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Atopic Dermatitis

Understanding Atopic Dermatitis

For people living with atopic dermatitis, the condition is much more than "just a rash."1-3 Atopic dermatitis is both the most common form of eczema and the most common chronic inflammatory skin condition.4

What is atopic dermatitis? 

Atopic dermatitis is a chronic, relapsing skin condition characterized by intense itching, dry skin and inflammation that can be present on any part of the body. The affected skin can become sore or painful; may crack and weep, or ooze; and may become scaly over time.5-7 

The dry skin that comes with atopic dermatitis often itches—and scratching the affected area can cause a rash that intensifies, leading to more scratching. This “itch/scratch cycle” can cause skin to crack and bleed, which can lead to infections.8

Signs and symptoms of atopic dermatitis can come and go, and may become worse during certain periods, known as "flares."1,9

What causes atopic dermatitis?

While the exact cause of atopic dermatitis is unknown, there are some key factors that may contribute to its development.10-11

Genetics

red DNA helix

Atopic dermatitis may run in the family. For example, if your parents have atopic dermatitis, you are more likely to develop it yourself.11-12

Immune System

red hand outline

People with atopic dermatitis can have an overactive immune system. When your body overproduces a protein called interleukin-13 (IL-13), and/or other inflammatory cytokines/proteins, your atopic dermatitis symptoms can worsen.10-11,13

Environmental Triggers

red outline of factory with smoke stacks

Triggers like pollution, allergens, fragrances and certain chemicals can make symptoms worse.11-14 Hot weather and sweat can also worsen atopic dermatitis symptoms.15-16

Who gets atopic dermatitis?

Seven percent of adults in the U.S. live with atopic dermatitis and 40% of them have moderate-to-severe cases.17 It’s even more prevalent for adolescents, ages 12 to 17. Almost 1 out of 10 (9.3%) of adolescents have atopic dermatitis, with more than 50% experiencing moderate-to-severe disease.18

Atopic dermatitis can affect anyone but may appear differently on varying skin tones. People with darker skin may see gray, purple or darker brown patches, while people with lighter skin tones may have red patches. Atopic dermatitis patches in people with darker skin tend to appear thicker and/or bumpier than in those with lighter skin.19 Data also indicates Black Americans are more likely to develop more severe cases.20

Can atopic dermatitis be treated?

Every person’s atopic dermatitis experience is different. The way each person manages the condition, including which treatments work best for them, also varies.1,5,21 Having a treatment plan that works is key to controlling atopic dermatitis. People living with the disease should talk to their health care practitioner openly and honestly to help ensure they fully understand the treatment options and are able to find one that works.22-23

1. Chandan N and Lio P. The shape of atopic dermatitis. Practical Dermatology June 2019:64-78. Available at: https://practicaldermatology.com/articles/2019-june/the-shape-of-atopic-dermatitis

2. Lohman ME and Lio P. Comparison of psoriasis and atopic dermatitis guidelines – an argument for aggressive atopic dermatitis management. Pediatr Dermatol 2017;34(6):739-42.

3. National Eczema Association. What is atopic dermatitis? Available at: https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/

4. Tsakok T, Woolf R, Smith CH, et al. Atopic dermatitis: the skin barrier and beyond. Br J Dermatol. 2019;180(3):464-474. doi:10.1111/bjd.16934

5. Weidinger S and Novak N. Atopic dermatitis. Lancet 2016;387(10023):1109-22

6. Ständer S et al. Clinical relevance of skin pain in atopic dermatitis. J Drugs Dermatol. 2020;19(10):217-22.

7. Eichenfield LF et al. Guidelines of care for the management of atopic dermatitis: Part 1. Diagnosis and assessment of atopic dermatitis. J Am Acad Dermatol 2014;70(2):338-51

8. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Atopic Dermatitis. Last reviewed November 2022. Accessed December 5, 2022. https://www.niams.nih.gov/health-topics/atopic-dermatitis#tab-living-with

9. Sidbury R et al. Guidelines of care for the management of atopic dermatitis: Part 4. Prevention of disease flares and use of adjunctive therapies and approaches. J Am Acad Dermatol 2014;71(6):1218-33

10. Allam JP, Novak N. The pathophysiology of atopic eczema. Clin Exp Dermatol. 2006;31(1):89-93. doi:10.1111/j.1365-2230.2005.01980.x

11. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Atopic Dermatitis. Last reviewed November 2022. Accessed December 5, 2022. https://www.niams.nih.gov/health-topics/atopic-dermatitis#tab-living-with

12. Mao W, Mao J, Zhang J, et al. Atopic eczema: a disease modulated by gene and environment. Front Biosci (Landmark Ed). 2014;19(4):707-717. Published Jan 1, 2014. doi:10.2741/4237

13. Weidinger S, Novak N. Atopic dermatitis. Lancet. 2016;387(10023):1109-1122. doi: 10.1016/S0140-6736(15)00149-X

14. Pavel P, Blunder S, Moosbrugger-Martinz V, et al. Atopic dermatitis: The fate of the fat. Int J Mol Sci. 2022;23(4):2121. Published online Feb 14, 2022. doi:10.3390/ijms23042121

15. Murota H, Katayama I. Exacerbating factors of itch in atopic dermatitis. Allergol Int. 2017;66(1):8-13. doi: 10.1016/j.alit.2016.10.005

16. Williams JR, Burr ML, Williams HC. Factors influencing atopic dermatitis-a questionnaire survey of schoolchildren’s perceptions. Br J Dermatol. 2004;150(6):1154-1161. doi: 10.1111/j.1365-2133.2004.05869.x

17. Chiesa Fuxench ZC, Block JK, Boguniewicz M, et al. Atopic dermatitis in America study: a cross-sectional study examining the prevalence and disease burden of atopic dermatitis in the US adult population. J Invest Dermatol. 2019;139(3):583-590. doi:10.1016/j.jid.2018.08.028

18. Silverberg JI, Barbarot S, Gadkari A, et al. Atopic dermatitis in the pediatric population: a cross-sectional, international epidemiologic study. Annals Allergy Asthma Immunol. 2021;126(4):417-428.e2. doi:10.1016/j.anai.2020.12.020

19. Sangha AM. Dermatological conditions in skin of color—managing atopic dermatitis. J Clin Aesthet Dermatol. 2021;14(3 suppl 1):S20-S22.

20. National Eczema Association. Eczema in skin of color: What you need to know. Available at: https://nationaleczema.org/skin-of-color/

21. Simpson EL et al. When does atopic dermatitis warrant systemic therapy? Recommendations from an expert panel of the International Eczema Council. J Am Acad Dermatol 2017;77:623-33.

22. National Eczema Association. Squad goals: Build your own eczema care team. 2019. Available at: https://nationaleczema.org/squad-goals/.

23. Pavlis J and Yosipovitch G. Management of itch in atopic dermatitis. Am J Clin Dermatol 2018;19(3):319-32.