Atopic Dermatitis, and its Symptoms, Causes, Diagnosis, Treatment, and Prevention

It's also known as dermatitis (skin inflammation), atopic eczema ("atopic" means a genetic tendency toward allergic hypersensitivity), or simply atopic dermatitis. In fact, the word "eczema" is often used interchangeably with "atopic dermatitis,” though clinically speaking, atopic dermatitis is the most common type of eczema.

Dyshidrotic Eczema

Small, itchy blisters on the soles of the feet and edges of the fingers, toes, and palms may be signs of dyshidrotic eczema. Stress and allergies are two possible triggers for this form of eczema.

Nummular Eczema

Compared to other types of eczema, nummular eczema appears differently: as itchy, coin-shaped spots on the skin.

Stasis Dermatitis

This occurs when fluid leaks out of the veins and into the skin due to blood flow issues.

Signs and Symptoms of Eczema

People with eczema have very dry, itchy skin and rashes on various parts of the body — particularly the face, hands, feet, insides of the elbows, and behind the knees.

In addition, skin lesions and blotches may develop on the wrists, ankles, sides of the neck, or around the mouth.

For most people, the main symptom of eczema is itching, which can lead to scratching and rubbing that further irritates the skin. This can, in turn, lead to the “itch-scratch cycle” or increased itching and scratching that worsens eczema symptoms.

Other skin symptoms associated with eczema include:

  • Rough, leathery patches of skin
  • Red, raised bumps (hives)
  • Increased skin creases on the palms of the hands
  • Small, rough bumps on the face, upper arms, and thighs
  • Scaly skin patches
  • Swollen, sore skin
  • Skin color changes

Causes and Risk Factors of Eczema

Skin affected by eczema is unable to retain moisture well, possibly because of low production of fats and oils. It is also caused by a disrupted skin barrier, allowing whatever moisture the skin has to freely evaporate into the air. This causes it to become dry and lose its protective properties.

It's not clear what causes certain people to develop eczema, specifically atopic dermatitis.

Children are more likely to develop eczema if other allergic diseases — such as hay fever and asthma — run in the family, which suggests that there may be a genetic component to the condition. Read more about conditions related to eczema below.

Though dermatologists don’t necessarily consider eczema an autoimmune disorder, the symptoms of atopic dermatitis are thought to be the result of an immune system overreaction or dysfunction.

In addition to genetic and immune system factors, environmental factors also play a role in worsening or triggering eczema.

  • Soaps, detergents, shampoos, and dishwashing liquids
  • Bubble bath liquids
  • Dust or sand
  • Cigarette smoke
  • Perfumes, and skin-care products that contain fragrances or alcohol
  • Wool or synthetic fabrics
  • Chemicals, solvents, and mineral oils
  • Mold
  • Pollen
  • Pet dander
  • Allergenic foods (such as peanuts, soy, and eggs)
  • Dust mites
  • A hot or dry climate
  • High or low humidity
  • Bacterial, viral, or fungal infections

How Is Eczema Diagnosed?

To diagnose eczema, your doctor will first conduct a physical examination to look at the state of your skin and see if you have the characteristic rash of the illness.

They may perform a skin biopsy (remove a skin sample for examination) to confirm the diagnosis and rule out other skin conditions.

Duration of Eczema

Atopic dermatitis in adults often lasts a long time and there is no way to determine if it will go away or last a lifetime. But the frequency and severity of symptoms usually decrease over time, and you can control atopic dermatitis through treatment, moisturizing, and by avoiding irritants that cause flare-ups.

Treatment and Medication Options for Eczema

There is no cure for eczema, and the goal of treatment is to reduce eczema symptoms, heal the skin, and prevent skin damage and flare-ups. Medication, moisturizers, and at-home skin-care routines make up an effective treatment plan for many people who live with eczema.

Diet Options

Elimination diets are also used to diagnose autoimmune conditions such as eosinophilic esophagitis (EoE), a chronic disease of the esophagus, according to the American College of Gastroenterology.

Prevention of Eczema

There is no proven way to prevent getting eczema. Nonetheless, research suggests children who are breastfed until they’re 4 months old may be less likely to get it. Alternatively, partially hydrolyzed formula, which contains processed cow milk protein, may also reduce a child's chance of developing atopic dermatitis.

  • Follow a healthy skin-care routine, including using moisturizing cream or ointment two to three times a day.
  • Use gloves when needed, such as when you’re at risk of coming in contact with irritants. That means while working outside or if you have to put your hands underwater (to absorb sweat, wear cotton gloves under plastic gloves).
  • Bathe smart, such as by using only mild soap and lukewarm water for your bath or shower, and patting your skin dry instead of rubbing it.
  • Stay cool by drinking lots of water, and avoiding getting hot and sweaty.
  • Wear loose clothes — that is, those that are made of cotton and other natural materials.
  • Keep your body temperature steady by avoiding sudden changes in temperature and humidity.
  • Tame stress by recognizing the signs and taking steps to manage it.
  • Limit exposure to known irritants and allergens as best you can.
  • Don't itch affected skin areas.

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