Eczema encompasses various types, such as allergic contact eczema, atopic eczema, discoid eczema, irritant contact eczema, and seborrhoeic eczema, each with its unique characteristics. However, the symptoms of different forms of eczema can generally be generalized. Regardless of the cause, eczema typically presents with symptoms including:
- Itching and redness of affected areas of the skin
- Dry and flaky skin, often accompanied by thickening in areas that have been scratched
- Presence of lumps or blisters in affected areas
- Weeping or crusty deposits if blisters burst or if scratching damages the skin
Itch: Itching is the primary symptom of eczema. If a rash lacks associated itchiness, it is unlikely to be eczema (unless the itch has been alleviated by treatment). Although itching is a key symptom in diagnosing eczema, it can also occur due to various other skin conditions, highlighting the need for comprehensive evaluation.
Redness: Inflammation and increased blood flow contribute to the redness of the skin in eczema. The presence of an extensive network of tiny blood vessels known as capillaries, particularly in the deeper layers of the skin, exacerbates this redness. In eczema flare-ups, bacterial infection can further intensify inflammation, emphasizing the importance of recognizing and treating infection promptly to manage and resolve eczema.
Thickening: Prolonged inflammation in eczema leads to the affected skin becoming thicker than unaffected skin. This thickening is a protective response to repeated scratching trauma. Eczema often affects skin around joints, such as the elbows, behind the knees, and in front of the ankles (the ‘flexures’), where the skin should ideally be flexible. However, persistent inflammation and thickening can result in skin splitting, known as fissures, as the thickened skin lacks normal flexibility.
Blisters: Active eczema may feature blisters, typically small but occasionally large ones may develop. Large blisters may arise in certain types of eczema or due to secondary skin infection. Infected blisters may contain clear fluid or pus.
Crusts: Inflamed skin in eczema may ooze fluid, rich in protein. When this fluid dries upon exposure to air, it leaves behind a crusty deposit composed mainly of protein. Crusting commonly occurs when eczema-affected skin becomes infected, with the infected crust often displaying a golden coloration.