Eczema & Atopic Dermatitis
What Is Atopic Dermatitis?
Atopic dermatitis is a long-term skin disease. “Atopic” refers to a tendency to develop allergy conditions. “Dermatitis” means swelling of the skin.
The most common symptoms of atopic dermatitis are:
- Dry and itchy skin
- Rashes on the face, inside the elbows, behind the knees, and on the hands and feet.
Scratching the skin can cause:
- “Weeping” clear fluid
- Thick skin
Often, the skin gets worse (flares), then it improves or clears up (remissions).
Who Gets Atopic Dermatitis?
Atopic dermatitis is most common in babies and children. But it can happen to anyone. People who live in cities and dry climates may be more likely to get this disease.
When children with atopic dermatitis grow older, this problem can improve or go away. But the skin may stay dry and easy to irritate. At other times, atopic dermatitis is a problem in adulthood.
You can’t “catch” the disease or give it to other people.
Other Types of Skin Problems
Atopic dermatitis is often called eczema. “Eczema” is a term for many kinds of skin problems. Atopic dermatitis is the most common kind of eczema. Other types include:
- Allergic contact eczema. The skin gets red, itchy, and weepy because it touches something that the immune system knows is foreign, like poison ivy.
- Contact eczema. The skin has redness, itching, and burning in one spot because it has touched something allergy-causing, like an acid, cleaner, or other chemical.
- Dyshidrotic eczema. The skin on the palms of hands and soles of the feet is irritated and has clear, deep blisters that itch and burn.
- Neurodermatitis. Scaly patches on the head, lower legs, wrists, or forearms are caused by a localized itch (such as an insect bite).
- Nummular eczema. The skin has coin-shaped spots of irritation. The spots can be crusted, scaling, and very itchy.
- Seborrheic eczema. This skin has yellowish, oily, scaly patches on the scalp, face, and sometimes other parts of the body.
- Stasis dermatitis. The skin is irritated on the lower legs, most often from a blood flow problem.
What Causes Atopic Dermatitis?
The cause of atopic dermatitis is not known. It is likely caused by both genetic (runs in the family) and environmental factors. People with this disease often have other atopic conditions, like hay fever and asthma.
How Is Atopic Dermatitis Diagnosed?
Diagnosis is based on the symptoms. Each person has his or her own mix of symptoms that can change over time. Doctors will ask for a medical history to:
- Learn about your symptoms
- Know when symptoms occur
- Rule out other diseases
- Look for causes of symptoms.
Doctors also may ask about:
- Other family members with allergies
- Whether you have conditions such as hay fever or asthma
- Whether you have been around something that might bother the skin
- Sleep problems
- Foods that may lead to skin flares
- Treatments you have had for other skin problems
- Use of steroids or medicine.
There isn’t a certain test that can be used to check for this disease. But you may be tested for allergies by a dermatologist (skin doctor) or allergist (allergy doctor).
Things That Make Atopic Dermatitis Worse
Irritants and allergens can make atopic dermatitis worse.
Irritants are things that may cause the skin to be red and itchy or to burn. They include:
- Wool or man-made fibers
- Soaps and cleaners
- Some perfumes and makeup
- Substances such as chlorine, mineral oil, or solvents
- Dust or sand
- Cigarette smoke.
Allergens are allergy-causing substances from foods, plants, animals, or the air. Common allergens are:
- Eggs, peanuts, milk, fish, soy products, and wheat
- Dust mites
- Dog or cat dander.
Stress, anger, and frustration can make atopic dermatitis worse, but they haven’t been shown to cause it. Skin infections, temperature, and climate can also lead to skin flares. Other things that can lead to flares are:
- Not using enough moisturizer after a bath
- Low humidity in winter
- Dry year-round climate
- Long or hot baths and showers
- Going from sweating to being chilled
- Bacterial infections.
How Is Atopic Dermatitis Treated?
Treatment works best when the patient, family members, and doctor work together. Treatment plans are based on:
- General health.
You need to carefully follow the treatment plan. Try to notice what is or isn’t helpful. Symptoms usually improve with the right skin care and lifestyle changes.
Atopic dermatitis treatment goals are to heal the skin and prevent flares. Your doctor will help you:
- Develop a good skin care routine
- Avoid things that lead to flares
- Treat symptoms when they occur.
You and your family members should watch for changes in the skin to find out what treatments help the most.
- Medications for atopic dermatitis include:
- Skin creams or ointments that control swelling and lower allergic reactions
- Antibiotics to treat infections caused by bacteria
- Antihistamines that make people sleepy to help stop nighttime scratching
- Drugs that suppress the immune system.
Other treatments include:
- Light therapy
- A mix of light therapy and a drug called psoralen
- Skin care that helps heal the skin and keep it healthy
- Protection from allergens.
Atopic Dermatitis and Vaccination Against Smallpox
People with atopic dermatitis should not get the smallpox vaccine. It may cause serious problems in people with atopic dermatitis.