Eczema (Atopic Dermatitis)

Eczema, most commonly atopic dermatitis, is a chronic condition that makes skin red, dry, and intensely itchy. It often begins in childhood but can appear or continue into adulthood.

Common signs and symptoms

• Dry, sensitive skin
• Intense itch (often worse at night)
• Red to brownish-gray patches
• Small raised bumps that may leak fluid when scratched
• Thickened, cracked, or scaly skin from long-term scratching

In infants it often affects the face and scalp. In older children and adults it commonly appears in the bends of the elbows and knees, on the neck, wrists, and ankles.

What triggers flares?

Triggers vary by person and may include:

• Dry air or low humidity
• Harsh soaps, fragrances, and certain fabrics (wool, synthetic)
• Sweat and heat
• Stress
• Allergens (dust mites, pet dander, pollen)
• Infections

Management principles

There is currently no cure, but good control is achievable:

• Moisturize frequently – thick creams or ointments work better than lotions for most people with eczema
• Gentle cleansing – short lukewarm showers or baths; mild, fragrance-free cleansers
• Prescription treatments – topical corticosteroids, calcineurin inhibitors, PDE4 inhibitors, or newer biologics/oral medicines for moderate-to-severe disease
• Identify and avoid personal triggers
• Treat infections promptly when they occur

When to see a dermatologist

• Symptoms interfere with sleep or daily life
• Over-the-counter moisturizers and mild treatments are not enough
• Signs of infection (increasing redness, warmth, pus, fever)
• Eczema covers large areas or is severe