Eczema Scars: Causes, Treatment, Advice

Skin Conditions

Eczema, also referred to as atopic dermatitis, is the most common form of itchy skin inflammation. Eczema scars are usually a reference to plaques of red, itchy rashes that characterize this condition. While most commonly seen in children, eczema occurs in adults as well.

What Causes Eczema Scars?

Eczema is a result of a malfunction with the skin’s barrier function. Normally, our skin should keep us hydrated by preventing moisture from leaving the body. The skin normally also functions as a barrier to keep germs such as bacteria, viruses, and fungus out. With eczema, the skin is “leaky”. Water too easily escapes from the skin leading to chronically dry skin. Eczema also allows bacteria to penetrate the skin more easily. This predisposes eczema scars to infections.

Who Gets Eczema?

People that get eczema frequently include:

  • children (15-30% of kids, mostly infants)
  • people that live outside cities more than in urban areas
  • those that have a family history of eczema
  • asthmatics
  • people with seasonal allergies
  • people with allergic rhinitis

Eczema Scars:

Eczema skin changes are often described as eczema scars. In reality, the skin changes that result from eczema are not usually scars. Leathery thickening of the skin from repeated scratching of the rashes is known as lichenification. This scaly change to the skin is different than scarring because it is temporary in nature, and unlike scarring, can be reversed. But if not treated, the skin changes of eczema can be permanent, leading to thickening and hyperpigmentation (darkening of the skin compared to the surrounding areas).

leathery thickening of skin associated with eczema scars
Lichenification is thickening and scaling of the skin often referred to as eczema scars.
hyperpigmentation associated with eczema scars
Hyperpigmentation like this can be a long-term consequence of scars.

Where Do Eczema Scars Occur On The Body?

The distribution of eczema scars and rashes varies mostly with age. In infants, areas affected are widely spread over the body and generally include the face and cheeks. Younger children will often have rashes on their wrists, ankles, knees, and elbows. School-age kids and adults show involvement mostly at the front of the elbow and back of the knee areas.

Treatment of Eczema & Eczema Scars:

The mainstay of eczema treatment is keeping the skin hydrated. This is accomplished by means of moisturizing ointments that are preservative-free and un-fragranced. Avoid soaps, clothing, detergents, and other irritants known to cause flareups. Reducing stress (known to cause flare-ups) is also helpful to keep the condition under control. Try not to scratch eczema rashes. Scratching can actually make the rash itchier and over the long run, it will increase the chances of lichenification and hyperpigmentation. Scratching persistently can also damage the skin leading to infection and genuine scarring.

For less severe cases, home remedies that generally soothe the skin, decrease inflammation and reduce itching include:

  • Oatmeal baths
  • Honey
  • Apple Cider Vinegar
  • Chamomile
  • Aloe Vera
  • Shea Butter

Other ways to prevent and treat eczema that are provided by medical practitioners include:

  • Topical anti-inflammatories such as steroids
  • Non-steroid topicals like Eucrisa
  • Oral antihistamines like Benadryl for nighttime itching
  • UV phototherapy and systemic immunomodulator therapies (for severe cases)

Conclusion:

Skin discoloration (hyperpigmentation) and thickening and scaling (lichenification) can result from eczema, especially with persistent scratching. Infections are a possible complication of eczema that can also damage the skin and potentially cause permanent scars. Minimize your chances of scars by avoiding scratching and using treatment modalities appropriate to the severity of your case.

Medical References:

Nemeth V, Evans J. Eczema. [Updated 2020 Nov 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538209/

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