What's in this article?
Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It’s common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically and then subside. It may be accompanied by asthma or hay fever.
No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps and other irritants, apply medicated creams or ointments, and moisturize your skin.
See your doctor if your atopic dermatitis symptoms distract you from your daily routines or prevent you from sleeping.
What are the symptoms of atopic eczema?
- The skin usually feels dry.
- Some areas of the skin become red and inflamed. The most common areas affected are next to skin creases, such as the front of the elbows and wrists, backs of knees and around the neck. However, any areas of skin may be affected. The face is commonly affected in babies with atopic eczema.
- Inflamed skin is itchy. If you scratch a lot it may cause patches of skin to become thickened.
- Sometimes the inflamed areas of skin become blistered and weepy.
- Sometimes inflamed areas of skin become infected.
Typically, inflamed areas of skin tend to flare up from time to time and then tend to settle down. The severity and duration of flare-ups varies from person to person and from time to time in the same person.
- In mild cases, a flare-up may cause just one or two small, mild patches of inflammation. Often these are behind the knees, or in front of elbows or wrists. Flare-ups may occur only now and then.
- In severe cases, the flare-ups can last several weeks or more and cover many areas of skin. This can cause great distress.
- Many people with atopic eczema are somewhere in between these extremes.
Does atopic eczema persist forever?
Atopic eczema affects 15-20% of children but is much less common in adults. It is impossible to predict whether eczema will improve by itself or not in an individual. Sensitive skin persists life-long.
It is unusual for an infant to be affected with atopic eczema before the age of four months but they may suffer from infantile seborrhoeic dermatitis or other rashes prior to this. The onset of atopic eczema is usually before two years of age although it can manifest itself in older people for the first time.
Atopic eczema is often worst between the ages of two and four but it generally improves after this and may clear altogether by the teens.
Certain occupations such as farming, hairdressing, domestic and industrial cleaning, domestic duties and care-giving expose the skin to various irritants and, sometimes, allergens. This aggravates atopic eczema. It is wise to bear this in mind when considering career options it is usually easier to choose a more suitable occupation from the outset than to change it later.
What causes atopic eczema?
The exact cause of atopic eczema is unknown, but it’s clear it’s not down to one single thing. It often occurs in people who get allergies – “atopic” means sensitivity to allergens.
It can run in families, and often develops alongside other conditions, such as asthma and hay fever.
The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather. Sometimes food allergies can play a part, especially in young children with severe eczema.
What Atopic eczema Look like?
How common is atopic dermatitis?
Atopic dermatitis is very common worldwide and increasing in prevalence. It affects males and females equally and accounts for 10%-20% of all referrals to dermatologists (doctors who specialize in the care and treatment of skin diseases). Atopic dermatitis occurs most often in infants and children, and its onset decreases substantially with age. Scientists estimate that 65% of patients develop symptoms in the first year of life, and 90% develop symptoms before the age of 5. Onset after age 30 is less common and often occurs after exposure of the skin to harsh conditions. People who live in urban areas and in climates with low humidity seem to be at an increased risk for developing atopic dermatitis.
About 10% of all infants and young children experience symptoms of the disease. Roughly 60% of these infants continue to have one or more symptoms of atopic dermatitis even after they reach adulthood. This means that more than 15 million people in the United States have symptoms of the disease.
What is the treatment for atopic eczema?
Treatment of atopic eczema may be required for many months and possibly years.
It nearly always requires:
- Reduction of exposure to trigger factors (where possible)
- Regular emollients (moisturisers)
- Intermittent topical steroids
In some cases, management may also include one of more of the following:
- Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment
- Antibiotics
- Antihistamines
- Phototherapy
- Oral corticosteroids
Longstanding and severe eczema may be treated with an immunosupressive agent.
- Methotrexate
- Ciclosporin
- Azathioprine
Other types of eczema
Eczema is the name for a group of skin conditions that cause dry, irritated skin. Other types of eczema include:
- discoid eczema – a type of eczema that occurs in circular or oval patches on the skin
- contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
- varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
- seborrhoeic eczema – a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
- dyshidrotic eczema (pompholyx) – a type of eczema that causes tiny blisters to erupt across the palms of the hands