Eczema vs. Dry Skin: What Are the Differences?

Eczema, also known as atopic dermatitis, is a skin disease characterized by itchiness, scaliness, and rashes. This inflammatory condition, usually seen in areas behind the knees and on the elbows, hands, and feet, affects around 10% to 20% of children and 1% to 3% of adults.

Though eczema causes dry skin, not all dry skin is eczema. Dry skin can cause similar symptoms, but it isn’t a chronic condition like eczema.

This article discusses the differences between eczema and dry skin, their symptoms, causes, treatment options, and more.

Symptoms

Both conditions cause itchiness, redness, scaliness of the skin, and dandruff-like flaking. Eczema is a chronic inflammatory condition. Dry skin, clinically called xeroderma, is a primary feature of eczema and can be a symptom that arises due to a range of external factors, including disease or specific environments and behaviors.

While symptoms between the two conditions overlap, there are several key differences:

Causes

Eczema is a chronic inflammatory condition caused by genetic and environmental factors. Dry skin can arise due to many factors, including as a symptom of eczema but may not necessarily relate to any disease.

Eczema Causes

While the exact cause of eczema is unknown, its tendency to run in families makes researchers believe it is linked to both genetic and environmental factors. Genetic factors can impact the body in several ways, including:

• Skin barrier dysfunction: The skin serves as the body’s barrier, preventing liquid or moisture from escaping. Researchers have found that a gene mutation resulting in an insufficiency of filaggrin (FLG), a key protein that helps with this function, may cause eczema.
• Immune system abnormalities: Genetic mutations that cause immune system dysfunction also contribute to skin barrier dysfunction and eczema. Abnormal responses to bacterial infections or viruses cause a systemic (whole-body) inflammatory response known as pruritus, which causes itchiness and dry skin associated with eczema.   
• Bacterial infection: As a result of the skin barrier dysfunction, researchers have linked eczema to infection with the Staphylococcus aureus (S. aureus) bacteria, or staph infection. The presence of this bacteria is seen in approximately 90% of cases.

Environmental factors can also contribute to or worsen eczema. These triggers vary depending on the individual and may include the following:

• Skin irritants: Soaps, laundry detergent, lotions, cleaning products, abrasive clothing, metals, ointments, and bandages
• Allergens: Dust mites, pet dander, certain pollens, mold, and other inhaled allergens
• Certain foods: Shellfish, eggs, soy, wheat, and peanuts, among other foods
  
• Infection: Staph, yeast infection, and herpes simplex, among others
• Stress

Causes of Dry Skin

Dry skin occurs when too much water and oil (lipids) escape from the skin and can affect anyone. Dry skin most commonly occurs due to the following:

• Cold, dry winter air or hot desert climates
• Indoor heat or air conditioner use
• Sun exposure
• Aging (the body’s ability to manufacture natural oils declines with age)
• Showering or bathing too frequently
• Certain soaps or detergents
• Exposure to chemicals or detergents
• Skin conditions, such as psoriasis and eczema
• Medical conditions (including diabetes, Sjogren’s syndrome, hypothyroidism)
• Medication side effects
• Smoking

Diagnosis

There are no specific tests for eczema or dry skin. Diagnosis aims to rule out other underlying conditions and determine the proper treatment. Diagnosis involves:

• Physical examination: Your healthcare provider will look at the affected areas of the skin and ask about your symptoms.
• Health history: Your healthcare provider will ask about your medical history and the medications you’re currently taking.
• Testing: There are no specific tests for eczema or dry skin. Further evaluation or testing may be recommended if dry skin is suspected to be linked to other diseases.

Treatment

Since treating eczema and dry skin can vary, proper diagnosis is crucial for managing these conditions. Lifestyle changes and treatment can effectively manage both.

Eczema Treatment

Depending on the severity of the symptoms, several treatment options are available. These include:

• Use of emollients (moisturizers)
• Topical corticosteroids (steroid creams, such as hydrocortisone)
• Immunosuppressive medications (drugs that suppress the immune system)
• Topical calcineurin inhibitors (TCI) (a class of immunosuppressant medications)
• Dupixent (dupilumab) (an injectable medication)
• Topical phosphodiesterase-4 inhibitors (drugs that suppress inflammation in the airways)
  
• Ultraviolet B (UV-B) phototherapy (exposing affected skin to UV rays)
• Antihistamines (allergy medications)

Eczema treatment strategies involve mixing methods to manage flare-ups and reduce their frequency. This is best done under the guidance of your healthcare provider or a specialist.

Dry Skin Treatment

As with eczema, the specific course of treatment for dry skin depends on the severity of the case. It often involves using creams or lotions to rehydrate the skin. In some cases, you may be prescribed topical corticosteroids. If it's a symptom of another disease, treatment for the underlying condition is crucial.

Prevention

You can do a lot to prevent dry skin and eczema flare-ups. However, since dry skin is typically a symptom, while eczema is a condition, there are some differences in how they are managed.

Eczema Prevention

Eczema is often triggered, and prevention usually involves a combination of strategies to avoid such triggers. Prevention approaches include:   

• Following a steady skin care routine, including regular use of prescribed topicals and moisturizing creams
• Bathing no more than once a day in lukewarm water for 10 to 15 minutes
• Washing with mild, unscented soap
• Patting the skin dry and moisturizing shortly after bathing
• Tracking your triggers
• Eating a healthy, anti-inflammatory diet
• Managing stress with meditation, exercise, or other strategies
• Wet wrap therapy, which involves laying damp gauze or towels over affected areas

Dry Skin Prevention

Several ways to prevent dry skin patches from forming include:

• Avoiding bathing or exposing skin to water for long periods
• Using lukewarm water when bathing and patting yourself dry instead of rubbing
• Using gentler, dye-free soaps and detergents

Summary

While eczema can cause dry skin, these are distinct conditions. Dry skin is an acute (temporary) condition that can affect anyone and is usually caused by climate, irritants, aging, or other health conditions. Eczema is a skin disease commonly found in children under 5, caused by genetics, and triggered by environmental factors.

Accurate diagnosis is critical for properly managing these conditions. Treatment may include using lotions, creams, or topical corticosteroids and treating other underlying conditions. Avoiding irritants and moisturizing can help prevent dry skin and eczema flare-ups.

A Word From Verywell

There's no reason to live with discomfort if you're experiencing dry skin or symptoms of eczema; prevention and treatment options can be highly effective. Be proactive about your health, and talk to your healthcare provider today if you're experiencing dry, itchy, flaky skin.