How Severe Is Your Eczema?

Eczema is a skin condition that can affect people of all ages. It causes the skin to become itchy, red, and inflamed. For some, eczema is a mild nuisance. For others, it can be a severe condition that impacts daily life. Understanding the severity of your eczema can help you manage it better.¹

How is eczema severity measured?

Eczema can vary widely from person to person. Unfortunately, there is no 1 specific way to determine the severity of someone’s eczema. Instead, doctors use several tools to assess the severity of eczema.^1,2

These tools give doctors a clearer picture of how severe the eczema is and what type of treatment is needed. They also help in tracking changes over time and evaluating the effectiveness of treatments.^1-3

What is the Eczema Area and Severity Index (EASI)?

The Eczema Area and Severity Index (EASI) is the preferred and most common tool doctors use to measure eczema severity. EASI looks at the amount of skin affected by eczema and the intensity of symptoms such as redness, thickness, and swelling.²

What is the EASI area score?

The area score is documented for each of the 4 regions of the body. The score is the percentage of skin affected by eczema.²

• Region 1: Head and neck
• Region 2: Trunk (including genital area)
• Region 3: Upper limbs
• Region 4: Lower limbs (including buttocks)

What is the EASI severity score?

Severity score is documented for each of the 4 regions of the body listed above. The severity score is the sum of the intensity scores for 4 symptoms. Each symptom is scored on a scale of 0 to 3. The 4 symptoms used as part of the severity score are:²

• Redness (erythema, inflammation)
• Swelling (raised areas of skin)
• Scratching (excoriation)
• Lichenification (skin thickening)

The EASI scoring assessment multiplies the percentage of the affected area (of 4 specific skin regions) and then adds this number to the severity scores of the 4 specific symptoms.²

What is the Patient-Oriented Eczema Measure?

The Patient-Oriented Eczema Measure is a tool that focuses on the person’s experience. It looks at how often the person feels symptoms over the course of 1 week. It asks questions about:³

• Itching
• Sleeplessness
• How often flare-ups occur

What is the SCORing Atopic Dermatitis (SCORAD)?

SCORAD is often used in combination with other tools. It looks at the physical signs of eczema, where on the body it is located, and the intensity of symptoms.^1,2,4

Recognizing the signs of severe eczema is essential. Knowing what to look for can help you get the right treatment sooner.^1-3

• Intense itching – One of the main symptoms of severe eczema is relentless itching. It can be so intense that it disrupts sleep and daily activities.
• Widespread rash – Severe eczema often covers large areas of the body. The rash may appear on the face, neck, arms, and legs.
• Thickened skin – Over time, the skin may become thick and leathery. This is known as lichenification and is a result of constant scratching.
• Cracked or bleeding skin – In severe cases, the skin may crack or bleed. This can lead to infections, which need immediate medical attention.
• Pain and discomfort – Severe eczema can be painful. The affected areas may feel tender or sore, making it difficult to perform everyday tasks.

If you notice any of these signs, talk to your doctor or a doctor who specializes in skin problems (dermatologist). Early treatment can prevent the condition from getting worse and help manage symptoms.¹

How can you talk to your doctor about it?

Having a conversation with your doctor about eczema severity is crucial. It helps in finding the right treatment plan and improving your quality of life.¹

• Be honest about your symptoms – When talking to your doctor, be open about how eczema affects you. Mention any physical symptoms, such as itching, pain, or bleeding. Also, discuss how it impacts your daily life, including sleep, work, or school.
• Keep a symptom diary – Consider keeping a diary of your symptoms. Note when flare-ups occur, what triggers them, and how severe they are. This information can help your doctor better understand your condition.
• Ask about treatment options – Many treatments are available for eczema. Examples are topical creams and oral medicines. Your doctor can help you find the best option depending on your eczema severity.
• Discuss lifestyle changes – Eczema can be influenced by many things, such as stress, diet, and your environment. Talk to your doctor about lifestyle changes that might help reduce symptoms.