Atopic Dermatitis

What is atopic dermatitis and what increases my risk for it?

• Atopic dermatitis is an itchy, red skin rash. It is also called eczema. You are more likely to have it if your parent or a family member has atopic dermatitis, asthma, or hay fever.
  
  
• It is a long-term condition that may cause flare-ups for the rest of your life. A flare-up means your symptoms get worse sometimes. Flare-ups are most common in winter.

What are the signs and symptoms of atopic dermatitis?

Patches of dry, red, itchy skin may appear on your hands, knees, elbows, or feet. They may also appear on your face, eyelids, neck, and chest. You may have itching in your genital area. You may have any of the following:

• Your skin is so itchy that you cannot stop scratching. You may scratch while you sleep.
  
  
• Your skin is red and bumpy.
  
  
• Your skin is blistered, crusty, or oozes clear fluid.
  
  
• Your skin feels thick and hard, like leather.
  
  
• Your skin has white or brown scales.

What triggers atopic dermatitis?

Triggers are things that cause atopic dermatitis to flare-up. Anything that increases dryness or makes you want to scratch is a trigger. The following are common triggers to avoid:

• Too many baths or showers: This can lead to dry, itchy skin.
  
  
• Sudden temperature changes: Cold air dries your skin and heat can increase sweating. Both can make you itch.
  
  
• Allergens: Dust mites (tiny bugs that live in house dust) and pet dander (tiny dead skin flakes) can worsen your symptoms. Pollen, mold, and cigarette smoke may irritate your skin.
  
  
• Some kinds of soap, makeup, and household cleaners: These may bother your skin. Ask your caregiver what kinds of mild cleaning products and makeup to use.
  
  
• Stress: Atopic dermatitis gets worse when your stress level is high.

How is atopic dermatitis diagnosed?

Your caregiver will examine your skin and ask you to describe your symptoms. Tell him how long you have had the rash and all of the places it appears on your body. He will ask how many times in the past you have had the same itchy rash. He will want to know if anyone in your family has allergies, asthma, or atopic dermatitis. There are no tests to diagnose atopic dermatitis. Your caregiver may test you for allergies to find out if they trigger your atopic dermatitis.

How is atopic dermatitis treated?

There is no cure for atopic dermatitis. The goal of treatment is to reduce your pain and itching and to add moisture to your skin. Your symptoms should improve after 3 weeks of treatment. You may need the following:

• Skin cream: Rub emollients (thick creams) into your skin often. Examples of emollients are unscented skin cream and petroleum jelly. Ask your caregiver which creams to use and how often to apply them. Do not use lotion that contains alcohol because it can dry your skin.
  
  
• Medicines:
  
  
  • Steroid cream: You need a doctor's order for this medicine. Apply this cream to your skin to reduce redness, pain, and swelling.
    
    
  • Antihistamines: This medicine is used to reduce itching.
    
    
  • Antibiotics: This medicine treats or prevents an infection caused by bacteria. You may need this if you have a skin infection.
    
    
  • Oral steroids: You may be given this to reduce redness, pain, and swelling if your atopic dermatitis is very bad.
  
  
• Phototherapy: This treatment uses ultraviolet light to heal your skin. It is also called light therapy.

How can I manage atopic dermatitis?

• Do not scratch: Pat or press on your skin for relief from itching. Your symptoms will get worse if you scratch. Keep your fingernails short so you do not tear your skin if you do scratch.
  
  
• Keep your skin moist: Rub cream or petroleum jelly into your skin. Do this right after a bath or shower when your skin is still damp. Apply cream as many times as needed each day to keep your skin moist and soft.
  
  
• Take short baths or showers: Bathe or shower in warm (not hot) water for 20 minutes or less. Use mild bar soap. Use soap only under your arms, between your legs, and on your feet. Gently pat your skin dry. Rub in emollients within 3 minutes after your bath or shower if you bathe every day. It is better to bathe less often.
  
  
• Wear cotton clothes: Wear loose-fitting clothes made from 100% cotton. Avoid wool. Do not wear clothes that make you hot and sweaty.
  
  
• Humidify your home: Use a humidifier to add moisture to the air in your home.
  
  
• Avoid changes in temperature: Avoid activities that cause you to sweat a lot because this can cause itching. Remove blankets from your bed if you get hot while you sleep.
  
  
• Reduce allergens and dust at home: Choose artificial plants instead of live plants. Do not keep cats, dogs, birds, or other pets.
  
  
• Avoid skin irritants: Do not use fabric softener. Do not wear perfume. Do not wear makeup that burns or itches.
  
  
• Manage stress: Learn relaxation skills like deep breathing or visualization.

What are the risks of atopic dermatitis?

You could develop a painful condition called erythroderma. This occurs if redness and swelling develop over most of the skin on your body. It can be life-threatening without treatment. You could develop eczema herpeticum. This is when your rash becomes infected with the herpes virus. You are also at risk for other skin infections caused by bacteria. The steroid creams used to treat your condition can weaken your skin. This means your skin could easily tear, bruise, or scrape.

When should I contact my caregiver?

Contact your caregiver if:

• Most of your skin is red, swollen, painful, and covered with scales.
  
  
• Your rash develops bloody, red, painful crusts.
  
  
• Your skin blisters and oozes white or yellow pus.
  
  
• You have questions about your condition or care.

When should I seek immediate help?

Seek immediate help if:

• You develop a fever, red streaks going up your arm or leg, or your rash gets more swollen, red or hot.
  
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Atopic Dermatitis