What Is Atopic Dermatitis?
Atopic dermatitis is the most common type of eczema, a skin condition that makes you itch and leaves red blotches, usually on your face, arms, and legs. While it happens most often in children, it also affects an estimated 18 million adults. The rashes tend to flare and go away, but then come back again.
Atopic Dermatitis Symptoms
Most people will have their first signs of eczema before they’re 5 years old. Infants may have red, crusted, scaly areas on their cheeks, scalp, or the front of their arms and legs.
Children and adults usually have very itchy, red rashes on the back of the neck and knees and in elbow creases. You may also have small bumps and flaky skin. The rash may also develop on the face, wrists, and forearms.
If you scratch, your skin can get thick, dark, and scarred. Itchiness is usually worse at night when you go to bed.
Scratching can also lead to infection. You'll notice red bumps that hurt and can be filled with pus. Be sure to see your doctor if this happens.
Other symptoms of atopic dermatitis include:
Scaly, dry skin
Rash that bubbles up, then weeps clear fluid
Cracked skin that hurts and sometimes bleeds
Skin creasing on the palms of the hand or under the eye
Darkening of skin around the eyes
Atopic Dermatitis Causes
Doctors aren't sure what causes eczema. It seems to run in families, so if one of your parents or siblings has it, there may be a stronger chance that you or your child will have it, too.
Kids with it sometimes have someone in the family who has allergies, hay fever, or asthma. Some experts think that makes them more likely to get eczema. About half of kids who get it will also get hay fever or asthma.
Living somewhere that’s often cold or has a lot of pollution may increase your chances of getting it, as well.
Food allergies don’t cause atopic dermatitis. But having atopic dermatitis may raise your risk for food allergies, such as to peanuts for example.
Atopic dermatitis isn't contagious. You can't catch it or give it to someone else.
Atopic Dermatitis Triggers
Your skin might be fine for a long time. But then something happens to cause a rash or itchiness. Some things that trigger atopic dermatitis or make it worse include:
Strong soaps and detergents
Some fabrics, like wool or scratchy materials
Perfumes, skin care products, and makeup
Pollen and mold
Stress and anger
Dry winter air/low humidity
Long or hot showers/baths
Skin infections or especially dry skin
Dust or sand
Certain foods (usually eggs, dairy products, wheat, soy, and nuts)
Atopic Dermatitis Diagnosis
If your doctor thinks you may have atopic dermatitis, they’ll start by asking you about your medical history and do a physical exam. They may also suggest a skin patch allergy test.
This kind of test can help you and your doctor figure out if your rashes are caused by an allergy to something you touch. You wear skin patches that have small amounts of things you might be allergic to in them for a couple of days. About 2 days after you take the patches off, your doctor will see if you have a rash around any of them.
Atopic Dermatitis Treatments and Home Remedies
You can't cure eczema, but your doctor may suggest some medication for your symptoms. These might include steroid creams or ointments for mild flares or steroid pills for more severe cases.
Other treatments may include:
Antihistamines to control itching, especially at night
Antibiotics if you have a bacterial infection
Drugs to suppress your immune system such as crisaborole (Eucrisa), a non-steroidal ointment that is used topically twice a day, and dupilumab (Dupixent), which is given as an injection every 2 weeks.
Injectable biologics: These newer medications are made from a kind of protein that helps your immune system fight off germs. They’re designed to slow down your immune system and ease the inflammation that leads to atopic dermatitis.
Other skin creams
You can do a few things at home to ease your flares:
Take warm oatmeal baths. Antioxidants in ground oatmeal may help ease inflammation and itching. Take a 10-minute bath, then moisturize your skin right away.
Use a humidifier. Adding moisture to the air can help keep your skin from drying out and being itchy.
Don’t scratch your skin. Try putting pressure on itchy areas instead of scratching them, and keep your nails trimmed. With children, you may want to have them wear gloves at night to keep them from scratching while they sleep.
Wear loose clothing that won’t bother your skin. Loose-fitting clothes won’t rub against your skin, and they can help keep you from sweating.
To treat it in babies (infantile eczema), use bath oils and creams after a bath to keep their skin moist and ease irritation. It’s also best to keep them out of extreme hot or cold temperatures. If the rash doesn’t go away, your pediatrician might recommend a medication with an antihistamine to help with the itching.
Atopic Dermatitis Complications
Flares caused by atopic dermatitis can sometimes cause or be linked to other health issues, like:
Asthma. This lung condition can be more likely in children with immune systems that have been affected by atopic dermatitis.
Neurodermatitis. Also known as lichen simplex chronicus, this can start as a small patch of itchy skin but gets bigger as you scratch. Over-the-counter medications can help, but the key is to resist the urge to scratch.
Skin infections. Scratching enough to break the skin can open up cuts that lead to infection.
Irritant hand dermatitis. This condition happens when you have a job or do something where you keep your hands in water for long periods of time or you often use harsh soap or detergents.
Allergic contact dermatitis. Also known as contact allergy, this happens when you touch something you’re allergic to.
Sleep issues. Itching can keep you awake at night and keep you from getting enough rest.
Atopic Dermatitis Prevention
After a flare-up, you can do things to keep your skin healthy and make another one less likely.
Avoid triggers. Figure out what causes your skin problems and try to avoid those triggers. For example, if certain soaps or fabrics seem to cause rashes, stop using them. Try to avoid cigarette smoke, animal dander, and pollen if those seem to make your skin worse.
Take care of your skin. It's key to keep your skin moisturized. The best choices are thick creams or ointments that have little water. Put them on as soon as you get out of the shower or bath while your skin is still wet.
Take shorter showers and baths. Limit your showers to 10 minutes, and use warm water instead of hot. After your bath, pat your skin dry with a towel then moisturize right away. An occasional bath with a small amount of household bleach also may help. Use only about a half-cup of bleach for a 40-gallon tub. Never duck your head under the water, and don’t take a bleach bath more than twice a week.
Use gentle soaps. Use only mild soaps on your skin. Deodorant or antibacterial soaps have ingredients that can dry it out.