How Eczema Affects the Skin and Body

Most people think of atopic dermatitis (eczema) as patches of red, itchy, dry skin. While these are common symptoms, the impacts of eczema can be farther reaching. Eczema can increase the risk of developing other health conditions. It can take a toll on mental and emotional health as well.¹

Where on the body is eczema located?

Eczema can occur anywhere on the body. Where eczema occurs and the specific skin changes it causes can vary from person to person. But there are some trends in where it is located based on age.¹

In very young babies, eczema often affects the face, cheeks, scalp, arms, and legs. In kids and teens, eczema more often impacts the flexural surfaces of the body. These are areas that bend or fold, including inner elbow creases, backs of the knees, palm side of the wrists, and parts of the neck.¹

As kids with eczema get older and rack up years of scratching their itchy skin, thickened patches of skin may start forming in these areas. This is called lichenification. Eczema can also occur on other areas of the body at any age. These areas include the eyelids, ears, nipples, and lips.^1,2

The areas affected by eczema tend to get more focused and localized as a person reaches adulthood. But for some adults, eczema can still be widespread if it is severe.^1,2

Types of skin changes found in eczema

One of the potential causes of eczema is a weakened skin barrier. Some people may have specific gene changes (mutations) that weaken the top layer of the skin, or epidermis.¹

One genetic mutation causes the body to produce less of a protein called filaggrin, which leads to skin breakdown. This weakening of the skin, combined with an overactive immune system response, leads to the dry, red, itchy patches of skin most commonly seen with eczema.¹

But other skin changes can occur too. These include:^1,3-5

• Lichenification
• Skin color changes that may appear red or pink on lighter skin, and brown or purple on darker skin
• Fluid-filled blisters or raised non-fluid-filled bumps (papules)
• Open sores that weep fluid (called wet eczema)
• Alternating areas of lightened or darkened skin where there used to be swelling (inflammation)
• Purple-gray darkening around the eyes
• Yellow skin crusting or pus around areas of infection
• Hair loss on the scalp or skin

Complications and related conditions

In addition to these skin changes, eczema may increase the risk of other health issues. These issues may include:^1,6-9

• Bacterial, viral, and fungal skin infections
• Food or environmental allergies
• Asthma
• Allergic eye diseases like atopic keratoconjunctivitis (AKC) or vernal

keratoconjunctivitis (VKC)

• Sleep issues
• Anemia (low red blood cell counts)
• Attention-deficit hyperactivity disorder (ADHD)
• Learning disabilities

This is not a full list of all potential issues that can occur alongside eczema. Talk with your doctor to find out what you might be at risk for. Some treatment options can also cause side effects. This is especially true for systemic drugs that weaken the immune system. Your doctor can tell you what signs to watch for and when to seek help.⁶

Mental and emotional health impacts

Itchy, irritated skin can impact a person’s sleep and their mood. Obvious skin changes can also affect self-image and self-confidence. All of these can lead to mental and emotional distress. In fact, people with eczema are at a higher risk of developing depression and anxiety.^1,7,10

If you notice signs of mental health distress, either in yourself or in your child, talk with your doctor. They can recommend support options or treatment if needed. Managing eczema can be frustrating at times, but you are not alone.