Eczema
Also known as: Atopic Dermatitis, AD
Red, itchy, inflamed skin - the most common chronic skin condition in children. Part of the atopic triad with asthma and hay fever.
What to look for
Side-by-side comparison
Normal skin
Smooth, hydrated
Eczema
Red, itchy, dry, cracked
Eczema (atopic dermatitis) is a chronic inflammatory skin condition causing red, itchy, dry, and sometimes weeping or crusting patches. It is the most common chronic skin disease in children, affecting up to 20% of children and 3% of adults worldwide.
Eczema is part of the atopic triad - the tendency to develop eczema, asthma, and allergic rhinitis (hay fever). About 50-70% of children with eczema develop asthma or hay fever later. The underlying cause is a combination of genetic skin barrier dysfunction (often involving the filaggrin gene) and immune dysregulation.
In infants, eczema typically appears on the face, scalp, and outer surfaces of limbs. In older children and adults, it shifts to the inner creases - elbows, behind the knees, wrists, and neck. The hallmark symptom is intense itching, which leads to scratching, which worsens the rash (the itch-scratch cycle).
Management focuses on restoring the skin barrier (regular moisturizing is the cornerstone), reducing inflammation (topical steroids, calcineurin inhibitors), avoiding triggers (irritants, allergens, stress, dry air), and controlling itch. Newer treatments include dupilumab (a biologic targeting IL-4/IL-13) and JAK inhibitors for moderate-to-severe disease.
Quick self-check
Does this look like eczema? Answer 2 questions.
Is there intense itching with red, dry, sometimes weeping patches?
Do you or family members have asthma or hay fever?
Risk factors
- Family history of eczema, asthma, or hay fever
- Filaggrin gene mutations (skin barrier dysfunction)
- Living in dry or cold climates
- Urban environments
- Higher socioeconomic status (hygiene hypothesis)
When to see a dermatologist
- ⚠Eczema not controlled with regular moisturizing and over-the-counter hydrocortisone
- ⚠Sleep disruption from itching
- ⚠Signs of skin infection (oozing, crusting, increased redness, warmth)
- ⚠Widespread or severe involvement
Often confused with
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Full ABCDE check →Frequently asked questions
Will my child outgrow eczema?
Many children do improve significantly - about 60-70% see major improvement by adolescence. However, some continue to have eczema into adulthood, and even those who improve may retain dry, sensitive skin.
Is eczema caused by food allergies?
Food allergies do not cause eczema, but they can coexist and may worsen it in some children. About 30% of children with moderate-to-severe eczema have food allergies. Elimination diets should only be tried under medical supervision.
How often should I moisturize?
At least twice daily, and immediately after bathing (within 3 minutes of patting skin slightly damp). Use a thick, fragrance-free cream or ointment - not a thin lotion. Moisturizing is the single most important eczema management step.