Health Library

Atopic Dermatitis

What is atopic dermatitis?

Atopic dermatitis is a chronic skin disorder. It causes dry, itchy, scaly patches on the skin, often on the face and scalp in babies. It’s most common in infants or very young children. Most will show signs of the condition in the first year of life. Symptoms may last until the teens or adulthood. It rarely starts in adulthood. Atopic dermatitis is not contagious.

Atopic dermatitis tends to run in families. This suggests a genetic link. It’s also associated with asthma and allergies, which are immune disorders.

Treatment for this condition is aimed at calming the skin and preventing infections. Good skin care and medicine to control itching and infection are used.

Dermatitis is often called eczema.

What causes atopic dermatitis?

The exact cause of atopic dermatitis is not known. It runs in families, which suggests a genetic link. It’s also linked to asthma and allergies.

Certain triggers can make atopic dermatitis worse. For example, stress, hot or cold temperature, certain fabrics, or detergents can cause a flare-up.

What are the symptoms of atopic dermatitis?

The area of the body affected by atopic dermatitis may change with age. In infants and young children, it usually affects the face, outside of the elbows, and on the knees. In older children and adults, it tends to be on the hands and feet, the arms, and on the back of the knees.

Symptoms are slightly different for each person. Common symptoms include:

  • Dry, scaly patches on the skin
  • Small bumps that open and weep when scratched
  • Redness and swelling of the skin
  • A thickening of the skin (with chronic eczema)

Too much rubbing and scratching can tear the skin and lead to infection.

The symptoms of atopic dermatitis may look like other skin conditions. Always talk with your healthcare provider for a diagnosis.

How is atopic dermatitis diagnosed?

Your doctor will ask about your health history and whether you have allergies or asthma. He or she will also ask about any family history of dermatitis, allergies, or asthma.  

A doctor can often diagnose atopic dermatitis by examining your skin. You may also have a patch test. This is used to find allergies by placing small amounts of allergens on the skin and watching for a response.

How is atopic dermatitis treated?

Factors such as your age, overall health, and health history will help your doctor find the best treatment for you.

There is no cure for atopic dermatitis. The goals of treatment are to reduce itching and inflammation of the skin, to keep the skin moist, and to prevent infection.

Your healthcare provider may also prescribe medicines in severe cases. The following are commonly used to treat atopic dermatitis:

  • Antihistamines. These medicines are taken by mouth. They may help to ease itching. Some examples include diphenhydramine and hydroxyzine. They may cause drowsiness. Some newer antihistamines available don’t cause drowsiness.
  • Steroid creams. These are put on the skin to help ease inflammation, itching, and swelling. Many topical steroids are available in various strengths. If overused, they can cause skin damage.
  • Systemic corticosteroids. These medicines ease inflammation, which can relieve itching. They are used for severe cases. They are available as a pill, liquid, or shot. These steroids have serious side effects from the long-term use. So they are only used for a short time. 
  • Oral antibiotics. These medicines kill bacteria that cause infections. Scratching the affected skin can bring bacteria to the area. This can lead to infection. Always take the antibiotic exactly as prescribed until it is all gone. 
  • Oral cyclosporine. This medicine has been used for years to treat atopic dermatitis that doesn’t respond to other treatments. It was first developed to prevent rejection after organ transplantation. It suppresses the immune system, stopping it from overreacting. This helps prevent flare-ups. It’s available as a capsule or liquid. It has many side effects that should be considered carefully.
  • Phototherapy. Two types are used to treat atopic dermatitis: ultraviolet (UV) light therapy and PUVA (chemophototherapy). Light therapy uses UV light of specific wavelengths to target the immune system. It stops the responses that lead to inflammation. Phototherapy may be used along with other treatment. There are risks and benefits of light therapy. Weigh these risks with your healthcare provider. 
  • Topical immunomodulator. These are a new class of drugs. They are put on the skin to change the immune response.

What are the complications of atopic dermatitis?

Complications of atopic dermatitis include:

  • Dry skin that is easily irritated
  • Skin infections
  • Eye problems such as eyelid dermatitis or cataracts
  • Difficulty in personal, family, and/or work relationships

Can atopic dermatitis be prevented?

Because the cause of atopic dermatitis is not known, there is no known way to prevent it. But avoiding triggers may reduce flare-ups.

Living with atopic dermatitis

The following steps can help manage atopic dermatitis:

  • Avoid triggers
  • Take brief baths or showers using lukewarm water.
  • Practice good skin care.
  • Prevent infections.
  • Don’t use harsh soaps. Ask your health care provider to recommend a brand.
  • Dress in light clothes. Sweating can make atopic dermatitis worse.
  • Use a good moisturizer at least once a day. Ask your health care provider to recommend a brand.
  • Avoid scratching the affected area.
  • Minimize stress.
  • Make lifestyle changes that prevent flare-ups.

When to seek medical care

Tell your healthcare provider if your symptoms get worse or you have new symptoms.

Key points about atopic dermatitis

  • Atopic dermatitis is commonly called eczema.
  • It’s an inherited and chronic skin disorder that is most common in infants or very young children.
  • Atopic dermatitis causes dry, scaly, red skin that has red bumps that open and weep when scratched.
  • It’s important to find and avoid things that make atopic dermatitis worse. Triggers include stress, high or low temperatures, bacterial infections, fabrics such as wool, and detergents.
  • The goals of treatment are to reduce itching and inflammations of the skin, to keep the skin moisturized, and prevent infection.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
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