Recognizing Atopic Dermatitis

Time of onset:

Atopic Dermatitis Child

This image displays small, separate bumps with red lesions (due to scratching) from atopic dermatitis (eczema).

This type of eczema usually begins during the first year of life and almost always within the first five years. It’s seldom present at birth, but it often comes on during the first six weeks. Other rashes also can start at any time, but most rashes disappear within a few days to weeks. AD tends to persist. It may wax and wane, but it keeps coming back.


Atopic dermatitis is a very itchy rash. Much of the skin damage comes from scratching and rubbing that the child cannot control.


The location of the rash can also help us recognize AD. In babies, the rash usually starts on the face or over elbows and knees, places that are easy to scratch and rub. It may spread to involve all areas of the body, although moisture in the diaper region protects the skin barrier. Later in childhood, the rash is typically in the elbow and knee folds. Sometimes it only affects the hands, and at least 70% of people with AD have hand eczema at some time in their life. Rashes on the feet, scalp or behind the ears are other clues that might point to AD. Be advised, though, that these symptoms may also indicate other conditions, such as seborrheic dermatitis.


Atopic Dermatitis Child

This image displays scratched skin lesions of a severe case of atopic dermatitis (eczema) in a young child.

The appearance of the rash is probably the least helpful clue, because it may be very different from one person to another. Scratch marks are often seen, along with scaly dry skin. The skin may become infected and show yellow crusts or little, pinpoint, pus-containing bumps. The skin also may thicken from long-term scratching and rubbing.


If other family members or relatives have AD, asthma or hay fever, the diagnosis of AD is more likely.

The bottom line:

Be sure to get your child diagnosed by a physician before assuming that the condition is atopic dermatitis.

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