Atopic Dermatitis

Atopic Dermatitis

Every itch does not bring money….some bring rash!

Eczemas are skin conditions that present with dry, itchy and rough patches of skin on the face, elbows, behind knees, and on the hands and feet of an individual. Atopic dermatitis (AD) is the most common form of eczema but most people typically refer to it as eczema.

Atopic dermatitis is a chronic (long-term) skin disease that can cause inflammation, redness and rash. It is not contagious (cannot be spread from person to person) and can occur again (relapse), if proper care is not taken. Usually seen in infancy and in childhood, atopic dermatitis can also occur in adults. Atopic dermatitis affects 2.4% of the population globally with children till the age of 10 being most susceptible to it.

Studies have shown that AD is most commonly seen in more socio-economically developed nations in comparison to nations with low socioeconomic status.

For understanding the symptoms, causes and treatment of atopic dermatitis, consult ​​Dr Priyanka Reddy, the best dermatologist in DNA Skin Clinic and Wellness Centre, Bangalore.


Causes of AD

There are many theories that revolve around to the causes of AD. It is believed that AD may be caused due to:

  • Defect in the skin barrier due to mutation in the genes- Our normal healthy skin barrier protects our body from bacteria and allergens while retaining moisture. In AD, there is a mutation in a gene which disrupts the skin barrier, allowing allergens and other irritants to rob the moisture from our skin. This leads to dryness of the skin and the development of rashes, culminating in AD.
  • Family history of developing AD.
  • Overactive immune system-due to exposure to external irritants/factors like smoke, chemicals, fragranced skin products, etc., our immune system gets triggered and becomes overactive. This makes our skin dry and predisposed to develop a rash and finally AD sets in.

Risk Factors for Developing AD

The risk factors for the development of AD are higher in children if there is a family history of eczema, asthma, hay fever (allergic reactions to pollen, dust or any other environmental factor) or any other allergies.


Itching is the most common symptom of atopic dermatitis, which can range from mild to severe. Itching may occur before the appearance of the rash. Symptoms of eczema may differ from person to person and may also appear in different areas for different individuals. The other skin symptoms in an AD person will be:

  • Drying of skin
  • The appearance of red patches on the skin
  • Thickening of skin
  • Blistering of the skin
  • Oozing of blood, clear fluid from the skin on scratching

These symptoms vary depending on the age of the individual

In infants and children < 2 years of age

The itchy, red rash appears mainly on the face, scalp and at the area of joint bends. The rash may also extend to the arms, legs and chest and oozes when scratched. Atopic dermatitis does not involve the diaper area of infants.

In children (> 2yrs) and teenagers

In children, the appearance of the red rash causes a thickening of the skin and may ooze blood when scratched. In later stages, the rash becomes scaly and crusting develops. It is most commonly seen on bends of the elbows, behind the knees, on the neck, on the wrists and ankles.

In adults

The skin with atopic dermatitis in adults and some teenagers appear dry, thick, and scaly with the presence of a rash on the backs of the knees, wrists, hands, and feet. These skin changes may start as a reddish patch and later turn brown in a fair skin individual. In darker-skinned individuals, the affected area becomes lighter or darker due to AD.

Other places on the body where the skin is affected by AD

  • Eyes-darkening of skin under the eyes; development of the extra layer/fold of skin under the eyes.
  • Palms and soles of the feet- Appearance of extra skin creases.

Conditions associated with Atopic Dermatitis

Atopic dermatitis just does not come with a specific set of skin problems but also carries a significant emotional burden with itself. People with atopic dermatitis are found to have low, self-esteem, and decreased quality of life with sleep disturbances. Other conditions associated with AD are asthma, food allergies,slin conditions like ichthyosis (dry, thick skin), anxiety and depression. It is believed that stress aggravates AD and leads to the worsening of the disease.

Diagnosis of Atopic Dermatitis

At DNA Skin Clinic and Wellness Centre, Bangalore, experienced dermatologists diagnose atopic dermatitis by history and physical examination. A patch test is sometimes done to diagnose the condition that identifies the allergen which has triggered AD. In this test, an allergen is applied to the skin and if that allergen is the trigger, the skin will get red, inflamed and would start to itch. The dermatologist would sometimes take a blood sample or a skin biopsy to rule out other causes of weeping or oozing dermatitis.

Management of Atopic Dermatitis

There is yet no cure for eczema, hence the treatment focusses on reducing symptoms, healing the skin, and preventing further flare-ups. Dr Priyanka Reddy, the best dermatologist in DNA Skin Clinic and Wellness Centre, Bangalore, believes that treatment for AD can be divided into:

  • Medical treatment.
  • Lifestyle modifications.
  • Other treatments like therapies and home remedies to relieve symptoms.

A combination of some of the options may work for some individuals.

Medical treatment

The doctor can prescribe some medications to reduce the symptoms and flare-ups. Depending on the condition, the following medicines can be given:

  • Creams and lotions for application on the skin to control the itch
  • Antibiotics for the infection
  • Anti-inflammatory medications to reduce inflammation, swelling and redness
  • Anti-allergics to decrease itching and other allergic reactions

Lifestyle Modifications

These will help in reducing the flare-ups and help you live well with AD

  • Meditation- Meditating daily will relieve stress and help in focussing on other things apart from the disease
  • Sound Sleep- Having a regular sleep pattern of 8 to 10 hours of sleep daily, will reduce the flaring up of symptoms
  • Yoga- Practicing yoga will help in maintaining overall health
  • Breathing exercises - Deep breathing exercises would reduce stress and lead to a healthier living
  • Listening to music- Will provide a relaxation effect and reduce stress
  • Cold compression on the areas affected would provide relief or taking a short light warm bath would ease the symptoms.

Light Therapy

Also known as phototherapy is the modality of treatment that can be tried if oral or topical creams are not effective. In light therapy, the skin is exposed to controlled doses of natural sunlight. The light sources used are Artificial ultraviolet A (UVA) and narrowband ultraviolet B (UVB) alone or in combination with other medications. Light therapy can be tried only after consultation with your dermatologist. Consultation for light therapy in AD can be taken from Dr Priyanka Reddy, the best dermatologist in DNA Skin Clinic and Wellness Centre, Bangalore. In infants and children, light therapy is not advised as it may predispose them to the risk of developing skin cancers.

Alternative therapies /Home Remedies

These are some ways in which the symptoms can be managed at home:

  • Skin Moisturizers, Creams and Lotions - Lotions and creams prescribed by the doctor would assist in healing the skin by decreasing the itching and restoring moisture. They are to be applied multiple times a day as per the doctor’s advice, especially after a bath. Creams lotions and moisturisers contain petroleum jelly and mineral oil hence they aid in building a thick skin barrier which locks moisture inside the skin.
  • Wet cloth application- If there is flaring up of the symptoms, gauze pieces, bandages or any soft fabric can be soaked in cold water and applied to the skin. This will help in easing itching and irritation in the skin. After the cold cloth application, use some cream or moisturiser on it and cover the area overnight with a soft cotton cloth.
  • Essential Oils- like sunflower oil, coconut oil or evening primrose oil have anti-inflammatory effects on the skin that help in reducing the redness and swelling which accompanies AD
  • Anti-inflammatory foods- like apples, broccoli, cherries fish, spinach and yoghurt can be consumed to reduce the swelling and inflammation of the skin.
  • Use of Colloidal Oats- Oats are used as they have a calming and soothing effect on dry and irritated skin. They can be used as a powder or a cream.
  • Wearing loose cotton fabric- Tight-fiiting clothes should be avoided as the skin would not be able to breathe in them. Loose cotton clothes allow the circulation of air and prevent itching of the AD skin.
  • Avoidance of Harsh Chemicals- Fragranced soaps, moisturises, and perfumes should not be applied on the skin as they would cause a flare-up of the symptoms. When washing your clothes, gloves are to be worn and the use of mild detergents should be practised to avoid irritation to the skin.

Prevention of AD


Symptoms of atopic dermatitis, if not cured, can definitely be prevented by using these measures:

  • Use cream, lotions and moisturizers daily. Twice a day application of creams and lotions would keep the moisture locked inside the skin. It would also prevent the drying and cracking of the skin.
  • Identify the allergens and irritants- Visit the doctor to identify the allergens that can lead to flaring up of the symptoms. Avoid those substances in food, drinks, cream, etc.
  • Use lukewarm water while bathing- As very hot water would cause drying, flaking and itching of the skin, use lukewarm water while bathing. Have short baths instead of long ones to avoid drying of skin.
  • Dry and clean properly- After a bath, it is essential that the skin should be fully dry as wearing clothes over wet skin would increase the chances of skin infections. It is imperative that skin should not be rubbed hard while drying ones self; instead a soft cloth should be use to pat dry and moisturizer should be applied on the skin after drying.
  • Relieve stress by yoga and meditation. Studies have shown that stress is a major contributor to AD flare-ups. Yoga, meditation, listening to music and other stress relieving activities would halt the flaring up of symptoms of AD.

Complications of Atopic Dermatitis

AD may lead to some complications that may sometimes be a cause for concern.

  • Skin infections- In atopic dermatitis, continuous scratching of the skin would result in open wounds and cracks on the skin. Due to this, bacterial viral infections, especially Herpes simplex virus (HSV) infections can penetrate the wounds and lead to skin infections.
  • Permanent Thick and Leathery skin- Continuous scratching of the skin in a particular area for a long time leads to the skin becoming discoloured, thick and leathery hard- a condition known as neurodermatitis.
  • Sleeping disturbances- Continuous itching causes an alteration in the sleep cycle and leads to waking up multiple times in the night. This results in daytime sleeping and disruption of daily routine making one fatigued throughout the day.
  • Chronic hand eczema- Individuals working with cosmetics like beauticians, make-up artists, and in laundry services, if have AD, have the probability of developing hand eczema. This is due to their use of harsh chemicals on their hands throughout the day.
  • Asthma and allergies- Studies have shown that by the age of 13, more than half of the children with atopic dermatitis develop asthma and hay fever.

When to visit your doctor?

It is advisable to visit your dermatologist if the symptoms flare up. Take an appointment with Dr Priyanka Reddy, the best dermatologist in DNA Skin Clinic and Wellness Centre, Bangalore, if:

  • Your symptoms are not responding to medicines and have aggravated
  • You are having continuous itching
  • You are unable to sleep at night due to your symptoms
  • There is blood or fluid oozing out of the wounds
  • Skin is becoming flaky, thick or scaly

Even though there is no cure for atopic dermatitis, the symptoms can be controlled and prevented by seeking medical help. It is important to consult your doctor to get a proper treatment plan and advise.

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