Eczema and Dermatitis: Types, Causes, and Treatment from Oregon Dermatologists
Eczema, also called dermatitis, refers to a group of conditions that cause dry, inflamed, and itchy skin. According to the National Eczema Association, it affects more than 31 million Americans and is one of the most common skin conditions treated by dermatologists.
The terms eczema and dermatitis are often used interchangeably, though they describe slightly different aspects of the same family of conditions.
At Goodskin Dermatology, our board-certified dermatologists diagnose and treat all forms of eczema at four locations in Oregon.
What Is Eczema? Understanding the Eczema-Dermatitis Relationship
Eczema refers to a group of inflammatory skin conditions characterized by itching, redness, and dryness.
Dermatitis is the medical term for “inflammation of the skin,” which is why eczema and dermatitis are often used interchangeably in both medical and everyday conversation.
Most people use the term eczema to describe atopic dermatitis, the most common form of this condition. However, eczema encompasses several skin disorders that share similar symptoms but differ in triggers, causes, and treatment approaches.
All forms of eczema involve impaired skin barrier function. The outer layer of skin normally protects the body by keeping moisture in and irritants out. In people with eczema, this barrier is weaker, allowing allergens, irritants, and microbes to penetrate the skin and trigger inflammation.
According to the American Academy of Dermatology, eczema is not contagious and affects millions of people across all age groups.
Because eczema includes multiple conditions, accurate diagnosis is essential. A dermatologist can determine the specific type of eczema and create a personalized treatment plan based on symptoms, triggers, and severity.
Types of Eczema and Dermatitis
Eczema is not a single disease but a category that includes several different skin conditions. Each type has unique causes, triggers, and symptom patterns.
Atopic Dermatitis
Atopic dermatitis is the most common form of eczema. It often begins in childhood and is linked to genetics, immune system activity, and a weakened skin barrier.
People with atopic dermatitis frequently have other allergic conditions such as asthma or hay fever, a pattern sometimes referred to as the “atopic march.”
This condition causes chronic itching, dry skin, and recurring rashes that may appear on the face, neck, elbows, knees, or hands.
Dyshidrotic Eczema
Dyshidrotic eczema causes small, intensely itchy blisters on the palms of the hands, sides of the fingers, and soles of the feet. These fluid-filled blisters often appear suddenly and may be triggered by stress, sweating, heat, or exposure to certain metals such as nickel.
Blisters usually last several weeks before drying and peeling.
Contact Dermatitis
Contact dermatitis occurs when the skin reacts to a substance it comes into contact with. This reaction may be caused by irritants such as soaps, detergents, or chemicals, or by allergens like nickel, fragrances, or preservatives.
The rash usually appears exactly where the skin came into contact with the trigger. Dermatologists may use patch testing to identify the specific allergen responsible.
Stasis Dermatitis
Stasis dermatitis develops when circulation problems cause blood to pool in the veins of the lower legs. This condition is most common in older adults or people with chronic venous insufficiency.
Symptoms may include swelling, discoloration, itching, and scaling around the ankles and lower legs. Untreated stasis dermatitis can lead to skin breakdown or ulcers.
Nummular Dermatitis
Nummular dermatitis produces round, coin-shaped patches of inflamed skin. These patches are often mistaken for fungal infections such as ringworm.
The rash may be triggered by extremely dry skin, insect bites, or skin injuries.
Seborrheic Dermatitis
Seborrheic dermatitis affects areas with many oil glands, including the scalp, eyebrows, sides of the nose, chest, and upper back. It is associated with an overgrowth of yeast on the skin and often appears as red, flaky, or greasy patches.
Dandruff is considered a mild form of seborrheic dermatitis.
Perioral Dermatitis
Perioral dermatitis appears as small red bumps around the mouth, nose, or eyes. It is more common in women aged 20 to 45.
Triggers may include topical steroid creams, heavy moisturizers, or certain toothpastes.
Dermatitis Herpetiformis
Dermatitis herpetiformis is an autoimmune skin condition associated with celiac disease. It causes extremely itchy clusters of blisters that often appear on the elbows, knees, and buttocks.
Treatment typically includes medication and strict adherence to a gluten-free diet.
Common Causes and Triggers of Eczema
Eczema develops due to a combination of genetic, immune, and environmental factors.
Research published in the National Library of Medicine shows that many people with eczema have changes in a gene responsible for producing filaggrin, a protein that helps maintain the skin barrier.
When the skin barrier is weakened, moisture escapes more easily, allowing irritants to enter the skin and trigger inflammation.
Environmental triggers vary by person but often include:
- Harsh soaps or detergents
- Fragrances and preservatives in skincare products
- Wool or rough fabrics
- Excessive sweating
- Dry or cold weather
- Stress
- Dust mites, pet dander, or pollen
- Cigarette smoke
Eczema is not caused by poor hygiene, and it is not contagious. It cannot be spread from one person to another through contact.
Symptoms of Eczema
Symptoms of eczema can vary depending on the specific type, but several features are common across most forms.
Typical symptoms include:
- Persistent itching that may worsen at night
- Red, inflamed, or discolored patches of skin
- Dry or sensitive skin
- Thickened or leathery skin from repeated scratching
- Rough, scaly areas of skin
- Swelling or irritation
Some types of eczema cause unique symptoms. Dyshidrotic eczema causes blistering on the hands and feet, while nummular dermatitis produces coin-shaped patches of rash. Stasis dermatitis may cause swelling and discoloration on the lower legs.
The constant itch associated with eczema can significantly affect sleep and daily life.
How Dermatologists Diagnose Eczema
Diagnosing eczema begins with a detailed medical evaluation by a dermatologist.
First, the dermatologist reviews the patient’s medical history and symptoms. This includes information about when the rash started, possible triggers, family history of eczema or allergies, and previous treatments.
Next, the dermatologist performs a physical examination of the skin. The location, appearance, and pattern of the rash often provide important clues about the specific type of eczema.
If contact dermatitis is suspected, patch testing may be performed. This test identifies allergens that may be causing a skin reaction.
In some cases, a skin biopsy may be recommended to rule out other conditions such as psoriasis or fungal infections.
Because eczema symptoms can resemble other skin disorders, professional diagnosis is important before beginning treatment.
Eczema Treatment Options
Treatment for eczema depends on the type and severity of the condition. Most treatment plans combine multiple approaches designed to restore the skin barrier, reduce inflammation, and prevent flare-ups.
Skincare and Trigger Management
Daily skincare is the foundation of eczema management. Dermatologists typically recommend applying fragrance-free moisturizer at least twice daily, especially immediately after bathing.
Using gentle cleansers, avoiding known triggers, and bathing in lukewarm water can also help reduce irritation.
Over-the-Counter Treatments
Mild eczema symptoms may respond to non-prescription treatments. Hydrocortisone cream can help reduce mild inflammation and itching for short periods of time. Colloidal oatmeal products can soothe irritated skin.
Oral antihistamines may sometimes help reduce nighttime itching.
Prescription Topical Treatments
Moderate eczema often requires prescription topical medications.
Topical corticosteroids are commonly used to reduce inflammation during flare-ups. Dermatologists may also prescribe topical calcineurin inhibitors such as tacrolimus or pimecrolimus, which are steroid-free anti-inflammatory medications.
Newer non-steroidal medications such as crisaborole and ruxolitinib cream may also be used to treat certain types of eczema.
Prescription Systemic Treatments
More severe eczema may require systemic therapy. Biologic medications such as dupilumab target specific immune pathways involved in eczema inflammation.
In some cases, dermatologists may prescribe oral medications that modify the immune response to reduce symptoms.
In-Office Treatments at Goodskin Dermatology
Dermatologists at Goodskin Dermatology offer several advanced treatment options, including:
- Phototherapy (light therapy) for widespread eczema
- Patch testing to identify contact allergens
- Wet wrap therapy for severe flare-ups
- Management of biologic medications for moderate-to-severe eczema
Struggling to control eczema flares? Book an appointment online. Our dermatologists provide care at four Oregon locations in Beaverton, Clackamas, Hillsboro, and Troutdale.
Treatment options require evaluation by a licensed healthcare provider. Do not start, stop, or change prescription medication without consulting your dermatologist.
Living with Eczema: Daily Skin Care Tips
Managing eczema often requires a consistent daily skincare routine.
Helpful strategies include:
- Moisturizing the skin at least twice daily
- Applying moisturizer immediately after bathing
- Using fragrance-free and dye-free skincare products
- Wearing soft, breathable fabrics such as cotton
- Keeping fingernails short to reduce damage from scratching
- Using a humidifier in dry environments
- Identifying and avoiding personal triggers
Keeping a symptom diary may help identify patterns and triggers that worsen eczema.
If your routine is not preventing flare-ups, a dermatologist can recommend additional treatment options.
When to See a Dermatologist for Eczema
You should consider seeing a dermatologist if eczema symptoms are persistent or severe.
Common reasons to seek professional care include:
- Over-the-counter treatments are not helping after several weeks
- Severe itching is disrupting sleep
- The skin becomes painful, swollen, or infected
- You are unsure which type of eczema you have
- Flare-ups occur frequently or worsen over time
Eczema in sensitive areas, such as the face, eyelids, or genitals, should also be evaluated by a dermatologist.
Why Choose Goodskin Dermatology for Eczema Care?
Goodskin Dermatology provides comprehensive diagnosis and treatment for all forms of eczema and dermatitis.
Our board-certified dermatologists and experienced providers have experience treating a wide range of eczema types.
Patients benefit from access to advanced treatment options, including prescription medications, biologic therapies, phototherapy, and patch testing.
Goodskin Dermatology also offers convenient access with four Oregon locations in Beaverton, Clackamas, Hillsboro, and Troutdale.
Most major insurance plans are accepted for medical dermatology visits. Contact us today to get started.
Frequently Asked Questions About Eczema
What is the difference between eczema and dermatitis?
Eczema and dermatitis are closely related terms. Dermatitis refers broadly to inflammation of the skin, while eczema typically describes a group of chronic inflammatory skin conditions. In everyday conversation, the terms are often used interchangeably.
Can eczema be cured?
Eczema cannot currently be cured, but it can be effectively managed with the right treatment plan. Many children experience improvement as they grow older, while adults may have periods of flare-ups and remission.
What triggers eczema flares?
Common triggers include harsh soaps, detergents, fragrances, dry weather, sweating, stress, allergens, and certain fabrics. Triggers vary from person to person.
Is eczema contagious?
No. Eczema is not contagious and cannot be spread through contact with another person.
What is the best treatment for eczema?
The most effective treatment depends on the type and severity of eczema. Moisturizers and trigger management form the foundation of care, while prescription medications and biologic therapies may be needed for more severe cases.
Does Goodskin Dermatology treat eczema in children and adults?
Yes. Goodskin Dermatology treats eczema in both children and adults. Dermatologists can develop treatment plans tailored to each patient’s age, symptoms, and skin type. Book an appointment at one of our Oregon locations.
