Types Of Eczema: How To Tell The Difference

Scott McDougall
Scott McDougallMPharmDirector & Registered Manager
Woman with eczema on feet treats it well

Dealing with a recurring skin condition? There are certain signs that usually point to eczema. If patches of your skin are dry, inflamed, scaly, itchy, and painful, then you can be reasonably confident of that diagnosis — but things actually aren’t that simple.

Eczema is much more complicated than it sounds, applying to a broad range of skin infections and encompassing many symptoms worse than the most common symptoms (such as swollen skin around varicose veins). Due to this, suspecting eczema doesn’t give you enough detail to treat it. Instead of simply assuming that it’s the most common form, atopic dermatitis, you should check the numerous types of eczema to make sure.

Once you have a better idea of the cause of your skin irritation, you can more easily find an effective treatment. To help you with this, we’ve put together this guide to the main types of eczema, explaining how they differ and what their symptoms are. This should help you get to grips with your condition and secure worthwhile treatment. Let’s get started.

What can cause itchy skin or irritated skin?

Something key to remember about eczema is that it’s more about symptoms than anything else, with its core identifier being the presence of some combination of the following: very dry skin, inflamed skin, scaly patches, and frustrating itchiness. If you suffer from recurring instances of these symptoms, it’s fair to describe your issue as eczema.

But that description, while certainly fitting atopic dermatitis, doesn’t cover anything about what causes those symptoms. You could have dry skin from a skin reaction after coming into contact with an unsafe substance, for instance, or develop scaly skin following a skin infection. If you want to clear up the affected skin (or even prevent eczema flare-ups from arriving), you need to know what’s causing your symptoms. Only then can you fully treat it.

Exact categories of eczema vary because there’s significant overlapping, but it makes the most sense to set out the following seven types. Take a look through them to see where you stand. If you need help afterwards (or during), let us know: we can help you assess your symptoms and determine suitable eczema treatments.

The seven different types of eczema

Atopic dermatitis

The most common form of eczema (more common than other types of eczema, and one of the most common skin conditions overall) is usually called atopic dermatitis. Also known as atopic eczema, this condition appears so frequently that it’s essentially what most people believe eczema to be.

Though it most severely affects children and adolescents, atopic dermatitis is unfortunately chronic, meaning there’s no way of curing it. Some reach adulthood and never experience it again, while others have flare-ups in perpetuity. If you continue to deal with it, your only option is to minimise its severity and frequency, doing what you can to manage symptoms.

Due to its inherent variability, atopic dermatitis can require anything from simple moisturisers to topical steroid creams. The latter are the most commonly prescribed treatments for mild to moderate symptoms, though, as they’re safe enough for semi-regular use on dry skin and significantly more potent than less powerful treatments.

It’s best to be generally cautious with skin occasionally affected by atopic dermatitis. Maintaining cleanliness without letting skin dry excessively is particularly key: using gentle soaps is hugely beneficial (standard soaps contain detergents that wash away vital skin oils), as is using a soft towel that won’t cause abrasion or wick away too much moisture.

Sufferers of atopic dermatitis also tend to benefit from improving their overall health, particularly since it often develops alongside asthma and allergies (sometimes food allergies, but most likely pollen allergies, with hay fever being a common result). Eating unhealthy foods and getting minimal exercise will raise stress and emotional variability, yielding an increased risk of experiencing flare-ups. The more you can do to stay healthy and keep your stress levels in check, the better your skin will fare.

Neurodermatitis

Though it isn’t as common as atopic dermatitis (which is incredibly common in young people), neurodermatitis has a widespread impact — and while it’s easier to address in principle, actually treating it can be extremely difficult. This is because it arises from (and is perpetuated by) people scratching their itches.

The itch that initially prompts the scratching can stem from almost anything: a new piece of clothing, for instance, or a change in shampoo. That early scratching damages the skin and irritates nerve endings, leading to further discomfort and itching that yields further scratching. The result is a self-perpetuating cycle of chronic and damaging scratching.

The patches of skin affected by neurodermatitis become rough, scaly, and discoloured. The repeated scratching may become so bad that it cuts the skin, raising the risk of infection and causing even greater pain. The huge issue with neurodermatitis is that it tends to escalate in severity: the worse it gets, the itchier it becomes, and the rougher the scratching gets.

As alluded to earlier, neurodermatitis (also known as lichen simplex chronicus) isn’t inherently chronic in the way that atopic dermatitis is. It’s perfectly possible to treat (and even cure) neurodermatitis, though it’s obviously much easier said than done. Sufferers inevitably want to stop scratching, but they find scratching almost irresistible.

Treatment, then, is only partially about reducing the symptoms by healing the damaged skin. It’s much more about reducing the scratching, whether by treating the itching that prompts it, addressing the psychological habits that worsen the urge, or physically protecting the skin from scratches by adding some kind of wrap.

Contact dermatitis

Producing similar symptoms to those of atopic dermatitis, contact dermatitis (as the name suggests) develops in response to skin contact with a substance that either incites an allergic reaction or simply irritates the skin (more on this shortly). This makes treatment relatively straightforward. If you can get rid of that substance, or simply prevent further exposure, the affected skin should eventually clear up with no further action needed (though you can speed things up by using appropriate topical applications).

Allergic contact dermatitis

Many people suffer from allergies, and it’s not uncommon for someone to be allergic to something they might come into contact with through clothing (latex, for instance). Figuring this out is largely a matter of tweaking variables until something changes: if your skin is becoming red and itchy, you can switch to clothing with different materials to see how that changes things. It shouldn’t be too difficult to resolve.

Irritant contact dermatitis

Sometimes you can come into contact with a substance that simply irritates your skin. A reasonably strong acid will cause problems, of course, or you could wear a material that proves abrasive on your skin and produces symptoms similar to those of neurodermatitis. Again, the solution to irritant contact dermatitis is simple: remove the source of the irritation.

Dyshidrotic eczema

Dyshidrotic eczema (also known as dyshidrosis, pompholyx, palmoplantar eczema, and vesicular endogenous eczema) is a common skin condition that produces itchy blisters on people’s hands and/or feet. As with atopic dermatitis, it develops for unclear reasons, and may stem from genetic risk factors, elevated stress levels, or seasonal allergies.

Hand eczema

In many sufferers, this form of eczema only affects the hands (and is accordingly referred to as hand eczema, hand dermatitis, or cheiropompholyx). This tends to be the result of local irritation stemming from work using the hands specifically, such as cleaning or hairdressing. Chemists also risk developing hand eczema if they don’t always wear safety gloves.

Foot eczema

In other sufferers, this form of eczema only affects the feet (and is thus referred to as foot eczema, foot dermatitis, or podopompholyx). People who do a lot of exercise on their feet, subjecting their feet to elevated heat, stress, and abrasion, are more likely to develop this, and footwear plays a key role (hence the further name of shoe contact dermatitis).

Nummular eczema

One of the most visually distinct types of eczema (though it can still be mistaken for atopic dermatitis in some cases), nummular eczema (also known as discoid eczema) is a form of eczema that produces small round lesions. These lesions tend to be itchy, red, and inflamed, and may ooze pus from open sores.

Causes of this form of eczema are as varied as they are for atopic dermatitis, but it’s consistently observed that discoid eczema lesions don’t tend to get better without treatment. When that treatment commences, though, the lesions typically clear up very well and don’t recur, even in patients who continue to suffer from other forms of eczema.

Stasis dermatitis

Stasis dermatitis (also known as venous eczema, gravitational eczema, or varicose eczema) is a form of eczema that stems from fluid pooling in the lower legs. Leg veins can become weaker through medical issues or simple aging, and this slows the return of blood to the heart, leading to water and blood gathering in the legs (you may know of varicose veins).

Those gathered fluids cause lower-leg swelling, impacting the skin in various ways. It bears noting that the issue will almost certainly be strongly distinct from atopic dermatitis. You may notice discolouration (particularly light redness from burst capillaries), itching, dryness, and a rise in susceptibility to contact dermatitis. If the swelling goes untreated, the skin can break open, leaving venous ulcers that ooze blood and pus.

Treating stasis dermatitis is largely about reducing the swelling caused by the pooled fluids. This can involve treating the skin to reduce inflammation (often with antibiotics, whether oral or topical), improving heart health through dietary improvements and exercise, and simply limiting opportunities for swelling by moving the legs and/or keeping them compressed.

Seborrheic dermatitis

The last in our list of types of eczema, seborrheic dermatitis (also known as seborrheic eczema or seborrheic psoriasis) can develop on any part of the body that features many sebaceous glands (glands that produce skin oil, or sebum). Most commonly, though, it affects the scalp. When it affects children, it’s known as cradle cap, producing scaly patches that can cover their heads (or bottoms in cases that are often mistaken for contact dermatitis). When it affects adults, it’s known as dandruff.

As with atopic dermatitis, anyone can contract seborrheic dermatitis, though it’s more common for men. Similarly, if it doesn’t clear up after childhood, it’s likely to periodically reappear. There are myriad risk factors associated with it, but it’s thought to be an inflammatory overreaction to a form of yeast (Malassezia yeast) that lives on the skin.

If you suffer from this form of eczema, you should aim to keep the affected skin hydrated, avoid anything abrasive, stay calm, eat healthily, and use anti-dandruff shampoo if suitable. If it’s really bothering you and you’re not sure what to do, though, you should let us know. We can help you find a more potent treatment to clear up your skin.

Summary

As we noted in the introduction, eczema — despite how common it is — happens to be awkwardly complicated. This makes it tough to effectively treat, and results in sufferers simply putting up with it for years on end because they’re unsure what to do about it. If you’re dealing with eczema, though, you mustn’t simply accept it. It can be treated.

The first step to making progress is identifying the type of eczema you’re facing, and this piece should help with that. Let us know if you can’t quite figure it out, as it can be really difficult to tell the difference between some types. After that, it all comes down to getting the right treatment, and our large range of eczema treatments means we can help there.

So what are you waiting for? Get in touch today, and we’ll start helping you build a path towards healthier skin.

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