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What Is the Main Cause of Eczema?

The cause of eczema is not known, but it tends to run in families and certain triggers can play a role. Eczema triggers include skin irritants (soaps, cleansers, shampoos, disinfectants, perfumes, cosmetics, and fresh fruit juices), emotional stress or anxiety, cold or dry environments, wool or synthetic fibers, sweating, rapid temperature changes, rust or sand, cigarette smoke, and metals.
The cause of eczema is not known, but it tends to run in families and certain triggers can play a role. Eczema triggers include skin irritants (soaps, cleansers, shampoos, disinfectants, perfumes, cosmetics, and fresh fruit juices), emotional stress or anxiety, cold or dry environments, wool or synthetic fibers, sweating, rapid temperature changes, rust or sand, cigarette smoke, and metals.

Eczema refers to a group of chronic skin conditions that cause itchy, red, inflamed, scaly skin, including:

Eczema Causes

The cause of eczema is not completely understood but people with a family history of eczema are at increased risk of developing the condition so it is believed that genetics, along with certain triggers, play a strong role. 

Triggers for eczema symptoms may include:

  • Skin irritants such as soaps, cleansers, shampoos, disinfectants, perfumes, cosmetics, and fresh fruit juices
  • Emotional stress or anxiety
  • Cold or dry environments
  • Wool or synthetic fibers such as polyester 
  • Sweating
  • Rapid temperature changes
  • Dust or sand
  • Cigarette smoke
  • Metals (especially nickel)

What Are Symptoms of Eczema?

Symptoms of eczema include: 

  • Intense skin itching 
    • Itching can worsen at night
    • Scratching may intensify itching and inflammation
    • If skin is scratched open, oozing, bleeding, or crusting may occur 
    • Pustules, blisters, and red, hot skin may occur if a secondary infection occurs
    • Repeated scratching may result in thickened, darkened, and scarred skin 
  • Patches of inflamed skin
  • Clogged hair follicles that cause small bumps, usually on the face, upper arms, and thighs
  • Scaly, rough patches of skin
  • Dry skin
  • Skin flaking 
  • Sensitive skin
  • Skin discoloration (especially red or pink)
  • Increased skin creasing on the palms and/or an extra fold of skin under the eye
  • Darkening of the skin around the eyes

What Is the Treatment for Eczema?

Eczema is a chronic condition that can periodically worsen (flare) in between times of mild to no symptoms. There is no cure for eczema but it can be managed with home care and medications. 

Home remedies to relieve or reduce symptoms of eczema may include: 

  • Identifying and avoiding triggers 
  • Keeping the skin hydrated
    • Emollients
      • Use thick creams or ointments 
      • Apply twice daily or more frequently as needed
    • Bathing
      • Lukewarm baths or showers can hydrate the skin and may relieve itching
      • Use unscented, mild soap or non-soap cleanser sparingly
      • Apply an emollient immediately after bathing or showering while skin is still damp
      • Avoid hot baths or showers, or those lasting more than 10 to 15 minutes which can dry the skin
      • Dilute bleach baths may be recommended decrease the number of bacteria on the skin that can cause infections or worsen symptoms 
        • Use one-fourth to one-half cup of bleach in a full bathtub (about 40 gallons) of water and bathe 5 to 10 minutes twice weekly, followed by emollient application 
  • Wet dressings (wet wraps) to help soothe and hydrate skin, reduce itching and redness, loosen crusted areas, and prevent skin injury due to scratching

Medications used to treat eczema include:

  • Over-the-counter (OTC) or prescription topical steroid creams or ointments 
  • Over-the-counter (OTC) or prescription oral antihistamines for itching 
  • Oral steroids (e.g., prednisone) may be used for a short duration to treat severe flares
  • Tacrolimus ointment (Protopic) and pimecrolimus cream (Elidel)
  • Injectable biologics such as dupilumab (Dupixent) for adults with moderate to severe eczema that has not responded to other treatments
  • Immunosuppressive drugs for patients with severe eczema who do not improve with other treatments

Ultraviolet light therapy (phototherapy) may be used to help control eczema but it is reserved for patients with severe eczema who do not respond to other treatments because it is expensive and may increase the risk of developing skin cancer.

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References
https://www.uptodate.com/contents/eczema-atopic-dermatitis-beyond-the-basics?search=Eczema&source=search_result&selectedTitle=2~150&usage_type=default&display_rank=2

https://nationaleczema.org/eczema/