What is Eczema (Atopic Dermatitis)?

Atopic dermatitis (AD) is a common chronic skin disease that is also called atopic eczema. One person in ten has this disease at some time in their life, usually in childhood. Atopic is a term used to describe allergic conditions such as asthma, hayfever and AD.

What are the symptoms?
What causes itching and rash?
What medicines will help?
How can National Jewish Health help?

 

What are the symptoms?

People with AD tend to have dry, itchy and easily irritated skin. This can continue for years and may result in damage to the skin.

Who gets eczema (atopic dermatits)?

 

What causes itching and rash?

The exact cause of AD is not known. Research has shown that a person is more likely to have AD if parents or other family members have ever had AD, hayfever, asthma, or food allergies.

There are many things that worsen the itching and rash of AD. These are different for each person. It's important to work closely with your healthcare provider to try to figure out what makes your itching, rash and other symptoms worse.

Learn more about avoiding things known to make eczema worse.

 

The Itch-Scratch Cycle

Scratching or rubbing the skin can make the itch and rash of AD worse. Scratching causes further irritation, injures the skin, and increases itchiness. This is called the itch-scratch cycle.

Irritants

An irritant is something that causes burning, itching or redness. Almost anything can be irritating to the skin when the rash of AD is severe. Chemicals, solvents, soaps, detergents, fragrances, some ingredients in skin care products, some fabrics, and smoke are irritants you may need to avoid. Your healthcare provider may recommend patch testing on the skin to try to determine if products you use or are exposed to cause an irritant or contact dermatitis.

Key therapy tips on how to reduce skin irritation.

Allergies

If you have a reaction to the same thing you touch, breathe or eat you might have an allergy. Allergies can cause or worsen AD symptoms. Your healthcare provider may recommend prick skin testing, blood tests, or food challenges to see if allergies are causing itching or rash. Allergens that worsen AD include foods, dust mites, furry animals, or allergens in the air.

Temperature and Humidity

Cold weather, heat and sweating may make AD worse. Extremes of temperature and humidity can be a problem for people with AD. Sweating caused by overheating and high humidity can irritate the skin. Low humidity causes water to be lost from the skin. This can lead to dryness and skin irritation.

Infections

Skin infections may occur more frequently than normal for people with AD. Infectious organisms are often present in higher than normal numbers on the skin. In addition, skin that has been scratched or has a rash is more easily infected.

Learn more about skin infections and eczema.

Dry Skin

Dry skin makes the itching and rash of AD worse. Wind, low humidity, soaps, some skin care products, and washing or bathing without proper moisturizing can cause dry skin. The most important treatment for dry skin is to put water back in it. The best way to get water into your skin is to soak in a bath. Gently pat dry and immediately apply a thick layer of moisturizer to seal the water in your skin. "Soak and seal" daily helps to prevent and treat dry skin.

Learn more about daily steps for good skin care.

Emotions and Stress

Emotions and stress do not cause AD, but they may bring on itching and scratching. Anger, frustration and embarrassment can cause flushing and itching. Day to day stresses as well as major stressful events can lead to or worsen the itch-scratch-itch.

Learn about key therapy tips for reducing stress.

 

What medicines will help?

Medicines are added to your daily skin care when itching and rash are not well controlled. Medicines also are required if there is an infection present.

Topical Steroids

Steroid medicines that are applied to the skin are called topical steroids. Topical steroids are drugs that treat inflammation. They are very helpful when rash is poorly controlled. Used correctly, topical steroids are safe and effective.

Topical Immunomodulators

Topical immunomodulators (TIMS) are also medicines that are applied to the skin. They also treat inflammation, but are not steroids. TIMS don't cause steroid side effects. A common side effect of TIMS is skin burning. This is often a short-lived problem.

National Jewish Health statement on TIMS

Tar Products

Skin and scalp products that contain coal tar extracts have long been used to reduce itching, red, and inflamed skin. They may provide long lasting action against inflammation and have fewer side effects than some other medicines, but, at times, are irritating. Tar shampoos often are helpful for a red, itchy scalp.

Medicines That Fight Infection

Skin infections may be caused by bacteria (e.g., impetigo), fungus (e.g., athlete's foot), and viruses (e.g., herpes). Some antibiotics, antifungal and antiviral medications are applied to the skin. Some are pills or liquids taken by mouth.

Antihistamines

Antihistamines taken by mouth can help reduce itching. They are also used to control allergy symptoms. Some antihistamines cause drowsiness. This can make you feel less itchy and help you sleep.

New Treatments

Studies at National Jewish Health focus both on understanding the disease process - including infection - and looking at new treatments.

Learn key therapy points for atopic dermatitis (eczema).

 

How can National Jewish Health help?

Atopic dermatitis (AD) can be very difficult to live with. Each person with AD deserves to learn what makes their symptoms worse, how to avoid them, and how to best treat them. Even though this is different for every person, you should be able to manage your symptoms and:

• Participate in family, social, school, and/or work activities.
• Have little or no rash.
• Have very few or no side effects from medicines.
• Feel good about your appearance and about your skin care.
• Have restful sleep.

National Jewish Health is one of the leading institutions in the United States for treatment and research of atopic dermatitis. National Jewish Health has a variety of comprehensive programs especially designed to teach patients and families how to care for AD. If you have questions, please contact the National Jewish Health LUNG LINE, 1-800-222-LUNG (5864).

 

This information has been approved by Donald Leung, MD, PhD (April 2006).