If you've ever dealt with persistently dry, itchy, inflamed skin, you may be familiar with eczema, even if you didn't know that's what it was. Eczema affects 31.6 million people in the United States, which is nearly 10% of the population. Despite how common it is, there's a lot of confusion about what eczema actually is, what causes it, and, most importantly, what you can do about it.
Here's a clear, evidence-based breakdown.
What Is Eczema?
Eczema is a condition that causes your skin to become dry, itchy, and bumpy. It weakens your skin's barrier function, which is responsible for helping your skin retain moisture and protecting your body from outside elements. The most common form is atopic dermatitis, though eczema is technically an umbrella term for several related conditions.
Eczema is a chronic condition; it can go away and come back unexpectedly. It is not contagious, and while it often begins in childhood, it can persist well into adulthood. Approximately 1 in 4 children develop atopic dermatitis, with symptoms typically appearing by age 5. By adolescence, approximately 60% of those affected will no longer show symptoms, but for many, it remains a lifelong condition requiring active management.
Symptoms of Eczema
Eczema symptoms vary from person to person, but the most common include:
- Dry, sensitive skin
- Intense itching, particularly at night
- Red, inflamed patches
- Rough, scaly, or leathery skin texture
- Oozing or crusting in severe cases
- Swelling from scratching
Eczema symptoms tend to come and go. When you have symptoms, this is known as an eczema flare. The location of flares can shift over time; in infants it often appears on the face and scalp, while in older children and adults it tends to concentrate in the creases of the elbows, knees, and neck.
One thing worth noting: an eczema rash may appear gray or brown in people with darker skin tones, which can make it harder to identify. People with darker skin tones may also experience dark or light patches even after eczema symptoms resolve.
What Causes Eczema?
Nobody knows exactly what causes eczema, but it can run in families and is thought to be caused by both genetic and environmental factors. At its core, eczema is a dysfunction of the skin barrier; the outer layer of skin isn't able to lock in moisture or keep irritants out effectively, which sets off a cycle of dryness, inflammation, and itching.
Common triggers include:
- Irritants: Soaps, detergents, fragrances, and synthetic fabrics
- Allergens: Dust mites, pet dander, pollen, and/or certain foods
- Temperature and humidity: Both cold, dry air and excessive heat or sweat can provoke flares
- Stress: Stress is not a direct cause of eczema, but it can worsen symptoms.
- Hormonal changes: Some people experience increased eczema symptoms when hormone levels fluctuate, such as during pregnancy or certain points in the menstrual cycle.
- Hard water: Water with high mineral content (calcium and magnesium) can disrupt the skin barrier and is an underrecognized trigger for some people. If you live in a hard water area, a shower filter or faucet filter may be worth trying.
Because triggers vary so widely, identifying your personal ones is one of the most effective things you can do for long-term management.
How to Treat Eczema
There is currently no cure for eczema, but symptoms are very manageable with the right combination of topical care, medical treatment, and lifestyle adjustments.
Topical Treatments
Moisturizing is the foundation of any eczema routine. Keeping the skin barrier hydrated reduces both the frequency and severity of flares. Look for fragrance-free, gentle formulas that contain ingredients clinically recognized for barrier support.
A few worth knowing about:
- Colloidal oatmeal has been used to soothe inflamed, itchy skin for decades and is FDA-recognized as a skin protectant. It forms a gentle film on the surface of the skin that helps lock in moisture and calm irritation.
- Allantoin is a well-researched ingredient that promotes skin cell renewal and helps reduce redness and sensitivity — particularly useful during and after flares.
- Niacinamide (vitamin B3) helps strengthen the skin barrier by supporting ceramide production, reducing water loss, and calming inflammation over time.
If you're looking for a single product that combines all three of these ingredients, you can find it here.
Topical corticosteroid creams and ointments are the standard anti-inflammatory option for managing eczema flares, available both over-the-counter and by prescription depending on the strength needed. For those who can't use steroids long-term, topical calcineurin inhibitors suppress the immune response in the skin and can help decrease inflammation and prevent flares.
Medical and Prescription Options
For moderate to severe eczema that doesn't respond to topical treatment, a dermatologist may recommend prescription biologics or oral medications. Phototherapy, which involves exposure to ultraviolet light, may also help treat moderate atopic dermatitis.
Lifestyle Adjustments
Managing eczema isn't just about what you put on your skin, it's also about your daily habits:
- Bathe in warm (not hot) water and keep showers short. Hot water strips the skin barrier.
- Moisturize immediately after bathing, while skin is still slightly damp, to seal in hydration.
- Consider a shower or sink filter if you live in a hard water area. High mineral content in tap water can irritate the skin barrier and contribute to flares for some people.
- Wear soft, breathable fabrics like cotton and avoid wool or synthetic materials directly against the skin.
- Wash clothing and bedding with fragrance-free detergent and rinse thoroughly.
- Stay hydrated. Drinking enough water helps keep skin moist.
- Manage stress through whatever works for you — exercise, sleep, meditation, or time outdoors. The skin-stress connection is real and worth taking seriously.
- Track your flares to identify patterns. Keeping a simple log of what you ate, what products you used, and your stress level on flare days can reveal personal triggers over time.
The Bottom Line
Eczema is common, chronic, and sometimes frustrating, but it can be managed with the right combination of treatments and lifestyle adjustments. The most effective approach combines consistent barrier-supporting skincare, trigger avoidance, and lifestyle habits that reduce inflammation from the inside out. If your eczema is severe or not responding to over-the-counter care, see a dermatologist. There are more effective options available now than ever before.
Sources
- Cleveland Clinic — Eczema: What It Is, Symptoms, Causes, Types & Treatment
- Medical News Today — Eczema (atopic dermatitis): Symptoms, treatment, and more
- Healthdirect — Eczema: Symptoms, causes and treatment
- WebMD — Eczema: Types, Symptoms, Causes, Diagnosis, and Treatment
- ACAAI — Eczema
- National Eczema Association — 2024 Eczema Treatment Roundup
- NIAID — Eczema Treatment Research
- Mayo Clinic — Atopic dermatitis (eczema): Diagnosis and treatment
