Eczema: Causes, diagnosis and cure

Eczema can strike anyone, anytime. And like any skin condition, it has both physical and psychological effects

Woman scratching her forearm due to eczema

Eczema is a condition where the skin becomes inflamed and irritated. The word ‘eczema’ has its origins in the Greek word ekzein meaning ‘to boil out’ [ek means ‘out’, while the Greek word zema means ‘boiling’].

The most common form of eczema is known as atopic eczema or atopic dermatitis. Atopic refers to a group of diseases that are often inherited, like asthma or hay fever. Other types of eczema are:

  • Scaly yellowish patches of skin that are usually oily, on the scalp and face [Seborrheic eczema]
  • Blisters on the palms and soles
  • Circular patches of irritated skin that are crusted, scaling and itchy
  • A reaction caused when the skin comes in contact with a substance that it is allergic to, like nickel in jewellery [Allergic contact eczema]
  • Usually related to circulatory problems, stasis dermatitis is a skin irritation on the lower legs
  • Insect bites may also cause eczema. It causes localised itchiness and scaly patches of skin on the head, forearms, wrists and lower legs.

Causes and symptoms of eczema

The exact cause of eczema is not known, but experts believe that it is most likely caused by the body’s reaction to an irritant. It is also frequently found in people with a history of other skin problems, allergies or asthma. Here are some commonly known triggers:

  • House-hold things like soap, detergent, animal dander and coarse materials
  • Colds and respiratory infections
  • Eggs, soy products, juices from fresh fruits, meat or vegetables, dairy products, nuts, wheat and seeds have been known to cause or worsen the condition. However it is recommended that you do not stop any food, unless there is a food sensitivity confirmed
  • Hormonal changes in women during pregnancy or at a certain point in their cycle can bring out symptoms of eczema
  • While stress cannot cause eczema, it can certainly exacerbate the condition.


The appearance of the eczema varies greatly from person to person and may include:

  • Thick and leathery patches
  • Scaly, red areas
  • Small, rough bumps
  • Bumps that leak fluid and crust over

Eczema is a great cause for embarrassment for those suffering from it because it affects the skin, and our self-image is often tied to how we look. The affected areas generally show up as thickened, scaly or excessively dry skin. In people who are fair-skinned the areas may initially appear reddish and slowly turn brown. Among those who are darker-skinned, eczema can make the affected area lighter or darker, thus changing the person’s pigmentation.

Eczema commonly appears on the face, hands, back of the knees, wrists and feet; though it can appear in other places. It is extremely itchy; sometimes the itchiness starts before the appearance of a rash. Because of the itchiness, sufferers might scratch anywhere from 500 to 1000 times a day! However, refrain from scratching as it worsens the condition and increases the risk of infection.

Diagnosis and cure

Treatment usually focusses on healing the damaged skin and alleviating the symptoms as opposed to ‘curing’ the disease.

There is no single test that can be used to diagnose eczema. However a patch test for allergies is the best way to find out if you have eczema. The outcome for people with this disease varies—for some the eczema will disappear completely, but for others it can remain for the rest of their life.

Let us look at ways to manage eczema.

Tips to manage eczema

  • Bathing with warm water more than once a day alleviates symptoms
  • Make sure that your soaps, shampoos, shower gels etc. do not contain harsh ingredients. Avoid perfumed products and refrain from using deodorants
  • As soon as you finish your bath, apply an oil-based moisturiser to lock the moisture in
  • After a bath do not rub your skin vigorously, instead gently pat it dry. Any harsh treatment of your skin will only worsen the condition
  • Wear clothes made of soft, light fabrics; cotton clothes work best. Avoid tight-fitting attire and clothes made of rough fibres
  • Keep your fingernails short so that you don’t cause further infection when you scratch
  • Avoid rapid changes in weather and if possible avoid doing activities that make you sweat
  • Adults with eczema need to adjust their lives and activities to manage their eczema. Jobs that require a lot of hand-washing or exposure to chemicals or other irritants, such as health care, house-cleaning, or hairdressing, may not be a good choice for someone with eczema.

Today, there are countless medications available to bring eczema under control. There are also specially formulated cosmetics to hide the unsightly rashes. So now you don’t need to let your scaly skin be in command of your life.

Cradle cap

Cradle cap is eczema in infants. Also known as crib cap, the condition gets its name from the observation that greasy, scaly, crusty, yellowish patches are formed on the baby’s scalp, much like a cap. The symptoms appear about three months after the baby’s birth; the rash is not itchy and doesn’t bother the baby. Besides the scalp, the other areas that are usually affected are the baby’s eyelids, nose, groin and the ears.

Cradle cap is not caused due to poor hygiene, allergy or bacterial infection. This condition is also not contagious, so you don’t have to worry about ‘giving’ cradle cap to anyone or ‘getting’ it from someone. The most common causes for cradle cap are overactive sebaceous glands and fungal infections. While cradle cap often goes on its own, if it thickens or if the baby develops other infections, take the baby to the doctor immediately. If the condition is mild, then treatment other than gentle washing is not recommended, since the scales dissipate by themselves. However, you can apply petroleum jelly at night to soften the cap and then gently brush the scales away.

However, do not embark on attempting to administer any medication or home-remedies without consulting your doctor first.

This article first appeared in the August 2014 issue of Complete Wellbeing magazine.

Magnifying lens over an exclamation markSpot an error in this article? A typo maybe? Or an incorrect source? Let us know!

Rameshwar Gutte
Dr Rameshwar Gutte is consultant dermatologist at Dr L H Hiranandani Hospital, Powai, Mumbai.


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