Eczema is a group of inflammatory skin conditions that damage the skin barrier and cause itchy, red, dry and sometimes cracked or blistered skin. Dermatitis is one form of eczema, and the two terms are often used interchangeably for atopic dermatitis. Eczema is a chronic condition with no cure, but flare-ups can be managed by avoiding triggers, moisturising daily with barrier-repair ingredients like urea and glycerin, and following your healthcare provider’s treatment plan.
Dermatitis vs eczema – what is the difference?
‘Dermatitis’ and ‘eczema’ are two terms that often overlap, and both describe a skin condition that causes irritation. The simplest way to think about it is that dermatitis is one of the causes of eczema. Dermatitis means red, inflamed and itchy skin. Eczema, rather than being a single condition, is an umbrella term for a group of skin diseases that cause inflammation, and that group includes dermatitis. In many cases, eczema refers specifically to atopic dermatitis, which is why many dermatologists use the terms ‘atopic dermatitis’ and ‘eczema’ interchangeably. You can read more on our eczema and dermatitis condition page.
The different types
Eczema covers several distinct conditions, and knowing which type you have helps guide treatment:
- Atopic dermatitis is the most common type. It is usually caused by a combination of genetic and environmental factors and often appears alongside other atopic conditions such as asthma and hay fever.
- Contact dermatitis develops when the skin reacts to an irritant or allergen it touches directly, such as harsh soaps, certain metals or harsh chemicals.
- Dyshidrotic eczema causes small, fluid-filled blisters, often on the hands and feet, that can be very itchy.
- Hand eczema, sometimes called hand dermatitis, affects the hands specifically and is common in people who wash their hands frequently or work with irritants.
A thicker, scaly form known as hyperkeratotic eczema can also appear on the palms. If you are unsure which type you have, a healthcare provider can help you work it out.
Causes
There is ample scientific evidence that the leading causes of eczema are genetic or environmental. A 2015 study found that the chance of inheriting eczema is approximately 75%, so children of parents with eczema are more likely to develop it too. On its own, genetics does not tell the whole story. A range of environmental factors and common triggers can set off or worsen a flare, including:
- Cold weather, dry weather and low humidity, which dry out the skin
- Harsh soaps, harsh chemicals and other irritants that strip the skin’s natural oils
- Emotional stress, which is a well-recognised trigger
- Food allergy in some people, and seasonal triggers such as hay fever
- Heat, sweat and sudden changes in temperature
Healthy skin retains moisture and protects you from these stressors. With eczema, the skin barrier does not work as well, so it leaks moisture and the skin becomes dry, irritated and more reactive. Learning to avoid triggers is one of the most effective ways to keep flare-ups under control.
Symptoms
Symptoms vary from person to person, and some people experience more severe cases than others, but eczema and dermatitis are typically marked by:
- Itchy skin, usually the first and most noticeable symptom
- Redness and irritated skin caused by extra blood flow to the affected skin
- Dry, cracked and flaky skin
- Itchy blisters or fluid-filled blisters, particularly with dyshidrotic eczema
- Weeping skin, stinging or painful cracks
- Rashes, swelling and, over time, pale patches or pigmentation
Itching is the symptom most people find hardest to live with, and scratching can break the skin and lead to bacterial infections. Weeping, crusting or increasing pain can be signs of a skin infection, which needs prompt attention.
Eczema on the hands
The hands are one of the most common places eczema and dermatitis appear, especially with frequent washing and sanitiser use since COVID, which strip away natural oils. Managing hand eczema starts with reducing contact with irritants and keeping the skin barrier topped up with moisture.
Gloves help a great deal. Wear protective gloves for wet work and cleaning, and wear cotton gloves underneath rubber or vinyl gloves so sweat does not build up against the skin. A pair of cotton gloves over a thick layer of hand cream at night is also a simple way to lock in moisture while you sleep. These small habits make a real difference when hand eczema is interfering with everyday tasks.
How it’s diagnosed
Eczema is usually diagnosed by a healthcare provider through a physical exam of the skin and a discussion of your history and triggers. If contact dermatitis is suspected, patch testing can identify which substances your skin is reacting to. Getting eczema diagnosed properly matters, because it confirms the type and guides the right treatment.
Treatment and management
There is no cure for eczema, but the right treatment plan keeps symptoms under control and helps the skin heal. Treatment options range from daily skin care through to prescription medications for severe cases.
Moisturise every day. Daily moisturising is the foundation of eczema care. Thick moisturisers and barrier-repair creams hold water in the skin, reduce inflammation and soothe itching far better than thin lotions. Colloidal oatmeal is a gentle, well-tolerated ingredient that calms irritated skin, and a cool bath or cold compresses can take the edge off itching during a flare.
Medical treatments your doctor may recommend. When moisturising alone is not enough, a healthcare provider may prescribe topical corticosteroids to reduce inflammation during a flare, or topical calcineurin inhibitors as a steroid-sparing option for delicate areas. Antihistamines may help with itching, especially at night. For more severe cases, treatment options can include light therapy (phototherapy) and, in some instances, injectable medications. Always follow your healthcare provider’s instructions and finish any course as directed.
Look after the basics. Take shorter, warm rather than hot baths, use mild, fragrance-free washes instead of harsh soaps, and pat the skin dry before moisturising. Managing stress can also reduce flares, since emotional stress is a known trigger.
What to look for in a cream
Look for a moisturiser with ingredients that help moisturise, soothe and repair the damaged skin barrier:
- Urea
- Glycerin
- Ceramides
- Colloidal oatmeal
- Hyaluronic acid
And avoid ingredients that dry out or irritate the skin and can make eczema worse:
- Retinoids
- Parabens
- Dioxins (1,4-dioxane)
- Drying alcohols
- Fragrance
How to prevent eczema flare-ups
Day-to-day prevention is about protecting the skin barrier and avoiding irritants before they trigger a flare:
- Moisturise daily, and more often in cold weather, dry weather or low humidity
- Avoid harsh soaps and harsh chemicals, and wear gloves to protect your hands
- Identify and avoid your personal triggers
- Manage stress where you can
- Treat dryness early to prevent flares and reduce the risk of cracks and skin infection
When to see a healthcare provider
Most eczema can be managed at home, but see a healthcare provider if the skin is severely inflamed, the rash is spreading, a flare will not settle with your usual routine, or there are signs of a bacterial infection such as weeping skin, crusting or increasing pain. A doctor or dermatologist can confirm the type of eczema or dermatitis and recommend prescription treatment if it is needed.
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Frequently asked questions
What causes eczema?
Eczema is caused by a mix of genetics and environmental factors. A faulty skin barrier, often inherited, lets moisture escape and irritants in, and common triggers such as cold or dry weather, low humidity, harsh soaps, stress and sometimes food allergy then set off a flare.
Is eczema contagious?
No. Eczema is not contagious, so you cannot catch it from someone else or pass it on. It is an inflammatory skin condition linked to the skin barrier and your immune response, not an infection.
How long does an eczema flare last?
It varies. With consistent moisturising and the right treatment, many flare-ups settle within a few weeks, but because eczema is a chronic condition, it can return, which is why daily skin care and avoiding triggers matter even when your skin is clear.
Can you get eczema on your hands?
Yes. Hand eczema, also called hand dermatitis, is very common, especially with frequent washing and sanitiser use. Wearing gloves for wet work and using a fragrance-free, barrier-repairing hand cream both help protect and soothe the skin.
Does eczema get worse in winter?
It often does. Cold weather, wind and low humidity dry out the skin, and indoor heating makes it worse, all of which weaken the skin barrier and can trigger a flare. Summer heat and sweat can be triggers too, so the goal is to keep skin moisturised year-round.
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