Eczema & Atopic Dermatitis

Eczema is a group of conditions that leave the skin dry, itchy and inflamed. The most common form is atopic dermatitis, in which the skin barrier does not hold moisture well and the immune system overreacts to ordinary triggers. It usually starts in childhood and often eases with age, but it can begin or carry on in adulthood, and it comes and goes in flares.

What eczema is, and what it is not

It is not a hygiene problem, and it is not contagious. The skin barrier itself behaves differently, which is why moisturising and bathing routines are part of care rather than an afterthought. It is also not usually caused by one food or one product: triggers vary from person to person, and for most people no single culprit is ever found.

The itch is not a minor detail either. It is often the hardest part, it disrupts sleep, and it can continue even when the visible skin looks better. Eczema also does not look the same on every skin tone: the Canadian Dermatology Association notes that on darker skin it often appears ashen, brown or grey rather than red, which can make it harder to recognise.

Signs and symptoms

• Intense itching, which is often the most difficult symptom
• Dry, scaly or rough patches of skin
• Redness on lighter skin, or ashen, brown, grey or purple tones on darker skin
• Skin that weeps, crusts, or becomes thickened and leathery over time
• Cracking, especially on the hands, behind the knees and inside the elbows
• Broken sleep caused by night-time itching
• Skin infections, which can follow scratching

Severity ranges widely. The Eczema Society of Canada describes the majority of Canadian cases as mild to moderate, and the same person can have long settled stretches between flares.

What raises the risk

Some things cannot be changed:

• A personal or family history of eczema, asthma, hay fever or food allergy
• Genetic differences affecting the skin barrier
• Age at onset, since most cases begin in early childhood
• Climate and environment, including cold, dry Canadian winters

Others can often be worked on, usually with support from a health care team:

• Contact with fragranced products, harsh soaps and detergents
• Dust, animal dander, smoke and other triggers you have identified
• Skin dryness from infrequent moisturising, long hot showers, and scratching

How eczema is diagnosed in Canada

Eczema is diagnosed clinically. A family doctor, nurse practitioner, paediatrician or dermatologist looks at the pattern, location and appearance of the rash, and asks about itch, family history of allergic conditions, and what makes it worse. No blood test confirms atopic dermatitis, although testing is sometimes used when allergy or another diagnosis is being considered. The Canadian Dermatology Association notes that patch testing is used specifically when allergic contact dermatitis is suspected.

Treatment and day-to-day management

Clinical research for Eczema & Atopic Dermatitis is enrolling. See the current studies ↓

Care in Canada usually combines daily skin care with something to settle inflammation during a flare, plus attention to itch and sleep. Depending on your situation and what matters to you, a health care team may discuss:

• Daily skin care with moisturisers and bathing routines to support the skin barrier
• Topical anti-inflammatory treatments, including topical corticosteroids and non-steroidal options such as calcineurin inhibitors, PDE4 inhibitors and topical JAK inhibitors
• Phototherapy delivered in clinic settings
• Systemic treatments for moderate to severe disease, including biologics that target type 2 inflammation and oral JAK inhibitors
• Identifying and avoiding triggers, managing itch and sleep, and treating skin infection when it occurs

Cost can shape what is realistic. In the Eczema Society of Canada 2025 survey, 25% of respondents reported a financial burden from treatment costs and 13% had delayed a prescription treatment because of cost, rising to 26% among those with severe eczema. Coverage differs by province, territory and private plan. What suits one person will not suit another, and which of these applies to you is a decision for you and your own clinician. This page is not a recommendation about any of them.

When to talk to a doctor

• See a clinician if itching disrupts sleep, school or work, if a rash keeps coming back, or if moisturisers and over-the-counter products are not enough.
• Book an appointment promptly for signs of skin infection, including yellow crusting, weeping, pus, increasing pain, spreading redness or fever.
• Seek urgent care for widespread painful blistering, for a rapidly worsening rash with fever and feeling unwell, or for eczema with a cluster of small punched-out sores, which needs immediate assessment.

Why clinical research matters for eczema

Researchers are still working out why the skin barrier and immune system behave differently in some people, why itch persists even when visible skin improves, and how to predict who will respond to which treatment. Canada also has no current national prevalence data: the figures above come from a national organisation, from one province\’s primary care records, and from a survey of 389 self-selected respondents, 77% of whom identified as BIPOC, so none of them is a representative national measurement. That survey also found that 44% of respondents said health care providers rarely or never ask about quality of life, while 83% want to be asked. Studies now recruiting include newer biologics and targeted oral medicines, non-steroidal topicals, treatments aimed specifically at itch, prevention studies in infants at high risk, and work on recognising and assessing eczema across the full range of skin tones.

Clinical studies are how those questions get answered. Taking part is voluntary, you give informed consent before anything begins, and you can stop at any time without affecting the care you get from your own doctor. Joining a study does not mean giving up your current treatment, and no one can tell in advance whether a study will help you personally.

Learn more from Canadian sources

• Eczema Society of Canada
• Canadian Dermatology Association: eczema
• Canadian Skin Patient Alliance
• Eczema Society of Canada: The Burden of Eczema in Canada 2025 survey report