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Complications Related to Eczema

Reviewed by: HU Medical Review Board | Last reviewed: December 2023

The most common symptom of atopic dermatitis (eczema) is patches of dry, irritated, itchy skin. But eczema can have other serious effects, including raising a person’s risk of developing certain health conditions. Many conditions and health problems commonly occur with eczema.1

Skin changes

Along with patches of itchy skin, eczema can lead to other potential skin changes. For example, long-term, aggressive scratching can cause skin thickening. This can create rough patches or even scars on the skin. This skin-thickening process is called lichenification, and it can be permanent.1,2

Skin in areas around eczema patches also may become lighter or darker. These changes may be related to inflammation. The skin can take months to return to its usual tone.1,2

In addition, eczema makes the skin more sensitive to irritants, which can lead to further skin reactions. When this affects the hands, it is called hand dermatitis. Some eczema patches also develop blisters. These blisters can start to weep or leak fluid. This change is called weeping eczema, and it can be painful or difficult to manage.2,3

Skin infections

Because people with eczema have skin that is dry and cracked, germs can get into their bodies more easily. This puts them at increased risk for skin infections. The most common types of skin infections are bacterial, viral, and fungal. Treatment for each of these types of infection differs.2-5

Some infections can spread quickly and become serious. For example, eczema herpeticum is caused by the herpes simplex virus (herpes or HSV). This virus causes simple cold sores in people without eczema. But it can lead to more widespread issues for those with eczema.2,4,5

Allergies and asthma

Eczema does not directly cause environmental allergies, food allergies, or asthma. But these issues often occur together. The process of developing eczema and then seasonal allergies and asthma is called the atopic march. Food allergies often develop in babies and young kids with eczema too.2,6

The atopic march may be related to a weakened skin barrier and an overactive immune system response. Experts think both of these factors play a role in eczema.2,6,7

Here is how it might work: Dry, cracked skin that is weaker than usual can let in potential allergens more readily. Once these allergens are inside the body, the immune system can become sensitized to them. Becoming sensitized to an allergen is what happens when you develop a formal allergy.2,6,7

Symptoms of an allergic reaction can vary. In mild cases, a skin rash or watery eyes may occur. In more serious cases, anaphylaxis may occur. Anaphylaxis is a severe allergic reaction that can impact breathing and other organs. This reaction can be life-threatening.2,6,7

A doctor who specializes in allergies (allergist) or lung conditions (pulmonologist) can help you determine the best way to manage eczema, allergies, and asthma if you are dealing with all 3 at once.2,6,7

Eye diseases

Some eye conditions are more common in people with eczema. These include atopic keratoconjunctivitis (AKC) and vernal keratoconjunctivitis (VKC), eye diseases that cause symptoms that look like those of allergies. The most common symptoms are itchy, burning, or watery eyes.1

But AKC and VKC can cause other eye problems too. They may need to be managed by a doctor who specializes in treating the eyes (ophthalmologist).1

Sleep issues

Constant irritation, pain, and itching from eczema can make it hard to sleep at night. This can impact a person’s ability to get good rest. Sleep issues may also be a side effect of some whole-body eczema treatment options.1,2

Mental health impacts

Trouble sleeping and changes in physical appearance due to eczema can take a toll on a person’s mental and emotional health. Depression and anxiety are more common in those with eczema. Problems with self-confidence and self-image are possible too.1,2,4

Also, learning disabilities and attention-deficit/hyperactivity disorder (ADHD) may be more common among people with eczema. More research is needed to understand these potential links. If you are experiencing mental or emotional distress, reach out to your doctor or a mental health professional for resources and support.1,2,4

Anemia

While experts do not yet understand the relationship between the 2 conditions, kids with eczema may have a higher risk of developing anemia. Anemia refers to having a low red blood cell count. Red blood cells play many roles in the body. A big job they perform is delivering oxygen throughout the body.1

Call your doctor if you notice signs of anemia in yourself or your child. These signs may include trouble breathing, very low energy, or skin that is paler than usual. Your doctor can help determine whether anemia is related to your eczema or another underlying problem.1

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