What Are Common Areas That Atopic Dermatitis Affects?

Atopic dermatitis (AD) can affect several different areas of the skin. The distribution of AD varies by individual. There are also common areas that get AD rashes depending on the age of the person with the condition.

Commonly affected areas in infants

The infant stage of AD includes babies and children up to two years of age. In this stage, commonly affected areas include the cheeks and the extensor surfaces of the limbs. The extensor surfaces are on the outside of the elbow or knee joints when they are bent. Infants may also have lesions of AD on their scalp, forehead, chin, and trunk. It is rare for the diaper area to be affected by AD, but some infants with AD have rashes in the crease between the buttocks. The lesions cause dry skin, redness, and an intense itch, which is frequently worse at night and may disrupt sleep. In addition, the areas affected by AD may be weeping or leaking fluid.1-3

Commonly affected areas in children

In the childhood stage of AD, which is considered from age 2 until puberty, the areas of skin affected become less weeping and more thickened, also called lichenified. The affected areas also change: children with AD experience the condition on the interior, or flexor, surfaces of the knees and elbows. AD in children can also affect the neck, hands, feet, wrists, ankles, and the skin around the mouth or around the eyes. The rash is red, itchy, and scaly in children with AD, and the color of the skin may lighten or darken where AD chronically affects the body.1-3

Commonly affected areas in adults

Many children with AD have their condition go into remission, but about 10-30% of people continue to have recurrences of AD throughout adulthood. Only about 5% of cases of AD begin in adulthood.3,4 In adults, AD affects the inside creases of the elbows or knees, the nape of the neck, face, hands, upper arms, back, wrists, the fingers, feet, and toes. In some people with AD, the rash may cover much of the body, with it being especially noticeable on the face and neck. Other adults only experience AD as hand or foot atopic eczema. Adults with AD have a scalier rash than younger patients with the condition. Areas of chronic AD appear thickened, while areas of acute AD appear with redness, bumps, and broken skin.1-3

Ear atopic eczema

Some people experience AD in the skin behind the ears or in the junction between the ear and the face. AD may also affect the pinna of the ear, which is the entire outer portion. Like other areas of the body, AD around the ears causes dryness, redness, and itchiness. Scratching can cause the skin to become broken and provides an opportunity for an infection. Atopic eczema around the ears can cause painful cracks in the skin, which also may become infected.5

Hand eczema

AD can appear on the hands and is frequently referred to as hand eczema or dyshidrotic eczema. Hand eczema appears on the hands as redness, itching, pain, dryness, blisters, and cracks in the skin. Dyshidrotic eczema forms small, itchy, fluid-filled blisters on the fingers, toes, palms of the hands, and soles of the feet.6

Nipple eczema

AD may also affect the nipples, causing irritation and sensitization. Nipple eczema can also be related to contact dermatitis.7

Emily Downward | June 2017
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