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Atopic dermatitis (atopic eczema) is an inflammatory skin condition that causes the skin to flare-up in red, itchy skin rashes. This skin condition is the most common type of eczema and is estimated to affect around 16.5 million U.S. adults (National Eczema Association.)
Atopic dermatitis is one of seven other types of eczema, including contact dermatitis, neurodermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis and stasis dermatitis.
This condition is an allergic skin reaction, and therefore, is not contagious, even during an active flare-up.
While atopic dermatitis cannot be prevented directly, people with eczema can take measures to minimize exposure to triggers and reduce the severity of flare-ups.
It’s important to treat atopic dermatitis early on, because this skin condition can cause the skin to crack and break at the site of flare-ups, leaving it vulnerable to bacterial infections. Because bacterial infections are the leading cause of sepsis, a serious life-threatening blood infection, understanding the signs and symptoms of atopic dermatitis is key.
Signs and Symptoms of Atopic Eczema
Common signs and symptoms of atopic dermatitis include:
- Red or brownish patches develop on skin
- Dry skin
- Itchy skin
- Irritated skin
- Raised bumps on skin
- Scaly skin
- Raw, bleeding or oozing skin
- Deep lines in the palms of the hands
- Declining emotional health: depression and anxiety
- Skin infections
This inflammatory skin disease is often present with comorbidities (other existing conditions), including:
- Allergic asthma
- Allergic rhinitis
- Food allergies
- Hay fever
Causes of Atopic Dermatitis
While it isn’t known what exactly causes atopic dermatitis, it is known that eczema is caused by a combination of factors, including:
- Environmental factors, such as irritants, harsh climate, airborne pollutants and exposure to tobacco smoke
- Chronic stress
- Food allergies
- Harsh chemicals in bath products, soaps, detergents, lotions or shampoos
Atopic dermatitis commonly occurs in people who have allergies as well as an overactive immune system that causes skin inflammation when exposed to irritants and/or allergens.
The National Eczema Association atopic dermatitis as “caused by an interaction between a person’s environment and their genes.”
There are a number of risk factors that can make a person more susceptible to eczema. These include:
- Having dry skin
- Using shampoo, soap or lotion with harsh ingredients
- Have allergies
- Living in cold, damp regions
- Living in high altitudes
How is atopic eczema diagnosed?
When you visit one of our dermatologists in Lake Nona, your doctor may perform a physical examination and discuss your medical health history as well as your family history to diagnose eczema.
To better understand your condition, your dermatologist may ask the following questions:
- Do you have a family history of eczema, asthma or environmental allergies?
- What symptoms are you experiencing?
- When did the inflammation begin?
Physical Exams
Your doctor may try to pinpoint any allergens or irritants that could be triggering flare-ups. This assessment may include questions about your frequently used shampoos, body washes, soaps, lotions and other substances that come in contact with your skin.
(Our experienced dermatologists can recommend mild soaps and fragrance-free formulas that won’t irritate your skin!)
Patch Tests
If allergies are suspected, your doctor may order a skin patch test to identify specific allergens. With a patch test, small patches containing a tiny amount of the suspected allergen is applied to the back, and the skin’s reaction is observed after 48 hours. While patch tests are not 100% accurate, they are often an effective measure for identifying common allergens.
Skin Biopsies
Depending on your case, your doctor may also order blood work and/or other lab tests to rule out other potential diseases or conditions. If the cause of atopic dermatitis isn’t identifiable via physical exam or patch test, a skin biopsy may be the next step.
To perform a skin biopsy, the skin is numbed with a local anesthetic, then a small piece of the skin at the site of the inflammation or rash is removed with a scalpel or a punch instrument. The skin sample is then taken to the lab and examined under a microscope to determine whether another condition is present.
How is atopic dermatitis treated?
The right treatment approach for atopic dermatitis will depend on the specific case and the severity of the condition. Potential treatment routes include prescription medications, topical corticosteroids and/or making lifestyle changes that encourage healthy skin.
When you meet with your board-certified UCF Health dermatologist, your doctor will discuss your eczema symptoms, assess your condition, explore potential triggers and perform or order any tests (if necessary.)
We’ll then work with you to develop a treatment plan that helps minimize or eliminate skin irritants and triggers in your daily life and helps you treat flare-ups.
Atopic Eczema Treatments
Lifestyle Changes
In some cases, atopic dermatitis can be treated with simple changes to bath products, fragrances and detergents. Harsh soaps and harsh ingredient in common bath products are known to irritate skin and exacerbate eczema.
Our doctors at UCF Health work with our patients to create healthy habits and lifestyle changes that can treat skin conditions, minimize symptoms or prevent conditions from developing in the first place.
Making healthy lifestyle changes is the most sustainable treatment method, because it can prevent the need for oral and/or topical medication and can benefit not only your skin, but overall health too.
Here are ways to treat atopic eczema symptoms at home:
- Choose mild soaps, detergents and shampoos that won’t cause a skin reaction.
- Avoid hot baths. Heat dehydrates the skin, which triggers eczema.
- Cover your body when going out in cold weather.
- Minimize dietary inflammation. Add anti-inflammatory food to your diet and limit inflammatory foods, such as sugar, dairy and wheat.
- Commit to healthy stress management techniques
- Get at least 8 hours of sleep each night
- Moisturize your skin with a mild formula daily
Topical Therapy
Topical therapy includes the use of prescription cream, corticosteroid creams, topical corticosteroids and wet wrap therapy to relieve inflammation.
Topical creams may be prescription or non-prescription and generally serve to relieve itching and scratching in order to allow the skin to heal.
Corticosteroids are topical steroids that are applied to the site of skin inflammation to reduce inflammation and help regulate immune function (National Eczema Association.)
Wet wrap therapy is a treatment measure often used alongside topical treatments. This therapy involves wrapping a wet gauze or fabric around the affected area to rehydrate the skin, relieve itching, reduce inflammation and help the corticosteroid or topical cream absorb into the skin.
Systemic Therapy
In cases of severe eczema, systemic therapy may be the most effective treatment. Systemic therapy focuses on treating eczema directly via the immune system.
Immunosuppressants work by suppressing the immune system and weakening its reaction to the allergen(s) causing atopic dermatitis.
Cyclosporine and methotrexate are immunosuppressant medications commonly prescribed for severe cases of atopic dermatitis.
Preventing Atopic Dermatitis
If you are noticing early signs of atopic dermatitis, we encourage you to schedule an appointment with us. We will create a plan to alleviate your symptoms, make positive lifestyle changes, minimize risk factors and triggers and help you feel comfortable in your skin again.
You can do your part to prevent atopic dermatitis from developing or worsening, by committing to a daily skin care routine that aims to keep your skin clean and hydrated.
Take a few minutes to research common inflammatory foods and anti-inflammatory foods and make some adjustments to your grocery list to promote healthy skin.
Keep your skin covered in cold weather, and pay attention to the ingredients in your soaps, shampoos and detergents. (Check out this list of hypoallergenic detergents!)
It’s important that you don’t ignore the signs and symptoms of atopic dermatitis to prevent a bacterial infection. Signs of infection at the site of a flare-up include pus or fluid oozing from the skin, yellow crust on top of the wound, fever and progressive swelling.
If you notice symptoms of a bacterial infection, visit the emergency room immediately to treat the infection and prevent sepsis.
Schedule an appointment today.
Our Lake Nona board-certified dermatologist, Dr. Naveed Sami, is here to help you diagnose, treat and manage your skin condition so you can experience your greatest quality of life.
We will help guide you toward the right eczema treatment for your case.
Use our convenient online scheduling tool to schedule an appointment with a leading dermatologist near you!
Sources:
https://www.aafa.org/media/2209/Atopic-Dermatitis-in-America-Study-Overview.pdf
https://nyulangone.org/conditions/eczema-dermatitis/diagnosis