Atopic Dermatitis
- Defining Atopic Dermatitis
- Incidence and Prevalence of Atopic Dermatitis
- Cost of Atopic Dermatitis
- Causes of Atopic Dermatitis
- Symptoms of Atopic Dermatitis
- Stages of Atopic Dermatitis
- Diagnosing Atopic Dermatitis
- Factors that Make Atopic Dermatitis Worse
- Treatment of Atopic Dermatitis
- Atopic Dermatitis and Quality of Life
- Atopic Dermatitis and Vaccination Against Smallpox
- Current Research
- Hope for the Future
- Additional Resources This booklet is for people who have atopic dermatitis (often called "eczema"), parents and caregivers of children with atopic dermatitis, and others interested in learning more about the disease. The booklet describes the disease and its symptoms and contains information about diagnosis and treatment as well as current research efforts supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other components of the Department of Health and Human Services' National Institutes of Health (NIH). It also discusses issues such as skin care and quality of life for people with atopic dermatitis. If you have further questions after reading this booklet, you may wish to discuss them with your doctor or your child's pediatrician.
Defining Atopic Dermatitis
Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. It is not contagious; it cannot be passed from one person to another. The word "dermatitis" means inflammation of the skin. "Atopic" refers to a group of diseases where there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever. In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, "weeping" clear fluid, and finally, crusting and scaling. In most cases, there are periods of time when the disease is worse (called exacerbations or flares) followed by periods when the skin improves or clears up entirely (called remissions). As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, although their skin often remains dry and easily irritated. In others, atopic dermatitis continues to be a significant problem in adulthood.
Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood.
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Atopic dermatitis is often referred to as "eczema," which is a general term for the several types of inflammation of the skin. Atopic dermatitis is the most common of the many types of eczema. Several have very similar symptoms. Types of eczema are described in the box on page 5.
Incidence and Prevalence of Atopic Dermatitis
Atopic dermatitis is very common. It affects males and females and accounts for 10 to 20 percent of all visits to dermatologists (doctors who specialize in the care and treatment of skin diseases). Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood. Scientists estimate that 65 percent of patients develop symptoms in the first year of life, and 90 percent develop symptoms before the age of 5. Onset after age 30 is less common and is often due to exposure of the skin to harsh or wet conditions. Atopic dermatitis is a common cause of workplace disability. People who live in cities and in dry climates appear more likely to develop this condition.
More than 15 million people in the U.S. have symptoms of atopic dermatitis.
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Although it is difficult to identify exactly how many people are affected by atopic dermatitis, an estimated 20 percent of infants and young children experience symptoms of the disease. Roughly 60 percent of these infants continue to have one or more symptoms of atopic dermatitis in adulthood. This means that more than 15 million people in the United States have symptoms of the disease.
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Types of Eczema (Dermatitis)
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Allergic contact eczema (dermatitis): a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions
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Atopic dermatitis: a chronic skin disease characterized by itchy, inflamed skin
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Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical
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Dyshidrotic eczema: irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn
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Neurodermatitis: scaly patches of the skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that become intensely irritated when scratched
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Nummular eczema: coin-shaped patches of irritated skin-most common on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy
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Seborrheic eczema: yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body
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Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems |
Cost of Atopic Dermatitis
In a recent analysis of the health insurance records of 5 million Americans under age 65, medical researchers found that approximately 2.5 percent had atopic dermatitis. Annual insurance payments for medical care of atopic dermatitis ranged from $580 to $1,250 per patient. More than one-quarter of each patient's total health care costs were for atopic dermatitis and related conditions. The researchers project that U.S. health insurance companies spend more than $1 billion per year on atopic dermatitis.
Causes of Atopic Dermatitis
The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors.
Children are more likely to develop this disorder if one or both parents have had it or have had allergic conditions like asthma or hay fever. While some people outgrow skin symptoms, approximately three-fourths of children with atopic dermatitis go on to develop hay fever or asthma. Environmental factors can bring on symptoms of atopic dermatitis at any time in individuals who have inherited the atopic disease trait.
Atopic dermatitis is also associated with malfunction of the body’s immune system.
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Atopic dermatitis is also associated with malfunction of the body's immune system: the system that rec
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