Why Does My Eczema Spread When I Scratch It?

If you’ve ever experienced the discomfort of eczema, you may have noticed a frustrating phenomenon: scratching seems to only make it worse. But why does this happen? In this article, we’ll explore the science behind why scratching can cause eczema to spread, and provide some tips on how to alleviate the itchiness without aggravating your skin further. So, if you’ve ever wondered why your eczema seems to have a mind of its own, keep reading to find out more!

Understanding Eczema

What is eczema?

Eczema is a chronic skin condition that causes inflammation and itching. It is characterized by red, itchy, dry, and sometimes scaly patches of skin. Eczema can occur on any part of the body and is often accompanied by a feeling of discomfort and irritation. It is a common skin condition that affects millions of people worldwide.

Types of eczema

There are several types of eczema, each with its own unique characteristics. The most common types include atopic dermatitis, contact dermatitis, nummular eczema, and dyshidrotic eczema. Atopic dermatitis is the most common form of eczema and often starts in childhood. Contact dermatitis is caused by direct contact with an irritant or allergen. Nummular eczema appears as coin-shaped patches of irritated skin, and dyshidrotic eczema causes small blisters on the hands and feet.

Causes of eczema

The exact cause of eczema is still unknown, but it is believed to be a combination of genetic and environmental factors. People with a family history of allergies or asthma are more likely to develop eczema. Additionally, certain triggers, such as irritants, allergens, stress, and changes in temperature or humidity, can worsen eczema symptoms. Understanding the causes of eczema is crucial in managing and preventing its spread.

Effect of Scratching on Eczema

Why does scratching feel good?

Scratching an itchy patch of eczema may provide temporary relief because it stimulates the nerve endings in the skin, diverting attention away from the itching sensation. This act of scratching triggers the release of neurotransmitters, such as serotonin and dopamine, which can temporarily mask the discomfort. However, scratching ultimately leads to more damage and can worsen the condition.

Damage caused by scratching

While scratching may initially relieve itchiness, it can cause physical damage to the skin. Scratching can break the skin, leading to open wounds, bleeding, and the formation of crusts. These wounds are more vulnerable to infection and can slow down the healing process. In severe cases, excessive scratching can even lead to thickening and discoloration of the affected skin.

Connection between scratching and eczema spread

One of the reasons why eczema spreads when scratched is due to a phenomenon called the Koebner phenomenon. This phenomenon refers to the development of new skin lesions or the spread of existing ones in response to physical trauma, such as scratching. When you scratch an already inflamed area, it can trigger the release of chemicals that further promote inflammation and the worsening of eczema symptoms.

Inflammatory Response

Role of immune system

The immune system plays a significant role in eczema. In individuals with eczema, the immune system is overly active and tends to overreact to triggers, leading to inflammation and itching. When you scratch the affected area, it signals your immune system to release inflammatory substances to protect the damaged skin. This inflammatory response is meant to aid in the healing process but can exacerbate eczema symptoms.

Release of histamines

Scratching eczema can also trigger the release of histamines, which are compounds involved in the body’s allergic response. Histamines cause blood vessels to dilate and become more permeable, resulting in redness, swelling, and itching. The release of histamines can further aggravate eczema symptoms and contribute to its spread.

Impact on eczema spreading

By scratching eczema, you are creating a vicious cycle of inflammation and itching. The more you scratch, the more your immune system responds by releasing inflammatory substances and histamines, leading to increased itching and the spread of eczema. It is crucial to break this cycle to prevent the further spread of eczema and alleviate its symptoms.

Koebner Phenomenon

Definition of Koebner phenomenon

The Koebner phenomenon is a unique characteristic of certain skin conditions, including eczema. It refers to the development of new skin lesions or the worsening of existing ones in response to physical trauma, such as scratching, rubbing, or irritation. When you scratch eczema-prone skin, the skin cells become damaged and release cytokines, which are signaling molecules that promote inflammation and the spread of eczema.

Why does eczema spread with scratching?

Eczema can spread with scratching due to the Koebner phenomenon. The damaged skin cells release inflammatory substances and trigger an immune response, which can cause neighboring skin cells to become inflamed and develop into new patches of eczema. This mechanism explains why scratching can result in the spread of eczema beyond the initial affected area.

Contributing factors to Koebner phenomenon

Several factors contribute to the occurrence of the Koebner phenomenon in individuals with eczema. These include the severity of eczema, the intensity and frequency of scratching, the depth of skin trauma caused by scratching, and individual susceptibility to the Koebner phenomenon. Understanding these factors can help individuals with eczema manage their symptoms and prevent the spread of the condition.

Open Wounds and Infection

Risk of open wounds

Excessive scratching can cause the skin to break, leading to open wounds. These wounds are more prone to infection and can significantly delay the healing process. Open wounds provide an entry point for bacteria, viruses, and fungi, increasing the risk of developing infections, such as cellulitis or impetigo. Proper wound care and hygiene are essential to prevent the spread of infection in individuals with eczema.

Infection in eczema

Eczema-prone skin is more susceptible to infections due to its compromised barrier function. The constant itching and scratching can create an entry point for microorganisms, which can then multiply and cause infections. Common signs of infection in eczema include increased redness, warmth, swelling, pain, tenderness, pus, and fever. Prompt medical attention is necessary to address infections and prevent further complications.

Spread of infection

When an infection occurs in eczema-prone skin, it can spread rapidly if left untreated. Bacteria, viruses, and fungi can move from one area of the body to another, leading to the formation of new patches of infected eczema. It is crucial to seek medical help if you suspect an infection in your eczema, as early intervention can prevent the spread of infection and support the healing process.

Psychological Factors

Impact of stress and anxiety

Stress and anxiety can have a significant impact on eczema symptoms. Emotional stress can trigger the release of certain hormones and chemicals in the body that can worsen inflammation and eczema symptoms. Furthermore, stress can also lead to increased scratching due to heightened emotional tension, further exacerbating the condition and its spread. Managing stress and anxiety through techniques such as relaxation exercises, counseling, and mindfulness can help prevent the spread of eczema.

The itch-scratch cycle

The itch-scratch cycle is a recurring pattern in individuals with eczema. It starts with itching, which triggers the urge to scratch. Scratching provides temporary relief but can damage the skin and worsen inflammation, leading to more intense itching. This cycle continues, creating a self-perpetuating loop that can contribute to the spread of eczema. Breaking the itch-scratch cycle is crucial in managing eczema and preventing its spread.

Emotional triggers of eczema spread

In addition to stress and anxiety, various emotional triggers can lead to the spread of eczema. Emotional factors such as anger, frustration, sadness, and even excitement can cause an increase in scratching and exacerbate eczema symptoms. Recognizing and addressing these emotional triggers, as well as implementing stress-management techniques, can help control the spread of eczema.

Preventing Eczema Spread

Using moisturizers

One of the key steps in preventing the spread of eczema is keeping the skin well moisturized. Regularly applying moisturizers or emollients can help repair and strengthen the skin barrier, reducing the risk of inflammation and itching. Choose moisturizers specifically formulated for eczema-prone skin that are free from fragrances and other potential irritants. Apply moisturizers immediately after bathing to lock in moisture and hydrate the skin throughout the day.

Avoiding triggers

Identifying and avoiding triggers that worsen eczema symptoms is essential in preventing its spread. Common triggers include certain fabrics, essential oils, perfumes, harsh soaps or detergents, extreme temperatures, and allergens such as dust mites or pet dander. By minimizing exposure to these triggers, you can help reduce inflammation and control the spread of eczema.

Keeping nails short

Keeping your nails short is an important step in preventing the spread of eczema. Short nails reduce the risk of accidental scratching and the damage it can cause to the skin. Trim your nails regularly and consider wearing gloves or applying fingertip bandages at night to further prevent scratching during sleep. By maintaining short nails, you can minimize the impact of scratching on eczema and reduce its spread.

Treatment Options

Topical creams and ointments

Topical creams and ointments are commonly used to manage eczema symptoms and prevent its spread. These medications can help reduce inflammation, relieve itchiness, and moisturize the skin. Common topical treatments include corticosteroids, non-steroidal anti-inflammatory creams, calcineurin inhibitors, and emollients. It is important to discuss with a healthcare professional to determine the most appropriate topical treatment for your specific condition and symptoms.

Oral medications

In severe cases or when topical treatments are not sufficient, oral medications may be prescribed to control eczema symptoms and prevent its spread. These medications, such as antihistamines, immunosuppressants, or oral corticosteroids, work to reduce inflammation, suppress the immune system, and alleviate itching. Oral medications should only be taken under the guidance and supervision of a healthcare professional.


Phototherapy, also known as light therapy, is a treatment option that involves the controlled exposure of the skin to specific types of light. This treatment can help reduce inflammation and itching in individuals with eczema. Phototherapy is typically conducted under medical supervision and may involve sessions at a specialized clinic or the use of phototherapy devices at home. It is recommended to consult a healthcare professional to determine the suitability and effectiveness of phototherapy for your specific eczema condition.

Home Remedies

Cold compresses

Cold compresses can provide immediate relief from itching and inflammation associated with eczema. Applying a cold compress or a clean, damp cloth to the affected area can help constrict blood vessels, reduce inflammation, and temporarily alleviate itching. Cold compresses can be particularly useful during flare-ups or after scratching, helping to soothe the skin and prevent the spread of eczema.

Oatmeal baths

Oatmeal baths are a popular home remedy for soothing eczema-prone skin. Simply add a cup of finely ground oatmeal to a warm bath and soak in the mixture for around 15-20 minutes. Oatmeal has natural anti-inflammatory properties that can help reduce itching and inflammation. It also forms a protective barrier on the skin, keeping it moisturized and preventing further irritation and spread of eczema.

Natural topical treatments

Various natural remedies can offer relief and help prevent the spread of eczema. These include coconut oil, aloe vera gel, chamomile tea compresses, apple cider vinegar, and honey. These natural substances possess anti-inflammatory, moisturizing, and soothing properties that can calm irritated skin and promote healing. However, it is important to note that natural remedies may not work for everyone, and it is best to consult with a healthcare professional before using them.

When to Seek Medical Help

Severe eczema symptoms

If you experience severe eczema symptoms that significantly affect your daily life, it is essential to seek medical help. Severe symptoms may include intense itching, widespread inflammation, thickening or discoloration of the skin, persistent pain, and difficulty sleeping or concentrating. A healthcare professional can provide a more accurate diagnosis, prescribe appropriate medications, and recommend further treatment options to manage and prevent the spread of eczema.

Persistent spreading

If your eczema continues to spread despite your best efforts to manage it, it is important to consult a healthcare professional. Persistent spreading may be an indication of an underlying issue, such as an allergic reaction, a secondary infection, or a need for stronger treatment options. A healthcare professional can evaluate your condition, assess any contributing factors, and adjust your treatment plan accordingly to prevent further spread.

Signs of infection

If you notice signs of infection in your eczema, such as increased redness, warmth, swelling, pain, tenderness, pus, or fever, it is critical to seek immediate medical attention. Infection in eczema-prone skin can spread rapidly and lead to further complications. Prompt medical intervention can help control the infection, prevent its spread, and support the healing process.

In conclusion, understanding the causes, effects, and management of eczema is crucial in preventing its spread. By avoiding triggers, addressing psychological factors, and following proper skincare routines, individuals with eczema can effectively manage their symptoms and minimize the spread of this chronic skin condition. If symptoms persist or worsen, seeking medical help is always recommended for accurate diagnosis and appropriate treatment.