Atopic Dermatitis in Children

Atopic dermatitis (AD) is the most common form of eczema and is chronic (long-lasting). About 13 percent of all children in the U.S. have atopic dermatitis.

Atopic dermatitis usually starts in infancy or early childhood. Children who come from families with a history of atopic dermatitis, asthma or hay fever are more likely to develop atopic dermatitis.

Considered an immune-mediated, inflammatory disease, atopic is caused by a combination of genes and external factors. The common symptoms of atopic — redness, dry skin and intense itch – happen when the immune system goes into overdrive, triggered by something in the child’s environment.

Symptoms of atopic dermatitis in children

The general symptoms of atopic dermatitis include:

• Itch
• Redness and rash
• Skin that is very dry or scaly
• Open, crusted or weepy sores

With infants and toddlers, atopic dermatitis usually starts on the face or on the elbows and knees — places that are easy to scratch and rub as they are crawling. It may spread to other areas of the body, but not in the diaper area, where moisture protects the skin.

In older children, atopic dermatitis usually appears in the folds of the elbows, hands and/or knees. Rashes or redness behind a child’s ears, on their feet or scalp, may also be a sign of atopic dermatitis.

In both infants and children, the skin can appear as red, dry and scaly. Scratch marks are often present. If the skin becomes infected, it may form a yellow crust or very small “pus bumps.” Your child’s skin may also become thicker, called lichenification, from too much scratching and rubbing. The appearance of atopic dermatitis may differ from one child to another.

Atopic dermatitis treatments for children

Depending on the severity of symptoms, atopic dermatitis can be treated with topical medications, which are applied to the skin; phototherapy, a form of light treatment; and immunosuppressant drugs that curb the immune system.

Read more about common treatments for children with atopic dermatitis.

Atopic dermatitis, asthma and allergies

Atopic dermatitis can exist with other known medical conditions. These other conditions are called “comorbidities.”

Atopic dermatitis is part of a group of allergic conditions. In fact, “atopic” means allergy. These include, asthma, hay fever and food allergies. If a child has one of these conditions, the likelihood of developing another atopic condition is increased. Contact dermatitis is also considered atopic, though its connection to asthma and hay fever is unknown.

About 50 percent of children with moderate to severe atopic dermatitis develop allergic asthma. Symptoms of allergic asthma include:

• Coughing
• Wheezing
• Shortness of breath
• A tight feeling in the chest

If you think your child is showing symptoms of allergic asthma, please contact your health care provider.

About 75 percent of children with moderate to severe atopic dermatitis develop allergic rhinitis or hay fever. Symptoms of hay fever include, itchy, watery eyes, nose and throat; stuffy, runny nose; ear pressure; and fatigue. Contact your doctor if you cannot control these symptoms with OTC medications or the symptoms have become severe.

Up to one-third of children with atopic dermatitis also have food allergies. A food allergy is defined by a reaction that occurs within 30 minutes of exposure and causes symptoms ranging from hives and swelling of the lips all the way to breathing troubles, vomiting and diarrhea. Common food allergies for children with AD include, peanuts, eggs, milk and soy. If you suspect your child has a food allergy, please see an allergist who specializes in identifying allergies in children.

Genes and atopic dermatitis

The development of atopic dermatitis in children is influenced by genetics, though the exact way it passes from parents to children is unknown.

If one parent has atopic dermatitis, or any of the other atopic diseases (asthma, hay fever), the chances are about 50% that the child will have one or more of the diseases. If both parents are atopic, chances are even greater that their child will have it.

However, the connection is not an absolute one: As many as 30% of the affected patients have no family members with any of these allergic disorders.