What is it?

Atopic dermatitis is a skin disease. When a person has this disease the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, “weeping” clear fluid, crusting, and scaling. Often, the skin gets worse (flares), and then it improves or clears up (remissions).

Atopic dermatitis is the most common kind of eczema, a term that describes many kinds of skin problems.

Who gets it?

Atopic dermatitis is most common in babies and children. But it can happen to anyone. People who live in cities and dry climates may be more likely to get this disease.

You can’t “catch” the disease or give it to other people.

What are the symptoms?

The most common symptoms of atopic dermatitis are:

  • Dry and itchy skin.
  • Rashes on the face, inside the elbows, behind the knees, and on the hands and feet.

Scratching the skin can cause:

  • Redness.
  • Swelling.
  • Cracking.
  • “Weeping” clear fluid.
  • Crusting.
  • Thick skin.
  • Scaling.

What causes it?

No one knows what causes atopic dermatitis. It is probably passed down from your parents (genetics). Your environment can also trigger symptoms. Stress can make the condition worse, but it does not cause the disease.

Is there a test?

Currently, there is no single test to diagnose atopic dermatitis, but your doctor may:

  • Ask you about your medical history, including:
    • Your family history of allergies.
    • Whether you also have diseases such as hay fever or asthma.
    • Exposure to irritants, such as:
      • Wool or synthetic fibers.
      • Soaps and detergents.
      • Some perfumes and cosmetics.
      • Substances such as chlorine, mineral oil, or solvents.
      • Dust or sand.
      • Cigarette smoke.
    • Sleep problems.
    • Foods that seem to be related to skin flares.
    • Previous treatments for skin-related symptoms.
    • Use of steroids or other medications.
  • Identify factors that may trigger flares of atopic dermatitis by pricking the skin with a needle that contains something that you might be allergic to (in small amounts).

Your doctor may need to see you several times to diagnose you. In some cases, your family doctor or pediatrician may refer you to a dermatologist (doctor specializing in skin disorders) or allergist (allergy specialist) for further evaluation.

How is it treated?

The goals in treating atopic dermatitis are to heal the skin and prevent flares. You should watch for changes in the skin to find out what treatments help the most.

Treatments can include:

  • Medications:
    • Skin creams or ointments that control swelling and lower allergic reactions.
    • Corticosteroids.
    • Antibiotics to treat infections caused by bacteria.
    • Antihistamines that make people sleepy to help stop nighttime scratching.
    • Drugs that suppress the immune system.
  • Light therapy.
  • Skin care that helps heal the skin and keep it healthy.
  • Avoiding things that cause an allergic reaction.

Who treats it?

Atopic dermatitis may be treated by:

  • Family doctors or pediatricians, who can help diagnosis the disease or refer you to specialists.
  • Dermatologists, who specialize in skin disorders.
  • Allergists, who specialize in allergies.

Living With It

Besides medications, there are a number of things you can do to help control your atopic dermatitis.

  • Skin care: Sticking with a daily skin care routine can prevent flares. Skin care should include:
    • Lukewarm baths to cleanse and moisturize the skin without drying it out.
    • Using mild bar soap or nonsoap cleanser.
    • Air-drying the skin after bathing, or gently patting it dry.
    • A moisturizer to seal in the water after bathing. Use creams and ointments and avoid lotions with high water or alcohol content.
    • Protecting the skin from rough clothing, such as wool or man-made fibers.
  • Stay away from things you are allergic to, such as:
    • Dust mites:
      • Put mattresses and pillows inside special dust-proof covers.
      • Wash sheets, blankets, and bed covers often using hot water.
      • Remove carpets.
    • Molds.
    • Pollen.
    • Cat or dog dander.
    • Some perfumes and makeups.
    • Certain foods such as eggs, peanuts, milk, fish, soy products, or wheat. You should change your diet to avoid any foods you are allergic to.
  • Stress management and relaxation techniques to decrease numbers of flares. Talking to family, friends, health professionals, and support groups can help.
  • Prevent scratching or rubbing, which irritates the skin, increases swelling, and actually increases itchiness. Keep your child’s fingernails short to help reduce scratching.

Atopic dermatitis and vaccination against smallpox. People with atopic dermatitis should not get the smallpox vaccine. It may cause serious problems in people with atopic dermatitis.

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