Atopic Dermatitis

Atopic dermatitis (atopic eczema) is a chronic, relapsing, itchy eczema that develops from disruption of the skin barrier and changes in the immune system. It usually begins in childhood, but can also be seen in adulthood or appear for the first time later in life.

The most prominent symptom is intense itching. It can be accompanied by dryness, redness, scaling, cracking and, at times, weeping eczematous areas. In infants it is seen mostly on the face, the outer arms, the fronts of the legs and the trunk, while in children and adults the insides of the elbows, backs of the knees, neck, wrists, hands and area around the eyes are most often affected.

Atopic dermatitis is not a contagious condition. Genetic predisposition plays an important role, and some patients also have asthma, allergic rhinitis (hay fever) or other atopic conditions.

Symptoms can flare with sweating, hot weather, woollen or synthetic clothing, stress, infections, some soaps and detergents, and various environmental factors. Because triggers can differ from patient to patient, identifying them and avoiding them as far as possible is an important part of treatment.

The diagnosis is usually made from the patient's history and dermatological examination. Where needed, the differential diagnosis from other types of eczema, contact allergies and similar skin conditions is made.

The basis of treatment is strengthening the skin barrier and bringing itching under control. Regular use of moisturisers, appropriate skincare and avoidance of triggers are indispensable steps in treatment. Depending on the severity of the condition, different options such as topical treatments, systemic medications or biologic treatments may be used.

Although atopic dermatitis is not a condition that can be eliminated entirely, with the right treatment and regular follow-up the flares can be brought largely under control and quality of life markedly improved.