Eczema: What it is, Causes, Symptoms, Treatment & Types

What is Eczema?

Eczema is a skin disease that causes it to become itchy, dry, inflamed, and irritated. It is generally linked to an overactive immune response, genetic factors, allergies, or environmental triggers.

The condition is usually chronic, meaning it can last for a long time and may flare up from time to time. However, it does not spread from one person to another through touch or contact.

It can affect people of all ages, although it is more commonly seen in children. The symptoms of eczema commonly appear on the hands, face, neck, elbows, knees, and feet, and can become worse at night.

What are the Types of Eczema?

The different types of eczema are as follows:

NOTE: A person may experience more than one type of eczema at the same time.

How Common is Eczema in India?

Eczema is a common skin condition in India that affects people of all ages, particularly children. A survey of 1,003 Indian parents of children under five years of age found that 17.85% of children had atopic dermatitis (eczema), highlighting the substantial burden of the condition in early childhood.

The prevalence of eczema appears to be higher in urban and metropolitan areas, where exposure to air pollution, environmental irritants, and lifestyle-related factors is more common. Cities such as Delhi NCR, Bengaluru, Mumbai, and Kolkata report a high number of eczema cases, making it one of the most common skin disorders in dermatology clinics.

What are the Symptoms of Eczema?

Eczema symptoms mainly affect the skin and can range from mild dryness to more severe irritation during flare-ups. The signs often appear in cycles, where they improve for a while and then return again depending on triggers and skin condition.

Common symptoms of eczema include:

• Itching: It is the most common and persistent symptom, ranging from mild to serious and often worsening at night.

• Dry or Sensitive Skin: The skin may feel rough, tight, or unusually dry even after moisturising.

• Red or Inflamed Patches: Depending on the skin colour, areas of skin may appear red, darker, or irritated.

• Rough or Scaly Texture: The affected skin can become uneven, flaky, or thick over time.

• Swelling: Mild swelling or puffiness may develop in affected areas during active flare-ups.

• Cracked or Broken Skin: In more severe cases, the skin may crack due to dryness and repeated scratching.

• Oozing or Crusting: Some flare-ups may cause small fluid leaks or crust formation on the skin.

What Causes Eczema?

Some of the most common causes of eczema are as follows:

• Genetic Factors: A family history of asthma, eczema or allergies can increase the chance of developing this skin problem.

• Immune System Dysfunction: The immune system may react strongly to irritants or allergens, causing skin inflammation.

• Skin Barrier Weakness: When the skin's natural barrier is not strong enough, it loses moisture easily and becomes dry and sensitive.

• Environmental Triggers: Dust, pollution, smoke, or weather variations can aggravate the skin and cause flare-ups.

• Irritants: Daily-use products such as soaps, detergents, perfumes, or specific types of clothing materials can worsen the problem.

• Stress: Emotional stress does not directly cause eczema but can trigger or worsen symptoms.

• Sweat and Heat: Excess sweating or overheating can irritate the skin, leading to itching or flare-ups.

What are the Complications of Eczema?

Eczema can lead to multiple complications that affect the skin and overall quality of life.

• Skin Infections: Constant scratching can damage the skin's protective barrier, allowing bacteria, viruses, or fungi to enter the skin. This may lead to infections that cause redness, swelling, pain, crusting, or fluid-filled blisters.

• Thickened and Discoloured Skin: Repeated itching and rubbing can cause the skin to become leathery, thick, and darker or lighter than the surrounding area. This condition, known as lichenification, is common in people with long-lasting eczema.

• Sleep Disturbances: Intense itching is likely to worsen at night, making it hard for a patient to fall asleep or get quality sleep.

• Emotional and Mental Health Issues: Living with chronic eczema can affect self-esteem and emotional well-being. Some people may experience stress, anxiety, social withdrawal, or symptoms of depression, especially when visible areas of the skin are affected.

• Eye-Related Problems: Eczema around the eyes can increase the risk of complications, such as eyelid inflammation, conjunctivitis, or irritation of the eye surface. Frequent rubbing may even worsen these symptoms.

• Increased Risk of Allergic Conditions: Many patients who suffer from eczema are prone to suffering from other forms of allergies such as asthma, food allergies, or rhinitis.

• Reduced Quality of Life: Severe eczema can interfere with daily activities, work, school, exercise, and social interactions. Ongoing symptoms and frequent flare-ups may significantly impact overall well-being.

When Should I See My Healthcare Provider?

It is a good idea to speak with your healthcare provider if your eczema symptoms are becoming difficult to manage or are affecting your daily life.

You should seek medical advice if:

• Your eczema does not improve despite using moisturisers and prescribed treatments.

• The itching is severe and is affecting your sleep, work, or everyday activities.

• Your skin may become red, swollen, painful, or start oozing fluid, which may be signs of an infection.

• You notice cracks, bleeding, or thickened patches of skin from frequent scratching.

• The rash spreads to other parts of your body or keeps coming back.

• You develop eczema around your eyes or experience irritation and discomfort in that area.

• Your symptoms are causing stress, anxiety, embarrassment, or affecting your confidence.

How is Eczema Diagnosed?

Mostly, a doctor diagnoses eczema by examining your skin, reviewing your symptoms, and discussing your medical and family history.

During the consultation, your provider may ask when the symptoms started, whether they come and go, and whether certain triggers, such as soaps, detergents, weather changes, stress, or allergens, make them worse. They may also ask if you or your family members have a history of eczema, asthma, hay fever, or other allergic conditions.

If the diagnosis is unclear or another skin condition is suspected, your healthcare professional may recommend additional tests, such as:

• Patch testing to detect allergic reactions to specific substances.

• Blood tests to look for signs of allergies tendencies or inflammation.

• Skin swabs if there are signs of a bacterial, viral, or fungal infection.

• Skin biopsy, in which a small piece of skin is removed for examination to rule out other skin disorders.

How is Eczema Managed?

Eczema cannot always be cured, but it can be managed with proper treatment and skincare routine.

Can Eczema Be Reversed?

Eczema cannot be permanently reversed or cured, especially in people with chronic conditions. However, with proper treatment, symptoms can often be controlled effectively, and many people experience long periods without flare-ups.

In some children, eczema may improve significantly or even disappear as they grow older. In adults, however, eczema may continue to recur; nevertheless, the disease is manageable.

How Can I Prevent Eczema?

Some of the helpful tips to prevent eczema or decrease its risk are as follows:

• Keep your skin moisturised by applying a fragrance-free moisturiser regularly, especially after bathing.

• Use gentle, skin-friendly skincare products that are free from irritants and strong chemicals.

• Take short baths or showers with lukewarm water instead of hot water to prevent excessive skin dryness.

• Wear soft, breathable clothing, such as cotton, to minimise skin irritation.

• Protect your skin from extreme temperatures, dry air, and sudden weather changes.

• Avoid scratching itchy areas, as scratching can damage the skin and increase the risk of infection.

• Keep your nails trimmed short to reduce skin injury from accidental scratching.

Does Health Insurance Cover Eczema?

Yes, health insurance policy covers eczema-related medical expenses requiring in-patient care. It includes room rent, ICU charges, doctor fees, nursing charge, diagnostic tests, prescription medications, etc.

If eczema is considered a pre-existing condition, a waiting period of up to 3 years applies before related claims can be made. Routine skincare products, such as moisturisers and over-the-counter creams, are usually not covered.

It is always recommended that you review the policy wordings carefully to understand the extent of coverage.

How Much Health Insurance Coverage is Needed for Eczema Treatment?

The cost of eczema treatment in India may vary depending on the severity of the condition, frequency of flare-ups, and the type of treatment required. Since it is a long-term condition, the treatment expenses may become recurring over time. The approximate treatment costs are up to ₹1,50,000 or more in severe cases.

For most individuals, a health insurance cover of ₹5-10 lakh is generally sufficient to manage eczema-related expenses.