Eczema in Adults: Causes, Symptoms, and Solutions

Eczema isn’t just a childhood issue—millions of adults live with it too, and some are diagnosed for the very first time later in life. Adult eczema can be frustrating, but there are effective ways to manage it.

This article explores the unique challenges of eczema in adults: causes, symptoms, and real solutions that work. Atopic dermatitis (AD), a common type of eczema, can persist into adulthood or even begin in adulthood. Adult-onset AD is being increasingly recognized.

If you’re new to the topic, you may want to read What Is Eczema? (And What It Isn’t) and Our Guide to the Different Types of Dermatitis for foundational insights.

Can Adults Get Eczema for the First Time?

Yes—adults can develop eczema even if they didn’t have it as children. While atopic dermatitis often begins in childhood, it can persist into adulthood or show up for the first time later in life.

It’s a common misconception that eczema only affects children. Eczema occurs in people of all ages, and adult-onset eczema is more common than previously thought.

Common Causes of Adult Eczema

The causes of eczema in adults are similar to those in children, involving a combination of genetic, immune, and environmental factors:

• Genetics: A family history of eczema, asthma, or hay fever increases the likelihood of developing eczema.
• Skin barrier dysfunction: A compromised skin barrier makes skin more vulnerable to irritants and allergens, and increases moisture loss.
• Immune system dysregulation: The immune system plays a central role in the inflammation seen in eczema.
• Environmental triggers: Soaps, detergents, fragrances, dust mites, pet dander, pollen, and even weather extremes can worsen symptoms.
• Occupational exposures: Adults exposed to irritants at work may develop or exacerbate dermatitis. Occupational Dermatitis: Jobs at Risk and Prevention Tips dives deeper into this topic.

Adult-onset eczema may also be linked to new lifestyle or health changes, including shifts in hormone levels, immune response, or skin microbiome.

Symptoms of Eczema in Adults

Eczema in adults can present differently from childhood eczema. Common symptoms include:

• Intense itching (pruritus) — often worse at night.
• Dry, thickened, or scaly skin — resulting from chronic inflammation or scratching.
• Red or brownish-gray patches — may appear differently on darker skin tones (gray, purple, or brown instead of red).
• Small, fluid-filled bumps — that may ooze or crust during flare-ups.
• Cracked, raw, or sensitive skin — particularly painful during flare-ups.
• Location-specific symptoms — typically on the hands, feet, neck, inner elbows, behind the knees, and eyelids.

For a closer look at how eczema can appear on different skin tones, refer to How Eczema Looks on Different Skin Tones.

Adults often have localized and persistent patches, and hand eczema is particularly common.

Eczema in Specific Adult Populations

Certain adult groups experience eczema differently:

• Older adults: Eczema can either continue or appear for the first time later in life, often as asteatotic eczema, which is linked to very dry skin.
• Occupational groups: People in frequent contact with irritants are more susceptible to contact dermatitis.
• Adults with a childhood history: Many continue to experience flare-ups, though the areas affected and severity may change over time.

You might also find Contact Dermatitis: Top 10 Triggers and Atopic Dermatitis: Top 10 Triggers helpful when trying to identify causes.

Eczema in adults can take an emotional toll. Anxiety, depression, and sleep issues are common—which we explore in The Emotional Toll of Eczema.

Everyday Habits That Make a Difference

Managing eczema begins with consistent, supportive routines:

• Moisturize frequently: Use thick, fragrance-free emollients multiple times daily—especially after bathing.
• Gentle cleansing: Choose mild, fragrance-free cleansers and avoid hot water or harsh scrubbing.
• Avoid known triggers: Identify environmental and personal triggers through trial, observation, or testing.
• Wear breathable fabrics: Cotton is ideal. Avoid wool and synthetic fabrics that can cause friction or irritation.
• Manage stress: Stress can aggravate symptoms. Techniques like meditation, yoga, or light exercise may help.

Treatment Options

Several effective treatments are available—ranging from topical therapies to systemic medications:

• Topical corticosteroids (TCS): First-line treatment for mild to moderate flare-ups.
• Topical calcineurin inhibitors (TCIs): Steroid-free options like tacrolimus or pimecrolimus.
• Topical PDE4 inhibitors: Such as crisaborole, to reduce inflammation.
• Topical JAK inhibitors: Ruxolitinib is one example used in adult AD.
• Systemic medications: For severe cases, oral corticosteroids or immunosuppressants (like methotrexate or cyclosporine) may be prescribed.
• Biologics: Dupilumab is a targeted biologic used for moderate to severe eczema.
• Phototherapy: Controlled UV light exposure can reduce inflammation.
• Wet-wrap therapy: Enhances the effects of topical treatments in severe cases.

Want a deeper look into treatments? Read Most Common Medications Prescribed for Dermatitis.

When to Seek Medical Advice

Adults with eczema should consult a healthcare professional when:

• Symptoms are severe, persistent, or worsening
• OTC treatments don’t work
• You suspect infection (redness, pus, warmth)
• Eczema interferes with sleep, work, or daily life
• You’re unsure of the best course of treatment

A dermatologist can provide diagnosis, personalized treatment plans, and may recommend patch testing to identify allergens. For more, see Patch Testing 101.

Takeaway: You’re Not Alone—And There Are Solutions

Living with adult eczema can be challenging, but you’re not powerless. With the right combination of understanding, daily habits, and medical support, you can minimize flare-ups and improve your quality of life.

Want to learn more about how eczema affects your day-to-day and emotional well-being?
Read:
The Emotional Toll of Eczema: Anxiety, Depression, and Coping
How Eczema Affects Daily Life and Social Interactions