skin-concerns
What Is Eczema?
Last reviewed: May 2026 · Haute MD Editorial Team
Eczema (atopic dermatitis) is a chronic inflammatory skin condition characterized by dry, itchy, inflamed skin — often appearing in the creases of elbows and knees, on the face and neck, and on the hands and wrists. It affects approximately 31 million Americans, beginning in childhood in most cases but persisting into or beginning in adulthood in many. Eczema results from a combination of genetic barrier dysfunction and immune dysregulation — the same immune imbalance associated with asthma and allergic rhinitis in the "atopic march." Modern treatments including dupilumab (Dupixent) have dramatically improved outcomes for moderate-to-severe disease.
Triggers and flare management
Eczema flares are triggered by dry skin (inadequate moisturization), irritants (soaps, detergents, fragrances, wool), allergens (dust mites, pet dander, certain foods in children), sweat, stress, and skin infections (Staphylococcus aureus colonization is nearly universal in eczema and worsens inflammation). Identifying and systematically reducing personal triggers is central to management. Moisturizing immediately after bathing (within 3 minutes, while skin is still damp) with fragrance-free ceramide-containing moisturizers is the cornerstone of daily management.
Treatment ladder
Mild eczema — fragrance-free moisturizers 2x daily plus OTC hydrocortisone 1% for flares. Moderate eczema — prescription topical corticosteroids for flares plus topical calcineurin inhibitors (tacrolimus, pimecrolimus) as steroid-sparing maintenance. Severe eczema — dupilumab (Dupixent), an injectable biologic blocking IL-4/IL-13 signaling, has transformed treatment, producing significant clearance without the long-term risks of systemic steroids. Newer JAK inhibitors (upadacitinib, abrocitinib) offer oral alternatives for severe disease.
Eczema in adults — recognition and management
Adult-onset eczema is increasingly recognized — often presenting in the hands, face, or eyelids without childhood history. Hand eczema is a particularly common adult presentation, frequently worsened by repeated handwashing or occupational exposure. Patch testing (to identify contact allergens) is an important diagnostic step in adult-onset or difficult-to-control eczema. Dermatology referral is appropriate when eczema is affecting quality of life, not responding to topical therapy, or when biologic therapy is being considered.
Frequently Asked Questions
Is eczema contagious?
No. Eczema is an inflammatory condition — not an infection. It cannot be transmitted by contact. Skin-to-skin contact with someone with eczema poses no risk.
Can eczema be cured?
There is no cure for eczema — it is a chronic condition with genetic roots. Many children experience significant improvement or apparent resolution by puberty. Modern biologics (dupilumab) can produce near-complete clearance in moderate-to-severe disease, effectively controlling the condition even if not curing it.
Does food cause eczema in adults?
In children, food allergy (milk, egg, peanut, wheat) is a more significant eczema trigger than in adults. In adults, food allergy is less commonly a primary eczema driver — contact allergens, irritants, and environmental triggers are more important. Patch testing and allergy evaluation may be helpful in certain cases.
What is the difference between eczema and psoriasis?
Both cause red, scaly skin patches but are distinct conditions. Eczema causes intensely itchy patches in skin folds and on the face, driven by barrier dysfunction and Th2 immune imbalance. Psoriasis causes silvery-scaled thick plaques on elbows, knees, and scalp, driven by Th17/Th1 immune dysregulation. They require different treatments and have different associated conditions.
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