“Itchiness is another hallmark symptom,” says Joshua Zeichner, MD, a board-certified dermatologist in New York City. “It usually develops on the inside of the elbows and behind the knees; however, it can occur almost anywhere on the body.” But eczema looks different on everyone, which is why it’s still a mystery to even the most well-versed dermatologists. While some only remember it as a childhood experience, others never seem to shake it off. But where exactly does eczema come from, and does it ever really go away? Here, Dr. Zeichner helps us break down the causes and effects of this all-too-common and often discomforting skin condition.
What Causes Eczema?
“Eczema occurs when the skin barrier cannot adequately protect itself from the environment, leading to microscopic cracks, loss of hydration, and inflammation,” explains Dr. Zeichner. Eczema is typically passed down through genes but, in some cases, may result from or be exacerbated by allergens, cold, dry weather conditions, and even certain skincare practices, says Zeichner. “This includes over-scrubbing and using formulas that contain harsh ingredients, such as hydroxy acid or retinol, which can lead to direct irritation with skin barrier disruption,” Zeichner adds. Proper bathing is essential for those suffering from eczema. “Excessive exposure to water, especially at hot temperatures, can strip the skin of oils essential for proper barrier function, making matters worse,” Dr. Zeichner cautions. He recommends keeping showers short (10 minutes or less) and temperatures around what you’d expect a heated pool to feel like in the summertime. “Then make sure to apply moisturizer immediately afterward.”
Can Someone Outgrow It?
Technically, yes—usually if they were born with it. In a study from the Journal of the American Academy of Dermatology, most eczema will present itself in early childhood. The good news? Most babies who develop eczema in the first few months of life will show improvements by age three, and around two-thirds of them will suffer only occasional breakouts or completely outgrow their symptoms by their teen years. Even when it does appear in adults, it tends to be milder. However, a small percentage of babies who develop eczema will not outgrow it. And in certain instances of adult-onset, eczema develops after individuals turn 18 years old. The National Eczema Association finds that roughly one in four adults with eczema report initial symptoms starting later in life. “When eczema is caused by genetics or developed as an adult, it can have longer-lasting effects, with flare-ups occurring throughout life,” says Dr. Zeichner. “If the eczema is caused by external factors like dry weather or irritating skincare products, it will usually improve once the aggressor is eliminated.”
What’s the Best Treatment?
According to Dr. Zeichner, eczema is often dealt with in one of two ways: “First, you’ll want to repair the skin barrier using good moisturizers, ideally with ceramides (lipid-restoring) or colloidal oatmeal (soothing). Second, you’ll want to reduce the inflammation, in which case over-the-counter anti-inflammatory creams can be useful.” If over-the-counter treatments are not helping, Dr. Zeichner suggests visiting a board-certified dermatologist for prescription treatment options. It is possible to keep the rashes at bay— even if it’s something you won’t outgrow.
