Red and itchy skin is a hallmark of atopic dermatitis, the most common type of eczema. Atopic dermatitis typically begins in childhood and can come and go throughout a person’s life. If you are one of the millions affected, you must learn to manage flare-ups and accompanying conditions such as asthma, hay fever, and other types of eczema.
October is Eczema Awareness Month, designed to raise awareness for the nearly 32 million sufferers in the United States. Once you receive a diagnosis, there are treatments and self-care measures that can reduce itching and associated pain. You should visit your dermatologist to identify the type of eczema. Your doctor will recommend treatment based on age, symptoms, severity, and other coexisting conditions.
What causes atopic dermatitis?
Doctors believe the chronic skin condition is linked to an overactive immune system response that triggers inflammation and damages the skin barrier. Research continues for causes and cures. People with a mutation of the gene responsible for creating filaggrin are more prone to eczema, especially atopic dermatitis. The protein filaggrin helps maintain a healthy, protective barrier on the top layer of skin. A lack of filaggrin can cause moisture to escape and bacteria and viruses to enter. This leads to dry and inflamed skin, prone to itching, irritation, and infections. Rashes that dry, scaly, red, and inflamed can appear over different areas of the body during an active flare.
Atopic dermatitis affects 9.6 million children and 16.5 million adults in the United States. It usually appears in the first 3 to 6 months of a baby’s life but isn’t solely a pediatric condition. One in 4 adults with atopic dermatitis report adult-onset of symptoms.
In addition, atopic dermatitis is often associated with two other allergic conditions: asthma and hay fever. Asthma sufferers, or people who have family members with allergies, are more likely to develop atopic dermatitis.
Weather changes and other irritants also can make the skin more prone to eczema flare-ups. Animal dander, smoke, pollen, temperature extremes, and soaps and fragrances can cause an outbreak.
Symptoms in children
Since atopic dermatitis primarily develops in children under 5, the leading risk factor is genetics and family history. Food allergies, such as nuts, soy, and dairy, may also trigger symptoms in some children.
The most common symptoms include:
- Redness or a rash on the scalp and cheeks
- Rashes inside the elbows, back of the knees, and on the wrists, ankles, and hands
- Dry, scaly skin
- Severe itching
- Small, raised bumps that look crusty and leak fluid if scratched
- Rough bumps on the face, upper arms, and thighs
- Skin changes around the mouth, eyes, or ears
- Raised, red areas (hives) or bumpy rashes
- Thickened skin, also known as lichenification
Treatment options for children with atopic dermatitis
In some children, outbreaks taper off as they grow up. Others have to learn to live with the condition and manage atopic dermatitis flares for a lifetime.
Most doctors will recommend at-home care for atopic dermatitis treatment before prescribing a cream or medication.
- Keep your child’s skin moisturized and used gentle skin care products
- Pay attention to products, foods, or environmental irritants that seem to irritate the skin
- Keep your child’s fingernails short
- Use warm, not hot, water for baths and a gentle cleanser to wash body folds only. There is no need to use cleansers for the entire body.
- Dress your child in light-colored breathable cotton fabric clothing
- Stay away from triggers, allergens, and scratching
- Corticosteroid cream or ointment, antibiotics, and antihistamines may be needed
Symptoms in adults
Like other eczema types, skin rashes and dry, itchy skin are the most common symptoms in adults. The rash may appear on the face, arms, legs, crease of elbows or knees, or back but can spread all over the body.
- Excessive itching
- Sore or painful skin
- Open, crusted, or bleeding sores
- Dry, scaly, and discolored skin
- Skin prone to infections
Treatment for adults with atopic dermatitis
Atopic dermatitis treatment can vary depending on the severity of the condition. Often, it’s about learning to manage the condition and reduce flares by making lifestyle changes.
One of the most important at-home treatments is to keep your skin moisturized to protect the skin barrier.
- Consult your dermatologist
- Pay attention to triggers and avoid them
- Take lukewarm baths
- Limit showers and baths to 5-10 minutes
- Practice good skin care with a mild cleanser and fragrance-free moisturizer
- Avoid harsh soaps, chemicals, and detergents
- Apply medicated creams or ointments, including topical corticosteroids and non-steroidal creams as prescribed and directed by your dermatologist
- Avoid itching skin and touching open infections
- Wear light-colored breathable cotton fabric clothing
- Try to follow a regular sleep schedule
- Avoid getting overheated and activities that cause sweating
- Reduce inflammation by eating a healthy diet
- Manage stress
- Use a humidifier to add moisture to the air
- Stay hydrated by drinking water
If at-home care is unsuccessful, there are prescription medications and in-office treatments that can help keep symptoms under control. Topical creams can help reduce itching and rashes, giving the skin time to repair and heal. Oral medications may be prescribed to clear up skin infections and alleviate itching. Your dermatologist also can discuss other treatment options, including ultraviolet light therapy.