Atopic Dermatitis

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Causes of Eczema

There are at least 11 different types of skin conditions that produce eczema. In order to develop a rational treatment plan, it is important to distinguish them. This is often not easy.

Atopic dermatitis: This condition has a genetic basis and is the most common type of eczema. Atopic dermatitis tends to begin early in life in those with a predisposition to inhalant allergies, but it probably does not have an allergic basis. Characteristically, rashes occur on the cheeks, neck, elbow and knee creases, and ankles.

Quick GuideEczema (Atopic Dermatitis) Causes, Symptoms, Treatment

Eczema (Atopic Dermatitis) Causes, Symptoms, Treatment

Atopic dermatitis facts

  • Atopic dermatitis is a chronic eczematous skin disease that usually begins in childhood.
  • A predisposition to atopic dermatitis is often inherited.
  • Patient's with atopic dermatitis have "super sensitive" skin and a decreased threshold for irritation.
  • Acute atopic dermatitis produces weeping, oozing plaques of very itchy skin.
  • Itching is a characteristic symptom.
  • Chronic atopic dermatitis appears as thickened, elevated plaques of scaling skin.
  • Patients with atopic dermatitis seem to have a misguided immune response.
  • Treatment of atopic dermatitis is centered around rehydrating the skin with emollients like petroleum jelly and the cautious use of topical steroids to reduce inflammation and itching.
  • Oral antihistamines may be helpful in breaking the "itch-scratch" cycle.
  • Since secondary infections can aggravate the rash, topical or oral antibiotics may also be occasionally indicated.

What is atopic dermatitis?

Atopic dermatitis is a common, often persistent skin disease that affects a large percentage of the world's population. Atopy is a special type of allergic hypersensitivity that is associated with asthma, inhalant allergies (hay fever), and a chronic dermatitis. There is a known hereditary component of the disease, and it is more common in affected families. Criteria that enable a doctor to diagnose it include the typical appearance and distribution of the rash in a patient with a personal or family history of asthma and/or hay fever. The term atopic is from the Greek meaning "strange." The term dermatitis means inflammation of the skin. Many physicians and patients use the term eczema when they are referring to this condition. Sometimes it is called neurodermatitis.

In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, vesicle formation (minute blisters), cracking, weeping, crusting, and scaling. This type of eruption is termed eczematous. In addition, dry skin is a very common complaint in almost all those afflicted with atopic dermatitis.

Although atopic dermatitis can occur in any age, most often it affects infants and young children. Occasionally, it may persist into adulthood or may actually appear at that time. Some patients tend to have a protracted course with ups and downs. In most cases, there are periods of time when the disease is worse, called exacerbations or flares, which are followed by periods when the skin improves or clears up entirely, called remissions. Many children with atopic dermatitis enter into a permanent remission of the disease when they get older, although their skin may remain somewhat dry and easily irritated.

Multiple factors can trigger or worsen atopic dermatitis, including low humidity, seasonal allergies, exposure to harsh soaps and detergents, and cold weather. Environmental factors can activate symptoms of atopic dermatitis at any time in the lives of individuals who have inherited the atopic disease trait.

Medically Reviewed by a Doctor on 12/21/2016

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