Overview

Atopic dermatitis (eczema) is a condition that causes dry, itchy and inflamed skin. It’s common in young children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare sometimes. It can be irritating but it’s not contagious.

People with atopic dermatitis are at risk of developing food allergies, hay fever and asthma.

Moisturizing regularly and following other skin care habits can relieve itching and prevent new outbreaks (flares). 

Symptoms

Atopic dermatitis (eczema) symptoms can appear anywhere on the body and vary widely from person to person. They may include:

  • Dry, cracked skin
  • Itchiness (pruritus)
  • Rash on swollen skin that varies in color depending on your skin color
  • Oozing and crusting
  • Thickened skin
  • Darkening of the skin around the eyes

Atopic dermatitis often begins before age 5 and may continue into the teen and adult years. For some people, it flares and then clears up for a time, even for several years.

When to see a doctor

Talk with a health care provider if you or your child:

  • Has symptoms of atopic dermatitis
  • Is so uncomfortable that the condition is affecting sleep and daily activities
  • Has a skin infection — look for new streaks, pus, yellow scabs
  • Has symptoms even after trying self-care steps

Seek immediate medical attention if you or your child has a fever and the rash looks infected.

Causes

In some people, atopic dermatitis is related to a gene variation that affects the skin’s ability to provide protection. With a weak barrier function, the skin is less able to retain moisture and protect against bacteria, irritants, allergens and environmental factors — such as tobacco smoke.

In other people, atopic dermatitis is caused by too much of the bacteria Staphylococcus aureus on the skin. This displaces helpful bacteria and disrupts the skin’s barrier function.

Atopic dermatitis (eczema) is one of several types of dermatitis. Other common types are contact dermatitis and seborrheic dermatitis (dandruff). Dermatitis isn’t contagious.

Risk factors

The main risk factor for atopic dermatitis is having had eczema, allergies, hay fever or asthma in the past. Having family members with these conditions also increases your risk.

Complications

Complications of atopic dermatitis (eczema) may include:

    • Asthma and hay fever. Many people with atopic dermatitis develop asthma and hay fever. 
    • Food allergies. People with atopic dermatitis often develop food allergies. 
    • Chronic itchy, scaly skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, which provides only temporary relief. 
    • Patches of skin that’s darker or lighter than the surrounding area.  post-inflammatory hyperpigmentation or hypopigmentation. It’s more common in people with dark skin. 
    • Skin infections. Repeated scratching that breaks the skin can cause open sores and cracks. These increase the risk of infection from bacteria and viruses. These skin infections can spread and become life-threatening.
    • Irritant hand dermatitis. This especially affects people whose hands are often wet and exposed to harsh soaps, detergents and disinfectant at work.
    • Allergic contact dermatitis. This condition is common in people with atopic dermatitis. Allergic contact dermatitis is an itchy rash caused by touching substances you’re allergic to. 
    • Sleep problems. The itchiness of atopic dermatitis can interfere with sleep.
  • Mental health conditions. Atopic dermatitis is associated with depression and anxiety. This may be related to the constant itching and sleep problems.

Prevention

Developing a basic skin care routine may help prevent eczema flares. The following tips may help reduce the drying effects of bathing:

  • Moisturize your skin at least twice a day. Creams, ointments, Choose a product or products that work well for you. Ideally, which is safe, effective, affordable and unscented?

Use petroleum jelly on your baby’s skin.

  • Take a daily bath or shower. Use warm, rather than hot, water and limit your bath or shower to about 10 minutes.
  • Use a gentle, non-soap cleanser. Choose a cleanser that’s free of dyes, alcohols and fragrance. For young children, you usually need only warm water to get them clean — no soap or bubble bath needed. Don’t scrub the skin with a washcloth.
  • Pat dry. After bathing, gently pat the skin with a soft towel. Apply moisturizer while your skin is still damp (within three minutes).

Common triggers for atopic dermatitis include:

  • Rough wool fabric
  • Dry skin
  • Skin infection
  • Heat and sweat
  • Stress
  • Cleaning products
  • Dust mites and pet dander
  • Mold
  • Pollen
  • Smoke from tobacco
  • Cold and dry air
  • Fragrances
  • Other irritating chemicals

Infants and children may have flares triggered by eating certain foods, such as eggs and cow’s milk. Talk with your child’s health care provider about identifying potential food allergies.

Once you understand what triggers your eczema, talk with your health care provider about how to manage your symptoms and prevent flares.

References

  • Christopher, Tanya, Daniel Creamer,  John R, Rosalind C. 2022. Rook’s Dermatology Handbook. Hoboken, NJ: Wiley-Blackwell.
  • Eichenfield LF, Tom WL, Chamlin SL, Feldman SR, Hanifin JM, Simpson EL, et al. Guidelines of care for the management of atopic dermatitis: section 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol. 2014 Feb. 70(2):338-51.

Disclaimer: All contents on this site are for general information and in no circumstances, information be substituted for professional advice from the relevant healthcare professional, Writer does not take responsibility for any damage done by the misuse or use of the information.