Atopic Dermatitis in Adults: What It Is and Why It Occurs

Atopic dermatitis is the most common form of eczema, and it occurs in adults too. Let's look at what this condition is, what causes it, and where it appears.

What atopic dermatitis and atopic skin are

Eczema is a general term for several types of skin inflammation, and atopic dermatitis is the most common among them. The skin itches, becomes dry, cracked, with crusts, scales, or thickened; the color changes — from redness to white, purple, or gray patches, and on darker skin the areas may be lighter or darker than the surrounding skin. There may be blisters and bleeding scratch marks.

Atopic skin is the skin of people with atopic dermatitis: dry, itchy, easily irritated. It does not become contagious: you cannot catch atopic dermatitis or pass it to someone else. The course is wave-like — flare-ups alternate with calm periods. The disease cannot be completely eliminated, but symptoms can be controlled.

What causes atopic dermatitis in adults

The exact cause is not always known. Heredity is noticeable: the risk is higher if one or both parents had atopic eczema, and also if you or a close relative has asthma or hay fever. These conditions are more common in people with atopic dermatitis. Food can be one of the possible triggers.

The following can make the course worse:

• contact with an irritant or allergen — soap, laundry detergent, certain fabrics, pets, pollen, house dust mites, certain foods;
• heat and temperature changes;
• skin infections, such as staphylococcal;
• stress;
• hormonal changes, including during pregnancy.

Where it appears: hands, face, legs

The rash can appear on various parts of the body, but the classic sites are the elbows, knees, and hands, including the inner side of the elbow and the area under the knees. Atopic dermatitis on the hands may affect the hands and fingers: the skin is dry, whitish, and flaky. In infants and young children, the same changes are common on the face, especially on the cheeks. The face is also among the common affected areas.

On the legs, the affected area may be on the back of the knees and in the ankle area.

How the course changes with age

Symptoms usually appear in infants and young children and soften over the years. In some people, the skin remains dry and easily irritated.

How a doctor confirms the diagnosis

The doctor examines the skin — dryness, thickening, scratch marks, crusts, blisters — and asks questions: when it started, how long flare-ups last, what triggers them, whether relatives have eczema, asthma, or hay fever. If the course is severe or the picture is atypical, the patient is referred to a dermatologist. The doctor distinguishes similar conditions — contact dermatitis, discoid eczema, pompholyx, varicose eczema — by examination and history.

When to see a doctor

You should see a doctor if there are signs of atopic eczema and usual care does not help. An urgent appointment is needed if the skin has become covered with blisters, crusts, is oozing, or purulent elements have appeared; if the area is painful, swollen, or hot; if the rash has suddenly become worse or larger; if there is a fever and the person feels worse. These may be signs of a skin infection or a more serious condition — eczema herpeticum.

Atopic dermatitis by itself is not a reason to call an ambulance; 103/112 — if a life-threatening condition occurs (for example, signs of stroke or heart attack) or the person becomes suddenly and severely unwell. With blisters, pus, pain, swelling, heat of the skin, and fever, an urgent doctor's appointment is needed the same day.

This material is for reference: it does not replace a doctor's consultation, and with persistent itching it is better to show the skin to a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer