What Happens If You Scratch Eczema?

Have you ever wondered what happens when you scratch eczema? It’s a question many people with this skin condition have asked. Eczema, also known as atopic dermatitis, is a chronic inflammation of the skin that causes itching, redness, and dryness. While it may be tempting to relieve the itch by scratching, doing so can actually worsen the symptoms and lead to further complications. In this article, we will explore what happens when you scratch eczema and why it’s best to resist the urge.

The Itch-Scratch Cycle

Having eczema can be a frustrating experience, especially when the unbearable urge to scratch arises. This itch-scratch cycle is a complex process that occurs with eczema and has a significant impact on the skin. When you scratch your eczema-affected skin, it releases histamines. These histamines are responsible for triggering the itching sensation, causing you to scratch even more. This cycle can quickly become relentless, intensifying the itching and making it difficult to resist the urge to scratch.

Release of Histamines

Histamines are chemicals that your body releases in response to an irritant or allergen. In the case of eczema, scratching the affected area stimulates the release of histamines, leading to an even greater itch. This release of histamines further exacerbates the itch-scratch cycle and can make the itching sensation feel unbearable.

Intensified Itching

The relentless scratching caused by the itch-scratch cycle leads to intensified itching. As you scratch, the nerve fibers in your skin become stimulated, eliciting more itch signals and intensifying the urge to continue scratching. This intensified itching can result in a vicious cycle, making it challenging to break free from the itch-scratch cycle.

Damage to the Skin

Persistent scratching can cause significant damage to the skin. The constant friction and pressure can lead to the breakage of the skin barrier, leaving it vulnerable to external irritants and bacteria. The damaged skin can become dry, cracked, and painful, compromising its ability to protect against infections and other environmental factors.

Risk of Infection

When the skin barrier is compromised due to scratching, there is an increased risk of bacterial invasion. Bacteria can easily enter through the broken skin, leading to the development of skin infections. These infections can cause further discomfort, redness, and swelling, prolonging the healing process and potentially causing additional complications.

Breakage of Skin Barrier

Continued scratching breaks down the protective layer of the skin, creating small openings through which bacteria can enter. These openings can range from microscopic to visible wounds, depending on the severity of scratching. The breakage of the skin barrier not only increases the risk of infection but also impedes the skin’s ability to heal.

Bacterial Invasion

Once the skin barrier is compromised, bacteria can invade the damaged areas. Common strains of bacteria, such as Staphylococcus aureus, can cause skin infections characterized by increased redness, warmth, and sometimes pus or crusting. These infections require medical intervention to prevent further complications.

Development of Skin Infections

The presence of bacterial invasion in the damaged skin can lead to the development of various skin infections. These infections can range from mild impetigo to more severe cellulitis. Skin infections can further intensify itching, exacerbate eczema symptoms, and extend the healing process.

Delayed Healing

Impaired skin regeneration is a consequence of persistent scratching. As the skin barrier is continually compromised, the normal process of skin regeneration is disrupted. This impaired regeneration leads to a prolonged healing time, making it difficult for the skin to fully recover from eczema flare-ups.

Prolonged Recovery Time

Eczema flare-ups typically resolve on their own with time, but scratching can significantly delay the recovery process. The constant irritation, inflammation, and bacterial infections resulting from scratching can lengthen the time it takes for the skin to heal. Therefore, avoiding scratching is crucial for promoting faster recovery.

Worsened Eczema Symptoms

The itch-scratch cycle not only prolongs the healing process but also worsens eczema symptoms. Continuous scratching leads to increased inflammation, causing the skin to become even more red, swollen, and itchy. Additionally, the constant scratching can make the skin thicker and rougher, further exacerbating the appearance and discomfort associated with eczema flare-ups.

Increased Inflammation

Scratching triggers a cascade of inflammation in the skin. As you scratch, more histamines are released, leading to an increased immune response and inflammation. This inflammation can make the skin red, tender, and warm to the touch. The longer the itch-scratch cycle persists, the more intense and widespread the inflammation becomes.

Redness and Swelling

Inflamed skin is often accompanied by redness and swelling. As the body’s immune response is activated, blood vessels in the affected area dilate, leading to increased blood flow. This increased blood flow causes the skin to appear red and can contribute to the swelling experienced during eczema flare-ups.

Thicker and Rougher Skin

Continued scratching can result in the thickening and roughening of the skin. The repetitive trauma caused by scratching causes the outer layer of the skin to become thickened and calloused. This thickening can make the skin feel rough, dry, and scaly, further adding to the discomfort and self-consciousness associated with eczema.

Scarring and Hyperpigmentation

Persistent scratching can leave permanent marks on the skin, known as scars. These scars can range from small, superficial marks to deeper, more noticeable indentations. Additionally, frequent scratching can lead to hyperpigmentation, causing the affected areas of skin to become darker than the surrounding skin. These marks and discolorations can persist long after the eczema flare-up has subsided.

Permanent Marks on the Skin

Deep scratching can cause damage to the deeper layers of the skin, resulting in permanent marks. These marks may appear as indentations, depressions, or changes in skin texture. While they may fade over time, they can leave a lasting reminder of the itch-scratch cycle and the damage caused to the skin.

Darkening of Affected Areas

Hyperpigmentation is a common consequence of persistent scratching. The prolonged inflammation and damage to the skin in eczema-affected areas can lead to an increase in melanin production, causing the skin to darken. This hyperpigmentation can take months or even years to fade, affecting the overall appearance and self-esteem of individuals with eczema.

Spread of Eczema

The itch-scratch cycle can cause eczema to spread, extending to nearby unaffected areas. The act of scratching can transfer the inflammatory response and histamines to neighboring skin, triggering new patches of eczema. This spreading of eczema can make the condition more challenging to manage and control.

Extension to Nearby Unaffected Areas

Through scratching, the inflammation and histamines can spread to previously unaffected areas of the skin. This can lead to the development of new eczema patches, expanding the area affected by the condition. It is essential to avoid scratching to minimize the risk of spreading eczema to healthy skin.

Development of New Patches

The spread of eczema can result in the development of new patches on the skin. These patches may appear as red, itchy, and dry areas and can be particularly distressing for individuals already dealing with existing eczema. Preventing the itch-scratch cycle is crucial to minimize the occurrence of new patches and manage the condition effectively.

Increased Sensitivity

Persistent scratching can lead to heightened sensitivity in the affected skin. The nerve fibers become hypersensitive as a result of the continuous stimulation, making the skin more prone to sensations of burning, stinging, or discomfort. This increased sensitivity can further contribute to the itch-scratch cycle and make it even more challenging to resist scratching.

Heightened Skin Sensitivity

As a result of the itch-scratch cycle, the skin can become more sensitive to various stimuli. Even mild irritants or gentle touch can trigger a heightened sensation of discomfort, leading to a desire to scratch. It is essential to avoid further aggravating the skin and protect it from potential triggers to minimize discomfort and promote healing.

Sensation of Burning or Stinging

Individuals with eczema who engage in persistent scratching may experience sensations of burning or stinging in the affected areas. The damaged and inflamed skin can become more sensitive to these sensations, intensifying the overall discomfort and impacting daily activities. Breaking the itch-scratch cycle is crucial to alleviate these distressing sensations.

Psychological Impact

The effects of the itch-scratch cycle extend beyond physical discomfort and can have a significant psychological impact. Dealing with chronic itching, constant skin irritation, and visible signs of eczema can lead to emotional distress. The frustration, embarrassment, and self-consciousness associated with eczema can have a detrimental effect on an individual’s mental health and overall quality of life.

Emotional Distress

Living with eczema and the relentless itch can take an emotional toll on individuals. The constant discomfort, appearance-related concerns, and limitations in daily activities can lead to feelings of frustration, sadness, and even depression. It is essential to seek support and effective management strategies to address the emotional distress associated with eczema.

Impact on Quality of Life

Eczema and the itch-scratch cycle can significantly impact an individual’s quality of life. The persistent itching and discomfort can disrupt daily activities, affect sleep patterns, and interfere with personal relationships and work productivity. It is crucial to manage eczema effectively and seek help from healthcare professionals to improve overall well-being.

Sleep Disturbances

The itch-scratch cycle can cause significant sleep disturbances, further exacerbating the impact on quality of life. The constant itching can make it difficult to fall asleep or stay asleep, leading to fatigue, irritability, and difficulties concentrating during the day. Establishing good sleep hygiene practices and managing eczema symptoms can help improve sleep patterns and overall well-being.

Potential for Allergic Reactions

Persistent scratching can worsen eczema symptoms and increase the risk of developing secondary allergies. The damaged and inflamed skin is more susceptible to reacting to various substances, leading to intensified symptoms. Additionally, the itch-scratch cycle can disrupt the skin’s natural barrier function, making it easier for allergens to penetrate and trigger allergic reactions.

Exacerbation of Eczema Symptoms

Continued scratching can exacerbate eczema symptoms, including redness, itching, dryness, and flakiness. The disruption of the skin barrier and constant inflammation can make the skin more reactive and sensitive, intensifying the overall allergic response. It is crucial to break free from the itch-scratch cycle to minimize the risk of worsening eczema symptoms.

Risk of Secondary Allergies

As the itch-scratch cycle persists, the damaged skin becomes more susceptible to developing new allergies. The continuous exposure to potential allergens, combined with the compromised skin barrier, can trigger an immune response and sensitization to certain substances. This increases the risk of developing secondary allergies, further complicating the management of eczema.

Potential Complications

Persistent scratching can lead to various complications associated with eczema. These complications can have long-term effects on the skin and often require medical intervention to manage effectively. Some potential complications include eczema herpeticum, neurodermatitis, and thickened and discolored skin.

Eczema Herpeticum

Eczema herpeticum is a rare but severe complication that can occur when eczema-affected skin becomes infected with the herpes simplex virus (HSV). Symptoms may include a rapidly spreading rash, fever, and the development of blisters. Eczema herpeticum requires immediate medical attention and antiviral treatment to prevent severe complications.


Persistent scratching can lead to the development of neurodermatitis, a condition characterized by thickened, rough, and leathery skin. Neurodermatitis typically occurs in localized areas on the body, such as the neck, wrists, or ankles, and is triggered by repetitive scratching and itching. Effective management of eczema and breaking the itch-scratch cycle are essential to prevent the development or worsening of neurodermatitis.

Thickened and Discolored Skin

Long-term scratching can cause the skin to thicken and become discolored. This thickening is known as lichenification and results from the repetitive trauma and inflammation caused by scratching. The affected skin may appear darker, rougher, and more leathery than the surrounding skin. The development of thickened and discolored skin can be challenging to treat and may require specialized care from healthcare professionals.

In conclusion, breaking the itch-scratch cycle is crucial for managing eczema effectively and minimizing its impact on your skin and overall well-being. By understanding the potential consequences of scratching, including intensified itching, the risk of infection, delayed healing, worsened eczema symptoms, scarring, and the spread of eczema, you can take proactive steps to break free from the cycle. Remember to seek support from healthcare professionals, adopt a consistent skincare routine, and implement strategies to relieve itching and minimize triggers. With proper management and care, you can improve your quality of life, reduce the risk of complications, and maintain healthy skin.