Atopic Dermatitis

Atopic dermatitis is a chronic (long-lasting) condition that causes dry, itchy and discolored patches of skin. It affects both children and adults and can flare up or come and go throughout your life.

When an atopic dermatitis rash develops, it can be uncomfortable and itchy. Your immediate reaction may be to scratch it. This can cause swelling, cracking, crusting and scaling. The rash might “weep” a clear fluid.

Dermatitis and eczema both refer to skin inflammation. Atopic dermatitis is the most common type of eczema. Eczema is a term describing a group of skin conditions that result from inflammation. 

Treatment options are available to help you manage symptoms.

Types of atopic dermatitis

Atopic dermatitis refers to a group of skin conditions related to underlying allergies. Its appearance can vary and change over time like the following types:

• Nummular (discoid) dermatitis, which has round, discolored and scaly patches (about the size of a coin).
• Prurigo nodularis, which consists of firm, dry, raised bumps.
• Erythroderma (exfoliative dermatitis), which presents as widespread skin discoloration and scaling on most of your body.
• Lichenoid dermatitis, with flat, dark, itchy and scaly patches of skin.
• Follicular dermatitis, which causes tiny, itchy bumps around hair follicles (tubes where your hair grows).
• Dyshidrosis (pompholyx), which shows up as small, itchy blisters on your hands and feet.

Your provider may refer to atopic dermatitis by its location:

• Flexural dermatitis (skin folds like elbows and knees)
• Face dermatitis
• Eczematous cheilitis (lips)
• Eyelid dermatitis
• Head and neck dermatitis
• Hand dermatitis
• Nipple dermatitis

Atopic dermatitis symptoms

Common atopic dermatitis symptoms may include:

• A skin rash
• Dry or cracked skin
• Itchy skin (can be severe)
• Red, purple, brown or gray skin discoloration
• Small, fluid-filled bumps or crusting
• Swelling

Symptoms can vary significantly from person to person. It’s common for atopic dermatitis to develop in areas where your skin bends or flexes, like behind your knees or on the inside of your elbow. But rashes can occur anywhere on your skin. Symptoms range from mild to severe.

What does atopic dermatitis look like?

Atopic dermatitis will have the features of a skin rash. But those features will look slightly different based on your skin tone. For example, if you have a light skin tone, the rash may look red. If you have a dark skin tone, it may be darker than your natural tone, brown, purple or gray.

It’s important to talk to a healthcare provider if you notice changes to your skin. They can pinpoint what’s going on and help you manage it.

Atopic dermatitis causes

A change in how well your skin’s protective barrier and immune system function causes atopic dermatitis.

Your immune system usually protects your body from things that can harm it, like irritants, allergens and illnesses. If you have atopic dermatitis, you may have a genetic variant that prevents your skin from creating a strong barrier against allergens and irritants. When your skin gets irritated, it inflames and feels itchy. This causes it to break down even further.

What triggers atopic dermatitis?

Triggers of atopic dermatitis may include:

• Allergens or irritants
• Hormonal changes (like during pregnancy)
• Skin infections
• Stress
• Temperature changes (heat or cold)

When you come into contact with an allergen or irritant that triggers symptoms, it’s called contact dermatitis. Common allergens and irritants may include but aren’t limited to the following:

• Foods (like peanuts, eggs, soy, wheat, shellfish, etc.)
• Skincare products (like those with fragrances)
• Plants
• Cleaning products
• Soaps and detergents

Sometimes, it’s difficult to figure out what’s causing symptoms to flare up, but your provider can try to help.

Risk factors of atopic dermatitis

You may be more at risk of atopic dermatitis if you:

• Have a history of the condition in your biological family
• Have asthma
• Had hay fever or other allergies

Complications of atopic dermatitis

Itching your skin may cause a rash to break open. It may bleed or turn into an infection. Signs and symptoms of an infection may include:

• Swelling
• Pain
• Oozing yellow pus

Is atopic dermatitis contagious?

No. Atopic dermatitis isn’t contagious. The rash doesn’t spread from person to person through physical contact.

How doctors diagnose atopic dermatitis

A healthcare provider will diagnose atopic dermatitis after reviewing your symptoms during a physical examination. They’ll look closely at your skin. They may ask you questions about your symptoms, like when they started and what it feels like. Your provider will also review your medical history and known family medical history.

In some cases, your provider may recommend a skin biopsy. This is a test to look at a sample of your skin more closely in a lab under a microscope.

Atopic dermatitis treatment

Your healthcare provider may recommend different options to treat your atopic dermatitis symptoms. This may include:

• Identifying and avoiding triggers and allergens
• Applying an over-the-counter, fragrance-free moisturizer (cream or ointment) to your skin at least twice daily
• Using topical prescription medication as directed by your provider
• Participating in allergen immunotherapy to reduce how many allergic reactions you have 
• Undergoing light therapy (phototherapy)

Atopic dermatitis medications

Two medications that your provider may prescribe to treat atopic dermatitis include:

• Topical corticosteroids
• Topical calcineurin inhibitors

Topical medications are creams or ointments that you rub on your affected skin in the same way you apply a lotion. You should use these medications as directed. They may have side effects if you overuse them.

How can I manage atopic dermatitis symptoms?

To soothe mild, itchy, dry and cracked skin from atopic dermatitis, you can:

• Use over-the-counter anti-itch creams (hydrocortisone)
• Take allergy medication (antihistamine) as directed
• Keep your skin moisturized with products that don’t contain perfumes or dyes, particularly immediately after a bath or shower
• Trim your nails or wear gloves at night to prevent itching
• Wear comfortable clothing that isn’t tight or scratchy
• Use a humidifier to prevent dry air environments
• Take an oatmeal bath (use colloidal oatmeal as directed in your bath water) to lock the moisture into your skin

How long does it take for atopic dermatitis to go away?

The timeline varies from person to person after you start treatment. For example, you may notice itch relief shortly after applying a prescription medication to your skin. The rash may start to fade within days to weeks.

Since there isn’t a cure for atopic dermatitis, the rash generally comes back after treatment. This is why it’s important to pay attention to your triggers and make sure you’re avoiding them, if possible.

If you have any questions about what you can expect, talk to your provider.

When should I see my healthcare provider?

Contact a provider if you notice changes to your skin that cause pain and discomfort. If you’re constantly scratching your skin and develop an infection (with swelling, pain and pus), your provider will help you treat it.

Can atopic dermatitis go away?

Atopic dermatitis symptoms may come and go throughout your life. But the condition doesn’t go away completely.

You may be able to reduce your symptoms by using a moisturizer at least twice daily. Even if you’re diligent in your skincare routine, you can still experience flare-ups. That’s why it’s important to know how to manage your symptoms when they come back. Your healthcare provider can help you do this.