What Are the Symptoms of Atopic Dermatitis?

Atopic dermatitis, commonly called eczema, causes skin changes and inflammation. Most people think of eczema as itchy patches of dry skin. But there can be many more symptoms. Eczema symptoms can also vary based on a person's age and skin color.^1,2

Most people with eczema will be diagnosed for the first time as a young child. Some children will outgrow their symptoms, and others will continue to have eczema into adulthood. Symptoms and their severity can change as time passes.^1,3-6

Common eczema symptoms

While each person’s experience with eczema will be different, some of the most common symptoms are:^1-5

• Itchiness, sometimes severe
• Dry or cracked skin
• Changes in skin color – These may look like pink patches or redness on lighter skin. They may look like brown, gray, or purple patches on darker skin.
• Swollen or inflamed skin
• Rough or leathery patches (lichenification or plaques)
• Blisters or sores that can ooze, crust, or weep

Many people with eczema have periods of symptom worsening called flare-ups or flares. The number of flares, how much time occurs in between flares, and how well symptoms clear between flares can vary.³

Affected areas

In babies, areas of eczema can be all over the body. Their eczema is especially common on the face, scalp, and cheeks. As a person gets older, areas of eczema are most commonly in places like the:^1,6

• Back of the knees
• Inner creases of the elbows
• Neck
• Wrists

Some people have eczema only on specific parts of their body. Some may have eyelid eczema. Darkening around the eyelids (periorbital thickening) can also occur. Eczema on the ears or lips can cause them to crack, crust, bleed, and ooze.¹

Other skin changes

In addition to the more common skin changes, there are other potential skin issues that can come with eczema too. These include:^1,2

• Areas of skin darkening (hyperpigmentation) or lightening (hypopigmentation) after inflammation
• Skin lightening in the middle of the face compared to the edges (centrofacial pallor)
• Patches of bumpy skin (keratosis pilaris)
• Multiple lines on the palms of the hands (palmar hyperlinearity)
• Thinning of the outer portions of the eyebrows (Hertoghe’s sign)
• Scratch marks from itching
• Lumps under the skin from long-term areas of skin thickening

Other health conditions that occur with eczema

Several other health conditions are linked to eczema. Some are related to mental or emotional distress, like depression or anxiety. It is also possible to have low red blood cell counts (anemia). This may be due to long-term inflammation or limiting exposure to certain food triggers.¹

Triggers for eczema

There are several factors that may increase your risk of a flare. Each person will respond differently to potential triggers, but common triggers include:^1,4,7

• Exposure to environmental allergens like mold, dust, pollen, or animals
• Contact with things that irritate the skin like scented soaps, lotions, or detergents
• Dry skin
• Stress
• Exposure to cold and dry air
• Recent infections
• Frequently showering, bathing, or swimming, especially in hot water
• Exposure to certain food allergens

Treating eczema symptoms

There is no cure for eczema at this time. However, there are many ways to manage symptoms and prevent flares. The first step is usually lifestyle changes. Your doctor may recommend that you:^4,8

• Moisturize your skin daily
• Avoid triggers like allergens (in the home and in food)
• Avoid skin irritants like scented lotions or detergents
• Avoid tight or scratchy clothing
• Limit scratching, especially with long nails
• Use over-the-counter anti-itch creams
• Take oatmeal baths and avoid scrubbing hard during regular baths and showers
• Use a humidifier
• Reduce stress

If symptoms continue even after making these changes, there are treatments that can help. Which ones you choose will depend on your symptoms and how severe they are. Some general treatment options are:^3-5,8,9

• Medicated topical treatments
• Systemic immunosupressant drugs, such as steroids or cyclosporine
• Targeted immune system drugs, including biologics and Janus kinase (JAK) inhibitors
• Over-the-counter allergy drugs, including antihistamines
• Creams or drugs to treat infections if needed, including antibiotics, antifungals, or antivirals
• Light therapy (phototherapy)
• Gradual exposure to an allergen to build tolerance (immunotherapy)

Each person’s treatment plan will be different, and there is no 1 right path. You and your doctor can work together to figure out your treatment goals and how to best achieve them.