Eczema (Atopic Dermatitis)

A common skin condition, atopic dermatitis is frequently described as “the itch that rashes.” Scratching often leads to redness, swelling, cracking, “weeping” of clear fluid, crusting, and scaling of the skin. Intensely itchy patches form, which can be widespread or limited to a few areas.

Between 10 and 20 percent of people worldwide develop atopic dermatitis, making it the most common type of eczema. For an estimated 65 percent‚ atopic dermatitis begins during their first year of life, and 90 percent have the condition before age 5. While rare, atopic dermatitis can first appear later in life.

When atopic dermatitis begins during infancy, it often is called infantile eczema. In infants, the itchy patches tend to develop on the scalp and face, especially on the cheeks. When atopic dermatitis develops in an infant or young child, the child tends to get better with time. For some children, the condition completely resolves by age two.

Atopic dermatitis also can be a lifelong condition. Fortunately, it tends to become less severe with age. During the teenage and young-adult years, the itchy patches often develop on the elbows and knees. Other common sites for these patches are the hands, feet, ankles, wrists, face, neck, and upper chest. Patches are not limited to these areas; they can appear anywhere on the body, including around the eyes and on the eyelids.

Having —or having once had—atopic dermatitis increases the risk of developing hand eczema. Some people who see their atopic dermatitis clear during adolescence develop hand eczema as adults. About 50 percent of those who develop atopic dermatitis continue to experience skin inflammation as adults, often in the form of hand eczema.

Hand eczema has many causes. Overexposure to an irritant, an allergic reaction, or a fungal infection can cause hand eczema. Since having — or having had— atopic dermatitis tends to leave one with a lifetime of dry, fragile skin, the skin is usually more susceptible to irritants, allergens, and fungal infections.

Without proper diagnosis and treatment, hand eczema can become chronic (long lasting), interfering with everyday activities and on-the-job tasks. Treatment involves using medication as directed and making lifestyle changes. Hand eczema can be stubborn. It may take months for the patches of red, scaly, and inflamed skin to heal. For hand eczema to resolve, patients must continue using the medication as directed, keep appointments with the dermatologist, and not get discouraged.