What is atopic dermatitis?

Dermatitis is irritation and swelling (inflammation) of the skin. Atopic means that you have inherited the risk for allergic conditions such as skin rashes, hay fever, and asthma.

Atopic dermatitis may also be called eczema. Eczema is a common skin problem that usually starts in childhood or early adulthood. It’s a chronic disease, which means you will likely have it all of your life.

What is the cause?

The immune system is your body’s defense against infection. When you have atopic dermatitis, your immune system may react when you are exposed to certain things such as:

• Allergies, for example to a food or medicine
• Hot baths or showers
• Soap
• Scratchy or tight clothing
• Quick temperature or humidity changes
• Stress

Eczema may always be present or may flare-up only in certain seasons. It often gets worse in the winter when indoor air can be very dry.

An allergy to dust mites may make eczema worse. Dust mites are very tiny bugs that you cannot see without a microscope. They live in mattresses, pillows, carpet, and upholstered furniture.

What are the symptoms?

Most people with eczema have a mild form. Symptoms may include

• Itching
• Dryness
• Fine scales or flaking
• Redness

Any area of skin may be affected, but the most common areas are:

• Behind the knees
• The inside of the elbows
• On the side of the neck
• Around the eyes and ears

Severe eczema causes intense itching. The skin is usually very sensitive to being touched. Even a light touch, like when your hair blows across your face, may cause itching. Many people who have severe eczema are quite sensitive to scratchy fabrics, especially wool.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine your skin.

Your provider may recommend testing for an allergy to dust mites.

How is it treated?

Treatment cannot cure eczema, but it can help lessen your symptoms and prevent eczema from getting worse. It may help to use a moisturizer. Or it may go away if you put 1% hydrocortisone cream on the area up to 4 times a day. No prescription is needed for this cream.

For more severe eczema, your healthcare provider may prescribe:

• Cream or ointment to stop the itching and other symptoms
• Antihistamine pills to help stop itching and any allergic reaction. Do not put antihistamine creams or lotions on your skin if you are taking antihistamine pills.
• Anti-inflammatory medicine, such as prednisone, if your symptoms are severe

If tests show that you are allergic to dust mites, your provider may recommend that you try to get rid of any dust mites in your home. In some cases, allergy shots for dust mites may be helpful.

Your healthcare provider will recommend how often you should bathe or shower and which soaps and moisturizers you should use. This helps keep your skin from getting too dry.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Avoid scratching your skin even though it itches. Scratching may break the skin and cause infection.
• Take short baths or showers no more than once a day. Use a mild moisturizing soap or nonsoap cleanser. Avoid long, hot baths. Hot water can increase itching. Pat your skin dry with a soft towel. Do not rub your skin dry.
• Use unscented moisturizing creams or ointments, rather than water-based lotions. Moisturize your skin regularly, several times a day, if possible. Helpful ingredients are petroleum jelly, lanolin, and glycerin. Ask your healthcare provider or pharmacist for recommendations.
• Avoid the things that you know will make your skin rash worse, such as wearing tight or scratchy clothing, or certain foods or medicines.
• Avoid humidity and sudden changes in temperature when possible.
• Avoid getting too hot (over-heating).
• Wash clothes and bedding in mild soap. Rinse your laundry twice to get rid of all the soap.
• Try to get rid of dust mites in your home. Use anti-allergy covers on bed pillows and mattresses. Wash bedding every week or two. You may want to get rid of wall-to-wall carpets and draperies that catch dust and cannot be damp-wiped or laundered.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax, for example take up a hobby, listen to music, watch movies, or take walks. Try deep breathing exercises when you feel stressed.

Ask your provider:

• How long it will take to recover
• What activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

You can get more information from:

• National Eczema Association
  800-818-7546
  http://www.nationaleczema.org