Eczema, also known as dermatitis, is an inflammatory skin condition affecting millions worldwide, presenting symptoms such as intense itching, redness, scaling, and in more severe cases, cracks and even small wounds. Although the term “eczema” is often used generically, it encompasses different types of skin manifestations, each with distinct causes and treatments.
Today we will explore the two main types of eczema: atopic eczema, which has a genetic origin, and contact eczema, caused by external substances. Understanding the differences between these forms of the disease is essential to obtain the correct diagnosis and follow the most appropriate treatment.
What is eczema?
Eczema is a broad term used to describe different types of skin inflammation. It is not contagious, but it can be quite uncomfortable, affecting the quality of life of those who live with it. The main characteristic of eczema is irritated and inflamed skin, frequently accompanied by itching and redness.
There are various classifications of eczema, but two of the most common and widely diagnosed are atopic eczema (or atopic dermatitis) and contact eczema (or contact dermatitis). Let’s understand each of them better.
Atopic eczema: the genetic form of the problem
Atopic eczema is a chronic and recurrent type of dermatitis with a genetic basis. It is part of the so-called “atopic triad,” which also includes asthma and allergic rhinitis. In other words, those who have one of these conditions are more likely to develop the others.
Main characteristics
Onset in childhood: it usually appears in the first years of life, although it can also occur in adults.
Extremely dry skin: the skin loses its natural ability to retain moisture.
Intense itching: constant itching can lead to wounds caused by scratching.
Typical locations: common in areas such as the face, neck, inside the elbows, behind the knees, and ankles.
Causes
The main cause of atopic eczema is a genetic predisposition. People with a family history of allergic diseases have a higher chance of developing it. Changes in the skin’s protective barrier, which allow allergens and irritants to penetrate, also significantly contribute to the development of the condition.
Additionally, environmental factors such as dry climate, pollution, harsh hygiene products, and emotional stress can trigger or worsen flare-ups.
Is atopic dermatitis chronic?
Yes, atopic eczema (or atopic dermatitis) is considered a chronic condition, meaning it has no definitive cure. However, this does not mean that the person will have symptoms all the time. The disease usually has periods of improvement and worsening, with flare-ups triggered by factors like dry weather, stress, allergens, or irritating products. With proper care, it is possible to keep the disease under control, minimizing symptoms and prolonging symptom-free periods.
Treatment of atopic eczema
Treatment involves a combination of daily care and medications prescribed by dermatologists:
- Constant skin hydration
- Use of mild soaps and fragrance-free products
- Avoiding hot and prolonged baths
- Use of topical corticosteroids during flare-ups
- In some cases, immunomodulatory medications and oral antihistamines
The key to controlling atopic eczema is to keep the skin protected and hydrated, as well as identify and avoid factors that worsen the condition.
Contact eczema: reaction to external agents
Contact eczema is caused by a reaction of the skin when it comes into contact with certain substances. It can be divided into two main types:
- Irritant contact eczema: occurs when the skin is repeatedly exposed to substances that damage its natural barrier, such as cleaning products, soaps, solvents, or constant friction with fabrics or objects.
- Allergic contact eczema: is an allergic reaction of the immune system to a specific substance. Sensitization can take time to develop and, once sensitized, the skin reacts even to minimal contact with the agent, such as nickel, perfumes, preservatives, and dyes.
Symptoms of contact eczema
- Intense redness and swelling at the site of contact
- Blisters, crusts, and peeling
- Localized itching and, in severe cases, pain or burning
Diagnosis
Diagnosis can be made by a dermatologist through a contact test (also known as patch test), which identifies which substance is causing the allergy.
Treatment
discontinuation of contact with the causative agent
application of topical corticosteroids
use of ointments with a soothing effect
in some cases, oral medication is indicated
The success of the treatment largely depends on identifying and eliminating the substance that causes the allergic or irritant reaction.
Daily Care and Prevention
Whether it is atopic or contact eczema, some daily care helps keep the skin healthy and reduce the frequency of flare-ups:
use moisturizers suitable for sensitive skin, daily
opt for cotton clothing and avoid synthetic or very rough fabrics
wash clothes with neutral soap, without dyes or perfumes
keep nails short to avoid injuries when scratching
avoid using perfumes directly on the skin, especially on sensitive areas
keep the environment ventilated and avoid excessive heat
Myths and Truths about Eczema
Although it is a very common condition, eczema is still surrounded by various myths that make understanding and proper management difficult. One of the most frequent misconceptions is the idea that eczema is contagious — which is not true. Even though the skin lesions may look alarming, eczema is not transmitted by touch, sharing objects, or proximity to other people.
Another common myth is associating eczema with poor hygiene. In reality, the condition originates from genetic, immunological, and environmental factors and is not related to skin cleanliness. On the contrary, excessive care or use of inappropriate products can even worsen the condition.
Many people also believe that only children develop eczema, but the truth is that the disease can appear or persist at any stage of life, including adulthood.
Furthermore, it is important to clarify a common perception: the worsening of symptoms at night. Although some informally call it “night eczema,” it is actually a worsening of symptoms, mainly itching, during rest hours. This happens because, at night, the natural production of anti-inflammatory hormones like cortisol decreases, favoring skin inflammation. Additionally, the skin tends to become drier during the early morning, which further increases discomfort.
Clarifying these myths is essential to combat prejudice and ensure that people with eczema receive the care, support, and understanding they deserve.
Conclusion
Eczema, whether genetic in origin or resulting from contact with external substances, requires constant attention and care. The good news is that, with correct diagnosis and a well-structured care plan, it is possible to live with the condition and minimize its manifestations.
Consulting a dermatologist is essential to determine the type of eczema and receive personalized guidance. Self-medication or using products without medical recommendation can worsen the condition and even cause new allergies or adverse reactions.
Education about one’s own body and adopting a care routine are the greatest allies of those living with eczema.
Are there other types of eczema besides atopic and contact?
Yes, besides atopic eczema and contact eczema (or contact dermatitis), there are other types of eczema, including:
nummular eczema (or nummular dermatitis): causes round patches on the skin that itch a lot and resemble coins.
dyshidrotic eczema (or dyshidrosis): mainly affects hands and feet, with small blisters that cause intense itching.
seborrheic eczema (or seborrheic dermatitis): usually occurs in oily areas such as the scalp and face.
stasis eczema: usually appears on the legs of people with poor venous circulation, causing swelling, redness, and scaling.
infantile eczema: a form of atopic dermatitis that affects babies and young children, often temporary.
