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Atopic dermatitis (eczema)

Medically reviewed by Drugs.com. Last updated on May 9, 2023.

Overview

Atopic dermatitis (eczema) is a condition that causes dry, itchy and inflamed skin. It's common in young children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare sometimes. It can be irritating but it's not contagious.

People with atopic dermatitis are at risk of developing food allergies, hay fever and asthma.

Moisturizing regularly and following other skin care habits can relieve itching and prevent new outbreaks (flares). Treatment may also include medicated ointments or creams.

Atopic dermatitis behind the knees

Atopic dermatitis can cause a very itchy rash. Atopic dermatitis most often occurs where the skin flexes — inside the elbows, behind the knees and in front of the neck.

Symptoms

Atopic dermatitis (eczema) symptoms can appear anywhere on the body and vary widely from person to person. They may include:

Atopic dermatitis often begins before age 5 and may continue into the teen and adult years. For some people, it flares and then clears up for a time, even for several years.

When to see a doctor

Talk with a health care provider if you or your child:

Seek immediate medical attention if you or your child has a fever and the rash looks infected.

Atopic dermatitis on the chest

Inflammation caused by atopic dermatitis can cover large areas of the body, such as the chest, or be limited to a few small spots.

Infantile eczema

Atopic dermatitis in infants (infantile eczema) appears here as red, itchy patches on very dry skin.

Causes

In some people, atopic dermatitis is related to a gene variation that affects the skin's ability to provide protection. With a weak barrier function, the skin is less able to retain moisture and protect against bacteria, irritants, allergens and environmental factors — such as tobacco smoke.

In other people, atopic dermatitis is caused by too much of the bacteria Staphylococcus aureus on the skin. This displaces helpful bacteria and disrupts the skin's barrier function.

A weak skin barrier function might also trigger an immune system response that causes the inflamed skin and other symptoms.

Atopic dermatitis (eczema) is one of several types of dermatitis. Other common types are contact dermatitis and seborrheic dermatitis (dandruff). Dermatitis isn't contagious.

Risk factors

The main risk factor for atopic dermatitis is having had eczema, allergies, hay fever or asthma in the past. Having family members with these conditions also increases your risk.

Complications

Complications of atopic dermatitis (eczema) may include:

Prevention

Developing a basic skin care routine may help prevent eczema flares. The following tips may help reduce the drying effects of bathing:

The triggers for atopic dermatitis vary widely from person to person. Try to identify and avoid irritants that trigger your eczema. In general, avoid anything that causes an itch because scratching often triggers a flare.

Common triggers for atopic dermatitis include:

Infants and children may have flares triggered by eating certain foods, such as eggs and cow's milk. Talk with your child's health care provider about identifying potential food allergies.

Once you understand what triggers your eczema, talk with your health care provider about how to manage your symptoms and prevent flares.

Diagnosis

To diagnose atopic dermatitis, your health care provider will likely talk with you about your symptoms, examine your skin and review your medical history. You may need tests to identify allergies and rule out other skin diseases.

If you think a certain food caused your child's rash, ask your health care provider about potential food allergies.

Patch testing

Your doctor may recommend patch testing on your skin. In this test, small amounts of different substances are applied to your skin and then covered. During visits over the next few days, the doctor looks at your skin for signs of a reaction. Patch testing can help diagnose specific types of allergies causing your dermatitis.

Treatment

Treatment of atopic dermatitis may start with regular moisturizing and other self-care habits. If these don't help, your health care provider might suggest medicated creams that control itching and help repair skin. These are sometimes combined with other treatments.

Atopic dermatitis can be persistent. You may need to try various treatments over months or years to control it. And even if treatment is successful, symptoms may return (flare).

Medications

Therapies

Baby eczema

Treatment for eczema in babies (infantile eczema) includes:

See your baby's health care provider if these steps don't improve the rash or it looks infected. Your baby might need a prescription medication to control the rash or treat an infection. Your health care provider might also recommend an oral antihistamine to help lessen the itch and cause drowsiness, which may be helpful for nighttime itching and discomfort. The type of antihistamine that causes drowsiness may negatively affect the school performance of some children.

Lifestyle and home remedies

Taking care of sensitive skin is the first step in treating atopic dermatitis and preventing flares. To help reduce itching and soothe inflamed skin, try these self-care measures:

Alternative medicine

Many people with atopic dermatitis have tried alternative (integrative) medicine approaches to easing their symptoms. Some approaches are supported by clinical studies.

If you're considering alternative therapies, talk with your health care provider about their pros and cons.

Coping and support

Atopic dermatitis can make you feel uncomfortable and self-conscious. It can be especially stressful, frustrating or embarrassing for adolescents and young adults. It can disrupt their sleep and even lead to depression.

Some people may find it helpful to talk with a therapist or other counselor, a family member, or a friend. Or it can be helpful to find a support group for people with eczema, who know what it's like to live with the condition.

Preparing for an appointment

You're likely to start by seeing your primary care provider. Or you may see a doctor who specializes in the diagnosis and treatment of skin conditions (dermatologist) or allergies (allergist).

Here's some information to help you get ready for your appointment.

What you can do

For atopic dermatitis, some basic questions you might ask your health care provider include:

What to expect from your doctor

Your health care provider is likely to ask you a few questions. Being ready to answer them may free up time to go over any points you want to spend more time on. Your health care provider might ask:

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