Atopic dermatitis is a term used to describe a skin condition in which one develops itchy dry skin that can become red, scaly, crusty or oozing, especially when repeatedly scratched.
Atopic dermatitis is sometimes called eczema, however this is technically not correct. Eczema actually refers to many different types of inflammatory skin condition to include atopic dermatitis, contact dermatitis, nummular eczema, and seborrheic dermatitis -- so atopic dermatitis is a type of eczema, but eczema is not necessarily atopic dermatitis.
Atopic dermatitis can affect both children and adults, but is much more common in children. It is estimated that 10-15% of all children will suffer from this skin condition. The vast majority (90%) of children with atopic dermatitis will have symptoms before the age of 5. It is rare for atopic dermatitis to suddenly develop after the age of 30.
Does it ever go away?
About 60% of affected children will still have the condition as adults, although it is typically less severe at that time. The condition is less likely to go away if the child has a history of hay fever, asthma, or if there is a family history of atopic dermatitis.
What causes atopic dermatitis?
The exact cause is not known. Most likely it is due to a combination of environmental exposures and hereditary factors. About half of children with severe atopic dermatitis end up developing hay fever or asthma by the time they reach their teens which suggest allergies is a factor. Further, the majority of people with atopic dermatitis (70%) have a family history of asthma, allergic rhinitis (hay fever, or environmental allergies), or atopic dermatitis. About half of children with severe atopic dermatitis end up developing hay fever or asthma by the time they reach their teens.
One thing that is clear is that itching worsens the development of the rash of atopic eczema. In fact, the condition is often called “the itch that rashes” because the more one scratches the worse the rash will become.
Typically, the skin will be dry and itchy. With scratching, the rash will worsen, resulting in red, scaly patches. When more severe, the rash can result in oozing and crusting lesions which can become infected. Over time, the skin can become thick or leathery in appearance. The rash tends to affect different parts of the body depending on the age of the individual.
In infants, the rash typically involves the cheeks. Sometimes, it may involve the whole body, except for the
In young children (ages 2-12), the most commonly affected area are the folds of the arms, the wrists, the ankles and behind the knees.
In teenagers and adults, the rash often occurs on the hands, the folds of the arms or knees, around the eyes, and in the groin.
What makes atopic dermatitis worse?
The skin of individuals with atopic dermatitis is much more sensitive than normal skin. Substances such as wool,
cosmetics, perfumes, and detergents can result in skin irritation and worsening of the rash. Even plain soap can
exacerbate the condition as it will remove the skin’s protective oil from the skin.
A dry environment will result in increased itching and flares of atopic dermatitis. This is why the condition often
worsens during the winter months. However summer can be a problem for some people too, because sweating can
irritate the skin and cause more itching.
Environmental allergens such as dust mite, animals, and pollens can make atopic dermatitis worse, and it is thus useful
to get tested for allergies to find out if these could be exacerbating the problem.
A common misconception is that atopic dermatitis is caused by stress. Stress clearly correlates with increased skin
itching and rashes of atopic dermatitis, but it is not the actual cause of the disease.
Yes...sometimes. This is more likely to be a factor in infants and young children compared to adults. It is estimated that foods may a factor in about one half of children sufferering from atopic dermatitis. Unlike regular food allergies which can result in life threatening reactions, the food allergy associated with atopic dermatitis results in the rash and it is not a life threatening condition. The most common foods associated with eczema in children are eggs, peanuts, milk, fish, soy, and wheat. Skin testing is usually preferred over blood testing for the evaluation of food allergies in infants and children with atopic dermatitis because young children with eczema often have highly elevated allergy (IgE) antibodies in their system which can cause inaccurate blood test results.
Getting atopic dermatitis, especially when severe, can be very difficult to control. The following stops are helpful in the management. Consistency is the key to control.
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