What is atopic dermatitis?
Atopic dermatitis (also known as AD) is the most common type of eczema. In fact, more than 18 million American adults have atopic dermatitis — which often appears as a red, itchy rash normally on the cheeks, arms and legs.
Severe atopic dermatitis on an adult arm
Atopic dermatitis typically begins in childhood, usually in the first six months of a baby’s life. Even though it’s a common form of eczema, it’s also severe and long-lasting. When you or your child have atopic dermatitis, it may improve at times, but at others it may get worse. Often, atopic dermatitis disappears as a child grows older, though some children will have atopic dermatitis flares into adulthood.
Atopic dermatitis exists with two other allergic conditions: asthma and hay fever (allergic rhinitis). People who have asthma and/or hay fever or who have family members who do, are more likely to develop AD.
What causes atopic dermatitis?
Atopic dermatitis on the backs of the knees coupled with a staph infection
We don’t know the exact cause of atopic dermatitis. Researchers do know that a combination of genetics and other factors are involved. When a substance from inside or outside the body triggers the immune system, it over-reacts and produces inflammation. It is this inflammation that causes the skin to become red, rashy and itchy.
Research also shows that some people with eczema, especially atopic dermatitis, have a mutation of the gene responsible for creating filaggrin. Filaggrin is a protein that helps our bodies maintain a healthy, protective barrier on the very top layer of the skin. Without enough filaggrin to build a strong skin barrier, moisture can escape and bacteria, viruses and more can enter. This is why many people with atopic have very dry and infection-prone skin.
We also know that atopic dermatitis runs in families, but we don’t know the exact way it is passed from parents to children. If one parent has AD, asthma, or hay fever, there’s about a 50% chance that their child will have at least one of these diseases. If both parents have one or more of these conditions, the chances are much greater that their child will, too.
An estimated 10% of all people worldwide are affected by atopic dermatitis at some point in their life. The condition seems to be more common in urban areas and developed countries. Either way, atopic dermatitis is not contagious. You or your child cannot “catch” it from another person, or give it to someone else.
Itching for relief?
If you scratch too much, it could cause your atopic dermatitis to flare up
- Get tips on managing the itch — like keeping your hands busy with other activities so you’re less likely to scratch
- Understand which allergens and substances can further irritate your atopic dermatitis
- Learn more about the best fabrics to wear that won’t irritate your skin
- Explore simple changes you can make in your daily life to help your symptoms
Sign up to learn how to stop the “itch-scratch cycle”
And you’ll also get the NEA digital guide to atopic dermatitis
What’s the difference between eczema and atopic dermatitis?
Atopic dermatitis is considered a more severe type of eczema. People with atopic dermatitis may experience a number of different sensitivities for the rest of their lives:
- Dry skin that becomes easily irritated
- Occupational skin diseases like hand dermatitis
- Skin infections like staph and herpes
- Eye problems like eyelid dermatitis or cataracts
There are other types of eczema that cause itching and redness, but some will also cause your skin to blister, “weep,” or peel. It’s important to understand which of the different types of eczema you or your child may have, so that you can better treat and manage it. The only way to be sure that you or your child has this condition is to make an appointment with your health care provider.
Atopic dermatitis rash, dry skin and scale on the feet of an adult male
Learn more about the different types of eczema and their symptoms and triggers.
What are the symptoms of atopic dermatitis?
Atopic dermatitis is chronic, meaning it does not usually go away in a few days or weeks. It might get better or worse but the symptoms typically return.
Atopic dermatitis is very itchy. Your or your child’s skin can become damaged from repeated scratching or rubbing. Atopic dermatitis normally appears on the cheeks, arms and legs, but can be anywhere on the body.
Symptoms of atopic dermatitis include:
- Dry, scaly skin
- Cracks behind the ears
- A rash on the cheeks, arms and/or legs
- Open, crusted or “weepy” sores (usually during flares)
If the skin becomes infected, it may form a yellow crust or small pus-filled bumps. The skin may also become thicker from scratching and rubbing.
Other types of eczema, such as contact dermatitis may look like atopic dermatitis. It is possible to have atopic dermatitis and another type of eczema at once.
What makes atopic dermatitis flare or get worse?
When trying to identify triggers that might aggravate your atopic dermatitis, keep in mind that a flare can appear some time after exposure.
Though triggers can vary from person to person, some of the most common atopic dermatitis triggers include:
- Dry skin — which can easily become brittle, scaly, rough, and tight
- Chemical irritants — everyday products or substances (hand and dish soap, laundry detergent, shampoo, bubble bath and body wash, or surface cleaners and disinfectants) that can cause your skin to burn and itch, or become dry and red
- Stress can cause a person’s atopic dermatitis to flare or get worse
- Hot/cold temps and sweating can lead to itchy skin or “prickly heat” symptoms from the heat and/or sweating and very dry skin can develop during the cold winter months
- Infection from bacteria and viruses that live in your environment (like staph, herpes, or certain types of fungi)
- Allergens from everyday materials in the environment like seasonal pollen, dust mites, pet dander and mold
- Hormones — flares may happen, especially in women, when certain hormones in the body increase or decrease
Learn more about the most common causes and triggers of eczema.
How can I control my atopic dermatitis?
Atopic dermatitis with thickened (lichenified) skin from repeated scratching
Managing atopic dermatitis comes down to these basics:
- Know your triggers
- Implement a regular bathing and moisturizing routine
- Use OTC and/or prescription medication consistently and as prescribed
- Watch for signs of infection — pus-filled bumps, pain, redness, heat — on the skin
When managing atopic dermatitis, it is important to be consistent with skin care including using OTC and prescription medications as directed.
Here are some things you can do to help control your atopic dermatitis:
Treatment for atopic dermatitis
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; immunosuppressant drugs that broadly curb the immune system; and biologic drugs that target specific areas of the immune system. In extreme cases, systemic (taken by mouth or injection) steroids are used, though not recommended for the treatment of atopic dermatitis.
Learn more about how to control and treat your atopic dermatitis.