Eczema impacts your skin due to an immune system response, leading to itching, rashes, and changes in color and texture. Symptoms, known as flare-ups, can be managed with treatment but may take time to subside. Scratching can sometimes result in temporary discoloration or scarring. Handling eczema scars involves avoiding triggers, managing flare-ups, and consulting your doctor for guidance.

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Causes of Eczema Scars | Pigmentation | Itch-scratch Cycle | Corticosteroids | Appearance of Eczema Scars | Post-inflammatory Hyperpigmentation | Lichenification | Post-inflammatory Hypopigmentation | Pityriasis Alba | Hypertrophic and Keloid Scars | Eczema Scar Resolution | Treating Eczema Scars | Preventing Eczema Scars | Conclusion

What causes eczema scars?

Over 30 million Americans grapple with eczema, with symptoms varying greatly. You might experience mild symptoms or severe ones with lasting skin alterations. Eczema scars typically result from pigment changes post-flare-up or from picking or scratching, which can lead to wounds and infections. While these skin changes may persist after a flare-up, they usually fade over time as your outer skin layer, the epidermis, heals itself. Permanent marks are rare unless changes occur beneath the epidermis.

Pigmentation

Skin color can influence eczema symptoms and scarring. Eczema is often identified earlier in lighter skin, allowing for prompt treatment. Recognizing eczema on darker skin may take longer. Flare-ups can worsen over time, causing more severe symptoms. It may take time for symptoms to improve and skin pigmentation to normalize.

Itch-scratch cycle

People with eczema often experience intense itching, leading to scratching that exacerbates symptoms. This creates a cycle called the itch-scratch cycle, as per a 2019 review. Continuous scratching can cause skin wounds, leading to pigment changes or scarring. Open wounds also increase the risk of bacterial infection, requiring antibiotic treatment. Delayed healing of infected skin can increase susceptibility to scarring.

Corticosteroids

Extended use of topical corticosteroids may result in lighter patches on your skin, particularly noticeable on darker skin tones. These patches typically fade once you discontinue steroid use.

What do eczema scars look like?

Eczema scars are often temporary changes in skin color or texture that endure beyond flare-ups. Here are several common ways in which eczema scars may manifest:

Post-inflammatory hyperpigmentation

Eczema inflammation varies based on skin tone:

  • Lighter skin may appear pink or red.
  • Darker skin may show brown, purple, or gray hues.
    These changes can persist for months post-flare-up, more visible on darker skin.

Lichenification

If eczema advances to lichenification, your skin may appear discolored, becoming thick and rough. This often happens in areas you frequently rub or scratch. Lichenification also increases skin pigmentation, appearing as dark pink on lighter skin and gray on darker skin tones.

Post-inflammatory hypopigmentation

Hypopigmentation, the opposite of hyperpigmentation, causes your skin to appear lighter after a flare-up until it fully heals.

Pityriasis alba

Pityriasis alba, a form of hypopigmentation, commonly affects children and teenagers with dry skin or eczema, as per a 2021 study. It presents as oval, scaly patches, more conspicuous in darker skin tones or after sun exposure. These patches remain unchanged in color, even as the surrounding skin darkens.

Hypertrophic and keloid scars

Excessive scratching can lead to dark, raised scars, which may be hypertrophic or keloid depending on their size. These scars can be intensely itchy and may require medical attention. Hypertrophic scars typically match the shape of the wound, while keloid scars grow larger and are usually darker. They are more prevalent in individuals with dark skin, with African Americans being 5 to 16 times more prone to keloid development than white Americans.

Do eczema scars go away?

Most eczema scars typically fade over time, with discoloration often being temporary and diminishing within a few months as inflammation subsides. Skin appearance may vary during the inflammation reduction phase, with darker skin tones experiencing longer-lasting discoloration. Scars resulting from skin breaks due to itching or rubbing may take longer to heal and could potentially lead to long-term scarring.

How can I treat eczema scars?

The key to managing eczema scarring is controlling flare-ups. Take these steps to manage symptoms effectively:

  1. Identify triggers and avoid known irritants or allergens.
  2. Keep your skin clean and moisturized, applying moisturizer after bathing.
  3. Follow prescribed medications.
  4. Steer clear of fragrances or irritating topical products.
  5. Explore home remedies like oatmeal baths or aloe vera.
  6. Seek prompt medical attention if you suspect an infection.
  7. Consider UV light therapy if advised by your doctor.
  8. Discuss concerns about skin discoloration with your doctor, especially regarding corticosteroid use.
  9. Address mental health concerns with your doctor if needed.
  10. Seek specialized treatment for severe scarring or pigment changes recommended by your doctor.

Can I prevent eczema scars?

Effectively managing your eczema symptoms is crucial for preventing scarring. Consult a doctor if symptoms worsen. Eczema flare-ups can be triggered by stress, extreme temperatures, irritating detergents, inadequate skincare, or exposure to allergens. Avoid scratching to reduce the risk of eczema-related scars. Keep nails short to prevent skin breakage from scratching.

Takeaway

Eczema can result in persistent skin alterations, such as changes in skin color even after other symptoms subside. Scarring may occur where skin was broken from scratching or due to bacterial infection. Fortunately, these scars often fade over time. Keeping eczema symptoms in check is crucial to prevent skin changes. Consult your doctor for guidance on managing eczema or if you’re worried about potential scarring.

Jump to Section

Causes of Eczema Scars | Pigmentation | Itch-scratch Cycle | Corticosteroids | Appearance of Eczema Scars | Post-inflammatory Hyperpigmentation | Lichenification | Post-inflammatory Hypopigmentation | Pityriasis Alba | Hypertrophic and Keloid Scars | Eczema Scar Resolution | Treating Eczema Scars | Preventing Eczema Scars | Conclusion