SRx Health

An Overview of Moderate to Severe Eczema

Types, symptoms, causes, treatments, and everything you need to know.

We all get some irritation or a rash on our skin from time to time – maybe from a bug bite or chafing on a humid summer day. If you’re getting rashes regularly, though, it might be a sign of moderate to severe eczema. To help you better understand your health and whether eczema could be affecting you, we have all the essentials you need to know.

Table of Contents

1. What Is Eczema?

2. What Is Moderate to Severe Eczema?

3. Types of Eczema

4. Symptoms of Moderate to Severe Eczema

5. What Causes Moderate to Severe Eczema?

6. Potential Complications of Moderate to Severe Eczema

7. Treatments for Moderate to Severe Eczema

8. Lifestyle Changes to Improve Moderate to Severe Eczema

9. What to Do if You Believe You Have Moderate to Severe Eczema

What Is Eczema?

Eczema is a chronic inflammatory skin condition that causes you to have frequent rashes and skin irritation. Those rashes are typically dry, itchy, inflamed, and potentially scaly or oozing.

There are different types of eczema, but most often, the rash is caused by your immune system fighting an allergen or trigger. It’s important to understand, though, that eczema isn’t an autoimmune condition because your immune system isn’t attacking your own cells. It’s attacking a foreign body like an allergen, and it’s this “battle” that causes the skin irritation.

What Is Moderate to Severe Eczema?

Eczema is a surprisingly common condition. In fact, about 17% of Canadians will be affected by it at some point. What separates mild eczema from moderate to severe eczema, though?

It isn’t a clear line. There’s no specific test, bloodwork, or other data that measures eczema severity and defines what is mild compared to moderate to severe. Your doctor will make that classification based on your symptoms, such as:

  • The severity of your itching, pain, inflammation, and other symptoms
  • The amount of your body that is affected by eczema
  • How frequently your eczema flares up
  • How significantly your eczema affects your life

Types of Eczema

Eczema varies from person to person, but there are also different types of eczema. They all cause recurrent skin irritation, but the source, location, and type of irritation are different.

Atopic Dermatitis

Atopic dermatitis is the most common type of eczema, and in fact, some people use the terms interchangeably. People with atopic dermatitis have a weakened skin barrier which makes their skin dry and also leads to immune reactions that cause skin irritation.

Contact Dermatitis

In contact dermatitis, your skin reacts to an irritant or allergen that has physically touched your skin, like cleaning chemicals or nickel. Your skin becomes inflamed and develops a rash.

Dyshidrotic Eczema

Dyshidrotic eczema is a slightly different rash than most types of eczema. It specifically affects your hands, feet, fingers, and toes, and the rash has small blisters.


Neurodermatitis is a unique type of eczema. Your nerves create an itching sensation on your skin, so you scratch the area and eventually cause irritation from the scratching.

Stasis Dermatitis

If you have blood circulation problems, it can lead to skin irritation and dryness in your lower legs. This is called stasis dermatitis.

Nummular Eczema

Nummular eczema also goes by the name discoid eczema. It creates a recurring rash of scattered circular patches on your skin, and these patches are itchy, scaly, and often crusted.

Seborrheic Dermatitis

Seborrheic dermatitis is eczema that specifically affects your scalp and sometimes other areas of your head as well. It’s often mistaken for dandruff because it can cause dry, flaky skin that looks like dandruff.

Symptoms of Moderate to Severe Eczema
Credit: Unsplash

Symptoms of Moderate to Severe Eczema

Curious if you might have moderate to severe eczema? The symptoms are rather noticeable, but they can also be tricky because they mimic so many other conditions.

While each type of eczema has slightly different symptoms, they all have one thing in common: skin rashes that go through repeated cycles of flaring up and fading away. The most common areas to have eczema symptoms are in creases of skin like your elbows and the backs of your knees, as well as your hands, neck, face, and ankles. Of course, this varies based on the type of eczema you may have.

The exact appearance and sensation of the rash vary too. It’s usually itchy, inflamed, and dry or scaly. It can sometimes be swollen as well, and some people have pain while others only have itchiness. In people with Caucasian skin, an eczema rash tends to be pink or red, while it’s more of a brown or grey shade in people of colour.

What Causes Moderate to Severe Eczema?

Medical researchers have not been able to determine specifically why some people have eczema, and others don’t. Genetics are involved, and in many cases, it seems that there is a gene that weakens the skin barrier, opening the door to skin irritation. It’s important to note that eczema is not contagious.

While we don’t know why some people have eczema, we do know that eczema symptoms and flare-ups are typically sparked by certain triggers. The most powerful triggers will vary from person to person, but the most common ones include:

  • Extreme temperatures
  • Dry air
  • Harsh soaps
  • Certain fabrics like synthetic fabrics & wool
  • Chemical additives in laundry detergents
  • Cleaning chemicals
  • Artificial fragrances
  • Certain metals, especially nickel
  • Dust mites
  • Smoke and air pollutants
  • Stress and other intense emotions

Potential Complications of Moderate to Severe Eczema

Moderate to severe eczema is a condition that can significantly affect your day-to-day quality of life because of both the discomfort and the appearance of the rash. The good news is that it is rarely associated with serious risks or complications.

You may be at risk for a bacterial skin infection if you scratch your rash enough to break the skin, allowing bacteria or another contaminant to get into your skin, and these can become severe. You are also at risk for a type of discolouration called post-inflammatory hyperpigmentation or PIH, or a slight darkening of your skin in an area where you have had an eczema rash. However, PIH is cosmetic and not a medical concern.

Treatments for Moderate to Severe Eczema

How does the road ahead look if you have moderate to severe eczema? While there is no cure for eczema, some children who have eczema early in life will outgrow it. For those whose eczema is lifelong, there are a number of treatments that can treat it effectively and keep your symptoms to a minimum.

Prescription Topical Medications

Your doctor may prescribe topical medications like creams to reduce your eczema symptoms. A common option is topical steroids to soothe the inflammation and irritation.

Prescription Topical Medications

Oral Medications

In addition to topical medications, there are oral medications that may be able to help with your eczema – some are prescription-only, and some are over-the-counter. Your doctor may prescribe or recommend medications like antihistamines, anti-inflammatory medicine, or corticosteroids.

Immunosuppressant Medications

Because eczema symptoms often stem from your immune system fighting an allergen, immunosuppressant medications can reduce that immune response and limit your symptoms. This does make you more vulnerable to other illnesses, though, so it’s usually reserved for severe cases.

Lifestyle Changes to Improve Moderate to Severe Eczema

Along with medications, your doctor will recommend lifestyle changes and routines to help you manage your eczema, from skincare to trigger avoidance.

Moisturize Regularly

Dry skin is a core part of eczema, so hydrating your skin routinely can make a powerful difference. Apply moisturizer immediately after you shower each day and apply it to particularly dry areas multiple times every day.

Track and Avoid Your Triggers

The less contact you have with your eczema triggers, the less often you’ll have eczema flare-ups, but you have to figure out what those triggers are first. Start keeping a journal that tracks any contact you have with common eczema triggers and log your symptoms too. Look for patterns of triggers that are often present when your symptoms flare up or get worse. Journal your contact with common triggers and your symptoms.

Choose Products Made for Sensitive Skin

If you have eczema, your skin is more prone to irritation in general compared to others. When you buy skincare products as well as detergents, look for products that are made for sensitive skin. Choose cleaning products as well that are fragrance-free and dye-free, and try to wear soft cotton fabrics rather than synthetic or rough-textured fabrics.

What to Do if You Believe You Have Moderate to Severe Eczema

Do you suspect you may have moderate to severe eczema? We’re here to help. Schedule an appointment with the SRx nearest you to discuss your symptoms and get a care plan in place so you can enjoy healthier, more comfortable skin.

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