Eczema is an inflammatory skin condition that causes inflamed, scaly, and itchy skin lesions. Before healing, these lesions can progress through different stages, each with different symptoms.
This article outlines the different stages of eczema and discusses how long it may take to stop itching.
It also discusses the itch and scratch cycle and provides some tips on easing itching during treatment. Finally, it offers advice on when to contact a doctor and answers some frequently asked questions about eczema.
Itching does not necessarily indicate that eczema is healing.
Eczema lesions can progress through three stages: acute, subacute, and chronic. A
While these lesions can progress through the subacute and chronic stages, they can also resolve at the acute or subacute stage.
As such, itching indicates that the eczema is in the acute stage, after which the condition may progress or resolve. The National Eczema Association (NEA) notes that scratching the itch may worsen the eczema.
As eczema starts to heal, a person may notice an improvement in eczema symptoms, such as:
- a reduction in skin inflammation
- a reduction in skin dryness, cracking, and bleeding
- a reduction of blisters
- less severe itching
According to the NEA, severe eczema can cause flare-ups that may last days or weeks. The term “eczema flare-up” refers to a period in which a person experiences one or more eczema symptoms or side effects from prolonged itching.
Treatments such as topical corticosteroids can help speed up skin healing and ease itching.
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However, eczema lesions do not always progress through all three stages. They can resolve at one of the earlier stages.
Acute
The acute stage is the initial stage of eczema. During this stage, eczema lesions involve the following:
- skin inflammation
- intensely itchy spots or scales
- crusting
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- thickening of the epidermis, which is the outermost layer of the skin
- spongiosis, which is an atypical buildup of fluid in the epidermis
Subacute
Subacute eczema lesions are more advanced than acute lesions but less advanced than chronic lesions. They involve the following:
- skin inflammation
- scaling
- intermittent crusting
Chronic
Chronic eczema
- skin thickening
- hyperpigmentation
- exaggerated skin lines
According to the NEA, the itch-scratch cycle is a common trigger for eczema flares.
The itch-scratch cycle refers to when a person scratches their skin to alleviate an itch, but this triggers the release of chemicals called inflammatory mediators, which trigger eczema.
The eczema then causes more dry skin, which causes more scratching, and so on.
The American Academy of Dermatology Association provides tips that can help bring immediate but temporary relief from skin itching relating to eczema. These include:
- applying an ice pack or other cool compress to areas of itchy skin for around 5 to 10 minutes
- applying cooling agents to the skin, such as menthol or calamine
- adding colloidal oatmeal to lukewarm bathwater and soaking for 10 to 15 minutes
- applying a topical anesthetic containing the active ingredient pramoxine
- applying a thick layer of moisturizing ointment to damp skin immediately after bathing and applying any necessary topical medications
- wearing loose-fitting cotton clothes
- avoiding extreme temperature changes
- managing stress levels, as stress can worsen itching
Wet wrap therapy
The NEA also recommends wet wrap therapy to help soothe and rehydrate the skin, manage the itching, and boost the effectiveness of topical medications.
The step-by-step procedure for applying wet wraps is as follows:
- Step 1: After bathing, apply medications and moisturizers to the affected areas of the skin.
- Step 2: Soak cotton wraps or gauze in warm water and apply them to the affected skin.
- Step 3: Add a dry layer of cotton wraps or gauze over the wet layer.
- Step 4: Wear night clothes over the top of the dry layer to avoid disturbing the dressings during sleep.
- Step 5: Leave the wraps on for several hours or overnight, ensuring they do not dry out before removal.
Learn more about applying wet wraps for eczema.
A person needs to contact a doctor if their eczema symptoms persist despite treatment or if they develop one or more of the complications of the condition below.
Bacterial infections
Eczema can cause the skin to become cracked and broken, increasing the risk of bacterial skin infections.
Bacterial skin infections may cause the following symptoms:
- a rapid worsening of eczema symptoms
- fluid oozing from the skin
- a yellow crust on the surface of the skin
- small, yellowish-white spots on the affected skin
- skin swelling and soreness
- fever and chills
- general feeling of being unwell (malaise)
Anyone who experiences any of the above symptoms needs to seek medical attention as soon as possible. These individuals likely require a course of antibiotics to resolve the infection.
Viral infections
Eczema can develop an infection with the herpes simplex virus, which can result in a serious condition called eczema herpeticum (EH).
Symptoms of EH include:
- areas of painful and rapidly worsening eczema
- clusters of fluid-filled blisters that burst, leaving open sores on the skin
- fever and chills
- malaise
Fungal infections
Candida and tinea (ringworm) are the two main types of fungal infections that can affect those with eczema.
Symptoms of a fungal infection can appear similar to eczema, including
- rash
- scaling
- pustules
- itchy and sore skin
- scaling
Ringworm rashes are usually ring-shaped.
Psychological effects
Eczema can affect a person psychologically and physically.
If eczema affects a person’s self-confidence, body image, sleep, or overall mood, a person needs to consider talking with a doctor.
Below are some answers to frequently asked questions about eczema.
Will eczema go away?
Eczema is a chronic condition, meaning that it lasts a long time. For some people, it can resolve over time, but for others, it can be lifelong.
Individuals with lifelong eczema tend to experience periods of waning symptoms. Treatments can help manage eczema flares and ease the associated symptoms.
How long do flare-ups last?
Severe eczema can cause flare-ups that may last days or weeks.
Is flaking a sign that eczema is healing?
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Itching is not typically a sign that eczema is healing. Intense itching typically occurs in the acute stage of eczema. It is important to note that the condition does not always progress through all three stages and can resolve at any stage.
If possible, a person needs to avoid scratching the skin, as this can worsen the itching.
Topical corticosteroids, such as those for treating eczema flares, can help ease skin itching. Home treatments, such as applying a cool compress to the skin, bathing in colloidal oatmeal, and practicing wet wrap therapy, can also help.
It is important to contact a doctor if these treatments are ineffective or if the skin shows signs of infection.