In the Journal of Allergy and Clinical Immunology study cited above, Dr. Silverberg and colleagues found that patients with mild eczema were more likely to have pain related to scratching, while those with moderate or severe eczema felt more constant discomfort and aching due to inflammation.

The researchers noted that for most eczema patients with pain, the issue was linked to open parts of the skin caused by scratching (27 percent) and with fissures in the skin (27 percent). About one-quarter said they were hurting from inflamed skin. Just 10 percent reported a burning sensation caused by topical medications like steroid creams.

Karan Lal, DO, a dermatologist and the chairman of the social media committee for the Society for Pediatric Dermatology, says that when inflamed skin opens up, exposed nerves increase the risk of pain as well as infection.

“I think a lot of people who get pain have more active eczema that is inadequately controlled and have chronic disease in the common eczema sites,” says Lal.

One Young Patient’s Battle

Dr. Lal described the experience of one of his pediatric patients who was highly active in sports and had severe eczema behind his knees that resulted in extreme pain. The 10-year-old’s pants rubbed against the affected areas of his legs, staining his jeans with blood and making the pain even worse.

Lal treated the boy with ointments and a topical steroid medication, and he instructed the parents to make sure their son’s legs were wrapped and lubricated at all times. Lal also prescribed Tylenol for pain relief.

“It was really aggressive management — he had to do these wraps on weekends when he could stay at home and rest and not move around a lot,” said Lal. “It took about nine days or so to clear him up, but it helped a lot.”