This skin disease is more than simply dryness. “Eczema is a rash that the body produces that results in varied skin dysfunction that does not allow the skin barrier to stay intact. As a result, the barrier breaks down into this itchy rash,” explains Edidiong Kaminska, MD, a board-certified dermatologist with Kaminska Dermatology in Chicago. If you have eczema or have been diagnosed with the skin condition, you may be wondering if there’s hope it will disappear with time or if it’s something that will stick with you for the long haul that you will have to actively manage. Here’s what doctors know. RELATED: What Causes Eczema?
Does Eczema Go Away on Its Own?
Eczema can start at any time during your life and can range from moderate to severe, notes the NEA. Although the skin condition is common, learning you have it can be truly upsetting. There are several types of eczema, ranging from atopic dermatitis (which is what people most associate with eczema) and seborrheic dermatitis (dandruff, or scalp eczema) to contact dermatitis (when your skin reacts to, say, using a new soap) and more. When it comes to atopic dermatitis, the disease is chronic. Jonathan Silverberg, MD, PhD, an associate professor of dermatology at The George Washington University School of Medicine and Health Sciences in Washington, DC, notes that a chronic disease means that symptoms stick around for six months or more — but they can also last a lifetime. “Diagnosing a patient with eczema is a difficult conversation to have,” he says. Therefore, it’s tough to say how long eczema lasts. “The important take-home is that we cannot assume that atopic dermatitis will magically disappear. We need to develop treatment plans that are appropriate and safe for long-term use,” Silverberg says. The lack of this type of plan is common, though, and it leaves many patients frustrated and prone to misinformation and phony cures in regards to their condition. RELATED: A Detailed Guide to Treating Eczema
How Long Do Eczema Flare-Ups Typically Last?
The length of a flare-up will depend on what type of eczema you have, as well as the severity of the flare. With proper treatment, flare-ups may last one to three weeks, notes Harvard Health Publishing. Chronic eczema such as atopic dermatitis can go into remission with the help of a good preventative treatment plan. “Remission” means that the disease is not active and you remain free of symptoms. Periods of remission can last for weeks or even years, according to the American Academy of Family Physicians. RELATED: Do You Need a Topical Steroid to Help Control Eczema?
What Are the Different Stages of Eczema?
Eczema can be broken down into three stages, says Dr. Kaminska: acute, subacute, and chronic:
Acute
This type of eczema presents as red, weepy patches, she explains.
Subacute
This is the “typical rash people think of,” says Kaminska, as it’s dry, red, itchy, and scaly.
Chronic
Over time, the skin can thicken “like armor” to protect against infection, she explains. Your treatment will depend on the stage and severity of the rash, says Kaminska. Mild flare-ups may require over-the-counter (OTC) care, such as ceramide- or hyaluronic acid–rich creams or colloidal oatmeal baths. Moderate atopic dermatitis, and sometimes even mild atopic dermatitis, may need a step-up to an OTC hydrocortisone cream. Moderate to severe eczema needs dermatologist care, particularly because cracks and fissures that result from the breakdown of the skin barrier are prone to infection. Your dermatologist may suggest a prescription-strength cortisone or non-cortisone anti-inflammatory cream; phototherapy, or light therapy; or a biologic injectable medication like Dupixent (dupilumab), Kaminska says. Topical corticosteroids, such as cortisone creams, should be used only in the short term, as side effects can include skin thinning or hypopigmentation in skin of color. Because of those possible side effects, it’s important to see your dermatologist regularly and adhere to your treatment plan. RELATED: I Tried a Home Light Therapy Device for Eczema and Psoriasis — and It Improved My Skin
Prevention of Flare-Ups
The first thing you want to do when you have atopic dermatitis is to practice what’s called gentle skin care, says Kaminska. Part of this is keeping showers to 5 to 10 minutes in lukewarm water, washing with a gentle, fragrance- and scent-free cleanser, and slathering on moisturizer right after bathing, when skin is still damp. Other factors, such as avoiding cigarette smoke, limiting contact with household cleaners, and avoiding other common irritants, like nickel and wool or polyester fabrics, can also help, according to the NEA. Many patients find that stress flares their eczema, so stress management can play an important role in overall skin health. RELATED: The Right Way to Take a Shower or Bath When You’re Managing Eczema
Causes of Itchy, Red Skin That Happens With Eczema
The cause of eczema is multifactorial. “There is both a genetic and environmental component to eczema,” says Kaminska. Some of these factors are out of your control. For example, you can’t change your genetics. As the Cleveland Clinic points out, eczema is caused by:
An overreactive immune systemGenetics: This includes a family history of asthma or allergies.Environmental factors such as irritants and hot and dry airStress
RELATED: How Stress Can Trigger an Eczema Flare-Up
Is There a Cure for Eczema, or Will I Have This Skin Condition Forever?
Gentle skin care, avoidance of triggers, and, if needed, medicated management can help keep symptoms at bay. But you may have eczema, such as atopic dermatitis, throughout your life. Addressing the skin disease with a short- and long-term view will care for your skin and health best. “We want to recognize that aside from the need to reduce itch and pain, we have to improve a patient’s quality of life. There is a lot of harm that comes from uncontrolled, untreated skin disease,” says Silverberg. For example, itch and pain can cause sleep deprivation that has a cascade effect on overall health. RELATED: How Antihistamines May Help Take the Itch Out of Eczema
A Final Word on Managing Eczema in the Long Term
While some people, especially children, may grow out of eczema as they age, it’s more important to look at this as a chronic skin condition that has no cure. That is not a pessimistic view, rather one that can help you take control, manage flare-ups, and stick to a healthy, gentle skin routine that benefits your overall wellness. RELATED: Tips for Building a Smart Skin-Care Routine for Eczema
