Itchy and rash
No matter which part of the skin is affected, eczema is almost always itchy. Sometimes the itching will start before the rash appears, but when it does the rash most commonly occurs on the face, knees, hands, or feet. It may also affect other areas as well. Affected areas usually appear very dry, thickened, or scaly. In fair-skinned people, these areas may initially appear reddish and then turn brown. Among darker-skinned people, eczema can affect pigmentation, making the affected area lighter or darker. In infants, the itchy rash can produce an oozing, crusting condition that occurs mainly on the face and scalp, but patches may appear anywhere.
Itchy before the rash
Almost always, there's an itch before a rash appears in eczema. Typically, eczema shows itself as:
- Patches of chronically itchy, dry, thickened skin, usually on the hands, neck, face, and legs. In children, the inner creases of the knees and elbows are often involved.
- Scratching can lead to sores with crusts.
Eczema can be diagnosed by a pediatrician, allergist, immunologist, dermatologist or your primary care provider. Since many people with eczema also suffer from allergies, your doctor may perform allergy tests to determine possible irritants or triggers. Children with eczema are especially likely to be tested for allergies.
Call Your Doctor About Eczema If
- You develop an otherwise unexplained rash and have a family history of eczema or asthma. You should have a medical diagnosis of the condition.
- The inflammation does not respond within a week to treatment with over-the-counter hydrocortisone creams. A doctor may suggest more aggressive forms of treatment.
- You develop yellowish to light brown crust or pus-filled blisters over existing patches of eczema. This may indicate a bacterial infection that should be treated with an antibiotic.
- During a flare-up of eczema, you are exposed to anyone with a viral skin disease such as cold sores or genital herpes. Having eczema puts you at increased risk of contracting the viral disorder.
- You develop numerous small, fluid-filled blisters in the areas of eczema. You may have eczema herpeticum, a rare but potentially serious complication caused by the herpes simplex virus.