Atopic eczema (dermatitis)
Also called: Atopic dermatitis, Eczema
A common long-term condition causing dry, itchy, inflamed skin that flares and settles. It often starts in childhood alongside asthma and hay fever.
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Up to 20% of children and 5–10% of adults.
What happens in the body
A faulty skin barrier (often filaggrin mutations) lets irritants and allergens in, triggering type-2 immune inflammation and an itch–scratch cycle.
Causes
- Genetic skin barrier defect plus immune dysregulation
Risk factors
- Family history of atopy
- Filaggrin mutations
- Urban living
- Triggers: soaps, heat, sweat, wool, stress, infections
Symptoms
- Intense itch
- Dry, red, scaly patches — face and creases in children, elbows and knees
- Weeping or crusting in flares
- Thickened skin from scratching
Diagnosis — tests and examinations
- Clinical diagnosis
Treatment
Medicines and medical treatment
- Emollients generously and often
- Topical corticosteroids for flares
- Topical calcineurin inhibitors (tacrolimus) for the face
- Antibiotics for infected eczema
- Systemic treatment for severe disease: dupilumab, tralokinumab, lebrikizumab, JAK inhibitors, ciclosporin, methotrexate
- Phototherapy
Self-care, home remedies and lifestyle
- Soap substitutes
- Avoid known triggers
- Keep nails short
- Cotton clothing
- Proactive twice-weekly steroid to prevent flares
Possible complications
- Skin infection (Staph aureus, eczema herpeticum — urgent)
- Sleep loss
- Psychological impact
Prevention
- Emollients in infancy may help some high-risk babies
Outlook
Many children improve with age; well controlled with treatment.
When to see a doctor
Seek urgent care for painful, rapidly worsening eczema with blisters or fever.
Sources and further reading
These sources cover this condition. They have not been checked against every statement on this page.
Related conditions
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