skin. Some dermatologists offer controlled light therapy as a treatment option for chronic eczema.

Is eczema curable?

Eczema is a chronic condition where the predisposition persists, but the symptoms are easy to manage. With the right treatment and skin care, many people can achieve prolonged periods without symptoms. The focus is on controlling the condition and preventing relapses, rather than on a complete cure. With good self-care and medical guidance, you can maintain a normal quality of life.

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