The Consequences of Misdiagnosed Eczema: Why It Happens - Verywell Health

Eczema is a chronic skin condition that causes a scaly, itchy, inflamed, and sometimes painful rash. Eczema is very common, affecting one in 10 Americans. However, the diagnosis criteria for eczema are not very specific, and skin conditions often have similar appearances. Plus, there is no definitive test to diagnose eczema. That can lead to eczema misdiagnosis.  

This article will explain why eczema misdiagnosis can occur and why it's important to get a proper diagnosis for your skin condition. 

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For an Official Diagnosis, Visit a Dermatologist

Misdiagnosis can often occur because primary care physicians aren't familiar with various skin conditions. In fact, a small 2020 study found that about 48% of skin conditions were misdiagnosed by general practitioners.


So, if you have recurring skin issues, it's best to see a board-certified dermatologist. These doctors are best qualified to diagnose eczema. 

How Is Eczema Diagnosed?

There's no simple test for diagnosing eczema. Healthcare providers will consider your symptoms and family history to determine whether you have the condition. Symptoms that start before age 5, a pattern of chronic flares or relapses, and a family history all indicate eczema. However, eczema can also begin in adulthood. 

What if a Provider Misdiagnoses You?

If you receive an eczema diagnosis but are not responding to medications, it could be a sign that you've been misdiagnosed. Or, you may have eczema and another skin condition. This is common because skin conditions can overlap or occur at the same time. 

If you don't respond to treatment, see a dermatologist. Ask them why you aren't seeing improvement with eczema treatment and whether or not they've considered that you may be misdiagnosed. If you're already working with a dermatologist, seek a second opinion about your diagnosis. 

Conditions Associated With Misdiagnosed Eczema

There are two ways that eczema misdiagnosis can occur: you can have eczema and be diagnosed with another condition or you can have another condition and be misdiagnosed with eczema. 


Either way is problematic because a proper diagnosis opens the door to treatment and symptom management. Here are the skin conditions that are commonly confused with eczema, leading to misdiagnosis. 

Ringworm

Telling the difference between ringworm and eczema is difficult. Like eczema, ringworm can cause dry, inflamed, itchy skin. Eczema is an inflammatory condition, while ringworm is a fungal infection, so they need very different treatments. 

Psoriasis

Psoriasis and eczema are both chronic skin conditions that cause itchy, inflamed rashes. Telling them apart can be very difficult, but there are subtle differences: for example, psoriasis is usually less itchy and causes more plaques on the skin. Some treatments, like moisturizing, work for both conditions. However, medical treatments differ, so a proper diagnosis is important. 

Scabies

Scabies is a rash caused by microscopic mites. It can appear similar to eczema, especially in infants. Both conditions cause itching, red patches, and flaky skin. Scabies is contagious, so you and everyone in your household will need treatment. Getting prompt treatment can keep the mites from spreading to other people. 

Seborrheic Dermatitis

Seborrheic dermatitis is an inflammatory condition that causes dandruff. In babies, it's often known as cradle cap. It's about as common as eczema. Like eczema, this is a chronic condition where symptoms wax and wane. However, the treatments differ, so it's important to have a proper diagnosis in order to better control your symptoms. 

Mycosis Fungoides

Mycosis fungoides is a type of lymphoma, or cancer of the lymph system. It can cause a red, itchy rash that's often misdiagnosed as eczema, especially in children. Mycosis is a cancer that grows very slowly and has a good prognosis. However, it's critical to get treatment to keep the cancer from spreading to other areas of the body. 

Treatment for Skin Conditions Isn't Identical

Eczema can be difficult to treat. However, progress in treating the condition continues to be made. In order to access new treatments, you need to have a proper diagnosis. In addition, in some cases, eczema can be mistaken for even more serious conditions, like mycosis. In those cases, getting a proper diagnosis can be lifesaving. 

Summary

Instead, eczema is diagnosed based on your symptoms and family history. However, it's possible for eczema to be misdiagnosed because the symptoms of many skin conditions overlap or mimic each other. If you've been diagnosed with eczema but are not responding to treatment, talk to a dermatologist about whether you may have a different skin condition. 

A Word From Verywell

Eczema can take a toll on your mental health and well-being. The condition is already tough to live with, so it's important that you have a proper diagnosis. This will help open the door to more effective treatments. If you ever question your diagnosis, talk with your doctor or seek a second opinion. 

Frequently Asked Questions

  • It's easy to mistake eczema for another skin condition, or vice versa. Many skin conditions have overlapping symptoms, like dry, itchy, inflamed skin. If you believe you've been misdiagnosed, talk to your doctor about your concerns. 

  • Eczema is closely associated with asthma and allergies, including hay fever. It's also linked to mental health conditions including depression and anxiety. People with eczema are also at increased risk of some infections.

  • Eczema is linked to having an overactive immune system. This may also put you at risk for other autoimmune diseases, but that does not mean they are caused by your eczema. 

11 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Dermatology Association. Eczema types: atopic dermatitis overview.

  2. Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic dermatitis in America study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population. J Invest Dermatol. 2019. doi:10.1016/j.jid.2018.08.028

  3. Onsoi W, Chaiyarit J, and Techasatian L. Common misdiagnoses and prevalence of dermatological disorders at a pediatric tertiary care center. The Journal of International Medical Research. 2020. Doi: 10.1177/0300060519873490

  4. Siegfried EC, Hebert AA. Diagnosis of atopic dermatitis: Mimics, overlaps, and complications. Journal of Clinical Medicine. 2015. doi.org: 10.3390/jcm4050884.

  5. Pierre Fabre Eczema Foundation. Are you sure it's eczema?

  6. Centers for Disease Control and Prevention. About ringworm. 

  7. Micali G, Lacarrubba F, Verzì AE, et al. Scabies: advances in noninvasive diagnosis. PLoS Negl Trop Dis. 2016;10(6):e0004691. doi:10.1371/journal.pntd.0004691

  8. Dessinioti C, Katsambas A. Seborrheic dermatitis: etiology, risk factors, and treatments: facts and controversies. Clin Dermatol. 2013 Jul-Aug;31(4):343-51. doi:10.1016/j.clindermatol.2013.01.001

  9. Medline Plus. Mycosis fungoides.

  10. National Eczema Association. Conditions related to eczema.

  11. National Eczema Association. Is eczema an autoimmune disease? Spoiler alert: nope.

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.

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