Eczema shows itself through a variety of signs that affect the skin in noticeable and often uncomfortable ways. The most common and defining sign is **intense itching**, which can be relentless and often worsens at night. This itching leads to scratching, which unfortunately damages the skin further, creating a cycle that can be hard to break.
Visually, eczema usually presents as **red or inflamed patches** on the skin. These patches can be dry, scaly, or cracked, and sometimes the skin looks rough or leathery due to repeated scratching and irritation. In some cases, the affected areas may ooze clear fluid or develop crusts, especially if the skin becomes infected or severely irritated.
The texture of the skin changes as well. You might notice **thickened skin** in areas that have been scratched frequently, a condition called lichenification. This thickening makes the skin feel tough and leathery. Sometimes, small raised bumps called papules appear, which can be red or skin-colored and add to the bumpy texture.
Eczema can cause **color changes** in the skin. On lighter skin tones, the affected areas often look red or pink, but on darker skin, these patches may appear brown, purplish, gray, or ashen. After flare-ups, the skin might show **hyperpigmentation** (darkening) or **hypopigmentation** (lightening), which can take a long time to fade and may cause distress.
Different types of eczema have specific signs:
– **Atopic eczema** (the most common form) often appears on the face, inside the elbows, behind the knees, and on the hands and feet. It causes dry, itchy, red patches that can crack and bleed.
– **Dyshidrotic eczema** affects the palms, soles, and sides of fingers and toes. It shows up as tiny, itchy blisters that can become thickened and cracked, often worsening in warm weather.
– **Discoid eczema** forms round, coin-shaped spots that may ooze or be dry and scaly, usually on the lower legs.
– **Venous eczema** occurs mainly around the ankles in people with poor circulation or varicose veins, causing redness, scaling, darkening, and itching.
– **Dermatitis herpetiformis** causes intensely itchy, symmetrical rashes on arms, thighs, knees, and back, often linked to gluten sensitivity.
In addition to these physical signs, eczema can cause **swelling or inflammation** in the affected areas, making the skin feel tender or sore. The skin may also become very dry and prone to cracking, which increases the risk of infection and pain.
On darker skin tones, eczema can be harder to recognize because the classic redness may not be visible. Instead, the skin might show bumps around hair follicles (follicular accentuation), thickening, and changes in pigmentation that are more subtle but still significant.
Overall, the signs of eczema are a combination of **persistent itching, visible skin changes (redness, dryness, scaling, thickening), and sometimes blistering or oozing**, with variations depending on the type of eczema and the individual’s skin color. These signs often come and go, flaring up in response to triggers like allergens, irritants, stress, or weather changes.
