Eczema is a skin condition that affects both children and adults. While it is a common condition, not all eczema is the same. There are different types, each with distinct causes, symptoms, and treatment approaches.
This article outlines the seven most common types of eczema and how to recognise and manage them.
What Is Eczema?
Eczema, also known as dermatitis, is an inflammatory skin condition characterised by itchy, red, and dry skin. It often flares up in response to specific triggers, with periods of improvement in between. Eczema is caused by a combination of genetic and environmental factors that affect the skin’s protective barrier.
Each type of eczema has unique underlying causes, appearance, and management approaches. Understanding the specific type affecting you can help determine the most appropriate treatment strategy.
1. Atopic Dermatitis
Atopic dermatitis is the most common form of eczema. It often begins in childhood and may continue into adulthood. It appears as red, dry, and itchy patches, commonly affecting the folds of the elbows, behind the knees, and on the face and neck. Symptoms often worsen at night.
This form of eczema frequently occurs alongside other allergic conditions such as asthma, hay fever, or food allergies. Genetics play a significant role, with the condition often running in families who have a history of atopic conditions.
Management involves regular moisturising, avoiding known triggers, and sometimes medicated creams or ointments prescribed by a dermatologist. For severe cases, phototherapy or oral medications may be recommended to control inflammation.
2. Contact Dermatitis
Contact dermatitis occurs when the skin reacts to something it touches, resulting in a localised rash. There are two main types:
Irritant contact dermatitis: caused by exposure to harsh chemicals or repeated hand washing
Allergic contact dermatitis: triggered by substances like nickel, fragrances, or certain plants
Symptoms include red, dry, itchy skin that may become cracked or blistered. The rash typically appears where contact occurred.
Identifying and avoiding the triggering substance is the key to managing contact dermatitis. Patch testing performed by an eczema specialist in Singapore can help identify specific allergens.
3. Dyshidrotic Eczema
Dyshidrotic eczema causes small, itchy blisters on the hands, fingers, feet, or toes. The blisters are commonly filled with fluid and can be painful. After the blisters dry, the skin may appear scaly with deep cracks.
This type can be triggered by stress, allergies, humidity, or contact with metals like nickel. It is more common in adults under 40.
Treatment usually includes prescription creams to reduce inflammation. Keeping hands and feet dry and moisturised can also help reduce flare-ups.
4. Nummular Eczema
Nummular eczema, also called discoid eczema, is characterised by coin-shaped patches of irritated skin that may be crusted, scaly, and intensely itchy. These round lesions often appear on the arms, legs, or torso.
Nummular eczema may develop after an injury to the skin such as a scratch, insect bite, or burn. It tends to flare up in colder weather and may affect older adults more often.
Moisturisers, steroid creams, and antihistamines may help control symptoms. Wet wrap therapy can be used for more stubborn cases.
5. Seborrhoeic Dermatitis
Seborrhoeic dermatitis appears in areas with more oil-producing glands, such as the scalp, eyebrows, sides of the nose, and upper chest. It causes flaky, greasy, yellowish patches and may be associated with dandruff.
This type is linked to both an overgrowth of a yeast called Malassezia and to an irregular response of the immune system. Stress, hormonal changes, and illness can trigger flares.
Management includes antifungal shampoos or creams and, in some cases, mild steroid applications for short-term use. It is usually not very itchy compared to other eczema types.
6. Stasis Dermatitis
Stasis dermatitis develops as a result of poor circulation in the lower legs, typically in older adults with varicose veins or a history of blood clots. Fluid builds up in these areas, leaks out of the veins, and irritates the skin.
Symptoms include swelling, redness, itching, and scaly or shiny skin around the ankles. Over time, the skin may become thickened or darkened.
Treatment focuses on improving circulation through compression stockings, leg elevation, and regular movement. Moisturisers and topical steroids may help manage symptoms.
7. Asteatotic Eczema
Asteatotic eczema, also known as eczema craquelé, predominantly affects older adults. The skin appears dry with a cracked, flaky skin, often on the shins and may worsen during dry or cold weather.
This type of eczema is primarily caused by extremely dry skin, which becomes more common with age. Environmental factors such as low humidity, excessive bathing, harsh soaps, and indoor heating can worsen the condition, particularly during winter months.
Management focuses on intense moisturisation with emollients to help restore the skin barrier. Using a humidifier, taking shorter lukewarm showers, and avoiding harsh soaps can help prevent flares.
Clinical Note: Distinguishing Facial Eczema from Acne
Because certain types of eczema, such as seborrhoeic dermatitis, primarily affect the face, they are frequently mistaken for other inflammatory conditions like acne. It is clinically appropriate to receive a professional dermatological assessment for facial rashes before beginning a new skincare regimen. Using aggressive anti-acne products on eczematous skin can further compromise the skin’s protective barrier, potentially leading to increased irritation and prolonged inflammation. A formal diagnosis ensures that the management plan is tailored to your specific skin condition, avoiding the risks of unsuitable self-treatment.
Conclusion
Identifying the specific type of eczema can help guide appropriate prevention and treatment. It allows you to recognise triggers, manage flare-ups more effectively, and understand when to seek medical advice.
If your symptoms persist or no longer respond to your current routine, consult an eczema doctor in Singapore for a personalised treatment plan that targets your unique skin needs.
