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- Randi Rush, DO
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- Lisa Benest, M.D.
- 1624 W. Olive Ave.
- Suite B
- Burbank, California 91506
- Tel: 818-729-9149
- Fax: 818-729-9119
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Atopic Dermatitis (Eczema) Basics
What is atopic dermatitis?
Atopic dermatitis (AD) is a chronic skin disorder that causes dry, itching, and inflamed skin. The rash of atopic dermatitis comes and goes in cycles. The worsening of atopic dermatitis, referred to as "flares" can be brought on by a variety of triggers.
Atopic dermatitis is very common, affecting 10-15 percent of people. The severe itching and irritation during flare-ups can be extremely bothersome. The resulting scratching can result in raw skin and skin infections.
Fortunately, most cases respond well to treatment.
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Before treatment |
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The term eczema is sometimes used to describe atopic dermatitis. Eczema refers to inflamed, itching skin from a variety of causes. Atopic dermatitis is the most common type of eczema.
The appearance of atopic dermatitis varies tremendously from person to person. Most people with atopic dermatitis experience a short-term flare for a few weeks (acute), during which the skin looks red, raised, and cracked. Between flares, the skin may appear normal or slightly dry. If the rash lasts a long time (chronic), the skin may start to change appearance, becoming thicker and darker. These patches of thickened skin take longer to respond to treatment.
What causes atopic dermatitis?
The exact cause of atopic dermatitis is unknown, but the tendency to develop atopic dermatitis runs in families. People with atopic dermatitis are more likely to suffer allergies and/or symptoms of asthma. The connection between these disorders appears to be an overactive immune system.
T-cells, a type of white blood cell that fights infections, appear to be more active in people with atopic dermatitis. Changes beneath the skin make the skin of people with atopic dermatitis more susceptible to losing water quickly, leading to dry, cracked skin.
Although the immune system is overactive in people with atopic dermatitis, it is not always effective at fighting infections. In fact, people with atopic dermatitis are more susceptible to skin infections, such as impetigo.
What are the signs and symptoms of atopic dermatitis?
The most obvious symptoms of atopic dermatitis are intense itching, along with red, dry skin that is sometimes scaly.
Infants - Children less than one year old often have atopic dermatitis widely distributed over their body. The skin is usually dry, scaly, and red. The baby may scratch the skin, leading to scratch marks. The cheeks of infants are often the first place to be affected. The diaper area is frequently spared because the moisture retained by the diapers prevents the skin from drying.
Toddlers - As children reach 2 to 3 years old, atopic dermatitis becomes more localized to areas such as the outer part of the joint, including the front of the knees, outside elbows, and top of the wrists. Older children are also more capable of a vigorous scratch, creating very red and inflamed areas.
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School-age children |
Adults - Adults with atopic dermatitis tend to have the rash localized to specific areas, particularly the hands, feet, eyelids, back of the knees, and insides of the elbows. However, the skin elsewhere on the body may feel dry and prone to itching.
Atopic dermatitis that starts in infancy often improves by the time the child is 5 years old and usually resolves by the teenage years. However, many people endure atopic dermatitis and need to manage it throughout their lives.
What are the treatment options for atopic dermatitis?
The goals of atopic dermatitis treatment are to heal the skin, prevent new flare-ups, and reduce the urge to scratch, which can further irritate and prolong symptoms.
Atopic dermatitis treatment may last for many months, and treatments often need to be repeated.
There are several treatment options available. Your doctor will recommend a treatment plan based on several variables, including:
- Your age
- Location (face vs. knee)
- Severity
- Acute vs. chronic (long-lasting symptoms may require more potent medications)
- Results of past treatments
- Your personal preferences
Treatment mainstays include trigger avoidance and frequent moisturizing.
Additional treatment options include:
- Moisturizers
- Topical corticosteroids
- Topical immunomodulators (Elidel, Protopic)
- Antihistamines
- Antibiotics
- Oral corticosteroids (prednisone)
- Immunosuppressants (cyclosporine)
What triggers atopic dermatitis?
Not everyone with atopic dermatitis will have the same triggers, so people with the disorder will have to keep track of their particular sensitivities. Because identifying triggers can be tricky (for example, sometimes there is a delay between eating a certain food and seeing a resulting flare-up), it’s a good idea to keep a journal of any atopic dermatitis symptoms and possible causes.
Some commonly reported atopic dermatitis triggers include:
- Irritants—These are substances that contact the skin directly, causing redness and inflammation. They include wool or other synthetic fabrics, soaps and detergents, perfumes and makeup, cigarette smoke, and chemicals (such as chlorine).
- Allergens—Allergens are more indirect triggers, where the skin becomes inflamed and itchy because of an allergic reaction, such as from pollen, mold, or animal and pet dander.
- Stress—While stress isn’t a known cause of atopic dermatitis, it can aggravate flare-ups.
- Temperature—Many people with atopic dermatitis have chronically dry skin that is sensitive to certain climate conditions, such as cold winter weather, indoor heating, or warm baths. Humid environments, such as a sauna, may cause sweating that could trigger a flare-up.
How can I prevent atopic dermatitis flare-ups?
Basic skin care tips may help to prevent atopic dermatitis flare-ups, including the regular use of moisturizers after bathing.
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Images courtesy of Gerald Goldberg, M.D.
© 2010 Vivacare.
Last updated July 12, 2010
This information is for general educational uses only. It may not apply to you and your specific medical needs. This information should not be used in place of a visit, call, consultation with or the advice of your physician or health care professional. Communicate promptly with your physician or other health care professional with any health-related questions or concerns.
Be sure to follow specific instructions given to you by your physician or health care professional.
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