These facts and figures represent a summary of the most current information from published scientific literature regarding the prevalence of eczema and the burden people living with eczema face every day.
The Big Picture
People of all skin colors and ethnicities can be affected by eczema 1:
- White – 11%
- African American/black – 10%
- Asian or Pacific Islander – 13%
- Native American – 13%
Prevalence of Childhood & Adult Atopic Dermatitis (AD)
The prevalence of childhood AD has steadily increased from 8% to ~12% since 1997. 4
An estimated 16.5 million U.S. adults (7.3%) have AD that initially began at >2 years of age, with nearly 40% affected by moderate or severe disease. 9
Children born outside the U.S. have a 50% lower risk of developing AD that increases after living in the U.S. for 10 years. 15
Impacts of Eczema
Disease Burden & Mortality
A recent study of adults with moderate to severe AD found that 70.5% reported severe, unbearable itch in the past two weeks, 85.8% reported daily itch, and 62.8% reported itching at least 12 hours per day. 22
Sleep disturbance occurs in approximately 60% of children with AD, and parents of children with AD are four to eight times more likely to average less than six hours of sleep per night compared with caregivers of healthy children. 25 26
One in four adults with AD rate their health as “fair” or “poor”; more than 16% are “very” or “somewhat” dissatisfied with life. Negative ratings of health and life satisfaction increase with AD severity. 21
Hospitalization due to AD flares and associated infections is associated with an 8.3-year reduction in lifespan compared to the general population. 31 Outside of hospitalization, the risk for death due to any cause is slightly increased in people with AD. 32
Eczema has the highest effect on disability-associated life years for patients with skin diseases worldwide. 33
Children with AD often develop other atopic conditions in a typical sequence of food allergy, allergic rhinitis and asthma – known as the atopic march. Some of these conditions may persist for years, others may resolve with increasing age. 34 35
One in three children with AD will additionally develop asthma or allergic rhinitis. The risk of developing asthma increases with AD severity as more than 50% of children with severe AD will develop asthma. 35 36 37 38 39
Autoimmune and Cardiac Disease
AD in adults is associated with other serious chronic conditions that contribute to poor health including diabetes, obesity, autoimmune disease, high blood pressure and heart disease. Risk for these conditions increases with AD severity. 45 46 47 48
For hospitalized adults with AD, the prevalence of serious infections including cutaneous, respiratory and systemic (heart, brain, GI, bone) infections is significantly higher compared to those without AD. 49
AD’s negative impact on mental health ranks greater than that for patients with heart disease, diabetes and high blood pressure. 21
Childhood AD has a significant impact on the emotional and social well-being of parents and caregivers. 64
Half of adults with moderate to severe AD indicate that AD significantly limits their lifestyle; nearly 35% of adults with mild AD also experience some lifestyle limitations. 21
More than one-third of people with AD say they “often” or “always” feel angry or embarrassed by their appearance due to the disease. 65
Parents and caregivers of children with AD report feeling embarrassed about their child’s appearance as well as frustration, helplessness, sadness and guilt due to their child’s disease. 68
Pre-adolescent girls with AD more frequently report impaired self-perceived health than their male counterparts. 70
Economic & Societal Impact
Adults with AD, regardless of disease severity, are more likely to take five or more days off work annually compared to their non-affected coworkers. 77
Nearly 5.9 million workdays annually are lost due to eczema. 77
Parents of children with AD experience lost work productivity that relates to their child’s AD severity. 14
U.S. adults with moderate to severe AD have nearly 16% less employment than those with mild AD. 78
- $371-$489 higher out-of-pocket costs per person each year, which is higher than the out-of-pocket costs for hypertension and diabetes. 77
- More outpatient doctor visits 28 80 81
- More visits to urgent/emergency care 82
- More hospitalizations 77 83
Cost of care considerations have been reported for AD patients: 77
- 17.6% delayed care due to concerns about cost
- 13.1% did not seek care due to concerns about cost
- 15.7% report an inability to cover the cost of prescriptions
Inpatient costs for AD care reach nearly $8.3 million/year for adults and more $3.3 million/year for children. 84
Total direct medical costs in 2013 averaged $11,660 per AD patient, which represents an incremental cost of $3,302 annually. Costs are higher in patients with more severe disease. 81
In 2013, the cost to the health system to treat atopic dermatitis patients was $314 million. 85
The annual economic burden of eczema, including direct medical costs, indirect costs from lost productivity, and quality of life impacts, is conservatively estimated at $5.3 billion. 86
- Hanifin JM, Reed ML, Eczema Prevalence and Impact Working Group. A population-based survey of eczema prevalence in the United States. Dermatitis. 2007;18(2):82-91.
- Silverberg JI, Hanifin JM. Adult eczema prevalence and associations with asthma and other health and demographic factors: a US population-based study. J Allergy Clin Immunol. 2013;132(5):1132-1138.
- Abuabara K, Magyari A, McCulloch CE, Linos E, Margolis DJ, Langan SM. Prevalence of Atopic Eczema Among Patients Seen in Primary Care: Data From The Health Improvement Network. Ann Intern Med. 2018.
- Silverberg JI. Public Health Burden and Epidemiology of Atopic Dermatitis. Dermatol Clin. 2017;35(3):283-289.
- Shaw TE, Currie GP, Koudelka CW, Simpson EL. Eczema prevalence in the United States: data from the 2003 National Survey of Children’s Health. J Invest Dermatol. 2011;131(1):67-73.
- Al-Naqeeb J, Danner S, Fagnan LJ, et al. The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium. J Am Board Fam Med. 2019;32(2):191-200.
- Silverberg JI, Simpson EL. Association between severe eczema in children and multiple comorbid conditions and increased healthcare utilization. Pediatr Allergy Immunol. 2013;24(5):476-486.
- Silverberg JI, Simpson EL. Associations of childhood eczema severity: a US population-based study. Dermatitis. 2014;25(3):107-114.
- Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic Dermatitis in America Study: A Cross-Sectional Study Examining the Prevalence and Disease Burden of Atopic Dermatitis in the US Adult Population. J Invest Dermatol. 2019;139(3):583-590.
- Abuabara K, Yu AM, Okhovat JP, Allen IE, Langan SM. The prevalence of atopic dermatitis beyond childhood: A systematic review and meta-analysis of longitudinal studies. Allergy. 2018;73(3):696-704.
- Lee HH, Patel KR, Singam V, Rastogi S, Silverberg JI. A systematic review and meta-analysis of the prevalence and phenotype of adult-onset atopic dermatitis. J Am Acad Dermatol. 2019;80(6):1526-1532 e1527.
- Silverberg JI, Hanifin J, Simpson EL. Climatic factors are associated with childhood eczema prevalence in the United States. J Invest Dermatol. 2013;133(7):1752-1759.
- Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: Results from an international survey. Allergy. 2018;73(6):1284-1293.
- Chung J, Simpson EL. The socioeconomics of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;122(4):360-366.
- Silverberg JI, Simpson EL, Durkin HG, Joks R. Prevalence of allergic disease in foreign-born American children. JAMA Pediatr. 2013;167(6):554-560.
- Weidinger S, Beck LA, Bieber T, Kabashima K, Irvine AD. Atopic dermatitis. Nat Rev Dis Primers. 2018;4(1):1.
- Kim JP, Chao LX, Simpson EL, Silverberg JI. Persistence of atopic dermatitis (AD): A systematic review and meta-analysis. J Am Acad Dermatol. 2016;75(4):681-687 e611.
- Margolis JS, Abuabara K, Bilker W, Hoffstad O, Margolis DJ. Persistence of mild to moderate atopic dermatitis. JAMA Dermatol. 2014;150(6):593-600.
- Dawn A, Papoiu AD, Chan YH, Rapp SR, Rassette N, Yosipovitch G. Itch characteristics in atopic dermatitis: results of a web-based questionnaire. Br J Dermatol. 2009;160(3):642-644.
- Maarouf M, Kromenacker B, Capozza KL, et al. Pain and Itch Are Dual Burdens in Atopic Dermatitis. Dermatitis. 2018;29(5):278-281.
- Silverberg JI, Gelfand JM, Margolis DJ, et al. Patient burden and quality of life in atopic dermatitis in US adults: A population-based cross-sectional study. Ann Allergy Asthma Immunol. 2018;121(3):340-347.
- Simpson EL, Bieber T, Eckert L, et al. Patient burden of moderate to severe atopic dermatitis (AD): Insights from a phase 2b clinical trial of dupilumab in adults. J Am Acad Dermatol. 2016;74(3):491-498.
- Silverberg JI, Gelfand JM, Margolis DJ, et al. Pain Is a Common and Burdensome Symptom of Atopic Dermatitis in United States Adults. J Allergy Clin Immunol Pract. 2019.
- Vakharia PP, Chopra R, Sacotte R, et al. Burden of skin pain in atopic dermatitis. Ann Allergy Asthma Immunol. 2017;119(6):548-552 e543.
- Chamlin SL, Mattson CL, Frieden IJ, et al. The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med. 2005;159(8):745-750.
- Meltzer LJ, Booster GD. Sleep Disturbance in Caregivers of Children With Respiratory and Atopic Disease. J Pediatr Psychol. 2016;41(6):643-650.
- Silverberg JI, Garg NK, Paller AS, Fishbein AB, Zee PC. Sleep disturbances in adults with eczema are associated with impaired overall health: a US population-based study. J Invest Dermatol. 2015;135(1):56-66.
- Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. Impact of atopic dermatitis on health-related quality of life and productivity in adults in the United States: An analysis using the National Health and Wellness Survey. J Am Acad Dermatol. 2017;77(2):274-279 e273.
- Simpson EL, Guttman-Yassky E, Margolis DJ, et al. Association of Inadequately Controlled Disease and Disease Severity With Patient-Reported Disease Burden in Adults With Atopic Dermatitis. JAMA Dermatol. 2018;154(8):903-912.
- Wei W, Anderson P, Gadkari A, et al. Extent and consequences of inadequate disease control among adults with a history of moderate to severe atopic dermatitis. J Dermatol. 2018;45(2):150-157.
- Egeberg A, Skov L, Andersen YMF, et al. Ten-year mortality is increased after hospitalization for atopic dermatitis compared with the general population, but reduced compared with psoriasis. J Am Acad Dermatol. 2017;76(1):98-105.
- Thyssen JP, Skov L, Egeberg A. Cause-specific mortality in adults with atopic dermatitis. J Am Acad Dermatol. 2018;78(3):506-510.
- Karimkhani C, Dellavalle RP, Coffeng LE, et al. Global Skin Disease Morbidity and Mortality: An Update From the Global Burden of Disease Study 2013. JAMA Dermatol. 2017;153(5):406-412.
- Barnetson RS, Rogers M. Childhood atopic eczema. BMJ. 2002;324(7350):1376-1379.
- Spergel JM. Epidemiology of atopic dermatitis and atopic march in children. Immunol Allergy Clin North Am. 2010;30(3):269-280.
- van der Hulst AE, Klip H, Brand PL. Risk of developing asthma in young children with atopic eczema: a systematic review. J Allergy Clin Immunol. 2007;120(3):565-569.
- Ricci G, Patrizi A, Baldi E, Menna G, Tabanelli M, Masi M. Long-term follow-up of atopic dermatitis: retrospective analysis of related risk factors and association with concomitant allergic diseases. J Am Acad Dermatol. 2006;55(5):765-771.
- Gustafsson D, Sjoberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis–a prospective follow-up to 7 years of age. Allergy. 2000;55(3):240-245.
- Kapoor R, Menon C, Hoffstad O, Bilker W, Leclerc P, Margolis DJ. The prevalence of atopic triad in children with physician-confirmed atopic dermatitis. J Am Acad Dermatol. 2008;58(1):68-73.
- Tsakok T, Marrs T, Mohsin M, et al. Does atopic dermatitis cause food allergy? A systematic review. J Allergy Clin Immunol. 2016;137(4):1071-1078.
- Hill DA, Spergel JM. The atopic march: Critical evidence and clinical relevance. Ann Allergy Asthma Immunol. 2018;120(2):131-137.
- Eigenmann PA, Sicherer SH, Borkowski TA, Cohen BA, Sampson HA. Prevalence of IgE-mediated food allergy among children with atopic dermatitis. Pediatrics. 1998;101(3):E8.
- Silverberg JI. Comorbidities and the impact of atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):144-151.
- Simpson EL. Comorbidity in Atopic Dermatitis. Curr Dermatol Rep. 2012;1(1):29-38.
- Paller A, Jaworski JC, Simpson EL, et al. Major Comorbidities of Atopic Dermatitis: Beyond Allergic Disorders. Am J Clin Dermatol. 2018;19(6):821-838.
- Silverberg JI, Gelfand JM, Margolis DJ, et al. Association of atopic dermatitis with allergic, autoimmune, and cardiovascular comorbidities in US adults. Ann Allergy Asthma Immunol. 2018;121(5):604-612 e603.
- Ascott A, Mulick A, Yu AM, et al. Atopic eczema and major cardiovascular outcomes: A systematic review and meta-analysis of population-based studies. J Allergy Clin Immunol. 2019;143(5):1821-1829.
- Silverwood RJ, Forbes HJ, Abuabara K, et al. Severe and predominantly active atopic eczema in adulthood and long term risk of cardiovascular disease: population based cohort study. BMJ. 2018;361:k1786.
- Narla S, Silverberg JI. Association between atopic dermatitis and serious cutaneous, multiorgan and systemic infections in US adults. Ann Allergy Asthma Immunol. 2018;120(1):66-72 e11.
- Thyssen JP, Toft PB, Halling-Overgaard AS, Gislason GH, Skov L, Egeberg A. Incidence, prevalence, and risk of selected ocular disease in adults with atopic dermatitis. J Am Acad Dermatol. 2017;77(2):280-286 e281.
- Beck KM, Seitzman GD, Yang EJ, Sanchez IM, Liao W. Ocular Co-Morbidities of Atopic Dermatitis. Part I: Associated Ocular Diseases. Am J Clin Dermatol. 2019.
- Strom MA, Fishbein AB, Paller AS, Silverberg JI. Association between atopic dermatitis and attention deficit hyperactivity disorder in U.S. children and adults. Br J Dermatol. 2016;175(5):920-929.
- Tsai JD, Chang SN, Mou CH, Sung FC, Lue KH. Association between atopic diseases and attention-deficit/hyperactivity disorder in childhood: a population-based case-control study. Ann Epidemiol. 2013;23(4):185-188.
- Yaghmaie P, Koudelka CW, Simpson EL. Mental health comorbidity in patients with atopic dermatitis. J Allergy Clin Immunol. 2013;131(2):428-433.
- Garg N, Silverberg JI. Association between childhood allergic disease, psychological comorbidity, and injury requiring medical attention. Ann Allergy Asthma Immunol. 2014;112(6):525-532.
- Silverberg JI, Gelfand JM, Margolis DJ, et al. Symptoms and diagnosis of anxiety and depression in atopic dermatitis in U.S. adults. Br J Dermatol. 2019.
- Yu SH, Silverberg JI. Association between Atopic Dermatitis and Depression in US Adults. J Invest Dermatol. 2015;135(12):3183-3186.
- Cheng BT, Silverberg JI. Depression and psychological distress in US adults with atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(2):179-185.
- Sandhu JK, Wu KK, Bui TL, Armstrong AW. Association Between Atopic Dermatitis and Suicidality: A Systematic Review and Meta-analysis. JAMA Dermatol. 2019;155(2):178-187.
- Patel KR, Immaneni S, Singam V, Rastogi S, Silverberg JI. Association between atopic dermatitis, depression, and suicidal ideation: A systematic review and meta-analysis. J Am Acad Dermatol. 2019;80(2):402-410.
- Ronnstad ATM, Halling-Overgaard AS, Hamann CR, Skov L, Egeberg A, Thyssen JP. Association of atopic dermatitis with depression, anxiety, and suicidal ideation in children and adults: A systematic review and meta-analysis. J Am Acad Dermatol. 2018;79(3):448-456 e430.
- Drucker AM, Thiruchelvam D, Redelmeier DA. Eczema and subsequent suicide: a matched case-control study. BMJ Open. 2018;8(11):e023776.
- Halvorsen JA, Lien L, Dalgard F, Bjertness E, Stern RS. Suicidal ideation, mental health problems, and social function in adolescents with eczema: a population-based study. J Invest Dermatol. 2014;134(7):1847-1854.
- Yang EJ, Beck KM, Sekhon S, Bhutani T, Koo J. The impact of pediatric atopic dermatitis on families: A review. Pediatr Dermatol. 2019;36(1):66-71.
- Anderson RT, Rajagopalan R. Effects of allergic dermatosis on health-related quality of life. Curr Allergy Asthma Rep. 2001;1(4):309-315.
- Zuberbier T, Orlow SJ, Paller AS, et al. Patient perspectives on the management of atopic dermatitis. J Allergy Clin Immunol. 2006;118(1):226-232.
- Paller AS, McAlister RO, Doyle JJ, Jackson A. Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr (Phila). 2002;41(5):323-332.
- Chamlin SL, Frieden IJ, Williams ML, Chren MM. Effects of atopic dermatitis on young American children and their families. Pediatrics. 2004;114(3):607-611.
- Roosta N, Black DS, Peng D, Riley LW. Skin disease and stigma in emerging adulthood: impact on healthy development. J Cutan Med Surg. 2010;14(6):285-290.
- Ballardini N, Ostblom E, Wahlgren CF, Kull I. Mild eczema affects self-perceived health among pre-adolescent girls. Acta Derm Venereol. 2014;94(3):312-316.
- Magin P, Adams J, Heading G, Pond D, Smith W. Experiences of appearance-related teasing and bullying in skin diseases and their psychological sequelae: results of a qualitative study. Scand J Caring Sci. 2008;22(3):430-436.
- von Kobyletzki LB, Beckman L, Smirnova J, et al. Eczema and educational attainment: a systematic review. Br J Dermatol. 2017;177(3):e47-e49.
- Holm EA, Esmann S, Jemec GB. The handicap caused by atopic dermatitis–sick leave and job avoidance. J Eur Acad Dermatol Venereol. 2006;20(3):255-259.
- Hon KL, Leung TF, Wong KY, Chow CM, Chuh A, Ng PC. Does age or gender influence quality of life in children with atopic dermatitis? Clin Exp Dermatol. 2008;33(6):705-709.
- Misery L, Finlay AY, Martin N, et al. Atopic dermatitis: impact on the quality of life of patients and their partners. Dermatology. 2007;215(2):123-129.
- Misery L, Seneschal J, Reguiai Z, et al. The impact of atopic dermatitis on sexual health. J Eur Acad Dermatol Venereol. 2019;33(2):428-432.
- Silverberg JI. Health Care Utilization, Patient Costs, and Access to Care in US Adults With Eczema: A Population-Based Study. JAMA Dermatol. 2015;151(7):743-752.
- Eckert L, Gupta S, Amand C, Gadkari A, Mahajan P, Gelfand JM. The burden of atopic dermatitis in US adults: Health care resource utilization data from the 2013 National Health and Wellness Survey. J Am Acad Dermatol. 2018;78(1):54-61 e51.
- Silverberg JI, Gelfand JM, Margolis DJ, et al. Atopic Dermatitis in US Adults: From Population to Health Care Utilization. J Allergy Clin Immunol Pract. 2019;7(5):1524-1532 e1522.
- Singh P, Silverberg JI. Outpatient utilization patterns for atopic dermatitis in the United States. J Am Acad Dermatol. 2019.
- Drucker AM, Qureshi AA, Amand C, et al. Health Care Resource Utilization and Costs Among Adults with Atopic Dermatitis in the United States: A Claims-Based Analysis. J Allergy Clin Immunol Pract. 2018;6(4):1342-1348.
- Kwa L, Silverberg JI. Financial burden of emergency department visits for atopic dermatitis in the United States. J Am Acad Dermatol. 2018;79(3):443-447.
- Cheng BT, Silverberg JI. Predictors of hospital readmission in US children and adults with atopic dermatitis. Ann Allergy Asthma Immunol. 2019;123(1):64-69 e62.
- Narla S, Hsu DY, Thyssen JP, Silverberg JI. Predictors of Hospitalization, Length of Stay, and Costs of Care Among Adult and Pediatric Inpatients With Atopic Dermatitis in the United States. Dermatitis. 2018;29(1):22-31.
- Lim HW, Collins SAB, Resneck JS, Jr., et al. The burden of skin disease in the United States. J Am Acad Dermatol. 2017;76(5):958-972 e952.
- Drucker AM, Wang AR, Li WQ, Sevetson E, Block JK, Qureshi AA. The Burden of Atopic Dermatitis: Summary of a Report for the National Eczema Association. J Invest Dermatol. 2017;137(1):26-30.