Table of ContentsView AllTable of ContentsAcute Stage EczemaSubacute (Healing) Stage EczemaChronic Stage EczemaSigns of HealingComplications
Table of ContentsView All
View All
Table of Contents
Acute Stage Eczema
Subacute (Healing) Stage Eczema
Chronic Stage Eczema
Signs of Healing
Complications
Eczema(atopic dermatitis) has three stages: acute, subacute (healing stage), and chronic. Each eczema stage has unique symptoms, though the most familiar is a red, scaly, blistered rash. The irritation can appear on any part of the body but most often breaks out around the eyes or on the hands, neck, elbows, knees, ankles, or feet.
Eczema does not always go through the three stages in order. For example, a rash may start during the acute stage and then move to the healing stage and chronic stages. The same rash can cycle through the stages many times. An eczema rash can also start and stop at nearly any stage.
This article will cover the three stages of eczema and the symptoms of each one, as well as common eczema treatments at each stage of healing.
Theacute stageof eczema is when a rash has just started. Eczema symptoms are usually intense during the first phase because there is a lot of inflammation (often called a flare-up).
Itching is typically the first sign of acute eczema. The itching often starts even before the rash shows up. That’s one way that eczema is different from other common rashes.
What Causes Acute Eczema?
Sometimes, a flare-up of eczema doesn’t have a specific trigger and is just a sign that the condition worsens.
The acute stage of eczema can cause:
This photo contains content that some people may find graphic or disturbing.See PhotoReproduced with permission from © DermNet New Zealand and © Dr. Richard Ashtonwww.dermnetnz.org2023.
This photo contains content that some people may find graphic or disturbing.See Photo
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from © DermNet New Zealand and © Dr. Richard Ashtonwww.dermnetnz.org2023.
Acute Stage Eczema Treatments
There are varioustreatment options for acute eczema, including:
Thesubacute stageof eczema is the most common. Acute eczema rashes may move into a new phase as they heal. However, healing eczema rashes can flare up again if not treated. In this case, eczema goes into the subacute stage. In this stage, healing eczema may even return to the acute phase.
The subacute stage is in the “middle” of the progression, but eczema can also start at this stage. Long-lasting subacute rashes can also become chronic.
During the subacute stage, eczema can cause:
There is still inflammation of the skin in the subacute stage. Some eczema symptoms are less severe in the subacute stage than in the acute stage—especially itching. However, symptoms like burning and stinging are usually more intense during the subacute stage.
Reproduced with permission from ©DermNet New Zealandwww.dermnetnz.org2023.
The rash will also be dry during the healing stage rather than blistered and oozing like it was during the acute stage.
Subacute (Healing) Stage Eczema Treatments
Here are a few strategies you can try to manage symptoms of healing or the subacute stage of eczema:
Chronic stageeczema means that flares are longer-lasting. In general, it takes three or more months for chronic eczema symptoms to appear.
The symptoms of chronic eczema include:
Chronic Stage Eczema Treatments
Treatments for chronic stage eczema are similar to those used during the healing stage and include:
If you haven’t already, you may want to talk to your provider about newer prescription treatments like biologics that have been approved to treat moderate-to-severe eczema. You can also ask about trying treatments like phototherapy for chronic eczema.
Eczema can cause the skin to itch, which can lead to scratching. When clear fluid drains from the skin after itching, it is called weeping eczema. As this fluid dries, it forms a crust on the skin. Speak to a healthcare professional about the best ways to prevent itching.
Most people experience eczema as a progression, and it can be helpful to know how to recognize signs of healing. As eczema moves from the acute phase to the sub-acute (healing) phase, the skin might become flaky and dry, with cracks in the skin and decreasing redness. It might burn or sting, but again, symptoms tend to improve during healing.
Healthcare providers often use a protocol known as “get control and keep control” when treating eczema. As healing begins, speak with your healthcare professional about how the management of your eczema should progress. For example, the frequency of topical steroid use might decrease once healing is underway.
Complications of Eczema
People with eczema might have trouble sleeping because of the discomfort of the condition, which can lead to mental health issues like depression and anxiety. It also increases the chances of infections like conjunctivitis and blepharitis.
Because eczema can lead to broken skin, a possibility for infection exists. Because of this, people with eczema-related complications might need to take antibiotics. Antibiotic overuse can lead to treatment-resistant infection and complications likeC. difficileinfection.
Although it is extremely rare, these complications from eczema can lead to septic shock.
Summary
It helps to know what you can expect during the three stages of eczema: acute, subacute (healing), and chronic. While providers call the stages a “progression,” the stages of eczema do not always proceed one right after another.
Many cases of eczema start in the subacute stage and stay there. Eczema in the healing stage can also work backward, especially when it’s not being treated. Over time, eczema flares can start lasting longer and become chronic.
The uncertainty of having eczema is why understanding the symptoms of each stage will be helpful when you talk to your provider to make a treatment plan.
Common Eczema Triggers
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Eczema types: Atopic dermatitis overview.National Eczema Association.Eczema causes and triggers.National Eczema Association.What is eczema?.National Eczema Association.Atopic dermatitis.Thomsen SF.Atopic dermatitis: Natural history, diagnosis, and treatment.ISRN Allergy.2014 Apr 2;2014:354250. doi:10.1155/2014/354250Halling-Overgaard AS, Zachariae C, Thyssen JP.Management of atopic hand dermatitis.Dermatol Clin. 2017 Jul;35(3):365-372. doi:10.1016/j.det.2017.02.010National Institute of Allergy and Infectious Disease.Eczema (atopic dermatitis).National Eczema Association.Prescription phototherapy.National Eczema Association.Available eczema treatments.Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021;21(4):386-393. doi:10.1097/ACI.0000000000000750National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health.Atopic dermatitis.Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol.2021;126(1):3-12. doi:10.1016/j.anai.2020.08.002
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Academy of Dermatology Association.Eczema types: Atopic dermatitis overview.National Eczema Association.Eczema causes and triggers.National Eczema Association.What is eczema?.National Eczema Association.Atopic dermatitis.Thomsen SF.Atopic dermatitis: Natural history, diagnosis, and treatment.ISRN Allergy.2014 Apr 2;2014:354250. doi:10.1155/2014/354250Halling-Overgaard AS, Zachariae C, Thyssen JP.Management of atopic hand dermatitis.Dermatol Clin. 2017 Jul;35(3):365-372. doi:10.1016/j.det.2017.02.010National Institute of Allergy and Infectious Disease.Eczema (atopic dermatitis).National Eczema Association.Prescription phototherapy.National Eczema Association.Available eczema treatments.Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021;21(4):386-393. doi:10.1097/ACI.0000000000000750National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health.Atopic dermatitis.Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol.2021;126(1):3-12. doi:10.1016/j.anai.2020.08.002
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Academy of Dermatology Association.Eczema types: Atopic dermatitis overview.National Eczema Association.Eczema causes and triggers.National Eczema Association.What is eczema?.National Eczema Association.Atopic dermatitis.Thomsen SF.Atopic dermatitis: Natural history, diagnosis, and treatment.ISRN Allergy.2014 Apr 2;2014:354250. doi:10.1155/2014/354250Halling-Overgaard AS, Zachariae C, Thyssen JP.Management of atopic hand dermatitis.Dermatol Clin. 2017 Jul;35(3):365-372. doi:10.1016/j.det.2017.02.010National Institute of Allergy and Infectious Disease.Eczema (atopic dermatitis).National Eczema Association.Prescription phototherapy.National Eczema Association.Available eczema treatments.Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021;21(4):386-393. doi:10.1097/ACI.0000000000000750National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health.Atopic dermatitis.Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol.2021;126(1):3-12. doi:10.1016/j.anai.2020.08.002
American Academy of Dermatology Association.Eczema types: Atopic dermatitis overview.
National Eczema Association.Eczema causes and triggers.
National Eczema Association.What is eczema?.
National Eczema Association.Atopic dermatitis.
Thomsen SF.Atopic dermatitis: Natural history, diagnosis, and treatment.ISRN Allergy.2014 Apr 2;2014:354250. doi:10.1155/2014/354250
Halling-Overgaard AS, Zachariae C, Thyssen JP.Management of atopic hand dermatitis.Dermatol Clin. 2017 Jul;35(3):365-372. doi:10.1016/j.det.2017.02.010
National Institute of Allergy and Infectious Disease.Eczema (atopic dermatitis).
National Eczema Association.Prescription phototherapy.
National Eczema Association.Available eczema treatments.
Olabi B, Williams HC.Evidence-based management of eczema: five things that should be done more and five things that should be dropped.Curr Opin Allergy Clin Immunol. 2021;21(4):386-393. doi:10.1097/ACI.0000000000000750
National Institute of Arthritis and Musculoskeletal and Skin Diseases. National Institutes of Health.Atopic dermatitis.
Wang V, Boguniewicz J, Boguniewicz M, Ong PY.The infectious complications of atopic dermatitis.Ann Allergy Asthma Immunol.2021;126(1):3-12. doi:10.1016/j.anai.2020.08.002
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