Atopic dermatitis (eczema)

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Symptoms

By Mayo Clinic staff

Signs and symptoms of atopic dermatitis (eczema) include:

  • Red to brownish-gray colored patches
  • Itching, which may be severe, especially at night
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Thickened, cracked or scaly skin
  • Raw, sensitive skin from scratching

Though the patches can occur anywhere, they most often appear on the hands and feet, in the front of the bend of the elbow, behind the knees, and on the ankles, wrists, face, neck and upper chest. Atopic dermatitis can also affect the skin around your eyes, including your eyelids. Scratching can cause redness and swelling around the eyes. Sometimes, rubbing or scratching in this area causes patchy loss of eyebrow hair and eyelashes.

Atopic dermatitis most often begins in childhood before age 5 and may persist into adulthood. For some, it flares periodically and then subsides for a time, even up to several years. Itching may be severe, and scratching the rash can make it even itchier. Breaking this itch-scratch cycle can be challenging.

Factors that worsen atopic dermatitis
Most people with atopic dermatitis also have Staphylococcus aureus bacteria growing on their skin. The staph bacteria multiply and can worsen symptoms, increasing the severity of the disease.

Other factors that can worsen signs and symptoms of atopic dermatitis include:

  • Long, hot baths or showers
  • Dry skin
  • Stress
  • Sweating
  • Rapid changes in temperature
  • Low humidity
  • Solvents, cleaners, soaps or detergents
  • Wool or man-made fabrics or clothing
  • Dust or sand
  • Cigarette smoke
  • Certain foods, such as eggs, milk, fish, soy or wheat

Infantile eczema
When atopic dermatitis occurs in infants, it's called infantile eczema. This condition may continue into childhood and adolescence.

Infantile eczema often involves an oozing, crusting rash, mainly on the face and scalp, but it can occur anywhere. After infancy, the rash becomes dryer and tends to be red to brown-gray in color. In adolescence, the skin may be scaly or thickened and easily irritated. The intense itching may continue.

When to see a doctor
See your doctor if:

  • You're so uncomfortable that you're losing sleep or are distracted from your daily routines
  • Your skin is painful
  • You suspect your skin is infected
  • You've tried self-care steps without success

If you suspect your child has atopic dermatitis or you notice the above signs and symptoms, see your child's doctor.

References
  1. Weston WL, et al. Epidemiology, clinical manifestations, and diagnosis of atopic dermatitis (eczema). http://www.uptodate.com/home/index.html. Accessed May 20, 2009.
  2. Weston WL, et al. Treatment of atopic dermatitis (eczema). http://www.uptodate.com/home/index.html. Accessed May 20, 2009.
  3. Bieber T. Mechanisms of disease: Atopic dermatitis. New England Journal of Medicine. 2008;358:1483.
  4. Eczema/atopic dermatitis. American Academy of Dermatology. http://www.aad.org/public/Publications/pamphlets/EczemaAtopicDermatitis.htm. Accessed May 20, 2009.
  5. What is atopic dermatitis? National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/hi/topics/dermatitis/ffdermatitis.htm. Accessed May 20, 2009.
  6. FDA public health advisory Elidel (pimecrolimus) cream and Protopic (tacrolimus) ointment. U.S. Food and Drug Administration. http://www.fda.gov/cder/drug/advisory/elidel_protopic.htm. Accessed May 20, 2009.
  7. Habif TP. Atopic dermatitis. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/138783445-3/843851716/1195/22.html. Accessed May 21, 2009.
  8. Huang JT, et al. Treatment of Staphylococcus aureus colonization in atopic dermatitis decreases disease severity. Pediatrics. 2009;123:e808.
  9. Atopic dermatitis: Possible complications. American Academy of Dermatology. http://www.skincarephysicians.com/eczemanet/complications.html. Accessed June 3, 2009
  10. German chamomile. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed June 3, 2009.
  11. Evening primrose oil. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed June 3, 2009.
  12. Witch hazel. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed June 3, 2009.
  13. Borage. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed June 3, 2009.

DS00986

Aug. 22, 2009

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