Everything You Need to Know About Atopic Dermatitis

Eczema is a broad term for a group of skin conditions that affects about 10% of the American population. The most common type of eczema is atopic dermatitis, and the terms are often used interchangeably.

Atopic dermatitis usually crops up in childhood. And while some people outgrow it, it can last into adulthood, or appear later in life.

The itchy and flaky red rashes usually associated with the condition may flare up once in a while. But in severe cases, the condition can be life altering.

Atopic dermatitis can also appear differently in different people. A person with darker skin might have purple, brown, or gray rashes, while someone with lighter skin might have pink or red rashes. Either way, itchy, dry rashes are a hallmark of the condition. Other symptoms can include scaly or thickened skin and oozing.

These rashes can appear anywhere on the body, but they usually show up on hands, feet, inner elbows, the neck, and behind the knees.

For those with severe atopic dermatitis, symptoms can also include trouble sleeping or focusing. They’re more likely to develop anxiety or depression, too.

Why do I have it?

While we’re not entirely sure what causes atopic dermatitis, several factors have emerged as clues.

Everyone with the condition has a damaged or weakened skin barrier, making it easier for irritants to penetrate the skin and for moisture to escape, causing inflamed, dry, and itchy skin.

There are various reasons why someone might have a compromised skin barrier and develop atopic dermatitis. Their genes are one. The condition usually runs in families. This, in part, is because those with a genetic predisposition for atopic dermatitis may have less of a protein called filaggrin, which keeps the skin barrier strong.

People with atopic dermatitis also tend to have an overactive immune response that makes them more sensitive to substances commonly found in personal care products that are normally harmless, like fragrances or preservatives. This response triggers their white blood cells to release too many cytokines, a type of protein that can cause skin inflammation.

People with the condition might also have less of certain healthy bacteria on their skin and more of bacteria that causes inflammation than those without it. This can cause symptoms to take hold, or further aggravate them.

What can I do about it?

Atopic dermatitis can’t be cured, but you can manage mild symptoms. And a board-certified dermatologist can help with the more severe ones.

For starters, moisturize. Moisturizing your skin barrier and can minimize flare-ups. Use a thick ointment or cream made with petroleum jelly, which will be more effective than a thinner lotion. Other moisturizing ingredients like glycerin, dimethicone, and ceramides are also beneficial. However, plant extracts like chamomile can make atopic dermatitis worse.

Next, limit your showers to 10 minutes and use lukewarm water. Long, hot showers dry out the skin. Afterward, lock in hydration by moisturizing your skin while it’s still damp.

Finally, one percent hydrocortisone cream – which is available over the counter – can help tamp down mild flare-ups. Follow the instructions on the label. If after a week, you see and feel little difference, stop using it and schedule an appointment with a dermatologist.

A dermatologist may prescribe a stronger topical cream, injectable medications, oral medications, or phototherapy to manage severe atopic dermatitis. No single treatment is perfectly effective for everyone, but since the first atopic dermatitis medications were developed decades ago, we’ve made tremendous progress in reducing symptoms.