Eczema (Atopic Dermatitis)

Atopic dermatitis, more commonly known as eczema, is a chronic skin condition that makes the skin dry, itchy, and red. Although this skin disease is more common in children, initial and chronic flare-ups can occur at any age: a study by the American Academy of Dermatology shows that 1-3% of adults and about 20% of children experience eczema symptoms. Patients coping with persistent dry skin, inflammation, and discomfort benefit from an accurate diagnosis and a personalized treatment plan from an experienced dermatologist like Dr. Michele Green.

Eczema is linked to the immune system, as are other atopic diseases, such as allergic rhinitis (hay fever) and asthma. Many patients with eczema also have a personal or family history of these related conditions. Although most cases of eczema are mild, flare-ups can affect quality of life, and severe eczema can sometimes impede daily activities or contribute to added stress and anxiety. Dr. Michele Green, a board-certified dermatologist in NYC, provides eczema treatment options that target symptoms and help keep them at bay, guiding patients toward lasting relief.

Dr. Michele Green is an internationally recognized, board-certified dermatologist with over 25 years of experience treating eczema, atopic dermatitis, and other inflammatory skin conditions at her private practice on NYC’s Upper East Side. Dr. Green takes a personalized, whole-patient approach to eczema care, combining prescription medications, in-office therapies, and at-home skin care—including her own MGSKINLABS product line—to calm inflammation and restore a healthy skin barrier.

What Is Eczema?

Eczema, also known as atopic dermatitis, is a chronic skin condition that makes the skin dry, itchy, inflamed, and red. It is one of the most common inflammatory skin conditions in children and adults. Although it cannot be cured, the right combination of prescription medications, moisturizing, and lifestyle adjustments can effectively manage its symptoms, guided by a board-certified dermatologist like Dr. Green.

What Does Eczema Look Like?

Eczema typically appears as red, inflamed patches of dry, itchy skin, most often on the face, neck, and the creases of the elbows and knees, though it can affect any part of the body, including the hands, with eczema on the palms and fingers. Over time, the affected skin may thicken, crack, or develop a scaly, brownish-gray appearance. Repeated scratching can cause raised bumps or areas of lichenification, or thickened skin.

Eczema Symptoms

Atopic dermatitis symptoms vary greatly from patient to patient, but eczema is generally identified by red patches of skin in affected areas. Though different severities or types of eczema vastly affect eczema symptoms, additional symptoms include:

• Dry skin
• Itchy skin
• Thick, cracked, or scaly skin, which can put patients at greater risk for skin infections
• Skin inflammation on affected areas
• Rash that first appears on the neck and/or elbow or knee creases, which can spread over the body
• Rash can turn from red to brownish-gray, developing raised bumps
• Rash that can develop into a chronically or permanently itchy rash
• Lichenification, or thickening of eczema rash

What Causes Eczema?

Eczema is believed to be linked to a genetic variation and environmental factors that weaken the body’s ability to retain moisture, preventing proper formation of the skin barrier against bacteria, irritants, and allergens. Many eczema patients are sensitive to particular irritants, which can be identified through allergy testing, such as:

• Dander, dust mites, pollen, and mold
• Food allergies (particularly wheat, soy, and eggs)
• Excessive washing or washing with harsh soaps (particularly antibacterial soaps or alcohol-based cleaners)
• Detergents or disinfectants (such as bubble bath, perfumed soaps, and household cleaners)
• Viruses and bacteria
• Extreme temperatures
• Changes in hormone levels

Increased stress and anxiety can also worsen eczema symptoms or trigger additional flare-ups. At its core, eczema results from a breakdown of the skin’s protective barrier, driven by a combination of genetic factors and immune activity. This weakened barrier allows moisture to escape and makes it easier for irritants, allergens, and bacteria to penetrate the skin, triggering inflammation and the itch characteristic of atopic dermatitis. Because eczema often overlaps with other atopic conditions such as asthma and allergic rhinitis, patients with a family history of these conditions are more likely to be affected. Identifying individual triggers through allergy testing is often an important step in long-term management with Dr. Green.

Other Types of Eczema

Although atopic dermatitis is the most common form of eczema, several other distinct types exist, each with its own causes, appearance, and treatment approach. Recognizing which type of eczema you have is an important step toward developing an effective treatment plan with your dermatologist.

Seborrheic Dermatitis

Seborrheic dermatitis primarily affects areas of the skin with a high concentration of oil-producing glands, such as the scalp, eyebrows, sides of the nose, ears, and chest. In its mildest form, it causes ordinary dandruff, but it can also produce a red, greasy, itchy rash with yellow or white flakes; in infants, this same condition is known as cradle cap. Seborrheic dermatitis is linked to an overgrowth of a yeast that naturally lives on the skin, and it tends to be chronic and relapsing, often flaring during colder months or periods of stress. Treatment typically includes medicated shampoos containing salicylic acid, selenium sulfide, zinc pyrithione, or ketoconazole, along with topical antifungal or anti-inflammatory creams for affected skin.

Allergic Contact Dermatitis

Allergic contact dermatitis is the second most common form of eczema, caused by direct contact with an allergen or irritant such as poison ivy, nickel, fragrances, or certain cosmetics and skin care products. It produces symptoms similar to atopic dermatitis, including redness, itching, and sometimes blistering. However, the rash is usually confined to the specific area of skin that touched the trigger and can often be traced to a particular exposure. A dermatologist can use patch testing to identify the exact allergen responsible, helping patients avoid future flare-ups by removing that irritant from their routine.

Neurodermatitis

Neurodermatitis, also known as lichen simplex chronicus, differs from other forms of eczema in that it begins with a single, localized area of itching, such as a bug bite or minor irritation, that can escalate into an intense itch-scratch cycle. Repeated scratching thickens the skin, making it leathery and extremely scaly or crusted, most often on the neck, wrists, forearms, ankles, or scalp. Neurodermatitis is more common in women and tends to develop in adulthood. Because the itch-scratch cycle can be difficult to break on its own, treatment often combines topical corticosteroids, oral antihistamines, and behavioral strategies to help patients stop scratching.

Dyshidrotic Eczema

Dyshidrotic eczema is distinguished by its symptoms: small, intensely itchy blisters develop on the palms, the sides of the fingers, and the soles of the feet, often accompanied by a burning or stinging sensation. As the blisters heal, the affected skin can become dry, cracked, and flaky, which may be painful and interfere with everyday hand use. Dyshidrotic eczema is often triggered or worsened by stress, sweating, seasonal allergies, and exposure to certain metals such as nickel or cobalt. It is generally managed with cool compresses, topical corticosteroids, and identifying and avoiding individual triggers.

Nummular Eczema

Nummular eczema, sometimes called discoid eczema, features distinctive, coin-shaped, circular patches of irritated skin that can be scaly, crusted, or oozing, most often on the arms and legs. Unlike atopic dermatitis, which typically begins in childhood, nummular eczema is more common in older adults. It tends to affect men later in life and women at a somewhat younger age. Flare-ups are often triggered by very dry skin, insect bites, or minor skin injuries, and treatment focuses on intensive moisturizing and topical corticosteroids to calm inflammation and control itching.

Stasis Dermatitis

Stasis dermatitis is marked by rashes and irritation on the lower legs. It is typically caused by poor circulation, or venous insufficiency, which causes blood to pool in the lower-leg veins. Over time, this pooling can damage small blood vessels and lead to swelling, itching, discoloration, and thickened or hardened skin, particularly around the ankles. Stasis dermatitis is most common in older adults and in those with a history of varicose veins. Management typically involves compression stockings, leg elevation, and topical treatments used alongside care for the underlying circulatory issue.

If you have any of the above symptoms, you can learn more about your specific skin condition and treatment options by consulting a board-certified dermatologist, like Dr. Michele Green in NYC.

What is the Best Treatment for Eczema?

Dermatology is at the forefront of atopic dermatitis treatment, and ongoing studies and clinical trials continue to provide meaningful symptom relief for patients with eczema. While there is currently no complete cure for eczema, patients can effectively manage symptoms with a combination of over-the-counter and prescription medications tailored to their needs. Eczema treatments include:

• Moisturizers, lotions, and ointments that repair the dry, depleted skin barrier
• Oral, systemic, or topical corticosteroids
• Antibiotics (for skin infections, which can aggravate eczema symptoms, causing cold sores and blisters)
• Antiviral and antifungal medications
• Biologic medications, such as dupilumab (Dupixent) or Tralokinumab (Adbry)
• Antihistamines
• Topical calcineurin inhibitors, which suppress immune responses to reduce skin inflammation, such as pimecrolimus (Elidel) and tacrolimus (Protopic)
• Phototherapy
• Home remedies and preventive skin care
• Over-the-counter or prescription topical steroids (such as hydrocortisone or triamcinolone)

Immunosuppressants are sometimes recommended for severe eczema to help relieve symptoms. Topical Janus kinase (JAK) inhibitors, such as ruxolitinib (Opzelura), are newer, nonsteroidal prescription medications approved for short- and long-term management of mild-to-moderate atopic dermatitis. Research on biologics and JAK inhibitors is ongoing, and the FDA approves new atopic dermatitis drugs each year. Dr. Michele Green develops a personalized eczema treatment plan for each patient based on symptom severity and medical history.

Finding the Eczema Treatment That’s Right for You

Your treatment will vary depending on the severity of your eczema symptoms. The goal of any eczema treatment regimen is to control itching, heal the skin, and prevent further flare-ups, with many patients reaching remission, when symptoms are minimal or absent. For those with mild eczema, home remedies may be enough to treat early signs, though it is important to see a dermatologist at the first sign of symptoms so the condition can be treated and monitored. For those with moderate to severe eczema, combination treatments, such as home remedies paired with topical steroids, or stronger treatments, such as biologics or topical calcineurin inhibitors, may be necessary to stave off painful symptoms.

Because a visible, chronic skin condition like eczema can also take a toll on emotional well-being, sometimes contributing to anxiety or depression, addressing both the physical symptoms and their impact on daily life is an important part of care. Some eczema treatments carry more serious side effects than others: topical steroids and corticosteroids may thin the dermis over time; topical calcineurin inhibitors can cause initial burning or discomfort; and immunosuppressive treatments such as cyclosporine or methotrexate may carry a higher risk of kidney problems or high blood pressure. Your dermatologist will know what is likely to work best for you based on your symptoms and medical history, and you should reach out to Dr. Green if your eczema disrupts daily life, shows signs of skin infection, or fails to improve with home remedies and current skin care.

Home Remedies for Eczema

Home remedies can help patients care for their skin and prevent additional flare-ups. Home treatments include:

• Using a humidifier to maintain moisture indoors during colder seasons or periods of low humidity
• Moisturizing twice daily using an unscented lotion to restore moisture
• Keeping fingernails short to avoid damage to the skin when scratching
• Avoiding itchy or scratchy clothing and fibers; cotton is an excellent go-to for fabric options
• Avoiding rapid temperature changes (extreme heat to cold or vice versa)
• Avoiding activities that cause sweat (intensive exercise, etc.)
• Reducing shower and bath length
• Using a mild temperature shower and bath water
• Using gentle soaps and shampoos to preserve natural oils (preferably without any scents or exfoliants)
• Drying yourself carefully after bathing (patting down with a towel rather than rubbing skin dry)
• Moisturizing within the few minutes following a bath or shower (3 minutes is the recommended window for best support to the natural skin barrier)

The National Eczema Association also recommends regular bleach baths to prevent eczema flare-ups.

Phototherapy to Treat Eczema

Phototherapy, or light therapy, is an effective treatment option for those with uncomfortable, chronic eczema flares. It is commonly used for those who don’t respond to topical treatments and home remedies or who depend on exposure to ultraviolet (UV) light. The simplest form of phototherapy is targeted exposure to natural sunlight. Additional light therapies use synthetic light, including UVA (artificial ultraviolet A) and UVB (narrow-band ultraviolet B), and can be used alongside other medications and treatments.

Although light therapy can be effective for patients with severe eczema, it is typically used sparingly because excessive UV exposure can cause premature skin aging and, if overused, increase the risk of skin cancer. Therefore, phototherapy and other light therapies are rarely recommended for young children.

Additional Therapies for Eczema Treatment

Additional therapies can further alleviate eczema symptoms. Wet dressing therapy is a highly useful treatment for severe eczema, in which the affected skin is wrapped in topical corticosteroids and wet bandages. This treatment is labor-intensive and is therefore more commonly performed in a hospital setting or by someone with nursing expertise. However, it can be very beneficial for those with more extensive rashes or lesions.

Relaxation therapy, behavioral modification therapy, or biofeedback therapy can help patients who have difficulty resisting the urge to scratch the itchy rash caused by eczema. Talk to your health care provider about how these therapies could help when combined with other eczema treatments.

Frequently Asked Questions (FAQs) About Eczema

Is Eczema Contagious?

No, eczema is not contagious and cannot be spread from person to person through touch or close contact. Eczema develops from a combination of genetic factors, immune system activity, and environmental influences rather than an infectious cause, so there is no risk of passing atopic dermatitis to another person.

Is Eczema Genetic?

Genetics play a significant role in eczema development. Patients with a family history of eczema, asthma, or hay fever (allergic rhinitis) are more likely to develop atopic dermatitis, as these atopic conditions often co-occur due to shared genetic and immune factors.

Is Eczema an Autoimmune Disease?

Eczema is not classified as an autoimmune disease, but it is closely tied to the immune system. Rather than the immune system mistakenly attacking healthy tissue, as in true autoimmune diseases, eczema involves an overactive immune response to allergens, irritants, and environmental factors, along with a weakened skin barrier that lets moisture escape and irritants enter.

How Does Eczema Start?

Eczema often begins with mild dry skin and occasional itching, then progresses to visible red, inflamed patches. It is typically triggered by exposure to an irritant, allergen, or environmental factor, combined with an underlying genetic predisposition. In infants and young children, eczema commonly begins on the face and scalp, while in older children and adults it more often starts in the creases of the elbows and knees.

Can You Develop Eczema as an Adult?

Yes, it is possible to develop eczema for the first time as an adult, even without a history of the condition in childhood. Adult-onset eczema can be triggered by hormonal changes, new environmental factors, increased stress, or a shift in the skin’s moisture barrier. See a dermatologist for an accurate diagnosis, since adult eczema can resemble other chronic skin conditions.

What Causes Eczema Flare-Ups?

Eczema flare-ups are commonly triggered by irritants and allergens, including harsh soaps, detergents, pollen, dust mites, and certain fabrics, as well as extreme temperatures and hormonal fluctuations. Emotional stress and disrupted sleep can also trigger flare-ups or make existing inflammation harder to control.

Can Stress Cause Eczema?

While stress does not directly cause eczema, it is a well-known trigger that can worsen existing symptoms or bring on a flare-up. Increased stress and anxiety affect the immune system and can weaken the skin’s barrier function, making the skin more reactive to irritants and allergens. For this reason, stress management is often included as part of a comprehensive eczema treatment plan.

Does Eczema Itch?

Yes, itching is a hallmark symptom of eczema, and for many patients, it is the most disruptive aspect of the condition. The itch associated with atopic dermatitis stems from inflammation and extremely dry skin, and scratching can further damage the skin barrier, leading to more inflammation, potential skin infections, and a worsening itch-scratch cycle.

How to Stop Eczema Itching Immediately?

To quickly relieve eczema itching, apply a thick, fragrance-free moisturizer or ointment to the affected area, use a cool compress to soothe inflammation, and avoid hot showers or scratching, which can further irritate the skin. Over-the-counter antihistamines and prescription topical steroids can also provide fast relief for more persistent itching. A dermatologist like Dr. Green can recommend the most effective option for your specific symptoms.

Does Eczema Spread?

Eczema itself is not contagious and cannot spread from person to person. However, the rash can spread across a patient’s own body, particularly if flare-ups go untreated or are aggravated by scratching. Patches that begin on the neck, elbows, or knees can spread to other areas over time, which is why early treatment from a dermatologist is recommended to help contain flare-ups.

Does Eczema Go Away?

For some patients, particularly children, eczema symptoms improve or go into remission over time, while for others, atopic dermatitis is a lifelong chronic skin condition that requires ongoing management. Even during remission, patients may have occasional flare-ups triggered by stress, irritants, or environmental factors, which is why dermatologists often recommend continued care.

How Long Does Eczema Last?

Eczema duration varies widely from patient to patient. Some children outgrow their symptoms by adolescence, while others experience flare-ups that persist into adulthood or develop eczema for the first time later in life. Because there is no complete cure, eczema duration and severity depend on genetics, environmental factors, and how consistently you follow a treatment plan.

How to Treat Eczema on Face

Eczema on the face requires a gentler approach than treatment for the body, since facial skin is thinner and more sensitive. Dr. Green typically recommends fragrance-free moisturizers, mild cleansers, and lower-strength topical corticosteroids or topical calcineurin inhibitors to reduce inflammation without thinning the delicate facial skin, along with daily sunscreen to protect healing skin.

How to Treat Eczema on Hands

Frequent handwashing, harsh soaps, and exposure to detergents and other irritants often worsen hand eczema. Treatment focuses on rebuilding the skin barrier and minimizing exposure to triggers. Wearing protective gloves for wet work, switching to gentle soaps, applying a thick moisturizing ointment after each handwashing, and using prescription topical steroids for active flare-ups can all help control hand eczema.

What Is the Difference Between Eczema and Psoriasis?

Eczema and psoriasis are both chronic, inflammatory skin conditions, but they have distinct causes and appearances. Eczema is driven by a weakened skin barrier and an immune overreaction to environmental triggers, producing intensely itchy, dry patches. Psoriasis is an autoimmune condition that causes skin cells to grow too quickly, resulting in thicker, well-defined, silvery-scaled plaques. Because these conditions can look similar, an accurate diagnosis from a board-certified dermatologist is important to ensure the right treatment plan.

Schedule Your Eczema Consultation with Dr. Michele Green

Eczema, or atopic dermatitis, is a common and often frustrating chronic skin condition. With the right combination of prescription medications, moisturizing skincare, and lifestyle adjustments, you can control its symptoms effectively. Because eczema triggers, severity, and treatment response vary widely from patient to patient, partnering with an experienced dermatologist is the most reliable way to find lasting relief. That is why so many patients trust their care to Dr. Michele Green.

Dr. Michele Green is an internationally recognized, board-certified dermatologist with over 25 years of experience treating eczema and other inflammatory skin conditions in her private practice on the Upper East Side of NYC. Castle Connolly, New York Magazine, Super Doctors, and The New York Times regularly recognize Dr. Green as one of NYC’s top dermatologists for her dedication to patients and clinical expertise. She develops a personalized treatment plan for each patient to calm inflammation, restore the skin barrier, and prevent future flare-ups. To learn more about eczema treatment or to determine which option is right for you, please call 212-535-3088 or contact us online today to schedule a consultation.