Eczema affects your skin through an immune system response, causing itching, rashes, and alterations in color and texture. These symptoms, referred to as flare-ups, can be controlled with treatment but may require time to diminish. Scratching can occasionally lead to temporary discoloration or scarring. Managing eczema scars involves avoiding triggers, controlling flare-ups, and seeking professional medical advice.
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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?
More than 30 million Americans experience eczema, with symptoms ranging from mild to severe. You might have temporary symptoms or persistent skin changes. Eczema scars typically develop from pigment changes after flare-ups or from scratching, which can cause wounds and infections. While these skin changes may remain after symptoms subside, they usually fade as your outer skin layer (epidermis) heals. Permanent marks are uncommon unless deeper skin layers are affected.
Pigmentation
Skin tone influences eczema symptoms and scarring. Eczema is often detected earlier in lighter skin, allowing quicker treatment. Diagnosis may take longer for darker skin tones. Untreated flare-ups can worsen, leading to more severe symptoms. Recovery time varies for symptom improvement and skin pigmentation normalization.
Itch-scratch cycle
Eczema often causes intense itching that leads to scratching, worsening symptoms in a cycle called the itch-scratch cycle (2019 review). Persistent scratching can create skin wounds, causing pigment changes or scarring. Open wounds also increase bacterial infection risks, potentially requiring antibiotics. Infected skin that heals slowly may scar more easily.
Corticosteroids
Long-term use of topical corticosteroids may cause lighter skin patches, particularly noticeable on darker skin. These typically fade after stopping steroid treatment.
What do eczema scars look like?
Eczema scars often appear as temporary skin color or texture changes that persist after flare-ups. Common manifestations include:
Post-inflammatory hyperpigmentation
Eczema inflammation varies by skin tone:
- Lighter skin may show pink or red tones
- Darker skin may display brown, purple, or gray hues
These changes can last months after flare-ups, being more visible on darker skin.
Lichenification
Advanced eczema may cause lichenification, where skin becomes discolored, thick, and rough, especially in frequently scratched areas. This increases pigmentation, appearing dark pink on light skin and gray on darker tones.
Post-inflammatory hypopigmentation
Hypopigmentation (opposite of hyperpigmentation) causes lighter skin patches that normalize as healing completes.
Pityriasis alba
Pityriasis alba, a hypopigmentation form common in children/teens with dry skin or eczema (2021 study), appears as oval, scaly patches. These are more noticeable on darker skin or after sun exposure, remaining light while surrounding skin darkens.
Hypertrophic and keloid scars
Excessive scratching can create dark, raised scars (hypertrophic or keloid). These may itch intensely and require medical care. Hypertrophic scars match wound shape, while keloids expand beyond it and darken. They’re more common in dark-skinned individuals, with African Americans 5-16 times more likely to develop keloids than white Americans.
Do eczema scars go away?
Most eczema scars fade over time, with discoloration typically lasting months as inflammation decreases. Darker skin may experience longer-lasting discoloration. Scars from broken skin may take longer to heal and could become permanent.
How can I treat eczema scars?
Effective eczema scar management focuses on controlling flare-ups:
- Identify and avoid triggers/allergens
- Maintain clean, moisturized skin (apply moisturizer post-bathing)
- Follow prescribed medications
- Avoid fragrances/irritating products
- Try home remedies (oatmeal baths, aloe vera)
- Seek immediate care for suspected infections
- Consider UV light therapy if recommended
- Discuss skin discoloration concerns with your doctor, especially regarding corticosteroids
- Address mental health needs if present
- Pursue specialized treatments for severe scarring as advised
Can I prevent eczema scars?
Preventing eczema scars requires effective symptom management. Consult a doctor if symptoms worsen. Flare-up triggers include stress, extreme temperatures, harsh detergents, poor skincare, and allergens. Avoid scratching to minimize scarring risk. Keep nails short to prevent skin damage.
Takeaway
Eczema can cause lasting skin changes, including persistent discoloration after other symptoms resolve. Scarring may occur from scratching or infections. Fortunately, most scars fade with time. Controlling eczema symptoms is key to preventing skin changes. Consult your doctor for eczema management or scarring concerns.
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