Atopic Dermatitis

What is atopic dermatitis?

Atopic dermatitis is a chronic condition that causes itchy skin that gets dry and scaly. It tends to come and go and may only be in childhood or may affect you your entire life. In people with light-colored skin, atopic dermatitis looks like red rashes. People with darker skin may develop brown, purple or gray rashes.

Atopic dermatitis vs eczema: What’s the difference?

Dermatitis and eczema both refer to inflammation of the skin. Eczema is a broad, umbrella term describing a group of conditions. Atopic dermatitis is the most common type of eczema.

Who does atopic dermatitis affect?

Atopic dermatitis is most common in children, but it can occur at any age. The condition affects people assigned male at birth (AMAB) and people assigned female at birth (AFAB) in equal numbers. Black people are slightly more likely to develop the condition compared to white people. Of all the people affected by atopic dermatitis, 65% develop the condition within the first year of life, while 90% develop the condition before age 5.

How common is atopic dermatitis?

The condition is quite common. Approximately 1 out of every 10 babies and young children develops symptoms of atopic dermatitis. Almost two-thirds of those affected continue to have flare-ups on into adulthood.

How does atopic dermatitis affect my body?

It’s common for atopic dermatitis to develop in areas where the skin bends or flexes, like behind your knees or on the inside of your elbow. But it can occur anywhere, including your:

• Hands and fingers.
• Feet and toes.
• Arms.
• Legs.
• Eyelids.
• Lips.

What are the symptoms of atopic dermatitis?

Symptoms can vary significantly from person to person, and they can range from mild to severe. Common atopic dermatitis symptoms include:

• Dry skin.
• Itching that can be quite severe.
• Swelling and inflammation.
• Red, brown, purple or gray rashes.
• Small, fluid-filled bumps or crusting.
• Cracked skin.

What triggers dermatitis?

Atopic dermatitis is multifactorial, meaning there isn’t just one cause, but many possible causes. It happens when your skin’s barrier function gets damaged. This results in skin that’s more sensitive and vulnerable to irritants, allergens and other environmental factors. When you come into contact with an irritant or allergen that triggers symptoms, it’s called contact dermatitis.

What foods trigger atopic dermatitis?

Many food allergens can trigger atopic dermatitis. Some of the most common include peanuts, tree nuts, eggs, soy, cow’s milk, wheat, shellfish and seafood.

Is atopic dermatitis contagious?

No. Even if you have an active rash, atopic dermatitis isn’t contagious. Keep in mind, however, if your rash starts to weep, it may mean you have an infection. If this occurs, it may be possible for the infection to spread to other people through physical contact.

How is atopic dermatitis diagnosed?

Your healthcare provider will examine your skin and review your medical and family history. In some cases, they may perform a skin or blood test to be sure of the diagnosis.

How is atopic dermatitis treated?

There are several medications and therapies that can help manage atopic dermatitis symptoms. These include:

• Topical steroid creams. Corticosteroid creams or ointments keep itching under control and help repair your skin. You should use them exactly as directed, as overuse can cause unpleasant side effects like thinning skin or loss of pigment.
• Oral steroids. In severe cases, your healthcare provider may prescribe prednisone or other oral corticosteroids to help control inflammation. Follow all instructions. These drugs are only used short-term due to potential side effects, such as high blood sugar, glaucoma, slowed growth in kids and slower wound healing.
• Dupilumab (Dupixent). This new, FDA-approved injectable medication can treat people with severe atopic dermatitis who haven’t had success with other treatment options.
• Antibiotics, antivirals or antifungals. If atopic dermatitis becomes infected, your healthcare provider will prescribe these medications to eliminate infection and relieve your symptoms.
• Wet dressings. This intensive approach involves applying steroid creams, then wrapping the skin with wet bandages. If you have a severe flare-up, a provider may perform this treatment in a hospital setting.
• Light therapy. People who have severe flare-ups after traditional treatments often benefit from light therapy. During this treatment, your provider will use controlled amounts of ultraviolet rays on your skin. This type of therapy isn’t recommended long-term, as it can eventually increase your risk for skin cancer and premature aging.

Can atopic dermatitis go away?

Children will sometimes outgrow atopic dermatitis, or have flares that are less severe over time. Though atopic dermatitis isn’t curable, it’s manageable with the right treatments. Most people can reduce their symptoms by using moisturizing creams at least twice daily. Even if you’re diligent in your skincare routines, you can still experience flare-ups. Therefore, it’s important to know how to manage your symptoms when they come back.

How can I manage my symptoms?

To soothe inflamed skin and reduce itching:

• Moisturize at least twice daily. Use creams, oils, sprays, ointments or a combination of these products, looking for products that have no perfumes or dyes. Find something that works for you and incorporate it into your daily self-care regimen.
• Use anti-itch creams. Over-the-counter (OTC) hydrocortisone cream can temporarily relieve itching associated with atopic dermatitis.
• Avoid scratching. If your skin is itchy, try pressing on it instead of scratching it. If your child has atopic dermatitis, trim their nails and consider having them wear gloves while they sleep.
• Take allergy or anti-itching medications. Antihistamines — such as fexofenadine (Allegra®) or cetirizine (Zyrtec®) — can alleviate itching. Talk to your provider about the best option, as these medications can be OTC or prescription.
• Take an oatmeal bath. As you soak in the tub, sprinkle colloidal oatmeal on your bath water. It will help lock the moisture in your skin and soothe inflamed, itchy skin. After you soak, pat dry and apply your moisturizer while your skin is still damp.
• Wear comfortable clothing. Avoid tight or scratchy clothing that could make itching worse.
• Use a humidifier. If the air in your home or work environment is too dry, it can make your atopic dermatitis symptoms worse. A humidifier adds moisture to the air, which can help your condition.
• Purchase dye- and perfume-free soaps. Mild, unscented soaps are best for people with atopic dermatitis.
• Find ways to reduce stress. Because stress and anxiety can trigger atopic dermatitis, mindfulness, meditation or relaxation techniques can be helpful in managing symptoms.

Can I prevent atopic dermatitis?

While you can’t prevent atopic dermatitis altogether, you can take steps to reduce your risk of flare-ups. To do this, avoid any possible triggers and keep your skin thoroughly moisturized.

What can I expect if I have atopic dermatitis?

Atopic dermatitis won’t go away completely. But once you find ways to properly manage your symptoms, your flare-ups likely won’t be as severe. People with atopic dermatitis should check in with their healthcare provider regularly, depending on the frequency of flares, to ensure they’re using the best treatments available.

When should I see my healthcare provider?

You should call your healthcare provider if your condition causes pain or discomfort, or if it keeps you from sleeping or functioning normally. If your rash begins to weep, or if you develop raised, fluid-filled bumps, schedule an appointment with your provider.

A note from Cleveland Clinic

While atopic dermatitis isn’t typically dangerous, it can wreak havoc on your comfort and quality of life. Fortunately, there are several treatments available to help keep your symptoms in check. Most people experience a dramatic improvement once they find a skincare regimen that works for them.