7 Types of Eczema: Causes, Symptoms And Treatment

Overview

Eczema is a prevalent condition affecting almost 32 million people in the United States. 

You can suffer from more than one type of eczema at a time. In addition, different types of eczema present with different symptoms; therefore, treatment varies accordingly. 

This article discusses seven types of eczema in detail, their symptoms, causes and treatment options.

What causes eczema to start?

A mixture of genetic and environmental factors can lead to you developing eczema. Common symptoms include a rash, dry skin and itchiness. These signs appear soon after you come into contact with a trigger in your environment that causes your symptoms to appear or flare up. Identifying environmental triggers such as dust, soaps, detergents, food items and dust mites, pets, pollens, and mold and avoiding them may reduce your risk of an eczema flare-up.

Different types of eczema and their symptoms 

Eczema comes in many forms. Each type has its own set of characteristic symptoms and triggers. 

Some common symptoms for all types of eczema include:

• dry, scaly skin
• itching
• redness
• hyperpigmentation

1. Atopic Dermatitis 

Atopic dermatitis (AD) is a prevalent form of eczema. This form affects more than 26 million Americans annually among the many types of dermatitis.

It is a long-term condition that appears in early childhood. You can have AD on its own, or it can overlap with other types of eczema. In many cases, symptoms often become milder or go away by adulthood. While individuals may experience symptoms on and off during their lifetime.

Atopic dermatitis is often a part of the atopic triad. “Triad” refers to three. The other two diseases included in the triad are hay fever and asthma. Many people with atopic dermatitis suffer from all 3 conditions. 

Individuals with AD have an overactive immune system that sets off the process of inflammation and damages the skin barrier resulting in symptoms like itching, rashes and dryness. Research has indicated that people with atopic dermatitis have a mutation of the gene responsible for making filaggrin. Filaggrin is a protein in our body that helps maintain a protective top layer of our skin. With insufficient production of filaggrin, the skin loses moisture making it prone to invasion by microbes. The skin thus becomes dry and prone to infection.  

Symptoms

Common symptoms of AD include:

• Itchy skin 
• Dry/cracked skin
• Skin redness
• Thick, leathery, or scaly skin
• Weeping, oozing, or crusty skin

During a flare-up, individuals with atopic dermatitis may also experience asthma, allergies, anxiety, depression, ADHD, and sleep disturbances.

Adults with severe AD are also at higher risk for diabetes, hypertension, autoimmune disorders, respiratory infections and eye-related conditions.

Although, many people have isolated atopic dermatitis as well.

Causes

The cause of atopic dermatitis has not been identified. However, doctors believe that a combination of genetics and exposure to environmental toxins/allergens triggers AD.

Common triggers include: 

• Dust mites, pollen, mould or pet dander
• Detergents, cleaning chemicals, shampoos, or soaps
• Food allergies 
• Polyester, nylon or wool
• Stress 
• Fluctuation in hormones 

If you have atopic dermatitis, you must keep track of your triggers to prevent flare-ups.

How is AD treated?

Atopic dermatitis treatment includes: 

• Avoid known triggers
• Application of moisturisers 
• Maintain a regular sleep schedule
• Eating a healthy diet 
• Managing stress
• Using topical corticosteroids
• Non-steroid topical creams
• Biologics

Complication of AD

What is eczema herpeticum?

This is a type of infection caused by the herpes simplex 1 virus.

Eczema herpeticum causes

An eczema herpeticum occurs when the herpes virus infects large areas of the skin. Individuals with atopic dermatitis are more prone to skin infections, including eczema herpeticum. Eczema herpeticum can also occur in those with seborrheic dermatitis or contact dermatitis. It commonly affects infants, young children, and those who suffer from a severe form of atopic dermatitis.

Eczema herpeticum symptoms

Common symptoms include:

• Blisters that take the form of clusters and are painful and itchy
• Red, purple or black blisters
• Blisters that ooze fluid

Other associated symptoms include:

• High-grade fever/chills
• Swollen lymph nodes
• Malaise

Eczema herpeticum treatment

Eczema herpeticum is treated with antiviral medications. However, if there are signs of a super-imposed bacterial infection alongside, antibiotics are required. 

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2. Dyshidrotic Eczema

Dyshidrotic eczema (dyshidrosis) is another well-known type of eczema. It affects individuals between 20 and 40 years of age and often affects individuals who already suffer from other forms of eczema or seasonal allergies. This is also called pompholyx, a greek word translated as ‘bubble’ This form commonly presents as eczema on fingers, hand eczema and eczema on feet.

Metals such as nickel are a common trigger. Other factors that lead to a flare-up include stress, seasonal allergies, and hot and humid weather. In addition, sweaty palms and prolonged exposure to water can worsen the rash.  

As with some other forms of eczema, dyshidrotic eczema and autoimmune disease are closely associated. Symptoms can come and go, but a person may experience one episode in a lifetime. 

What are the symptoms of dyshidrotic eczema?

Dyshidrotic eczema affects the sides of the fingers, palms of the hands, and soles of the feet. Eczema between fingers can be an indication of stress-related eczema on the hands.

Symptoms may occur regularly for months or years at a time.

These symptoms include:

• Fluid-filled pustules/ blisters that appear in clusters or merge together and are referred to as pustular eczema
• Intense itching or burning skin
• Scaly or red skin surrounding the blisters
• Dry skin/cracked skin
• Thickened skin in the areas where the blisters first appeared

The blisters that develop due to dyshidrotic eczema can last for 2-3 weeks before drying out. New blisters can develop even before the old ones heal. 

Causes

No particular cause of dyshidrotic eczema has been established. However, it is widely believed that the disease may have a genetic component.

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 on the hands or dyshidrotic eczema feet that are bothering you, contact a doctor to learn how to manage and treat your condition.

How is dyshidrotic eczema treated?

Identification of the triggers and avoiding them can help prevent flare-ups. Maintaining a skincare routine can help manage dyshidrotic eczema as well. 

Some measures that help manage the condition include:

• Wash the affected area with mild soap and pat it dry.
• Apply a moisturiser regularly, preferably one containing ceramides.
• Wash the area of the body that comes in contact with a potential trigger and apply a moisturiser afterwards. 
• Practise stress management techniques.
• Avoid scratching the skin.

Dyshidrotic eczema can be diagnosed based on skin examination and medical history. Topical corticosteroids and the application of cool compresses to the affected site a few times a day usually help. This eczema can be linked to a fungal infection on the hands or feet and, therefore, antifungal medical if often prescribed. Moreover, the risk for bacterial skin infection is greater and requires treatment with oral antibiotics. In case of severe flare-ups, dermatologists prescribe oral steroids, topical calcineurin inhibitors and light therapy. 

3.Contact Dermatitis

Individuals with contact dermatitis experience symptoms when their skin comes into direct contact with a substance or material that triggers a rash. Contact dermatitis doesn’t is associated with seasonal allergies. Additionally, there isn’t any genetic predisposition for this condition. 

Contact dermatitis has two types:

1. Irritant contact dermatitis:

This type is more common and occurs in 80% of the cases. Symptoms occur when the skin is exposed to irritating substances like detergents, soaps, bleach, nickel-containing jewellery, wool, makeup, hair dye and that results in skin damage/rash.

2. Allergic contact dermatitis:

This is a result of a delayed allergic reaction to an allergen. A rash appears after a day or more after exposure. Poison ivy causes this type of dermatitis. Different types of fragrances or nickel can result in allergic contact dermatitis as well. 

What are the symptoms of contact dermatitis?

Contact dermatitis is a well-known skin condition that affects people who come in contact with allergens, chemicals or irritants. Hairstylists and health care workers often face this issue. 

Contact dermatitis can be triggered by coming in contact with an allergen like poison ivy.

Although it is non-contagious, it is usually very uncomfortable. Symptoms include: 

• Mild to severe itching
• Bumpy rash
• Red skin 
• Dry or cracked skin 
• Tender or swollen skin 
• Blisters 

Causes

There are two types of contact dermatitis: irritant and allergic contact dermatitis.

Irritant contact dermatitis occurs when a person comes into regular contact with an irritating substance that causes skin damage over time.

These irritants can include: 

• Harsh soaps and detergents
• Hair dyes
• Makeup
• Wool 
• Nickel or cobalt
• Zippers or belt buckles

Overwashing the hands in hot water can also lead to this form of dermatitis. 

An allergic contact dermatitis is a form of allergic reaction that occurs when a patient comes into contact with something that triggers an immune response.

Some triggers include: 

• Fragrances
• Poison ivy, poison oak and poison sumac 
• Nickel 
• Preservatives found in topical medicines

Once an exposure to an allergen occurs, symptoms of allergic contact dermatitis appear after a few days.

How is contact dermatitis treated?

Steroids are commonly prescribed to treat symptoms of contact dermatitis. Topical steroids usually help resolve the symptoms such as itching and the rash, but if the rash is widespread, a short course of oral or injectable corticosteroids may be required. In addition, identifying and avoiding the irritant or allergen that triggers a flare-up helps prevent future outbreaks. 

With irritant contact dermatitis, the trigger can be easily identified as the symptoms appear after contact. Still, for allergic contact dermatitis, patch testing may be required to determine what an individual is allergic to. The patch test can be done at your doctor’s office. This involves the application of small amounts of different allergens on the patient’s arm, and then the skin is evaluated for a reaction after 48hours or so.

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4. Discoid Eczema

 Discoid eczema is also known as nummular eczema. This chronic medical skin condition is characterised by coin-shaped or round patches of inflamed or blistered skin. The word “nummular” is derived from a Latin word that means “coin,” as these spots are coin-shaped and thus are called so. 

For people who have a light complexion, these patches will appear red. In contrast, those with a darker complexion may develop brown patches instead.

Discoid eczema can be mistaken for other skin conditions like fungal infections, ringworm, or psoriasis.

Nummular eczema is more prevalent among men and worsens during winter. It can coexist with other types of eczema or occur on its own.

Symptoms

Discoid eczema can develop anywhere on the body. Most commonly, it appears on the arms, torso or legs. Individuals with mild nummular eczema can have a single patch of discoid eczema or more than one patch at a time.

Some common symptoms include: 

• Itchy or burning skin 
• Small coin-shaped patches of red skin that merge into larger patches of inflammation 
• Oozing fluid from the patches that may crust over
• Scaly/inflamed skin around the blisters 
• A ring of discoloured skin with a clear centre

Eczema typically does not lead to a fever, malaise, or hot or tender skin. However, such symptoms can indicate a skin infection and require treatment. 

Causes

The specific cause of nummular dermatitis has not been identified, but the following factors may play a role:

These include: 

• Extremely dry or sensitive skin 
• Harsh soaps and detergents
• Chemical burns 
• Frequent bathing 
• Rough or synthetic clothing 
• Insect bites 

When patches of discoid eczema occur on the lower legs, poor circulation can be a cause.

How is nummular eczema treated?

Nummular eczema can be confused with conditions such as ringworm or psoriasis or other forms of eczema such as atopic dermatitis or stasis dermatitis. 

For this reason, a skin scraping to confirm a diagnosis. Nummular eczema treatment includes a mild or high potency topical corticosteroid and topical antibiotic. Application of astringent compresses may help patches that are oozing. Nummular eczema resolves with the right treatment. Patches of discoid eczema can become infected with staph and may require treatment with antibiotics. 

5. Neurodermatitis

Neurodermatitis often begins with a chronic itch. This usually occurs when patients go through a stressful event or emotional turmoil.

This widespread condition affects up to 12% of the population and adults between 30-50 years of age. Women are more commonly affected, and people with a history of atopic ad contact dermatitis are more prone to developing this form of eczema.

Other conditions that increase the risk of developing such a form of eczema include:

• Psoriasis
• Anxiety
• Wearing tight clothes or synthetic fabric
• Bug bites
• Never injury
• Dry skin

According to research, specific personality types are more prone to developing neurodermatitis. These include people who are classified as people pleasers or those who suppress emotions or are extremely responsible. 

Compared to other forms of eczema, neurodermatitis is usually limited to one or two areas of the body and does not appear in multiple areas.

Symptoms  

Individuals with neurodermatitis can develop symptoms on their hands, wrists, ankles, feet, shoulders, face, neck, scalp, or genitals. Therefore, breast eczema, eczema on ankles, eczema on face, ear eczema, eczema on lips or eczema on penis may be a flare-up of neurodermatitis.

Common symptoms include: 

• Intense itching often leads to bleeding 
• Prominent skin lines 
• Scaly skin 
• Discoloured skin 
• Dry, leathery and thick skin 
• Scarring and hair loss 

People suffering from neurodermatitis also experience insomnia and sexual dysfunction due to the itching associated with their condition. 

Causes

The exact cause of neurodermatitis has not been determined but the following factors may put an individual at risk for developing neurodermatitis: 

• Having depression, anxiety, or obsessive-compulsive disorder
• Excessive stress
• People between the ages of 30-50 years old 
• Women 
• Belonging to African and Asian descent 
• Those who have psoriasis, contact dermatitis or atopic dermatitis
• Those who have nerve injuries or insect bites 
• Dehydrated skin, allergies, or poor circulation
• Exposure to pollution, heat, or humidity

Neurodermatitis is rare in children, but some pediatric patients with atopic dermatitis can develop symptoms.  

How is neurodermatitis treated?

The treatment of neurodermatitis is focused on helping alleviate the itching and healing the skin. Some treatment options include:

• Topical steroids (help deal with inflammation and itching)
• Injectable steroids(if the skin is thick)
• Calcineurin inhibitors
• Salicylic acid ointments
• Occlusive treatments such as applying plastic wrap after creams can help control itching and prevent further skin damage. 
• Medicated patches containing lidocaine and numbing agents help relieve itching/discomfort. 
• Antihistamines(help control itching)
• Counselling or CBT (helps manage anxiety and mental health issues)
• Moisturisers, cool compresses and colloidal oatmeal baths

6.Seborrheic Dermatitis

Seborrheic dermatitis, also known as scalp eczema, is a common type of eczema that usually affects the scalp, nose, and upper back. In adults, it is sometimes called seborrheic eczema. In infants, the condition is referred to as cradle cap. 

Symptoms

Seborrheic dermatitis can occur in an infant or affect the age group between 30-60 years old.

In adults, the symptoms can appear now and then, often flaring when individuals are under stress or are exposed to cold weather. In infants, the condition clears up with time and doesn’t return.

Infants with a “cradle cap” have scaly patches on the scalp and a greasy scalp. They may also have dermatitis on their bottoms, which is often mistaken for diaper rash.

Adults with seborrheic dermatitis present with:

• Red, itchy skin 
• Dry, flaky skin on the face, eyebrows, scalp, back, chest, groin, or armpits 
• Greasy skin (white or yellow scales) 

Causes

Overactive immune system response to an overgrowth of yeast that naturally occurs on human skin is one identified cause of this dermatitis.

Certain diseases put you at higher risk of developing seborrheic dermatitis.

• Depression 
• Acne
• Parkinson’s disease
• Psoriasis
• Rosacea
• Epilepsy
• Heart attack
• HIV
• Alcoholism
• Cancer 
• Stroke

Hormonal fluctuations, drastic changes in weather, stress, or the use of harsh detergents and cleaning chemicals can make you more prone to developing seborrheic dermatitis. 

How is seborrheic dermatitis treated?

A proper skincare routine can help manage the symptoms of seborrheic dermatitis. Some measures that help treat/mang the condition include:

• Washing the area with 2% zinc pyrithione
• Mineral oil or petroleum jelly helps loosen the scales
• Application of moisturisers
• Management of stress
• Topical antifungal cream/antifungal shampoo
• Topical corticosteroid or calcineurin inhibitor(if the condition is severe)

7. Stasis Dermatitis

Stasis dermatitis is also termed gravitational dermatitis. Venous eczema/ venous stasis dermatitis occurs due to poor circulation in the lower legs. Venous insufficiency usually results from weakened valves in the veins of the lower legs that generally help push blood back to the heart. When these valves loose their function due to advanced age or another health condition, blood pools in the lower legs. Stasis dermatitis occurs in such patients who have poor circulation in their legs. This condition is common in old age, affecting up to 20 million people in the United States.

Symptoms

Patients with stasis dermatitis experience a variety of symptoms due to worsening circulation. 

Initially, small spots of discolouration may appear, that is followed by:

• A heavy sensation or pain in the legs is noticeable after sitting or standing for a prolonged duration.
• Dry skin 
• Itchy or scaly skin
• Hair loss on the legs and ankles
• Large ulcers that bleed 
• Red/ brown/grey discolouration of the skin on their legs
• Thick, dark or scarred skin
• Shiny skin 

Stasis dermatitis may affect one or both legs simultaneously. Although, it rarely affects other parts of the body. 

Causes

Stasis dermatitis is closely associated with poor circulation and is typically more common in women.

Some risk factors include: 

• Varicose veins 
• Multiple pregnancies 
• Obesity 
• Blood clot
• Heart failure 
• Hypertension
• History of a leg injury
• Kidney conditions

Sitting for long periods and standing for a long duration can increase the risk of developing stasis dermatitis.

How is stasis dermatitis treated?

In order to treat stasis dermatitis, a doctor will run tests to identify the underlying cause of poor circulation. Some treatment options include:

• Using compression stocking to reduce swelling
• Topical and oral antibiotics in case of an infection
• Elevation of legs to reduce the swelling
• Avoiding excessive intake of salt
• Topical steroid to calm inflammation and itching
• Vitamin C supplementation to help maintain the healthy vessels

When to Consult a Doctor

You should consult a doctor for a proper management plan if you have eczema. In order to prevent eczema flare-ups and discuss your eczema symptoms take to our doctor at Your Doctors Online.  

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FAQs on Types of Eczema Answered by Your Doctors Online Team