Atopic Dermatitis vs Contact Dermatitis

Atopic dermatitis: It is a long-term (chronic) itchy inflammatory skin condition that can affect anyone but usually starts in early infancy (before the child turns 1 year old). Atopic dermatitis is also called atopic eczema. It is a common type of dermatitis.

Contact dermatitis: This refers to inflammation of the skin when the skin directly comes in contact with the substance it is allergic or sensitive to. Unlike atopic dermatitis, contact dermatitis is generally seen in adults.

Atopic dermatitis causes:

• There is no single known cause of this condition.
• The immune system seems to play a major role in causing atopic dermatitis.
• Kids who have a family history of dermatitis, asthma, or hay fever have a high risk of atopic dermatitis. Studies have revealed certain genes that form defective skin proteins, resulting in this condition.
• Women have a higher risk of atopic dermatitis than men.
• The condition seems to be more common in people belonging to the African American race.
• Certain conditions such as viral infections, teething, or eating certain foods can cause atopic dermatitis flare-ups.
• In many cases, there may be no obvious trigger.

Contact dermatitis causes:

• Unlike atopic dermatitis, contact dermatitis does not run in families.
• It is not a result of a generalized immune phenomenon and is thus not associated with other forms of allergies such as hay fever and asthma.
• In over 80% of people, contact dermatitis results when the skin cells are damaged on exposure to irritants such as detergents, solvents, bleach, fragrances, soaps, and nickel jewelry.
• In the rest of the people, an allergic reaction may occur 1 or 2 days after exposure to an allergen such as poison ivy.

Atopic dermatitis: Atopic dermatitis may present with the following signs and symptoms:

• Pruritus (excessive itching)
• Xerosis (dry skin)
• Lichenification (thickening of the skin associated with an increase in skin markings)
• Bumps or scaly patches on the skin

Atopic dermatitis can affect the skin on any part of the body such as the face, neck, arms, and hands. The armpits and groins are generally spared. Bacterial infection may occur on the skin leading to crusting, oozing, and ulcer formation.

Contact dermatitis: The symptoms generally appear within minutes to hours of the exposure and are mainly confined to the area exposed to the allergen. Symptoms include:

• Itching
• Redness
• Bumps or blisters that may ooze and crust
• Burning or pain
• Dry and scaly skin
• Swelling over the affected area

Atopic dermatitis treatment:

• Treatment is mainly directed to prevent itching.
• The doctor may advise ways to keep the skin moist such as the use of emollients or moisturizers.
• Taking a 5-minute bath in lukewarm water (not hot water because it may further make the skin dry and itchy) followed by the application of a moisturizer such as white petrolatum generally helps.
• The person should keep their body wet after the bath instead of rubbing or drying it with a towel.
• Infants should be bathed thrice a day, whereas adults can take a bath once or twice a day.
• A capful of emulsifying oils such as coconut or peppermint oil in lukewarm bath water will help keep the skin moist.
• Steroid ointments may be prescribed during flare-ups.
• Ointments containing tacrolimus or creams containing pimecrolimus may be prescribed in severe cases.
• People with severe itching may need oral antihistamine or steroid medications.
• Antibiotics may be needed when there is an infection.
• People with chronic and severe eczema may require the use of immunosuppressants (drugs that calm the immune system) such as methotrexate, azathioprine, and cyclosporine.

Contact dermatitis treatment:

• The first step for treating contact dermatitis is the removal of the irritant (for example, remove the nickel jewelry, change the clothes contaminated with the detergent/solvent or fragrance, and take a bath).
• Applying cool compresses or taking a cool bath may ease the irritation.
• Sprinkling some baking soda or taking an oatmeal-based bath may soothe the skin.
• Avoid scratching and apply over-the-counter (OTC) anti-itch lotion or cream containing 1% hydrocortisone once or twice a day.
• The doctor may prescribe oral antihistamines or steroids to control the symptoms.