Similarities, differences, treatment and more

Eczema is also known as atopic dermatitis. It is a chronic problem that is often rooted in the immune system. Eczema is a common condition in children affecting up to 20 percent of all children, but it can also appear for the first time in adulthood.

There are many types of eczema, and the symptoms and triggers can vary depending on the type. Symptoms include:

• drought
• itching which may be worse at night
• discolored spots on the skin
• scaly, cracked skin
• chronic problem with periodic flare-ups
• Raised bumps that may be filled with fluid or have crusted edges
• rough patches of skin

In people of color, eczema may appear differently. In ethnic groups with different skin colors, the rash can be difficult to see. For people with dark skin, eczema usually appears as:

• drought
• swelling of the skin
• flaking
• goosebumps or bumps around hair follicles
• thick, raised nodules
• dark circles around the eyes

Eczema tends to appear in certain areas of the body like the face and scalp, or extremities like the arms or legs. The disease is usually linked to other immune disorders such as food allergies, allergic rhinitis, and asthma.

Eczema that begins in childhood can go away during the first few years of life. But when it doesn’t, the key is to control symptoms by avoiding known triggers. Triggers for eczema vary from person to person, but can include:

• long showers or hot baths
• scratch
• sweat
• Heat
• cold and dry weather
• soaps, detergents and cleaners
• wool and synthetic fabrics
• physical irritants (dirt, sand, smoke)
• allergens (pollen, dander, dust)
• stress

Urticaria, or hives, is often associated with acute or singular allergic reactions, but it can also be chronic. Hives appear as a raised area that is often itchy or red. Although allergic reactions are a common culprit, they can also have physical or autoimmune triggers. These include heat, cold, vibrations or even stress.

Autoimmune triggers are triggered by antibodies to an allergen or an individual condition. In some cases, it can be difficult to identify specific triggers for chronic urticaria, and these cases are called chronic idiopathic urticaria.

In most cases, hives go away within hours to days, but can come and go when linked to another chronic condition. Allergy testing can help identify triggers, which is essential for preventing chronic and acute hives.

Hives may be more difficult to detect in people with colored skin where pink or red tones are not easy to see. In colored skin, hives may appear only as raised or inflamed areas and may even be mistaken for other types of rashes.

While eczema and hives appear with rash-like symptoms and are triggered by the immune system, there are differences between them.

Each has specific triggers, and the way they respond to immune cells varies.

There are a few subtle signs to help you decide if your rash is eczema or hives.

• Eczema most often presents as dry, rough pink patches on the skin or tiny blisters, called dyshidrotic eczema, on the hands.
• Hives usually come in the form of wheels – or larger bumps – that aren’t often filled with liquid. Instead, mast cells, a type of immune cell, release chemicals like serotonin and histamine. These build up under the skin’s surface to fight the allergen that triggered the reaction.
• While hives can be itchy on their own, eczema papules often appear as a result of dry or itchy skin.
• If you have chronic urticaria or eczema, your flare-ups may be related to certain environmental conditions or triggers. Keeping a journal of when irritation occurs can help identify any common threads.

There are several things you can do to help resolve, improve, or prevent eczema flare-ups. One of the main goals of eczema management is to minimize triggers and keep the skin hydrated. These include:

Treatment for hives will depend on what triggered the reaction in the first place. Triggers can include things like stress, temperature changes, or allergens. There are several treatment options for hives, such as:

• avoiding irritants and other triggers
• natural remedies to soothe and moisturize the skin
• over-the-counter or prescription antihistamines or steroids to control allergic reactions

Some people may be more prone to eczema than others. There may be a genetic component to eczema, and people whose family members have eczema are more likely to develop the disease themselves.

Other allergic or immune conditions like hay fever, food allergies, and asthma can also increase your risk for eczema.

People who have a history of allergies or certain medical conditions may be more prone to hives than others. Apart from allergies, people with the following conditions may experience hives more often:

In most cases, eczema is a chronic disease. It impacts 10 to 20 percent of children and 3% of adults in the United States. Most cases of chronic eczema start in childhood, and it is less common for this disease to appear in adulthood without a history of childhood. In some cases, eczema may go away after childhood.

With hives, acute cases can resolve themselves in just a few hours. Other times, especially in chronic cases, the hives can last for weeks. Chronic urticaria will also come and go as exposure to triggers or certain conditions changes.

With eczema and hives, the key to managing these conditions is to identify the triggers or allergens and find ways to avoid them or at least reduce your exposure. There are several treatments and medications that can help you manage flare-ups. Talk to your doctor about holistic, over-the-counter or prescription options.

Eczema and hives have similar characteristics but are not the same rash. One thing these conditions have in common is that they can be related to a trigger or an allergen.

Identifying allergens and trying to avoid certain triggers is essential for managing acute cases of hives and chronic urticaria or eczema. Talk to a doctor about how to identify and manage your triggers.