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Atopic dermatitis

Infantile eczema; Dermatitis - atopic; Eczema

Atopic dermatitis is a long-term (chronic) skin disorder that involves scaly and itchy rashes. It is a type of eczema.

Other forms of eczema include:

Images

Keratosis pilaris - close-up
Atopic dermatitis
Atopy on the ankles
Dermatitis, atopic in an infant
Eczema, atopic - close-up
Dermatitis, atopic on a young girl's face
Keratosis pilaris on the cheek
Dermatitis, atopic on the legs
Hyperlinearity in atopic dermatitis

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Causes

Atopic dermatitis is due to a skin reaction in the skin. The reaction leads to ongoing itching, swelling and redness. People with atopic dermatitis may be more sensitive because their skin lacks certain proteins that maintain the skin's barrier to water.

Atopic dermatitis is most common in infants. It may start as early as age 2 to 6 months. Many people outgrow it by early adulthood.

People with atopic dermatitis often have asthma or seasonal allergies. There is often a family history of allergies such as asthma, hay fever, or eczema. People with atopic dermatitis often test positive to allergy skin tests. However, atopic dermatitis is not caused by allergies.

The following can make atopic dermatitis symptoms worse:

Symptoms

Skin changes may include:

The type and location of the rash can depend on the age of the person:

Intense itching is common. Itching may start even before the rash appears. Atopic dermatitis is often called the "itch that rashes" because the itching starts, and then the skin rash follows as a result of scratching.

Exams and Tests

Your health care provider will look at your skin and do a physical exam. You may need a skin biopsy to confirm the diagnosis or rule out other causes of dry, itchy skin.

Diagnosis is based on:

Allergy skin testing may be helpful for people with:

Your provider may order cultures for infection of the skin. If you have atopic dermatitis you may get infections easily.

Treatment

SKIN CARE AT HOME

Daily skin care may cut down on the need for medicines.

To help you avoid scratching your rash or skin:

Keep your skin moist by using ointments (such as petroleum jelly), creams, or lotions 2 to 3 times a day. Choose skin products that do not contain alcohol, scents, dyes, and other chemicals. A humidifier to keep home air moist will also help.

Avoid things that make symptoms worse, such as:

When washing or bathing:

MEDICINES

At this time, allergy shots are not used to treat atopic dermatitis.

Antihistamines taken by mouth may help with itching or allergies. You can often buy these medicines without a prescription.

Atopic dermatitis is usually treated with medicines placed directly on the skin or scalp. These are called topical medicines:

Wet-wrap treatment with topical corticosteroids may help control the condition. But, it may lead to an infection.

Other treatments that may be used include:

Outlook (Prognosis)

Atopic dermatitis lasts a long time. You can control it by treating it, avoiding irritants, and by keeping your skin well-moisturized.

In children, the condition often starts to go away around age 5 to 6, but flare-ups will often occur. In adults, the problem is generally a long-term or returning condition.

Atopic dermatitis may be harder to control if it:

Possible Complications

Complications of atopic dermatitis include:

When to Contact a Medical Professional

Call your provider if:

Prevention

Children who are breastfed until age 4 months may be less likely to get atopic dermatitis.

If a child is not breastfed, using a formula that contains processed cow milk protein (called partially hydrolyzed formula) may cut down on the chances of developing atopic dermatitis.

Related Information

Asthma
Allergic rhinitis
Chronic
Immune response
Allergies - overview
Itching

References

Boguniewicz M, Leung DYM. Atopic dermatitis. In: Adkinson NF Jr, Bochner BS, Burks AW, et al, eds. Middleton's Allergy: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 34.

Eichenfield LF, Boguniewicz M, Simpson EL, et al. Translating atopic dermatitis management guidelines into practice for primary care providers. Pediatrics. 2015;136(3):554-565. PMID: 26240216 www.ncbi.nlm.nih.gov/pubmed/26240216.

McAleer MA, O'Regan GM, Irvine AD. Atopic dermatitis. In: Bolognia JL, Schaffer JV, Cerroni L, eds. Dermatology. 4th ed. Philadelphia, PA: Elsevier; 2018:chap 12.

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Review Date: 10/14/2018  

Reviewed By: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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