Atopic dermatitis is a type of eczema, and is currently the most common type of eczema diagnosed in the United States. Approximately eighteen million adults in the United States have this chronic condition, and the symptoms of atopic dermatitis typically begin in the first six months after birth.
The condition often presents in areas where the skin flexes, including the backs of the knees, insides of the elbows, and front of the neck. Patients who have allergic rhinitis or asthma are at an increased risk of developing atopic dermatitis, and it tends to be more prevalent in dry climates.
To diagnose this skin condition, doctors will look at the skin, and it could be necessary to perform a skin biopsy or cultures to test for infection.
Treatment methods for atopic dermatitis include light therapy, corticosteroids, antibiotics, and antihistamines. Patients will also need to avoid any known allergens that could exacerbate their symptoms.
5 Signs and Symptoms of Atopic Dermatitis
The major signs and symptoms associated with atopic dermatitis are outlined below.
1. Dry Skin
Patients with atopic dermatitis often have patches of severely dry skin, which can cause skin flaking, and the skin may also feel tight and uncomfortable.
To soothe dry skin and reduce future dryness, dermatologists recommend for patients to establish a regular skincare routine that emphasizes hydrating the skin. The use of moisturizers will help protect the outermost layer of the skin typically damaged atopic dermatitis.
Patients should use moisturizers that do not contain dyes or fragrances, and any prescription creams should be applied before using moisturizer.
Putting on moisturizer within three minutes of finishing a bath or shower will improve the effectiveness of the product, and it needs to be applied with downward strokes. Any excess should be allowed to remain on the skin; it will be absorbed in a few minutes.
The patient must apply moisturizer to their hands after hand washing or other contact with water. A dermatologist can help the patient select an appropriate moisturizer that will help treat dry skin.
2. Severe Itching
Severe itching is one of the most debilitating symptoms of atopic dermatitis. Generally, patients tend to experience the most severe itching at night, and itching usually increases as a patient ages.
Severe itching typically causes chronic sleep deprivation, and this may lead to mental health issues, including low self-esteem, anxiety, depression, and difficulties in relationships. Patients could become very isolated, and they might experience problems at work or school.
Since itching is subjective, doctors may ask the patient to rate their itching on a scale of zero to ten, and treatment is planned accordingly. Patients who have itching associated with dry skin could experience some relief with the use of moisturizers, and antihistamines may help reduce the urge to scratch.
Topical treatments such as menthol can provide a cooling sensation, and dermatologists may also prescribe numbing creams like strontium or pramoxine to numb the nerve fibers responsible for itching sensations.
3. Raising Skin Bumps
Atopic dermatitis causes a rash composed of raising skin bumps, which are normally red and circular, and are often extremely itchy. Common locations for the bumps include the face, arms, and legs. If scratched, the bumps could blister, and clear discharge may leak from the sores.
Patients tend to experience the most severe bumps during flare-ups, which could be triggered by exposure to an allergen. For example, some types of laundry detergent may contain chemicals that are too strong for patients with this condition, and this could trigger the formation of bumps.
Other potential triggers include lanolin, wool, and eggs. Since raised red bumps could be caused by a variety of skin issues, patients who notice these for more than one or two weeks should have a medical evaluation.
Allergy testing may be considered, and the results of the test could help patients avoid substances that might cause flares. Patients will need to closely monitor any bumps for signs of infection such as pus, warmth, or pain.
Keeping a journal documenting the location of bumps and how long they last could provide useful information for atopic dermatitis patients to share with their dermatologist, as it may help with adjusting treatment plans.
4. Cracked and Scaly Skin
Cracked and scaly skin could develop if a patient scratches their skin. Sometimes, a patient’s skin may be so dry and fragile that it cracks even with gentle movement. Patients could notice thickened areas of skin, and cracks in these areas are at a high risk of infection.
For example, affected areas could develop dry crusts of yellow discharge that might indicate an infection, and antibiotics could be necessary.
Moisturizers and the use of prescription creams may help prevent skin cracking and scaling. Creams that contain coal tar or anthralin are often prescribed to treat thickened skin, and patients might also be asked to use a barrier repair cream with ceramides to repair cracked skin.
Individuals who use coal tar creams may experience side effects such as stinging at the application site.
Depending on the severity of cracks and scales on the skin, wet-wrap treatment with topical corticosteroids could be beneficial; however, this must be done properly to prevent infection, and it should not be used on already infected skin.
5. Patches on The Skin
Patches on the skin are considered a classic sign of atopic dermatitis. For patients with this condition, the patches on the skin are often raised and rough, and extremely dry.
These patches can occur anywhere on the body, though they are especially common on the hands, cheeks, and scalp. The color of the patches can vary.
For example, many patients have red patches, and others might notice their patches are slightly brown or gray.
Topical steroid creams and light therapy may be appropriate for patients with these symptoms, and some individuals might be offered biologist to provide additional relief from inflammation and treat the patches.
To prevent infection and reduce the tendency to scratch patches, it might be helpful to bandage affected areas. Patches on the face can sometimes be covered with makeup.
Patients with atopic dermatitis who notice any changes to the patches on their skin might want to consult their dermatologist about additional treatment options.