May 5, 20207 min read

Types of Eczema

Updated: May 12, 2020

Asteatotic eczema

Asteatotic eczema (also known as ‘eczema craquelé’) is a type of eczema that is more common in older people. It usually affects the shins but sometimes affects other areas such as the thighs, arms, tummy and back. In asteatotic eczema the skin becomes very dry, rough and scaly, and sometimes resembles crazy paving or a dried-up riverbed.

Atopic eczema

Atopic eczema (also known as ‘dermatitis’) is a non-contagious dry skin condition that can affect people of all ages, including 1 in 12 adults and 1 in 5 children. Atopic eczema is the most common form of eczema and tends to run in families. ‘Atopic’ is a term used to describe the tendency to develop eczema, asthma and hay fever. Some people may only have atopic eczema, but others may also have asthma and/or hay fever. The chief characteristic of atopic eczema is the ‘itch’, which at times can become almost unbearable, leading to sleep loss, frustration, stress, and depression.

Contact dermatitis

Contact dermatitis or contact eczema (‘dermatitis’ and ‘eczema’ can be used interchangeably) is the name given to types of eczema that occur as a result of contact with irritants or allergens in the environment. Contact dermatitis affects 9% of the UK population and is the most common type of work-related skin disease. Contact dermatitis can be broadly divided into two types: irritant contact dermatitis (ICD), where eczema develops as a result of contact with substances that directly damage or irritate the skin; and allergic contact dermatitis (ACD), which develops when an individual becomes sensitized or allergic to something in the environment. However, there is overlap between the two and it is possible to have both at the same time.

Irritant Contact Dermatitis

Irritant contact dermatitis is a reaction to frequent contact with everyday things that irritate the skin, such as soap, detergents, oils, hair cosmetics, bleach, household cleaning products, cold wind, and raw food. Common sites for irritant contact dermatitis are the hands and face, but the condition can affect other parts of the body. A person who had atopic eczema as a child is at an increased risk of developing irritant contact dermatitis. Symptoms of irritant contact dermatitis range from mild dryness and skin redness to the appearance of skin burns. It can be painful, red, fluid-filled and ulcerated. Occupations at greatest risk for developing irritant contact dermatitis include: chefs, hairdressers, metal workers, nurses, cleaners and construction workers.

Allergic contact dermatitis (ACD)- Allergic contact dermatitis is much less common than irritant contact dermatitis. It is caused by an individual developing a specific allergy to a chemical. For an allergy to develop, repeated exposure to the chemical is required over a period of time, usually months or years. Once this has happened, the body’s defense mechanisms learn to recognize the chemical and the individual develops a reaction when the chemical contacts the skin again. The allergy is ‘remembered’ by the body for many years. In medical terms the body has become ‘sensitized’ to a chemical. The reaction can be immediate or delayed depending on the type of allergen in question. Most frequently seen on the hands, allergic contact dermatitis can cause the skin to become dry, red, split, cracked, weeping, fluid-filled and intensely itchy, sore, painful and stinging. The severity will depend upon the allergen and the length of time it is in contact with the skin. The most common contact dermatitis allergens in Europe are: fragrance, thiomersal (antiseptic), cobalt (cement), nickel, paraphenylenediamine (hair dye, henna, temporary tattoos) and formaldehyde (chemical preservative). If allergic contact dermatitis is thought to be a possibility, then you need to be referred to a dermatologist, who may recommend patch testing.

Discoid eczema

Discoid eczema is a fairly common type of eczema, seen in people with and without a history of atopic eczema. It has a distinctive appearance with oval or round patches, and can be very itchy.

Ear eczema

Ear eczema can be an extremely irritating and, at times, painful condition. It can range from slight dryness of the pinna (the visible, projecting part of the ear) to extensive skin loss and soreness, as well as infection of the external and internal parts of the ear. Eczema can affect the entire ear including the ear lobes, conchal bowl (the area outside the ear-hole), the ear opening (meatus), ear canal (also known as the external auditory canal – the part of the ear which leads to the ear drum) and the ear drum itself (also known as the tympanic membrane). The ear-folds, backs of the ears and the area where the ears meet the face are also common areas for eczema.

Eczema around the eyes

There are several conditions, (e.g. blepharitis and allergic conjunctivitis), and types of eczema, (e.g. contact dermatitis and seborrheic dermatitis), which affect the eye and the eye area. These occur more commonly in people with eczema elsewhere on the body – usually those with atopic eczema and related conditions (asthma and hay fever).

The eyelid skin of children with atopic eczema is often affected by eczema. Eyelid eczema is also common in adults with eczema elsewhere on the face. Seborrheic dermatitis of the eyelids tends to affect just the eyelid margins and is seen more frequently in adults. The itchy, red, dry, scaling skin of eyelid eczema is particularly problematic for all ages as the skin is very thin and sensitive here.

Facial eczema

Eczema often affects the face, and facial eczema can be particularly distressing because it is so visible. In addition, facial skin is very sensitive, and even the mildest degree of inflammation can feel sore, itchy and uncomfortable. Like eczema on other areas of the body, affected skin is red, dry and flaky, and sometimes weepy, crusty or blistering. In most people there is no identifiable cause, but usually there is a history of atopic eczema. In some cases, contact with an external irritant chemical or allergen can be the cause (contact dermatitis). If allergy is suspected, a referral to a dermatologist for patch testing is often required, as it is not always possible to tell if someone has an allergic facial eczema by appearance alone.

Scalp eczema

The scalp is an area of the body that can be affected by several types of eczema. Types of eczema that can affect the scalp include: seborrheic dermatitis, atopic eczema, allergic contact dermatitis and irritant contact dermatitis. The scalp may be dry, itchy and scaly in a chronic phase and inflamed (red), weepy and painful in an acute (eczema flare) phase. Apart from eczema, there are a number of other conditions that can make the scalp dry and itchy (e.g. psoriasis, fungal infection, ringworm, head lice etc.), so it is wise to get a firm diagnosis if there is uncertainty.

Female genital eczema

With any genital condition it is important that you have the correct diagnosis made by your doctor so that any possible underlying conditions can be identified and treated. Please do not feel embarrassed about asking for a proper examination to be performed. There are different types of eczema that could affect the genital area, including atopic eczema, seborrheic dermatitis, allergic contact dermatitis and irritant contact dermatitis.

Male genital eczema

Hand eczema

Hand eczema is one of the most common types of eczema. It mainly affects the palms but can also affect other parts of the hand. The main symptoms are dry, itchy and red skin affecting the whole hand, including the fingers. Other symptoms include cracking, soreness and bleeding. In some cases, blisters develop. The skin is generally dry, scaly and thickened, and the fingers can become swollen when the eczema is flaring. If the eczema is severe over a long time, the hands can become very painful, making it difficult to carry out day-to-day tasks such as doing up buttons, holding a pen or using a computer.

Pompholyx eczema

Pompholyx eczema, (also known as dyshidrotic eczema), is a type of eczema that affects the hands and feet. In most cases, pompholyx eczema involves the development of intensely itchy, watery blisters, mostly affecting the sides of the fingers, the palms of the hands and soles of the feet. Some people have pompholyx eczema on their hands and/or feet with other types of eczema elsewhere on the body. This condition can occur at any age but is usually seen in adults under 40 and is more common in women.

Seborrheic dermatitis (cradle cap in infants)

Infantile seborrheic dermatitis, (also known as ‘seborrheic eczema’), is a common skin condition is seen in infants, which appears before the age of 3 months and usually resolves by 6-12 months. It commonly affects the scalp as cradle cap or the baby’s bottom as napkin dermatitis, but sometimes the eyebrows, forehead, temples, folds around the nose and the area behind the ears are affected.

Seborrheic dermatitis

Seborrheic dermatitis is a common scaly rash that often affects the face, scalp, and chest, but it can affect other areas. ‘Dermatitis’ is another word for ‘eczema’. ‘Seborrheic’ (pronounced seb-or-a-ik) simply means that the condition appears in those areas of the skin with large numbers of grease (sebaceous) glands, such as the scalp and sides of the nose. The condition affects 1-3% of the adult population and is more common in men than women.

Varicose eczema

Varicose eczema, also known as ‘gravitational eczema’ or ‘stasis eczema’, is a common skin condition which affects the lower legs of adults. If left untreated, the skin can break down to form ulcers, which are then difficult to heal. Varicose eczema is usually seen in middle-aged or older people, but it can occur in younger people if they have a genetic predisposition to varicose veins. You are most likely to develop this type of eczema if you have high blood pressure or varicose veins, or have had a deep vein thrombosis, phlebitis or cellulitis in the past.