Eczema (atopic dermatitis) is a common type of skin condition that’s primarily known for itchy, dry skin. It’s classified into three stages.
Eczema can also cause discolored skin rashes. These can be red, brown, or purple, depending on your skin tone.
Globally, at least 1% to 3% of adults and 15% to 20% of children are thought to have eczema, according to a 2017 research review. Experts estimate that more than 31 million Americans are affected.
It’s also estimated that about half of people with moderate to severe forms of eczema also have allergic conditions, such as hay fever, food allergies, or asthma.
While eczema is common, there are seven main types you can have. To help with diagnosis and treatment, a doctor may also classify eczema as one of three stages: acute, subacute, or chronic.
Learn more about the three stages of eczema, including their similarities and differences from a symptom and treatment standpoint.
Eczema is thought to be linked to a leaky skin barrier, which makes the skin dry and vulnerable to chemical and environmental irritants, according to the American Academy of Allergy, Asthma & Immunology (AAAAI).
This skin condition is often lifelong, with periods of flare-ups and remission.
However, eczema stages do not always follow a linear order. In fact, it can begin at any stage, experts say. It can eventually progress into another stage.
Each stage may be identified by molecular changes in skin lesions and onset, according to 2019 research. You can also have more than one type of eczema at the same time.
Here’s how each stage of eczema is classified and what the common symptoms look and feel like.
Acute eczema consists of more severe symptoms, including rashes that:
- may be filled with fluids
- are leaking fluids (a process called weeping)
- have crusted
These symptoms are in addition to the swelling, skin discoloration, and itchiness you may experience during any stage of eczema.
The word “acute” generally means severe and short lasting. As its name suggests, acute eczema refers to sudden flare-ups that may be more severe but will go away with focused treatment.
Subacute eczema is the most common stage. It is marked by mild to moderate inflammation that may come and go throughout your lifetime.
In addition to some of the more common symptoms of eczema, such as itchiness and discolored skin, you may also notice raised bumps (papules) and swollen lesions.
Chronic eczema consists of lesions and papules that may be enlarged and thickened. If eczema is considered chronic, you may notice leathery or thickened areas of skin from previous rashes.
Unlike acute eczema, chronic eczema flares tend to be more persistent. Also, unlike acute or subacute eczema, the chronic stage
Depending on the underlying causes of eczema, including genetic and environmental factors, it can come and go throughout your lifetime.
Eczema itself is not completely curable. But treatments can help improve your symptoms and prevent underlying inflammation that contributes to flares.
Some children may even experience improvement in their eczema after they reach adulthood.
Treatment for eczema primarily consists of strategies to support a leaky skin barrier to prevent irritants from causing flares. Common treatments include using moisturizers or emollients for dry skin and avoiding possible triggers, like allergens.
These strategies may help treat eczema at any of its three stages, but you may need additional treatments in the case of severe eczema.
- over-the-counter allergy medications, such as antihistamines
- prescription steroids to control inflammation
- topical corticosteroids
- topical calcineurin or phosphodiesterase-4 inhibitors to reduce inflammation when other creams don’t work
- Janus kinase (JAK) inhibitors to help stop inflammation in severe cases
- injectable biologics
Using fragrance-free soaps, detergents, and skin care products may also help reduce eczema severity at any stage.
No matter what stage of eczema you may have, this skin condition may potentially lead to issues that affect your health and quality of life.
Consider seeing a doctor if you:
- notice your symptoms are worsening despite treatment
- have tried home treatments, such as moisturizers and over-the-counter ointments, and your condition is not improving
- have itchiness, pain, and other symptoms that are disrupting your sleep
- are experiencing rashes with fluid-filled lesions or any oozing
- have signs of infection in eczema rashes, such as thick-colored fluids, swelling, or pain
Eczema is identified by its physical symptoms, such as discoloration, rashes, and leathery patches of skin. It is also identified by self-reported symptoms of itchiness, frequent infections, and sleep disturbances.
A doctor can also identify eczema stages based on additional symptoms, as previously discussed. For example, weeping lesions may indicate acute eczema. Swollen, raised plaques and bumps could be signs of subacute stages.
In some cases, a doctor may recommend a patch test. The results can help rule out other causes of your skin rashes, such as contact dermatitis or psoriasis, and help them make a more definitive diagnosis.
The doctor can also perform a skin biopsy if they suspect psoriasis. This involves removing a small amount of affected skin and sending it to a lab for testing.
Though blood tests cannot look specifically for eczema, some doctors may request these tests to get additional information to help them make a diagnosis.
For example, some people living with eczema may have elevated levels of cytokine proteins and immunoglobulin (IgE) antibodies. A blood test can tell a doctor whether this is the case for a certain individual.
As a common skin condition, eczema may come in various forms. Its triggers are also highly individual.
Additionally, a doctor may classify eczema into three stages: acute, subacute, or chronic. Each stage carries slight variations in symptoms and outlook.
What’s perhaps most important is working with a doctor to understand the underlying causes of your eczema. Avoiding triggers, keeping your skin hydrated, and taking oral or topical medications are all treatment options that may help.