How Eczema Changes Over Time

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Eczema is the name for a family of itchy, irritating skin conditions. While certain kinds are more likely to first develop in childhood, others can and do develop in adulthood.

Learning more about the type of eczema you have and how it typically manifests can help you get a handle on successfully managing the symptoms. (Hint: try not to scratch!)

When you say “eczema,” most people think of atopic dermatitis. That’s for good reason: atopic dermatitis is the most common type of eczema. Its hallmark is the itch-scratch-rash cycle. First, you feel an itch, and you scratch it. Then you develop a red, swollen rash, which may then crack, weep or bleed. Afterward, the rash will crust over and form scaly patches. Sometimes, you’ll go into a period of remission, without any flare-ups of eczema, only to experience an exacerbation later on down the road.

As many as 60% of people who had atopic dermatitis as children go on to experience it in adulthood. If you first developed this form of eczema as a baby or young child, as many people with eczema do, you’re well acquainted with the cycle. You’ve probably dealt with it countless times over the years. And you’ve probably developed a successful routine for managing any exacerbations.

If you developed atopic dermatitis as an adult, however, it may take you some time to recognize the telltale itch and be prepared for the rash. Your doctor can talk to you about the appropriate treatment, which usually starts with topical corticosteroid creams. You’ll have to learn how to treat your skin carefully, which includes regular moisturization. You’ll also have to work on resisting the urge to scratch your skin, which can cause further damage and even lead to infections.

But atopic dermatitis can be unpredictable in adults, regardless of when they first developed it. Some people are relieved to experience fewer flare-ups of their eczema in adulthood. But some continue to experience significant and frequent exacerbations, even as adults. You might also notice that the symptoms affect your hands. In many cases, this type of eczema tends to take the form of hand dermatitis in adulthood—that is, you tend to develop rashes or itchy redness mostly just on your hands and fingers.

Since it’s the most common form, atopic dermatitis is probably the best known type of eczema. But you can develop another type of eczema, since there are actually eight different types. The other seven include:

• Contact dermatitis. An allergen or irritant that comes into direct contact with your skin can cause inflammation and itching. Think: detergent, skin care products, chemicals and solvents, and wool.

• Lichen simplex chronicus. This type of eczema is similar to atopic dermatitis and is characterized by thick, scaly patches that appear on your skin.

• Hand eczema. This common form of eczema usually results from exposing your hands to an irritating chemical or other substance.

• Dyshidrotic eczema. Small, incredibly itchy blisters form on your feet and hands, and they tend to be worse during spring allergy season.

• Stasis dermatitis. Swelling, irritation, sores, and even varicose veins tend to develop in your lower legs (or other areas with poor circulation) in this form of eczema, which is also called gravitational dermatitis.

• Nummular eczema. Oval or round sores develop after a skin injury and can last for weeks or even months. This type of eczema affect more men than women.

• Seborrheic dermatitis. You might develop dry flakes or greasy scales on your scalp or other places with lots of oil-producing glands.

To understand how your eczema is likely to progress over the course of your life, it’s important to make sure you have the right diagnosis. Some of these kinds of eczema are indeed more common in adults, like hand dermatitis and statis dermatitis. Understanding the type of eczema you have can help you gain a better understanding of what to expect, including your symptoms, your triggers, and the progression of the condition.

Stress does not cause eczema. But it can trigger a flare-up. And what adult isn’t intimately acquainted with stress in this day and time? Your job, your family, even the political climate can negatively affect your stress levels. For example, stress, among a few other factors, is known to trigger flare-ups of dyshidrotic eczema. To further complicate the situation, having eczema and experiencing frustrating flare-ups can raise your stress levels, too.

If you’ve noticed that periods of stress tend to result in an eczema exacerbation, it may be time to devote some energy to developing a stress management strategy.