Atopic dermatitis, also known as eczema, is a common skin condition that causes irritation, redness, itching and inflammation. It most often begins in childhood and can persist into adulthood. Here’s an in-depth look at what atopic dermatitis is, how to identify it, and treatment options that can provide relief.
What Is Atopic Dermatitis?
Atopic dermatitis is a chronic, inflammatory skin condition that flare ups periodically. It is one of the most common forms of eczema. Atopic refers to a group of diseases with an often inherited tendency to develop other allergic conditions like asthma or hay fever.
With atopic dermatitis, the immune system overreacts, causing the skin to become red, cracked and extremely itchy. Scratching leads to further irritation known as the “itch-scratch” cycle. The condition may come and go, with flare ups mixed with periods of remission.
Symptoms Of Atopic Dermatitis
Common Symptoms
Where Symptoms Occur
Atopic dermatitis often appears in areas with folds or creases such as:
In infants and children, rashes often appear on the face, scalp, chest, back, arms and legs. Symptoms typically improve with age.
Causes And Risk Factors
The exact cause of atopic dermatitis is unknown, but believed to involve genetics, immune system dysfunction, environmental exposures, skin biology and microbiome disruption.
Risk Factors
- Family history of atopic dermatitis, asthma or hay fever
- Gene mutations affecting skin barrier or immune function
- Having other atopic conditions
- Exposure to allergens or irritants
- Contact with certain bacteria and viruses
- Stress, sweat, hot/cold weather
- Dry skin
- Aggressive washing or bathing habits
Flares can occur due to various triggers ranging from environmental to emotional stressors. Identifying and managing triggers is an important part of treatment.
Diagnosis Of Atopic Dermatitis
A dermatologist can diagnose atopic dermatitis by reviewing symptoms and examining the appearance and locations of rashes. They may also review medical history for other atopic conditions.
No definitive lab test exists, but blood work or allergy testing can help rule out other disorders. A skin biopsy may sometimes be done to confirm the diagnosis if uncertain.
Atopic Dermatitis Treatment Options
While there is no cure for atopic dermatitis, various treatments can relieve symptoms and prevent flares. A combination approach is often needed.
1. Moisturizers and Emollients
Frequently applying fragrance-free moisturizing creams or ointments helps hydrate and protect skin. Ointments work better than lighter lotions.
2. Medicated Ointments and Creams
Topical prescription treatments like corticosteroid, tacrolimus or Eucrisa ointments can reduce inflammation during flares.
3. Oral Medications
For moderate to severe cases, oral immunosuppressants like cyclosporine may be prescribed to calm overactive immune response.
4. Phototherapy
Exposing skin to UVA or UVB light under medical supervision can relieve symptoms in some cases.
5. Biologic Drugs
Injectable biologics like Dupixent can inhibit specific parts of the immune system involved in eczema.
6. Wet Wrap Therapy
Wet dressings covered by a dry bandage can allow medicated ointments to better penetrate the skin.
7. Itch-relief Treatment
Antihistamines, cold compresses, or topical numbing creams may temporarily relieve itching.
8. Avoid Triggers
Reducing exposure to irritants, allergens, changes in temperature and emotional stress can prevent flares.
With a combination approach tailored to each individual, atopic dermatitis can often be effectively managed. See a dermatologist to develop an appropriate treatment regimen.
Conclusion
Atopic dermatitis is a common chronic skin condition affecting both children and adults, causing red, irritated and itchy rashes. While not completely curable, its symptoms can be managed with a variety of moisturizing, medical, and lifestyle approaches. Identifying and avoiding triggers is also key. With proper treatment guided by a dermatologist, periods of remission are possible.
Frequently Asked Questions
A: No, eczema itself is not contagious and cannot spread from person to person. But bacterial infections can result from excessive scratching.
A: Yes, atopic dermatitis most often starts in childhood but can persist into or develop during adulthood in some patients.
A: Common food allergens like eggs, milk, soy, wheat and nuts may contribute to flares in some cases. An elimination diet can help identify problematic foods.
A: No, treatment needs to be continued even when in remission to prevent recurring flares. Slowly taper off medications only under a doctor’s supervision.
A: Yes, people with family members who have atopic dermatitis or related allergic conditions are at a higher risk. There appears to be a genetic component involving mutations in certain genes.
