Is that itch eczema or just dry skin?

Feeling dry and itchy?

Nearly everyone will experience dry skin at some point in their lives. For some, it can be a chronic, long-lasting condition — for others, it may be more situational.

But when that itching and redness is accompanied by other more intense and persistent symptoms, it’s time to talk to your doctor or other health care provider.

Dry skin vs. eczema 

The primary difference between dry skin and eczema is the presence of an overactive immune system response, explains David Larrymore, MD, dermatologist at MultiCare Rockwood Clinic.

“With eczema, it’s an outsized, unnecessary response of the immune system to a compromised skin barrier,” he says. “Dry skin generally occurs more mildly.”

Telltale signs in spotting the difference:

• Eczema: Intensely itchy, dry and inflamed skin; discoloration ranging from red and purple to brown or gray; swelling or thickening of the skin; crusting or cracking of the skin; red bumps
• Dry skin: Mild to moderately itchy, flaky and dry skin; some discoloration from inflammation and scratching; minor to moderate cracking or peeling of the skin

The causes of dry skin can often be found, but eczema can be more mysterious.

What is the cause of eczema?

First, eczema is an umbrella term for a range of different skin conditions that can manifest in different ways at any point in your life, explains Dr. Larrymore.

“It’s quite complex, and we don’t completely understand it yet,” he says. “We know there are changes in the structure and barrier of the skin that we see with eczema, but we also see a very prominent inflammation of the skin … it all comes down to a molecular level.”

Some people are born with eczema — which is often easier to explain, understand and treat from the start. Other people may develop it later in life or see it come and go. As we age and come into contact with new germs and environments, our skin biology changes, too, Dr. Larrymore explains.

“You likely always had a predisposition, and it just needed the right stressor, circumstance or strain on the immune system and then boom, it manifests,” he adds. “Maybe you had a few clues here or there, but never had exposure to the right series of events to cause it, which is why it’s so impossible to predict from one person to the next.”

Eczema isn’t your fault

A common misconception is that you did something to cause your eczema.

“Many people believe food allergies to be a cause of their eczema,” Dr. Larrymore says. “While it’s fair to say that some foods may cause eczema to flare, it’s not the food itself causing it. Eczema is always there if you have it, but the right conditions will exacerbate it.”

Eczema is a common condition, affecting nearly one in 10 people in the United States. But without a single specific cause, it can be confusing and frustrating.

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Find a provider

That doesn’t mean you should lose hope, though. Science has come a long way with treatments and reducing eczema symptoms and flare-ups.

Knowing when to see a provider versus when it may just be a case of dry skin is key. If you have an occasional patch of dry skin or minor rash that clears up with use of a moisturizer, you’re safe to continue treating that at home, Dr. Larrymore says.

But if your symptoms are impacting your life, disrupting your sleep or not subsiding no matter what you do, schedule an appointment with your provider, he recommends.

Lock in the moisture

Whether you’re battling seasonal dryness, consistent dry skin or an eczema diagnosis, moisture plays a huge role in keeping your skin happy and healthy.

Many people think irritation is a result of poor hygiene and go to extremes with long, hot showers, harsh cleansers and exfoliants.

But dry, itchy skin does not equate to being dirty, Dr. Larrymore says. Those approaches will likely only make the problem worse, he warns — especially if you live in areas where the public water supply has higher levels of calcium or magnesium (hard water), which can cause further irritation.

Instead, focus on keeping your skin barrier supported with regular use of moisturizers and creams formulated to keep you hydrated.