Allergies

Atopic Eczema (Atopic Dermatitis)

Atopic eczema is also called atopic dermatitis (AD). It is a condition where your skin becomes dry and itchy too easily, leading to allergies and inflammation. “Atopic” means the tendency to develop allergies. “Dermatitis” means inflammation of the skin.

What Are the Symptoms of Atopic Eczema?

Eczema can look and feel different for everyone. But it usually involves an itchy, scaly, red rash that can show up on the face, hands, arms, legs and other parts of the body. Eczema is linked to dry skin. Scratching eczema can lead to red, broken skin with oozing and skin infections.

eczema in an infant
eczema in an adult

Eczema usually starts in babies. Eczema in babies can often show up on their faces. Children and adults also can have eczema. It can appear different at times or show up on different parts of the body. Eczema is usually linked to a personal or family history of allergies.

How Is Atopic Eczema Diagnosed?

There is no single test used to diagnose eczema, but there are a few things doctors use to tell if you have eczema:

Physical exam and review of medical history. Along with examining the rash, your doctor may ask when symptoms appeared and what happened around that time. For example, did you:

  • Go hiking?
  • Wear a new necklace?
  • Use a new product, like laundry detergent?
  • Go to the hairdresser for hair color, a perm or other treatment?
     

Patch test. Certain types of dermatitis might suggest contact allergy. If your doctor suspects contact dermatitis, they may ask you to wear skin patches containing small amounts of possible allergens for 2 days. If you are allergic to the substance, you should develop a local itchy rash. The doctor will do a follow-up exam to check your reaction, usually two days after you remove the patch.

The doctor may need to see you more than once to make an accurate diagnosis. If you are seeing a general doctor, they may refer you to a specialist like a dermatologist or allergist.

What Triggers Atopic Eczema?

Eczema is different for everyone, but knowing what irritates your eczema will help you manage the symptoms.

Common triggers of eczema include:

  • allergens like dust mites, pet dander and pollenAllergens (like dust mites, pet dander and pollen)
  • soap and household cleanersSoaps and household cleaners
  • metals such as nickelMetals such as nickel (in jewelry, cellphones, belt buckles, etc.)
  • rubber products such as latex glovesRubber products (latex gloves, elastic waistbands)
  • perfumes and dyesPerfumes, dyes and other fragrances
  • formaldehydeFormaldehyde (found in nail products, disinfectants and some types of clothing)

What Is the Treatment for Atopic Eczema?

If you know what triggers your eczema, avoiding those triggers is important. Other treatments, like the ones below,  relieve and prevent symptoms:

  • Over-the-counter moisturizers and barriers aim to moisturize your dry skin and to prevent loss of water from the skin. Examples include Vaseline or a variety of lotions, creams and ointment. Sleeping with moistened gauze over the affected areas also moisturizes your dry skin.
  • Over-the-counter medicines and products like topical hydrocortisone reduce inflammation.
  • Over-the-counter antihistamines do not typically help the itching from dry skin. Although sedating antihistamines such as diphenhydramine (Benadryl®) may help with sleep, they also impair alertness, even the next day. This can affect performance in school or driving ability.
  • Prescription medicines that reduce inflammation, such as:
    • oral or more potent topical corticosteroids
    • topical calcineurin inhibitors (TCIs)
    • systemic medicines and biological drugs
  • Oral or topical antibiotics treat skin infections.
  • Phototherapy, which is the use of ultraviolet light under medical supervision, also may treat inflammation.
     

Treating eczema can help relieve pain and itching, prevent infections and improve quality of life. Remember to talk to your doctor to help create a treatment and management plan that will work for you.

Medical Review October 2017.