Eczema is a condition that affects your skin because of a response from your immune system. It causes your skin to itch, develop rashes, and even change in color and texture. Eczema symptoms can come and go. You might refer to them as flare-ups when they are active. These symptoms will subside with proper treatment, but it can take time. In some instances, scratching from eczema may cause temporary discoloration or possible scarring. Avoiding triggers, managing flare-ups, and talking with your doctor are the best ways to handle eczema scars.

What causes eczema scars?

More than 30 million Americans have eczema, and symptoms can vary a lot. You may have few symptoms and no lingering effects or more severe symptoms with long lasting skin changes. Eczema scars are usually the result of:
  • changes in pigmentation after an eczema flare-up
  • picking or scratching at skin that can lead to an open wound and possible infection
These changes in your skin may persist long after your flare-up, but in most cases, they’ll eventually go away. Your outer layer of skin, or epidermis, can usually heal itself completely. More permanent marks may form if changes occur beneath the epidermis, but this is unlikely.

Pigmentation

The color of your skin can impact your symptoms and any lingering scarring. It can be easier to spot and diagnose eczema in lighter skin, leading to earlier treatment. The symptoms of eczema on darker skin may take longer to recognize. Active eczema flare-ups can worsen with time and lead to more severe symptoms. It may take some time for your symptoms to subside and skin pigmentation to return to its original state.

Itch-scratch cycle

People with eczema tend to itch more than people without eczema. Itching leads to scratching, which causes the skin to react further and eczema symptoms to worsen. This results in even more itching, a sequence known as the itch-scratch cycle, according to a 2019 review. If your skin is wounded from repetitive scratching, it can lead to pigment changes or scarring. Open skin can allow unwanted bacteria into your body. This results in an infection that requires antibiotic treatment. You may be susceptible to scarring from infected skin that takes too long to heal.

Corticosteroids

You may also develop lighter patches on your skin if you use topical corticosteroids for too long. These light patches tend to be more noticeable on darker skin tones. The patches should disappear shortly after you stop using topical steroids.

What do eczema scars look like?

Eczema scars are typically temporary changes in the color or texture of your skin that last beyond your flare-ups. Here are some ways eczema scars may appear.

Post-inflammatory hyperpigmentation

Eczema inflammation looks different depending on your skin tone:
  • Your skin may be pink or red if you have a lighter complexion.
  • Your skin may look brown, purple, or gray if you have a darker complexion.
These skin changes can last for months after your flare-up. They are more apparent on darker skin.

Lichenification

Your skin may also appear discolored if your eczema progresses to lichenification, which is when your skin becomes thick and rough. This can occur in spots that you rub or scratch a lot. Lichenification also makes your skin more pigmented. It may appear dark pink on light skin and gray on dark skin.

Post-inflammatory hypopigmentation

Hypopigmentation is the opposite of hyperpigmentation. Instead of your skin staying darker after a flare-up, it looks lighter until it’s completed healed.

Pityriasis alba

Pityriasis alba is a type of hypopigmentation often seen in children and teens with dry skin or eczema, according to 2021 research. It appears as oval, scaly patches that are more noticeable in darker skin tones or after being in the sun. The patches won’t change color even when the rest of your skin darkens.

Hypertrophic and keloid scars

If your scratching causes a cut in your skin, you may develop a dark, raised scar. These can be hypertrophic or keloid scars, depending on how large they are. They can be extremely itchy and may need medical treatment. Hypertrophic scars tend to be in the shape of the wound. Keloid scars grow larger than the original wound. They’re also usually darker. These scars are more common in people with dark skin. African Americans are 5 to 16 times more likely than white Americans to develop keloids.

Do eczema scars go away?

Most eczema scars resolve over time. The discoloration is often temporary and fades over the course of a few months. Your skin may look different while the inflammation decreases. You may experience a longer period of discoloration if you have darker skin. Scars caused by breaking the skin from itching or rubbing may take longer to heal and could result in long-term scarring.

How can I treat eczema scars?

The most important thing you can do for eczema scarring is to control your flare-ups. The long-term effects of eczema will decrease if you handle symptoms as they occur. To manage symptoms:
  • Know your triggers, and avoid any known irritants or allergens.
  • Keep your skin clean.
  • Moisturize your skin right after bathing or showering, and apply additional coats throughout the day as needed.
  • Take medications as prescribed by your doctor.
  • Avoid using fragrances or topical products that irritate your skin.
  • Try home remedies to relieve itching and inflammation, such as oatmeal baths, aloe vera, and shea butter.
  • See a doctor for prompt treatment if you suspect your skin is infected.
  • Get ultraviolet light therapy if recommended by your doctor.
Talk with your doctor about discontinuing topical corticosteroids if you are concerned about skin discoloration at the treated skin sites. Allowing eczema to persist or living with scars could impact your well-being. Make sure you talk with your doctor about concerns related to your condition and seek mental health assistance if needed. Your doctor could recommend a specific treatment to reduce severe scarring or pigment changes to your skin.

Can I prevent eczema scars?

Managing your eczema symptoms is key to preventing scarring. You should see a doctor if you notice your symptoms getting worse. Eczema may flare up if you are:
  • stressed
  • spending time in cold, hot, or dry environments
  • wearing clothing washed in irritating detergents
  • neglecting daily skin care
  • exposed to triggers or allergens
You should also avoid scratching your skin to decrease the likelihood of developing eczema-related scars. Keep your fingernails short to prevent scratching that can break your skin.

Takeaway

Eczema can lead to lingering skin changes. You may notice changes to your skin color for some time after other symptoms go away. Scars may develop where scratching broke the skin or if you developed a bacterial infection. In many cases, these scars will fade with time. It’s important to keep your eczema symptoms under control to avoid changes to your skin. Talk with your doctor about how to manage your eczema or if you are concerned about possible scarring.