If you have dry, itchy patches that won’t go away, or you’re seeing them on your child, you’re probably wondering: is this eczema?

October is Eczema Awareness Month, so it’s a good time to learn what eczema actually looks like, how it differs from person to person and age to age, and when to see a doctor.

Eczema is common. The National Eczema Association (NEA) reports that more than 31 million people in the U.S. live with it, roughly 1 in 10. It often starts in early life: about 80% of people with atopic dermatitis (the most common type of eczema) first have symptoms before age 6. But it can also continue into adulthood or appear for the first time later in life.

The good news is that once you know what to look for, you can spot eczema early and get comfortable sooner, whether it’s your skin or your child’s.

 

 

What Is Eczema?

Eczema, also called dermatitis, is a chronic inflammatory skin condition. The most common form is atopic dermatitis. It tends to come and go, with calm periods and flare-ups.

Researchers now understand a good deal about why it happens. In many people with eczema, the skin barrier doesn’t work as well as it should, so skin loses moisture and lets irritants in more easily. The immune system also overreacts, and genetics play a role. Eczema often runs in families alongside asthma, allergies and hay fever.

Flares can be set off by things like dry air, harsh soaps, fragrances, sweat, certain fabrics, allergens, infections and stress. Triggers are different for every child, so noticing patterns is helpful.

 

Common Signs of Eczema

Eczema looks different from person to person and changes with age, but these signs are the most common:

• Intense itching, often worse at night
• Dry, rough or scaly patches
• Redness, or darker patches on deeper skin tones (more on this below)
• Small bumps or tiny blisters that may ooze or weep
• Cracked or thickened skin, especially after lots of scratching
• Skin that feels warm, stings or burns

The itch is often the first clue. In fact, many doctors describe eczema as “the itch that rashes”: scratching leads to the rash, not the other way around.

 

 

What Does Eczema Look Like on Different Skin Tones?

On lighter skin, eczema often looks pink or red. On darker skin tones, redness can be hard to see. Instead, the American Academy of Dermatology (AAD) and other dermatology sources describe patches that look purple, dark brown or ashen gray, sometimes with small, rough bumps. After a flare calms down, the skin may stay lighter or darker than the surrounding area for a while. This is temporary discoloration, not a sign that you did something wrong.

Because eczema can be easy to miss on darker skin, it’s worth paying attention to texture and itch, not just color. If the skin is dry, rough, bumpy and itchy, mention it to a doctor even if it isn’t red.

 

 

What Does Eczema Look Like by Age?

Eczema in Babies and Infants

In babies, eczema often begins in the first months of life. It commonly shows up on the cheeks, forehead, chin and scalp. The skin may look red or dark and dry, with small bumps, and it can weep or crust. The diaper area is often spared because it stays moist and covered.

Babies can’t tell you they’re itchy, so look for rubbing their face on bedding or your shoulder, fussiness, and trouble sleeping.

 

 

Eczema in Toddlers

As babies start crawling and walking, eczema often moves to the inner elbows, backs of the knees, wrists and ankles. These are the “bend” areas, called flexural areas, where sweat and friction build up. Skin may look dry, scaly or crusty.

Eczema in Older Children and Teens

In older kids, patches typically show up in the bends of the elbows and knees, hands, neck and around the eyes. With long-term scratching, the skin can become thick and leathery, a change called lichenification.

Eczema in Adults

In adults, eczema often appears in the bends of the elbows and knees, on the hands, neck and eyelids, but it can show up almost anywhere. It may be a continuation of childhood eczema, or it can appear for the first time later in life. Skin tends to be very dry, scaly and intensely itchy, and long-standing patches can thicken. Stress, frequent handwashing, workplace irritants and changes in weather are common triggers.

 

 

Eczema on the Face

Facial eczema can be especially upsetting because it’s so visible. In babies and toddlers it usually affects the cheeks. In older children and adults it’s more likely to appear around the eyelids and mouth.

Facial skin is thin and sensitive, and it’s exposed to weather, saliva, food and sun every day, which can make flares harder to calm. Eyelid skin can look wrinkled, dry and irritated. Because the face is a delicate area, ask your pediatrician or dermatologist before using any new product there.

Eczema on the Hands

Hand eczema often affects the palms, fingers and the skin between the fingers. Frequent handwashing, sanitizer, water and cold weather can all make it worse. Skin may be dry, cracked and painful, and some types cause small, very itchy blisters that eventually dry and peel.

There are several kinds of eczema, including contact dermatitis (triggered by an irritant or allergen touching the skin), dyshidrotic eczema (small blisters on the hands and feet) and nummular eczema (round, coin-shaped patches). Each has its own triggers, which is one more reason a proper diagnosis helps.

 

 

Could It Be Something Else?

Several skin conditions can look like eczema, including psoriasis, seborrheic dermatitis (which includes cradle cap), ringworm, scabies, contact allergy and heat rash. Dermatologists note that doctors check the history, the pattern on the body and how the skin responds to care to tell them apart.

That’s why it’s best not to self-diagnose. A pediatrician or dermatologist can confirm what you’re dealing with and help build a plan that fits you or your child.

When to See a Doctor

Schedule an appointment if:

• The rash isn’t improving after a couple of weeks of gentle skin care
• Itching is disrupting sleep, work, school or play
• The rash is spreading or covers large areas

Call the doctor promptly if you see signs of infection, such as yellow crusts, pus, increasing redness or swelling, or if a fever comes along with the rash.

Get urgent care if there is a painful cluster of blisters or sores on top of eczema and a fever. This can be a serious infection that needs same-day treatment.

Everyday Skin Care Basics

These everyday habits are widely recommended by dermatology organizations for supporting the skin barrier:

• Moisturize daily, at least once and often twice, with a fragrance-free cream or ointment
• Apply moisturizer soon after bathing, while skin is still slightly damp
• Keep baths short and lukewarm, and use gentle, fragrance-free cleansers
• Pat skin dry instead of rubbing
• Choose soft, breathable fabrics like cotton, and wash new clothes before wearing
• Keep nails short to limit damage from scratching
• Track triggers, noting what happened before flares

A simple ointment can be a helpful part of this routine, especially for dry, sensitive skin. One option is Waxelene aerated balm, a petroleum-free ointment made with four ingredients: organic beeswax, organic soy oil, natural vitamin E oil and organic rosemary oil. A thin layer helps moisturize the skin and form a protective barrier.

Here is one real example from someone who has made this balm part of their routine:

 

Frequently Asked Questions

What does eczema look like at first?

Often it starts as dry, itchy, rough skin. Redness or darker patches, small bumps and scaling may follow, usually in the skin folds or on the cheeks for babies.

Is eczema contagious?

No. Eczema can’t be passed from person to person.

Will eczema go away?

Many children see their symptoms improve as they get older, and some outgrow it, but others continue to have it into adulthood. Early care helps keep it manageable.

Can eczema be cured?

There is no cure yet, but eczema can be managed well.

Join the Conversation This Eczema Awareness Month

Eczema affects far more than the skin. It can mean lost sleep, stress and a lot of daily effort for the whole family. The NEA’s Eczema Awareness Month campaign, #UnhideEczema, encourages people to share their experiences and help end the stigma. Consider sharing your story, or simply asking a friend or family member how their skin, or their child’s skin, is doing today.