The symptoms of eczema can be mistaken for other conditions. The rash that occurs may appear to be sunburn, an allergic reaction to something you have put on your skin, or a reaction to food or medicine. An eczema rash tends to look different each time it flares and varies based on its location on your body. The rash is usually always dry and the skin tends to be very sensitive. The associated itching tends to be very severe. Some people scratch to the point of bleeding which can worsen the condition. If you experience any of the following symptoms, see your doctor for a correct diagnosis:

• Skin that is dry and sensitive
• Severe itching
• Inflammation and redness of the skin
• Rash that tends to recur
• Skin that appears scaly, rough, and leather-like
• Bleeding skin after itching
• Discolored areas on the skin
• Areas that ooze and crust over
• Swelling

The exact cause for eczema is still unknown, but several factors contribute to the condition. Here is a comprehensive list:

Allergies. You will notice eczema flares when you are exposed to allergy triggers such as pets, dust mites, mold, and outside pollens.

Topical irritants. You may be sensitive to things you commonly use such as shampoo, laundry detergent, lotions, and household cleaners. If you are allergic to certain foods, contact with bare skin when cooking can trigger a flare.

Stress. If you have eczema, excessive emotional or physical stress can trigger a flare.

Hormonal changes. Women may notice flares with monthly cycles, pregnancy, and during menopause.

Bacteria or fungal infections. Certain fungi or bacteria that normally live on the skin may trigger flares.

Food. You may not experience anything internal if you are allergic to a food, but an eczema reaction when eating certain foods may mean you have a food allergy. This often happens with shellfish, nuts, berries, and citrus foods. Eggs, wheat, and dairy can also be eczema triggers.

Temperature changes. Some sufferers notice flares in extreme cold or extreme heat. Sweating can also trigger the rash, along with changes in humidity.

Researchers have found that people with eczema have a few common risk factors, which include:

• Family history of eczema
• Family or personal history of allergies and asthma
• Environment (high pollution or high allergy areas like farms, big cities, etc.)
• Female gender (less common in males)

There is no actual lab test to diagnose eczema. A dermatologist can do skin scrapings to check for bacterial or fungal causes and rule those out. Once any other cause is ruled out, a recurring rash is usually diagnosed as eczema after being watched over some time. The doctor can also take a thorough history of allergies and asthma, which usually occur with eczema.

If you have symptoms of eczema, it is important to see your doctor for a proper diagnosis and discuss ways to treat it. While minor cases may be successfully treated with home remedies, some of the more severe cases only respond to medical treatments, including:

Your doctor may first prescribe a steroid cream and/or a cream that reduces the immune response in your skin [i.e., tacrolimus (Protopic©) or pimecrolimus (Elidel©)]. You may also be told to apply antibiotics or antifungals if an infection is suspected to be the cause. Your doctor may also have you try oral antihistamines to stop the itching. If your case is severe enough, you may be given a steroid injection in the doctor’s office.

Your doctor may recommend other treatments to help your skin heal, such as skin dressings and bandages, light therapies with UV light, stress reduction techniques, and possibly counseling for stress.

For babies, your child’s pediatrician may recommend changing soaps, keeping your baby out of excessive heat or cold, and using lotions. In severe cases, mild steroids may be used.

Certain alternative medical therapies have been very promising for eczema sufferers. It’s important to discuss any therapy with your doctor so that he/she can monitor you for any side effects. Alternative therapies include:

Vitamin therapy. Some studies have shown that increasing your intake of vitamin D and using vitamin B12 topically can help heal the skin and reduce immune system reactions.

Herbs. Certain herbs have powerful anti-inflammatory properties and can help relieve eczema. Sunflower oil is helpful, as well as tea tree oil, and evening primrose.

Hypnosis. Hypnosis can help to relieve the stress which can contribute to eczema.

Acupuncture. Acupuncture placed on the right meridians may help reduce itching and nerve irritation. It may also help balance the immune system and reduce flares.

Probiotics. Probiotics may help to improve skin health, by increasing healthy bacteria in the gut. This can help strengthen the immune system and reduces sensitivities.

• Keep your skin clean and dry
• Try keeping wood floors with no carpet in your home
• Keep your pets clean (dander contains mites that can cause eczema)
• Keep your skin moisturized
• Wear only 100% cotton clothing
• Avoid allergy or asthma triggers
• Stay out of extreme heat or cold
• Treat any allergies or asthma promptly

Many sufferers find that gaining control of eczema starts with lifestyle changes. Just giving the house a good dusting, getting rid of stress, and avoiding allergens can be a big help. Other tips to help control eczema include:

• Take cool showers
• Apply creams before drying
• Wear loose clothing that is non-irritating, avoid wool
• Do not scratch if at all possible
• Avoid exercise to the point of perspiration
• With your doctor’s permission, try an over-the-counter anti-itch cream or Benadryl
• Use mild soaps, detergents, shampoos, and household cleaners
• Eat a healthy balanced diet and avoid food triggers (nuts, eggs, shellfish, dairy, etc.)

Australian Society of Clinical Immunology and Allergy. (2019). Eczema (atopic dermatitis). Retrieved from Australian Society of Clinical Immunology and Allergy: https://www.allergy.org.au/patients/skin-allergy/eczema

Lun Hon, E. K., Chan, B. C-L. & Chung, L. P. (2011, April). Chinese herbal medicine research in eczema treatment. Chinese Medicine, 6(1), 17-. Retrieved from ResearchGate: https://www.researchgate.net/publication/51083593_Chinese_herbal_medicine_research_in_eczema_treatment

Mayo Clinic Staff. (2020, June 12). Atopic dermatitis (eczema). Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/symptoms-causes/syc-20353273

McIntosh, J. (2020, July 21). What to know about eczema. Retrieved from Medical News Today: https://www.medicalnewstoday.com/articles/14417

U.S. National Library of Medicine. (2020, December 07). Eczema. Retrieved from MedlinePlus: https://medlineplus.gov/eczema.html

Zari, S. T. & Zari, T. A. (2016, June 25). A review of four common medicinal plants used to treat eczema. Journal of Medicinal Plants Research, 9(24), 702-711. Retrieved from Academic Journals: https://academicjournals.org/article/article1435738061_Zari%20and%20Zari.pdf