The different types of eczema: understanding to take better action

Eczema is not a simple passing irritation: it is a chronic inflammatory skin disease that affects approximately 15 to 20% of children and nearly 5% of adults in France.
It manifests itself through intense itching , red patches and persistent dryness , which can severely impact quality of life.

But be aware, eczema is not a single disease. There are several forms, with different causes and characteristics.
The most frequent ones are:

• Atopic eczema.
• Contact eczema.
• Seborrheic dermatitis .
• Hand eczema.
• Nummular eczema.

Approximately 15 to 20% of the population has contact sensitization. In this case, the skin reacts after repeated contact with a substance.

• Irritant form : caused by aggressive products (detergents, solvents, disinfectants).
• Allergic form : triggered by an allergen (nickel, perfume, preservatives, dyes).

The right actions:

• Identify and avoid the responsible substance (patch test if necessary).
• Repair the skin barrier with lipid-replenishing treatments.

It affects approximately 4.4% of the world's population.

For what ?

It appears in areas rich in sebum ( scalp , eyebrows, sides of the nose, chest), favored by a proliferation of the Malassezia fungus.

Symptoms :

• Red, greasy, yellowish patches .
• Often confused with psoriasis , but finer.

The right actions:

• Gentle antifungal shampoos.
• Sebum-regulating treatments.
• Avoid overly greasy creams.

Very common, it affects 9 to 14% of the population each year.

Symptoms :

Small, itchy blisters filled with clear fluid, located on:

• The palms.
• The sides of the fingers.
• Sometimes the soles of the feet.

The right actions:

• Dry your hands and feet thoroughly.
• Limit repeated exposure to water and irritants.
• Apply non-occlusive emollients.

Rarer (≈ 2 people out of 1000, or 0.2%), it mainly affects adults.

Symptoms :

• Round, red, dry or oozing patches.
• Located on the legs, arms or torso.

The right actions:

• Intensely moisturize with rich balms.
• Clean with gentle care.
• Avoid scratching, as this worsens the lesions.

Regardless of the type of eczema, two common mechanisms are found:

• A weakened skin barrier.
• An imbalance in the microbiome.

The skin microbiome, composed of billions of protective microorganisms, plays a key role in:

• Regulating immunity.
• To reduce inflammation .
• Protect the skin against unwanted microbes.

When it is disrupted (dysbiosis), the skin becomes more vulnerable and eczema flare-ups are promoted.

1. Clean without damaging:

• Gentle cleansing care (soap-free, sulfate-free, physiological pH).
• Warm water, gentle drying by patting.

2. Hydrate and repair:

• Apply an emollient (cream or balm) daily. Ideally after showering and as often as needed. This simple step reduces the frequency of flare-ups.

3. Limit the triggers:

• Cold, heat, friction, wet work, irritants, known allergens,
• Appropriate protective gear: gloves, soft clothing.

4. Supporting the microbiome:

People with eczema often present with:

• A loss of microbial diversity .
• Over-colonization by Staphylococcus aureus.
• Increased inflammation .
  

To rebalance this protective flora:

• Choose gentle formulas (without harsh soap, without irritating preservatives, without perfume).
• Opt for skincare products enriched with prebiotics and postbiotics .
• Opt for High Tolerance, natural products that reduce irritation and strengthen the skin's balance.

This approach, centered on the skin microbiome, is now considered an innovative complement in the management of eczema.

• Eczema encompasses several diseases: atopic, contact, seborrheic, hand and nummular.
• The common key: a weakened skin barrier and an unbalanced microbiome.
• Gentle care, regular hydration, and respecting the microbiome help to better control flare-ups.

1. INSERM – Epidemiological data France and Europe (2024).
2. Contact Dermatitis Journal – Data on contact eczema (2023).
3. Journal of the European Academy of Dermatology and Venereology – Prevalence of seborrheic dermatitis (2024).
4. Contact Dermatitis Journal – Prevalence and burden of hand eczema (2023).
5. French Society of Dermatology – Recommendations 2025.
6. Frontiers in Cellular and Infection Microbiology (2022) – Skin microbiome and atopic dermatitis.