What Is Atopic Dermatitis (Eczema)?

Atopic dermatitis is a common skin condition that causes dry, itchy, and scaly skin. It is one of several types of eczema. About 8 in 10 cases of atopic dermatitis are diagnosed before age 5.^1,2

What is dermatitis?

Dermatitis refers to any skin inflammation or irritation. There are many types of dermatitis, but the most common is atopic dermatitis.^3,4

What does atopic mean?

The word "atopic" comes from the word "atopy." Atopy is a genetic tendency to have allergic reactions to things in the environment. This can lead to diseases like allergic rhinitis, asthma, and eczema.⁵

How does it appear on the body?

Eczema often causes dry, red, itchy, and scaly skin on the face, hands, and feet. It also is common on the arms and legs. In severe cases, it can lead to open sores and crusting of the skin. This is made worse by scratching and resulting skin infections.^1,4

Eczema can look different depending on the age of the person who has it.⁴

Infants

In babies, eczema may cause a rash on the scalp, face, arms, and legs. The inflammation makes the skin dry, itchy, and scaly. Sometimes the rash will have areas that are bumpy or have fluid coming out of them.⁶

Children

In children, eczema often occurs in the:⁶

• Inside creases of the elbows or knees
• Neck
• Wrists
• Ankles
• Crease between the buttocks and legs

The rash is itchy and scaly. It may form bumps or occur in patches. The skin may lighten or darken where eczema affects the body.⁶

Adults

Eczema is often thought of as a childhood disease. But adults can have the condition as well. If you are diagnosed after age 18, your doctor will call it adult-onset atopic dermatitis. Adult-onset eczema may be a sign of a more serious skin condition.⁷

Eczema in adults can appear anywhere on the body, but it often appears on the:⁷

• Face
• Back of the neck
• Backs of the knees
• Creases of the elbows

Unlike children, adults often have eczema around their eyes. The skin around the eyes is often darkened, thickened, dry, and itchy.⁷

Lichenification

Lichenification is a condition where the skin becomes thick and leathery from chronic scratching and rubbing. This can happen if eczema is not treated properly or keeps coming back.⁸
Lichenification appears differently on people depending on their skin color. Affected areas may be pink or red. They also may appear darker than the unaffected skin.⁸

What causes it?

The exact cause of eczema is unknown. Most experts believe it is caused by a combination of genetic and environmental factors. People with eczema often have family members with other atopic conditions, such as allergies or asthma.⁹

Diagnosis of eczema

Eczema is diagnosed by looking at your skin and taking a history of your symptoms. A doctor also may take a small skin sample to look at under a microscope.¹⁰

A test called a patch test may be needed to see if you have skin sensitivities to certain chemicals. A skin prick test may be done to see if you have environmental allergens that could be affecting the skin.¹⁰

How is it treated?

There is no cure for eczema, but there are treatments that can help relieve the symptoms. People with eczema usually need a combination of skin care, medicines, and lifestyle changes.

General skin care can help maintain the moisture in the skin and relieve discomfort. This care may include:¹¹

• Applying moisturizer
• Using unscented, non-dyed soaps and detergents
• Taking baths with colloidal oatmeal
• Taking bleach baths
• Wrapping wet gauze around affected skin to provide intense moisture

Drugs can help reduce inflammation, control itch, and prevent future flare-ups. Common drugs used to treat eczema include:¹⁰

• Corticosteroid (steroid) creams or ointments
• Antihistamines
• Antibiotics
• Immunomodulators
• Calcineurin inhibitors

Also, some people with eczema may benefit from phototherapy.¹⁰

Eczema is a common skin condition that can be treated but not cured. There also is no sure way to prevent eczema. However, avoiding triggers and using available treatments can help reduce the severity of symptoms. Talk to your doctor about the best treatment plan for you or your child.^1,10