An Overview of the 7 Types of Eczema

Eczema is a "catch-all" phrase used to describe a group of conditions that cause irritated, inflamed, and often itchy skin. There are seven different types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, neurodermatitis, nummular dermatitis, seborrheic dermatitis, and stasis dermatitis.

This article describes the seven different types of eczema and their symptoms. We also discuss how each type is diagnosed and treated and what you can do to prevent flare-ups.

What Is Eczema?

Eczema is an inflammatory condition of the skin. While there are several different forms of eczema, all of them cause dry, flaky, scaly skin, redness, and itching.

Atopic Dermatitis

Atopic dermatitis is the most common form of eczema. It typically begins during childhood.

Signs and Symptoms

Atopic dermatitis often causes a red rash in the creases of the elbows and knees. Babies also often get atopic dermatitis on the scalp and cheeks.

Atopic dermatitis is common among people with a personal or family history of hay fever or asthma as these conditions commonly occur together. Affected areas of the skin may turn darker and develop small bumps that can become infected if they're scratched and the skin is broken.

Diagnosis, Prevention, and Treatment 

Atopic dermatitis is diagnosed by a dermatologist based on family history and the physical appearance of your skin. A skin biopsy may also help confirm diagnosis.

Atopic dermatitis cannot be cured, but treatment can help decrease symptoms. This includes moisturizing the skin, managing stress, and avoiding triggers like irritating skin products, irritating clothing, extreme temperatures, and fragranced products. Topical treatment with steroids, crisaborole ointment, pimecrolimus cream, or coal tar can help reduce pain, redness, and itching.

For atopic dermatitis that does not respond to other treatments, phototherapy or biologics like Dupixent (dupilumab) or Adbry (tralokinumab-Idrm) may be recommended. Phototherapy involves exposing the affected skin areas to ultraviolet (UV) light two to three times a week to promote skin healing. Dupilumab and tralokinumab-Idrm are monoclonal antibodies that work within the body to suppress inflammation and help improve redness and itching.

When to Seek Professional Help

If you or your child has red, itchy patches of skin that have not gone away within a month, you should schedule a visit with your doctor to determine if you have atopic dermatitis and discuss appropriate treatment options.

Contact Dermatitis

Contact dermatitis occurs when your skin comes in contact with an irritating substance. The two forms of contact dermatitis are irritant contact dermatitis and allergic contact dermatitis.

Irritant contact dermatitis occurs from direct skin exposure to an irritating chemical. Allergic contact dermatitis occurs when your body initiates an immune system response and causes an allergic reaction in response to certain substances that come in contact with your skin.

Urushiol, a substance naturally found in the sap and oils of Rhus plants such as poison ivy, poison oak, and poison sumac, is one of the most common causes of contact dermatitis. It causes red streaks with raised bumps. Other common triggers include fragrances and metals like nickel found in jewelry and belt buckles.

Signs and Symptoms

Irritant contact dermatitis typically causes burning and pain at the exposed area. Itching is the main symptom of allergic contact dermatitis. Irritant contact dermatitis will more commonly cause dry, cracked skin, while allergic contact dermatitis can form fluid-filled blisters. 

Diagnosis, Prevention, and Treatment

Contact dermatitis can be diagnosed by a primary care physician or dermatologist based on the physical appearance of your skin and reported symptoms. The best way to prevent irritant contact dermatitis is to:

• Avoid exposure to heavy chemicals.
• Use gloves when possible.
• Wash your skin immediately if it comes into contact with an irritating chemical.
• Apply a cool compress and calamine lotion on the affected area to soothe symptoms.

If you suspect you may have an allergy to a certain substance, your doctor can perform skin patch testing, where patches that contain small amounts of common allergens are applied to the surface of your skin. These patches are typically applied to your back or arm and left in place for 48 hours.

During this time, you should avoid bathing, showering, swimming, and activities that cause a lot of sweating. Irritated skin at the site of application may indicate an allergy to a particular substance that you should avoid contact with.

Allergic contact dermatitis localized to a specific area can be treated with topical steroid creams such as triamcinolone 0.1% or clobetasol 0.05%. If more than 20% of your skin is affected, oral steroid medications like prednisone are often required. They can reduce pain and inflammation within 12 to 24 hours.

Oral prednisone should generally be tapered off over the course of two to three weeks to prevent rebound dermatitis that can come back with sudden discontinuation of the medication.

While generally not effective for alleviating itching from allergic contact dermatitis, the antihistamines Benadryl and Vistaril may provide some symptom relief.

When to Seek Professional Help

You should see a doctor if you think you have a skin allergy so that you can have patch testing performed. If your patch testing comes up positive for a skin allergy, your doctor can prescribe topical or oral steroids to treat your contact dermatitis. 

Irritant and allergic contact dermatitis can worsen with a bacterial infection. If your rash has exudate or pus, weeping, or crusting, schedule an appointment with your doctor to receive further treatment. 

Dyshidrotic Dermatitis

Dyshidrotic dermatitis is a form of eczema that causes small fluid-filled blisters to form on your hands and feet, causing the skin to crack, scale, and flake.

This condition can result from a variety of different causes, including atopic dermatitis, allergic contact dermatitis, systemic allergic reaction, fungal infection, excessive sweating called hyperhidrosis, or as a side effect of intravenous immunoglobulin therapy. The exact cause of dyshidrotic dermatitis is not fully known.

Signs and Symptoms

Dyshidrotic dermatitis blisters can be itchy or painful, but typically resolve over time as the blisters dry up and the skin peels and falls off. 

Diagnosis, Prevention, and Treatment

Dyshidrotic dermatitis can be diagnosed by a primary care physician or dermatologist based on the physical appearance of your skin and symptoms. Patch testing may be performed to see if you have an allergy to a particular substance.

Dyshidrotic dermatitis can be managed by avoiding exposure to known irritants and treated with topical or oral steroids.

When to Seek Professional Help

When treatment for dyshidrotic dermatitis does not improve symptoms after two to four weeks, further testing should be performed to determine if a different condition is causing your symptoms. A biopsy of your affected skin area can determine if there is a bacterial, fungal, or viral infection causing your symptoms that requires further treatment.

Neurodermatitis

Neurodermatitis is a form of eczema that causes thick, dry, leathery patches of skin that itch. It is similar to atopic dermatitis, and is often triggered by stress or other types of eczema.

Signs and Symptoms

Skin patches caused by neurodermatitis can occur anywhere on the body, but occur most commonly on the arms, legs, shoulders, elbows, ankles, hands, and wrists.

Sometimes your face and genital region can be affected as well. Itching can come and go, and can vary in intensity. Neurodermatitis can also cause pain and hair loss if the scalp is affected.

Diagnosis, Prevention, and Treatment

While the cause of neurodermatitis is unknown, itching often begins or worsens during times of increased stress, anxiety, or depression. Even when periods of stress stop, the itching can continue.

Effectively managing stress can help prevent and decrease the severity of neurodermatitis symptoms. Neurodermatitis rarely improves without treatment, and requires treatment with topical steroids, oral antihistamines, and products like moisturizers and coal tar to reduce skin redness, swelling, itching, pain, and dryness.

When to Seek Professional Help

Neurodermatitis patches can become infected. If your skin lesions are particularly painful or do not improve in two to four weeks with steroid treatment, you should see your doctor to determine if you have a skin infection that's delaying the healing process.

Nummular Dermatitis

Nummular dermatitis, also called nummular eczema and discoid eczema, causes itchy, coin-shaped round patches of skin. It occurs most commonly on the arms and legs but can also affect the hands, feet, or body. Because of the round appearance, it can be mistaken for ringworm or psoriasis.

While the cause of nummular dermatitis is unknown, it often occurs in people with dry skin where there is an increased permeability of the skin to allergens. Nummular dermatitis is also associated with interferon and ribavirin therapy for treating hepatitis C and tumor necrosis factor inhibitor medication used to treat autoimmune diseases.

Signs and Symptoms

Tiny bumps and blister-like sores may appear after you injure your skin. For example, a scrape on the back of one knee could trigger nummular eczema bumps on the backs of both knees.

If you have a darker skin tone, your patches may appear brown. They can also appear lighter than your natural skin color. On lighter skin tones, the patches are usually pink or red. Regardless of color, these raised (and often scaly) patches can last for weeks or months.

Diagnosis, Prevention, and Treatment

Nummular dermatitis often heals on its own or improves with topical steroid treatment. Because it can be associated with other forms of eczema, those conditions should be treated first to help alleviate symptoms. 

To prevent and treat nummular dermatitis, management should focus on regularly moisturizing your skin with thick emollients and avoiding activities that dry and irritate your skin, such as taking long hot showers, using harsh soaps and cleansers, and wearing tight clothing. Antihistamines like Benadryl and Vistaril can help relieve the itching.

When to Seek Professional Help

Nummular dermatitis patches can become infected. If your skin lesions are particularly painful or do not improve in two to four weeks with steroid treatment, you should see your doctor to determine if you have a skin infection that's delaying the healing process.

Seborrheic Dermatitis

Seborrheic dermatitis is caused by an inflammatory reaction of the skin in response to the Malassezia yeast. Seborrheic dermatitis occurs more often in cold and dry climates and during periods of stress.

Signs and Symptoms

Seborrheic dermatitis causes itchy, flaky, scaly patches on areas of the skin that contain a lot of oil glands, called sebaceous glands. These areas include the scalp, face, chest, back, armpits, and groin.

Diagnosis, Prevention, and Treatment

The condition can usually be diagnosed through a physical exam. However, your dermatologist may perform a skin biopsy to rule out other diseases if your condition does not get better with treatment.

Seborrheic dermatitis is treated with topical antifungal medication like ketoconazole for affected areas on the face and body. For scalp dandruff that results from seborrheic dermatitis, over-the-counter dandruff shampoo that contains selenium sulfide, zinc pyrithione, or coal tar can help minimize flaking and scaling.

Antifungal shampoo containing ketoconazole can also be used at least two to three times a week for long-term management until symptoms subside. 

When to Seek Professional Help

Seborrheic dermatitis can be especially hard to treat for people who have compromised immune systems, especially those who have an HIV infection or AIDS. If your symptoms have not improved with the above treatment methods after a month, talk to your doctor. You may need further testing to determine if there is an underlying condition that's preventing your skin from healing.

Stasis Dermatitis

Stasis dermatitis is a skin condition that primarily affects the lower legs of patients 65 years and older. Stasis dermatitis is mainly caused by chronic venous insufficiency and venous hypertension that result in poor circulation and decreased return of blood from the legs back to the heart.

Signs and Symptoms

Stasis dermatitis skin lesions tend to be very itchy, which can increase the risk of skin infections due to chronic scratching. Discolored patches of stasis dermatitis often occur over varicose veins (enlarged, twisted veins), and stasis dermatitis is more likely to affect individuals who are sedentary, overweight, sit or stand for long periods of time, have heart problems or blood clots, or have had a leg injury or surgery.

Diagnosis, Prevention, and Treatment

A dermatologist can diagnose stasis dermatitis based on the physical appearance of your skin and reported symptoms. A Doppler ultrasound of your legs may also be performed to examine your circulation and check for a blood clot or blood vessel damage.

To prevent stasis dermatitis, you should avoid standing or sitting for long periods of time and move regularly throughout the day to promote circulation. Exercises like ankle pumps can also help support return of blood flow from the legs to the heart to improve circulation, as can elevating your legs above your heart.

To reduce leg swelling, inflammation, and itching from stasis dermatitis, topical steroids can be applied to your legs. Wearing compression stockings or wraps can also help improve your circulation.

When to Seek Professional Help

Stasis dermatitis lesions can become infected if the skin is broken, and may require further treatment with topical or oral antibiotics prescribed by your doctor. If your circulation is significantly compromised, vein surgery may be needed to improve your blood flow.

If you have any cardiac symptoms like chest pain, shortness of breath, irregular heartbeat, or significant leg swelling, you may have a heart condition that's contributing to your stasis dermatitis symptoms. It will require further treatment from a cardiologist.

Summary

All types of eczema cause dry, itchy, and inflamed skin. Atopic dermatitis is the most common type of eczema. It usually causes a red rash in the creases of the elbows and knees. Another type of eczema called contact dermatitis occurs when you come into contact with an allergen. Dyshidrotic dermatitis, neurodermatitis, nummular dermatitis, seborrheic dermatitis, and stasis dermatitis are also types of eczema.

A Word From Verywell

Eczema can be effectively managed if correctly diagnosed and treated accordingly. To help confirm an accurate diagnosis, it is helpful to keep track of what you eat, what skin products you use, what medications you are on, and whether you have come in contact with certain chemicals. Talk to a dermatologist if you have been treating your type of eczema but the condition is not improving.

Frequently Asked Questions

Can vitamins heal each type of eczema?

Vitamins cannot necessarily heal eczema, but some vitamins like vitamin A, vitamin C, vitamin D, vitamin E, and vitamin K can help improve the ability of your skin to heal.

What is the most common type of eczema? 

The most common type of eczema is atopic dermatitis, which usually starts during childhood and improves over time.

Which foods are associated with types of eczema?

Eczema flare-ups are often triggered by allergies to food. The most common food allergies that can worsen eczema include dairy, wheat, eggs, peanuts, soy, and shellfish.