Atopic dermatitis is a type of eczema—an itchy skin rash where allergens may be a contributor. Atopic dermatitis (also called atopic eczema) mostly occurs in infants and young children. Children who have atopic dermatitis may be more prone to develop other allergic conditions such as allergy-induced asthma and allergic rhinitis. This is called the “allergic march.” It cannot be spread to others. Children with atopic eczema also tend to have family members with atopic eczema, asthma and/or seasonal allergies.
Atopic dermatitis is triggered by a number of causes, including dry skin, irritants like wool and possibly allergens. The condition may be triggered by foods such as eggs, milk, wheat, soy, peanuts or fish.
The classic symptom of atopic dermatitis is itchy skin. The skin is dry, flaky and rough, and there may be small bumps on the skin. As your child scratches the skin, the rash can become infected, causing it to ooze or leak fluid. The rash may form crusts or scaly patches.
About 1 in 5 children get atopic dermatitis. Most cases develop before 5 years of age. While atopic dermatitis may persist into adulthood, it often gets better as children get older. Different areas of the body are affected at different ages:
- Infants under a year old. In infants, atopic dermatitis occurs on the face, scalp, cheeks, back of the arms and front of the legs.
- Children 1 to 12 years old. Areas that are typically affected in children of this age range include the inner folds of the arms at the elbows and behind the knees.
- Teenagers 13 years old and up. In teenagers and adults, atopic dermatitis may appear as a rash on the hands, feet and back of the neck.
Diagnosis of Atopic Dermatitis
Doctors at Riley at IU Health diagnose atopic dermatitis by reviewing your child's health history and conducting a physical exam. If you have noticed that there is a specific trigger or cause for your child’s skin irritation, please tell the doctor about this during the appointment.
Your child's doctor may also recommend:
- Allergy testing. In moderate to severe cases, your child's doctor may prescribe allergy testing to see if your child is allergic to certain foods.
- Food challenge. This test helps the doctor learn whether an allergy to a specific food may be causing or adding to your child's symptoms.
- Blood test. If the doctor suspects a connection between your child’s atopic dermatitis and an allergy, blood work may be done to check for allergic triggers.
- Biopsy. This involves removing a small skin sample and sending it to the pathologist for study under a microscope. This can help rule out other skin conditions.
There is no cure for atopic dermatitis, but certain treatments can help relieve the symptoms. In many cases, your child may need to use a prescription steroid ointment to relieve itching. Your child’s doctor may also prescribe an antihistamine to help with sleep.
Other ways to relieve the symptoms of atopic dermatitis include:
- Avoid any known allergens. These include foods and environmental allergens that may cause an eczema flare-up.
- Avoid scratching. Do not let your child scratch his or her skin, and keep your child’s fingernails short.
- Use an unscented moisturizer daily. This is especially important after bathing. Ask your child’s doctor for the types or brands that are most safe and effective.
- Avoid irritating the skin. Keep your child away from things that irritate his or her skin such as wool and polyester clothing, extreme hot or cold temperatures, scented soaps and fabric softeners.
- Anti-inflammatory therapies. Topical steroids, topical calcineurin inhibitors, ultraviolet light therapy and oral immunosuppressive medicines can be used to treat skin inflammation in atopic eczema. While topical steroids are the most common anti-inflammatory therapy used, treatment recommendations depend on a number of factors.
- Wet wraps. Wet wrap therapy involves applying topical steroids or moisturizers to the skin and then covering the treated areas with slightly wet dressings or clothing to enhance the anti-inflammatory and moisturizing effects of the topical agents.
- Antihistamines. These oral medications sometimes help relieve itchy skin.
- Antibiotics. These are topical and oral medicines used to treat skin infections.
- Bleach baths. Your child's doctor may recommend a bleach bath. Your child will soak in bath water that contains a diluted bleach solution. This can help treat and prevent recurrent infections in patients with atopic dermatitis.
For many children, stress can trigger an eczema flare-up. Talk to the doctor about ways to help your child manage stress at home or at school.
Key Points to Remember
Key Points to Remember
- Atopic dermatitis is a type of eczema—an itchy skin rash where allergens may be a contributing factor.
- Children who have atopic dermatitis may be more prone to develop other allergic conditions such as allergy-induced asthma and allergic rhinitis.
- The main symptom of atopic dermatitis is itchy skin that becomes dry, flaky and rough, sometimes to the point of crusting or oozing.
- The doctor diagnoses atopic dermatitis by reviewing your child's health history and performing a physical exam, but allergy testing may also be necessary.
- There is no cure for atopic dermatitis, but treatments like ointments and moisturizers can help relieve the symptoms.
Support Services & Resources
Support Services & Resources
Learn more about atopic dermatitis by visiting the trusted websites below.
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
Learn more about atopic dermatitis and other types of skin allergy.
Learn more about treatments for atopic dermatitis.
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