Scratching can worsen eczema (also called atopic dermatitis) for the following reasons:
Skin barrier damage:
Eczema is characterized by a compromised skin barrier. Scratching can further damage this already fragile barrier, making it more susceptible to irritants and allergens.
Scratching triggers an inflammatory response in the skin, causing redness, swelling, and increased itching. The more scratches you have, the more inflamed your skin will be.
Scratching creates an itch-scratch cycle. When you scratch an itch, nerve fibers in the skin release substances that cause itching. While scratching can temporarily relieve itching, it can also stimulate more itching, perpetuating a vicious cycle.
Scratching with dirty nails or dirty surfaces can introduce bacteria into open skin, causing secondary infection. Infection can worsen eczema symptoms and may require additional treatment.
Continuous scratching can lead to lichenification, thickening and hardening of the skin. Lichenified skin is more prone to cracking and can be difficult to manage.
Pigmentation and scarring:
Chronic scratching can lead to hyperpigmentation (darkening of the skin) and scarring, which may persist even after an eczema episode subsides.
Tips to control itching and reduce scratching:
Keep your nails short:
Keep your nails short to minimize damage to your skin when scratching.
To avoid scratching:
Try to resist the urge to scratch. Instead, gentle tapping or tapping can relieve itching.
Keep skin well moisturized. Dry skin can worsen itchiness, so use an emollient or moisturizer regularly.
Apply a cold compress to the affected area to reduce inflammation and relieve itching.
Over-the-counter or prescription anti-itch creams containing ingredients such as hydrocortisone can help relieve itching. Use them under the guidance of a healthcare professional.
In severe cases, your healthcare provider may prescribe topical or oral medications to control eczema symptoms and itching.