Atopic dermatitis (eczema)

DEFINITION

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.

CAUSES

The exact cause of atopic dermatitis (eczema) is unknown. Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is likely related to a mix of factors:

• Dry, irritable skin, which reduces the skin’s ability to be an effective barrier
• A gene variation that affects the skin’s barrier function
• Immune system dysfunction
• Bacteria, such as Staphylococcus aureus, on the skin that creates a film that blocks sweat glands
• Environmental conditions

SYMPTOMS

Atopic dermatitis (eczema) signs and symptoms vary widely from person to person and include:

• Itching, which may be severe, especially at night
• Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and, in infants, the face and scalp
• Small, raised bumps, which may leak fluid and crust over when scratched
• Thickened, cracked, dry, scaly skin
• Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

Factors that worsen atopic dermatitis

Most people with atopic dermatitis also have Staphylococcus aureus bacteria on their skin. The staph bacteria multiply rapidly when the skin barrier is broken and fluid is present on the skin. This in turn may worsen symptoms, particularly in young children.

Factors that can worsen atopic dermatitis signs and symptoms include:

• Dry skin, which can result from long, hot baths or showers
• Scratching, which causes further skin damage
• Bacteria and viruses
• Stress
• Sweat
• Changes in heat and humidity
• Solvents, cleaners, soaps and detergents
• Wool in clothing, blankets and carpets
• Dust and pollen
• Tobacco smoke and air pollution
• Eggs, milk, peanuts, soybeans, fish and wheat, in infants and children

Atopic dermatitis is related to allergies. But eliminating allergens is rarely helpful in clearing the condition. Occasionally, items that trap dust — such as feather pillows, down comforters, mattresses, carpeting and drapes — can worsen the condition.

When to see a doctor

See your doctor if:

• You’re so uncomfortable that you are losing sleep or are distracted from your daily routines
• Your skin is painful
• You suspect your skin is infected (red streaks, pus, yellow scabs)
• You’ve tried self-care steps without success
• You think the condition is affecting your eyes or vision

Take your child to the doctor if you notice these signs and symptoms in your child or if you suspect your child has atopic dermatitis.

Seek immediate medical attention for your child if the rash looks infected and he or she has a fever.