What Are Myths and Misconceptions About Atopic Dermatitis?

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Although atopic dermatitis (AD) is one of the most common skin conditions, there are many myths and misconceptions about the disease.

Myth: Atopic dermatitis is contagious.

AD causes visibly irritated skin, and the itching and scratching may cause others to wonder if it’s contagious. Atopic dermatitis is not contagious but is caused by a combination of genetic and environmental factors.1

Myth: Atopic dermatitis is the same as eczema.

Atopic dermatitis is a type of eczema, and in fact, it is the most common form of eczema. AD is sometimes called atopic eczema. The term “eczema” refers to a number of skin conditions that cause redness, inflammation, and dry, flaky skin.2

Myth: Children with atopic dermatitis will outgrow it.

Some children with AD do seem to outgrow the condition. Most children go into remission, although some continue to have relapses into their teen years. Between 10% and 30% of children with AD continue to have symptoms into adulthood. In addition, a small number of cases (5%) of AD begin in adulthood.3,4

Myth: Moisturizers provide moisture to the skin.

Moisturizers do not actually add moisture to the skin, but they do help keep moisture in by creating a lipid (fat) barrier. People with AD have a dysfunction in their skin barrier. The skin barrier is important in protection against microorganisms as well as keeping water in the skin. The compromised skin barrier in AD causes more water loss to occur from the skin, which exacerbates the dry skin that is characteristic of AD. Applying moisturizers daily, particularly just after bathing, can help seal in the moisture from the bath and can help repair the skin barrier.5

Myth: People with atopic dermatitis shouldn’t bathe every day.

Some people have proposed that bathing too often may dry out the skin even more, however, most dermatologists agree that once daily bathing can help hydrate the skin as well as remove any bacteria or other microorganisms that can cause infection. A small study that compared bathing to moisturizers found that the most important factor in hydrating the skin is the application of moisturizers. Doctors recommend that people with AD apply moisturizer after bathing, and those who bathe less frequently should apply moisturizer regularly to improve skin hydration.6

Myth: A restrictive diet helps treat atopic dermatitis.

Children with AD are more likely to have food allergies, and a smaller number of adults with AD have food allergies. In people with food allergies, eating certain foods can trigger their AD. The most common food allergies include cow’s milk, eggs, fish, peanuts, soy, tree nuts, and wheat. Testing for food allergies is recommended in children who have persistent AD despite treatment and who have an immediate allergic reaction after ingesting a specific food. However, restrictive diets or elimination diets should not be initiated for everyone with AD. Excessively restrictive diets, especially in children, may lead to weight loss, poor growth, and calcium or vitamin deficiency. People with a suspected food allergy should talk to their doctor and get nutritional counseling from a dietician.7

Myth: The itch is all in your mind.

“Just stop scratching,” is not useful advice for people with AD. While the scratching can lead to lichenification (thickened skin) and can increase the risk of infection, it is not easily avoided. Research continues to explore the processes that cause itch in AD and understand the itch-scratch cycle (the skin feels itchy, which leads to scratching, which then causes the skin to feel even more itchy). Treatments that can help with the itch include topical medications, antihistamines, wet wraps, and moisturizers.Keeping nails short can also limit the damage done to the skin with scratching.

view references
  1. Tollefson MM, Bruckner AL. Atopic dermatitis: skin-directed management. Am Acad Pediatrics. 2014 Dec;134(6):e1735-1744. doi: 10.1542/peds.2014-2812.
  2. National Eczema Association. Accessed online on 4/11/17 at https://nationaleczema.org/.
  3. Eichenfield LF, Tom WL, Chamilin SL, et al. Guidelines of care for the management of atopic dermatitis. Journal of the American Academy of Dermatology 2014;70:338- 351.
  4. Lyons JJ, Milner JD, Stone KD. Atopic dermatitis in children: clinical features, pathophysiology, and treatment. Immunol Allergy Clin North Am. 2015;35:161-183.
  5. Giam YC, Hebert AA, Dizon MV, et al. A review on the role of moisturizers for atopic dermatitis. Asia Pacific Allergy. 2016;6(2):120-128. doi:10.5415/apallergy.2016.6.2.120.
  6. Chiang C, Eichenfield LF. Quantitative assessment of combination bathing and moisturizing regimens on skin hydration in atopic dermatitis. Pediatr Dermatol. 2009 May-Jun;26(3):273-8.
  7. Sidbury R, et al. Guidelines of care for the management of atopic dermatitis. J Am Acad Dermatol. 2014;71(6):1218-1233.
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View Written By | Review Date
Emily Downward | June 2017
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