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Eczema Stages

Different Stages of Eczema Have Different Appearances


Updated July 03, 2014

Eczema Stages

Acute Phase of Eczema

Photo © Heather L. Brannon, MD

Eczema is a term that is used often, but can be confusing because it's often used incorrectly. As technology improves, we are learning more about the actual causes of eczema. This has led researchers to divide eczema into two groups, atopic and non-atopic, based on whether certain parts of the immune system are overactive.

While there are some subtle differences between the appearance of these two eczema types, they often look the same depending on how long the rash has been present. Both rashes can go through the different stages of eczema the longer they persist.

This difference in stages is important because certain treatments work better on different stages of the rash. All three stages respond to antihistamines like Benadryl or Zyrtec and topical steroids. Oral antibiotics like cephalexin and dicloxacillin are useful in all three stages if bacteria have invaded breaks in the skin. Some of the treatments that tend to be useful for each stage are discussed below.

Acute Stage

Acute refers to the fact that the rash has just started. Some characteristics of acute eczema include:
  • Blisters and very red skin
  • Very itchy
  • In addition to the common treatments, cold wet compresses can provide some relief

Subacute Stage

The subacute stage is a transition between the acute and chronic stages. The eczema rash evolves and takes on these new characteristics:
  • Flaky skin that isn't as red as the acute stage
  • Cracks in the skin
  • Itching is not as intense now but the skin can burn and sting
  • Moisturizers and coal tar can be used in the subacute stage for treatment

Chronic Stage

The chronic stage occurs after the rash has been present for a long time. There is no specific time when eczema turns from subacute to chronic. Chronic eczema is different from the other two stages in the following ways:
  • Thickened skin, or lichenification, with accentuated skin lines
  • Cracks in the skin
  • Larger areas of skin breakdown called excoriations
  • Intense itching resumes
  • Topical steroids are often more effective if they are covered with a barrier such as plastic wrap.
  • Moisturizers may also be helpful at this stage.


Habif, Thomas. "Eczema and Hand Dermatitis." Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 41-9.

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