Eczema: Why It Happens, What Triggers Flares, and How to Treat It

Eczema is a common inflammatory skin condition that causes dry, itchy, irritated skin. It can appear at any age, and while some people experience occasional flares, others deal with constant symptoms that interfere with sleep, comfort, and daily life.

Eczema develops through a combination of skin barrier dysfunction, immune system activity, genetics, and environmental exposures. Understanding which factors matter for your skin is often more helpful than simply trying another moisturizer.

What Is Eczema?

Eczema is a general term for several conditions that cause inflammation of the skin. But what most people mean when they say eczema is what a dermatologist calls atopic dermatitis. Atopic dermatitis is chronic condition associated with a weakened skin barrier and an overactive inflammatory response in the skin.

Your skin barrier helps retain moisture and keeps potential irritants and allergens from entering the skin. In people with atopic dermatitis, this barrier doesn't function as effectively. Moisture escapes more easily, and substances that would not normally cause problems may trigger irritation and inflammation.

This helps explain why eczema-prone skin is often dry, sensitive, and easily irritated, even between visible flares.

What Does Eczema Look and Feel Like?

The most recognizable symptom of eczema is itching. Itching often begins even before a visible rash develops.

Common symptoms include dry or rough patches, redness or other skin discoloration, scaling, cracking, and areas of thickened skin from repeated scratching. Some flares produce small bumps, oozing, or crusting.

Eczema can look different depending on your skin tone. On lighter skin, inflamed areas often appear pink or red. On darker skin, they may look purple, brown, gray, or simply darker than the surrounding skin.

The location also varies with age. Babies frequently develop eczema on the cheeks and outer arms or legs, while older children and adults often notice it in the folds of the elbows, behind the knees, on the neck, or on the hands.

Not every itchy rash is eczema. Allergic contact dermatitis, psoriasis, fungal infections, and other conditions can sometimes look similar. This is one reason an accurate diagnosis matters, particularly when a rash is persistent or not responding to treatment.

What Causes Eczema to Flare?

Eczema-prone skin is more reactive to certain exposures, but triggers vary considerably from person to person.

Some of the most common include:

• Dry air and temperature changes: Low humidity can increase moisture loss from the skin, while heat and sweating can aggravate itching.

• Harsh soaps and skincare products: Fragrances, certain cleansers, and irritating active ingredients can disrupt an already vulnerable skin barrier.

• Frequent washing: Repeated exposure to water, soaps, and cleaning products can contribute to hand eczema.

• Environmental allergens: Dust mites, pollen, and animal dander may worsen symptoms in some people, although they are not universal eczema triggers.

• Stress: Stress does not directly cause eczema, but it can contribute to flares and make itching more difficult to manage.

In Scottsdale and Paradise Valley, Arizona, our dry climate can be particularly challenging for eczema-prone skin. Even patients who have never considered their skin especially sensitive may notice more irritation in our climate.

One important distinction: eczema is not simply an allergic reaction. Although allergies and eczema can occur together, many people with atopic dermatitis do not have a specific allergy driving their symptoms.

Is Eczema Caused by Food Allergies?

This is one of the most common misconceptions I discuss with patients.

Food allergies and eczema are associated, particularly in young children with moderate to severe atopic dermatitis. But that does not mean food is causing the eczema, or that eliminating certain foods will improve it.

For most adults with eczema, broad food allergy testing and restrictive diets are not helpful unless there is a history suggesting a true food allergy.

Unnecessary food elimination can create nutritional problems, especially in children. When a food allergy is genuinely suspected, evaluation should be guided by your symptoms rather than indiscriminate testing.

How Do You Treat Eczema Effectively?

Effective eczema treatment addresses both the impaired skin barrier and the inflammation responsible for itching and rash.

Repairing and protecting the skin barrier

A consistent moisturizing routine is foundational. I recommend a fragrance-free cream or ointment rather than a lightweight lotion, especially for patients with significant dryness.

Applying moisturizer immediately after bathing helps retain water in the skin. Gentle cleansers, lukewarm showers, and minimizing unnecessary skincare products can also reduce irritation.

Patients are sometimes surprised that products marketed as natural, botanical, or clean can aggravate eczema. Essential oils and plant extracts, for example, may cause irritation or allergic contact dermatitis in susceptible individuals.

Treating inflammation during flares

Moisturizers are important, but they may not be enough to control active inflammation.

Topical corticosteroids remain an effective treatment for many eczema flares when the appropriate strength, location, and duration are considered. Nonsteroidal prescription options, including topical calcineurin inhibitors, PDE-4 inhibitors, and topical JAK inhibitors, may also be appropriate for certain patients.

For more extensive or difficult-to-control atopic dermatitis, treatments that target specific inflammatory pathways, including biologic medications and oral therapies, may be indicated.

The right treatment depends on the diagnosis, severity, areas involved, age, and medical history. The goal is not simply to make a rash disappear temporarily, but to reduce itching, improve skin function, and limit recurring flares.

Can Eczema Be Cured?

Atopic dermatitis is generally considered a chronic condition, although its course is highly variable.

Some children improve significantly as they get older. Others continue to experience eczema into adulthood, and some people develop symptoms for the first time as adults.

There is currently no definitive cure for atopic dermatitis, but many patients can achieve excellent control with an appropriate treatment plan.

Importantly, eczema management does not necessarily mean using prescription medication every day indefinitely. Some patients need treatment only during occasional flares, while others benefit from a proactive maintenance approach.

When Should I See a Dermatologist for Eczema?

A dermatologic evaluation is worthwhile if your eczema is recurring frequently, interfering with sleep, spreading, or not improving with gentle skincare and over-the-counter treatments.

I also recommend evaluation when a rash affects the eyelids, face, or hands, or when the diagnosis is uncertain.

In some cases, what appears to be eczema is actually allergic contact dermatitis, a reaction to a specific ingredient or material touching the skin. Patch testing may help identify relevant contact allergens when this is suspected. It is different from skin-prick testing used to evaluate environmental allergies.

Pain, pus, rapidly worsening redness, fever, or clusters of painful blisters warrant prompt medical evaluation because these can signal infection.

The Bottom Line

Eczema is more than dry skin. It involves changes in the skin barrier and immune response, which is why moisturizer alone does not always solve the problem.

The most useful approach is to identify the type of eczema, understand what may be aggravating it, and choose treatment based on how the condition is affecting your skin and daily life.

If you're dealing with persistent itching, recurring rashes, or skin that never seems to settle down, a dermatologic evaluation can help clarify the diagnosis and create a manageable treatment plan. Schedule a consultation to learn more about Dr. Jeffy’s approach to eczema.