What Is Eczema? Symptoms, Causes, Treatment, and Medications
Eczema is a general term for several types of skin inflammation that cause dry, itchy, and inflamed skin. The most common type is atopic dermatitis, an often long-lasting condition linked to both genetic and environmental factors. According to MedlinePlus, eczema is not contagious. Treatment includes moisturizers, topical corticosteroids, calcineurin inhibitors, crisaborole, and newer biologics and JAK inhibitors for moderate-to-severe disease.
Key Highlights
- Eczema is a general term for several types of skin inflammation; the most common type is atopic dermatitis, which causes dry, itchy, inflamed skin.
- The exact cause is unknown but likely involves both genetic and environmental factors, and eczema is not contagious.
- Everyday care centers on moisturizers (emollients) and avoiding triggers such as harsh soaps, stress, and allergens.
- Prescription options include topical corticosteroids, calcineurin inhibitors (tacrolimus, pimecrolimus), and crisaborole (Eucrisa).
- Moderate-to-severe eczema may be treated with biologics such as dupilumab (Dupixent) and tralokinumab, or JAK inhibitors such as upadacitinib, abrocitinib, and ruxolitinib cream.
- PriceMyMeds discount coupons can help reduce the cost of eczema medications at participating pharmacies.
What Is Eczema?
Eczema, also called dermatitis, is a general term for several types of skin swelling and inflammation. According to MedlinePlus, most types cause dry, itchy skin and rashes, commonly on the face, inside the elbows, behind the knees, and on the hands and feet. Scratching can make the skin turn red and swell and itch even more. The most common type of eczema is atopic dermatitis, which is most common in babies and children but can also affect adults.
Eczema is not contagious. Its exact cause is unknown, but it is likely caused by both genetic and environmental factors, including a weakened skin barrier and an overactive immune response. Eczema may get better or worse over time and is often a long-lasting (chronic) disease. People who have it may also develop hay fever and asthma, a pattern sometimes called the atopic march.
Key Facts:
- Generic names: hydrocortisone, triamcinolone, tacrolimus, pimecrolimus, crisaborole, dupilumab, tralokinumab, upadacitinib, abrocitinib, ruxolitinib
- Drug classes: topical corticosteroids, topical calcineurin inhibitors, PDE4 inhibitors, IL-4/IL-13 and IL-13 monoclonal antibodies (biologics), and Janus kinase (JAK) inhibitors
- FDA approvals: dupilumab (Dupixent) approved for patients 6 months and older; crisaborole (Eucrisa) approved for patients 3 months and older; tralokinumab approved for those 12 and older
- Typical costs: generic topical corticosteroids often $5-$30; brand and specialty medicines cost much more
- Common uses: mild, moderate, and severe atopic dermatitis and related forms of eczema
Eczema vs. Psoriasis: Understanding the Difference
Eczema and psoriasis both cause red, scaly, itchy skin, but they are different conditions. Eczema usually causes intense itching and often appears in skin folds such as the inner elbows and behind the knees, while psoriasis tends to produce thicker, well-defined plaques with silvery scale on areas like the elbows, knees, and scalp. A dermatologist can tell them apart and recommend the right treatment.
What You Need to Know
Understanding Eczema: Causes, Symptoms, Diagnosis, Treatment, and Prevention
1.What Are the Causes of Eczema?
The exact cause of eczema is unknown, but research points to a combination of genetics, a weakened skin barrier, immune system overactivity, and environmental triggers.
Contributing factors:
- Genetics and family history of eczema, hay fever, or asthma
- A weakened skin barrier that loses moisture and lets in irritants and allergens
- An overactive immune response that drives skin inflammation
Common triggers that can cause flares:
- Irritants such as certain soaps, detergents, and fragrances
- Rough fabrics such as wool, and some lotions
- Allergens such as pollen, pet dander, dust mites, and certain foods
- Dry air, sweating, and extreme temperatures
- Stress
- Skin infections
Identifying and avoiding your personal triggers is an important part of managing eczema, because different people react to different things.
2.What Are the Symptoms of Eczema?
The hallmark of eczema is dry, itchy, inflamed skin, though the appearance can vary by skin tone and age.
Common symptoms include:
- Dry, sensitive skin
- Intense itching, which is often worse at night
- Red, brown, or grayish patches (inflammation may look purple, brown, or gray on darker skin)
- Rashes on the face, inside the elbows, behind the knees, and on the hands and feet
- Small, raised bumps that may leak fluid and crust over when scratched
- Thickened, cracked, or scaly skin from long-term scratching
- Raw, sensitive, or swollen skin
How Long Do Eczema Symptoms Last?
- Eczema is often a long-lasting condition with periods of flares and periods of clearer skin (remission)
- Flares can last days to weeks, especially if triggers continue
- Many children improve or outgrow atopic dermatitis as they get older, though skin may stay dry and easily irritated
- Good daily skin care and avoiding triggers can reduce how often and how severely flares occur
3.How Is Eczema Diagnosed?
Eczema is usually diagnosed by a healthcare provider or dermatologist based on the appearance of the skin and a review of your symptoms and history. There is no single test for eczema.
A provider may ask:
- When did the rash and itching start, and where on the body?
- Do you or your family have a history of eczema, hay fever, or asthma?
- What seems to trigger or worsen the symptoms?
- What soaps, lotions, or products do you use?
Diagnostic steps may include:
- A physical exam of the skin
- A review of personal and family medical history
- Patch testing to identify allergens that may trigger contact dermatitis
- Rarely, a skin biopsy to rule out other conditions
Because several skin conditions look similar, a professional evaluation helps confirm eczema and guide treatment.
4.How Is Eczema Treated?
Treatment aims to relieve itching, calm inflammation, repair the skin barrier, and prevent flares. Care is often stepped up based on severity.
Moisturizers (Emollients) and Skin Care
Daily moisturizing is the foundation of eczema care. Applying a fragrance-free moisturizer, especially after bathing, helps repair the skin barrier and lock in moisture. Gentle cleansing and avoiding harsh soaps are also important.
Topical Corticosteroids
Topical steroids such as hydrocortisone (low potency) and triamcinolone (medium potency) reduce inflammation and itching during flares. They come in different strengths for different body areas and severities.
Topical Calcineurin Inhibitors and Crisaborole
Non-steroid topicals are useful for sensitive areas and for steroid-sparing, long-term control:
- Tacrolimus (Protopic) and pimecrolimus (Elidel) are topical calcineurin inhibitors
- Crisaborole (Eucrisa) is a topical PDE4 inhibitor for mild-to-moderate eczema
- Ruxolitinib cream (Opzelura) is a topical JAK inhibitor for mild-to-moderate eczema
Biologics (for Moderate-to-Severe Eczema)
Injectable biologics target the immune signals that drive eczema:
- Dupilumab (Dupixent) blocks IL-4 and IL-13 and is approved for patients 6 months and older
- Tralokinumab (Adbry) blocks IL-13 and is approved for patients 12 and older
Oral JAK Inhibitors (for Moderate-to-Severe Eczema)
Upadacitinib (Rinvoq) and abrocitinib (Cibinqo) are oral JAK inhibitors that can rapidly reduce itch and inflammation, and they require monitoring for side effects.
Other Therapies
- Phototherapy (light therapy) for widespread or stubborn eczema
- Wet wrap therapy for severe flares
- Antihistamines to help with sleep, and treatment of any skin infections
5.What Are the Complications of Eczema?
While eczema itself is not dangerous, ongoing inflammation and scratching can lead to complications.
Possible complications include:
- Skin infections (bacterial, viral, or fungal) from scratching and a broken skin barrier
- Eczema herpeticum, a serious widespread herpes virus infection of eczema-affected skin that needs urgent care
- Thickened, leathery skin (lichenification) from long-term scratching
- Sleep problems due to intense nighttime itching
- Emotional effects, including stress, anxiety, and reduced quality of life
- Hay fever and asthma, which are more common in people with atopic dermatitis
Seek prompt care if eczema becomes painful, oozes pus, develops yellow crusts, or is accompanied by fever, since these can signal an infection.
6.How Can Eczema Flares Be Prevented?
Eczema cannot always be cured, but consistent skin care and trigger avoidance can reduce how often and how severely flares happen.
Prevention and management tips:
- Moisturize daily, especially right after bathing, with a fragrance-free cream or ointment
- Take shorter, lukewarm (not hot) baths or showers and pat skin dry gently
- Avoid things that irritate your skin, such as certain soaps, fabrics, and lotions
- Identify and avoid your personal allergens, such as pollen, pet dander, or certain foods
- Manage stress, which can trigger flares
- Use a humidifier in dry weather
- Wear soft, breathable fabrics such as cotton and avoid wool next to the skin
- Keep fingernails short to reduce damage from scratching
Following a consistent daily routine, even when the skin looks clear, helps keep the skin barrier healthy.
7.When to See a Doctor for Eczema
Many mild cases of eczema can be managed at home, but a healthcare provider or dermatologist should be seen when symptoms are severe or not improving.
See a doctor if you experience:
- Eczema that interferes with daily life or sleep
- Symptoms that do not improve with over-the-counter moisturizers and hydrocortisone
- Widespread or worsening rashes
- Signs of skin infection, such as pus, yellow crusts, warmth, swelling, or fever
- Painful cracks in the skin
- A new or unusual rash that you are unsure about
Seek urgent care for a rapidly spreading, painful, blistering rash with fever, which could be eczema herpeticum, a serious infection that needs prompt treatment. A specialist can also help when stronger prescription options, such as biologics or JAK inhibitors, are being considered.
8.OTC vs. Prescription Eczema Medications: When Do You Need a Prescription?
Over-the-counter (OTC) products manage mild eczema and everyday skin care, but moderate-to-severe eczema usually needs prescription treatment.
OTC options include:
- Fragrance-free moisturizers and emollients (creams, ointments)
- Low-strength hydrocortisone (1%) cream for mild flares
- Gentle, soap-free cleansers
- Colloidal oatmeal products and antihistamines for itch relief
You need a prescription for:
- Medium- and high-potency topical corticosteroids such as triamcinolone
- Topical calcineurin inhibitors, tacrolimus (Protopic) and pimecrolimus (Elidel)
- Crisaborole (Eucrisa) and ruxolitinib cream (Opzelura)
- Biologics such as dupilumab (Dupixent) and tralokinumab (Adbry)
- Oral JAK inhibitors such as upadacitinib (Rinvoq) and abrocitinib (Cibinqo)
If OTC care is not controlling your eczema, a provider can determine which prescription option best fits your severity and the areas of skin involved.
Save on Your Medications
Eczema medications can vary widely in price depending on the specific product, brand versus generic, and whether it is a topical, biologic, or oral medication. Generic topical corticosteroids are often inexpensive, while brand-name topicals, biologics, and JAK inhibitors can be far more costly. With PriceMyMeds discount coupons, patients may be able to reduce the cost of eczema medications at participating pharmacies across the United States.
Simply search for your medication on PriceMyMeds, compare prices at pharmacies near you, and present your free coupon at the pharmacy counter to save. No insurance required.
Comparing medication prices and using discount coupons may help lower out-of-pocket costs for prescription eczema treatments.
The Bottom Line
Eczema is a common, often long-lasting skin condition that causes dry, itchy, inflamed skin, with atopic dermatitis being the most common type. It is not contagious and is likely driven by a mix of genetic and environmental factors, along with a weakened skin barrier and immune overactivity.
Daily moisturizing and trigger avoidance form the foundation of care, while prescription options range from topical corticosteroids, calcineurin inhibitors, and crisaborole to advanced therapies such as dupilumab, tralokinumab, and JAK inhibitors for moderate-to-severe disease. Knowing when to see a doctor, especially for signs of infection, helps prevent complications.
If you are prescribed eczema medication, use PriceMyMeds to compare prices at nearby pharmacies and potentially save on your prescription. No insurance or signup required.