Fitness facts: Atopic dermatitis

Connie Colbert

By Connie Colbert
Director, Canyon Health and Wellness Clinic

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It is common in children but can occur at any age. Atopic dermatitis is long lasting and tends to flare periodically. Most people who have atopic dermatitis have a personal or family history of allergies, such as hay fever, allergic rhinitis or asthma.

The cause of atopic dermatitis is not clear, but it affects your skin's ability to hold moisture.  

Symptoms include:

  • Dry skin;
  • Itching, which may be severe, especially at night;
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp;
  • Small, raised bumps, which may leak fluid and crust over when scratched;
  • Thickened, cracked, scaly skin;
  • Raw, sensitive, swollen skin from scratching.

The condition often starts with dry skin that is often very itchy. Scratching causes the dry skin to become red and irritated (inflamed). Infection often occurs. Tiny bumps that look like little blisters may appear and ooze fluid or crust over. The symptoms of dryness, itchiness, scratching, and inflammation can come and go. Over time, a recurring rash can lead to tough and thickened skin.

Mild eczema affects a small area of skin and may be only itchy occasionally, but moderate and severe eczema cover larger areas of skin and are itchy more often. And at times, the itch may be intense.

People tend to get the rash on certain parts of the body, depending on their age. Common sites for babies include the scalp and face (especially on the cheeks), the front of the knees, and the back of the elbows. In children, common areas include the neck, wrists, legs, ankles, the creases of elbows or knees, and between the buttocks. In adults, the rash often appears in the creases of the elbows or knees and on the back of your neck.

A healthcare provider usually can tell if you have atopic dermatitis by doing a physical exam and asking questions about your past health.

You may be advised to do allergy testing to find the things that trigger the rash. Allergy tests can be done by an allergist (immunologist) or dermatologist.

No cure has been found for atopic dermatitis, but treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps, moisturize your skin regularly, and apply medicated creams or ointments

It's important to recognize the condition early so you can start treatment. If regular moisturizing and other self-care steps do not help, your healthcare provider may suggest additional treatments, such as:

  • Creams that control itching and help repair the skin. Your healthcare provider may prescribe a corticosteroid cream or ointment. Apply it as directed, after you moisturize. Overuse of this drug may cause side effects, including thinning skin.
  • Drugs to fight infection. You may be prescribed an antibiotic cream if your skin has a bacterial infection, an open sore or cracks. He or she may recommend taking oral antibiotics for a short time to treat an infection.
  • Oral drugs that control inflammation. For more-severe cases, your healthcare provider may prescribe oral corticosteroids, such as prednisone. These drugs are effective but cannot be used long term because of potential serious side effects.
  • Newer option for severe eczema. The Food and Drug Administration recently has approved a new, injectable drug called dupilumab (Dupixent). It is used to treat people with severe disease who do not respond well to other treatment options. This is a newer medication, so it doesn't have a long track record in terms of how well it helps people. Studies have shown it to be safe if used as directed but can be very expensive.

For more information and a self- care handout, click here.

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