Atopic dermatitis, also called as atopic eczema, is a chronic and non-contagious disease affecting the skin. The term "dermatitis" refers to inflammation of the skin whereas "Atopic" refers to diseases occurring by heredity and tending to run in families. Asthma, hay fever, and atopic dermatitis are such diseases.

Atopic dermatitis occurs with skin turning extremely itchy and inflamed resulting in redness, swelling, cracking, weeping, crusting, and scaling. Though infants and young children are mostly affected by atopic dermatitis, the disease can continue into adulthood.

In many cases, the disease turns worse at some periods of time, but later the skin improves or clears up altogether, called remissions. Although permanent remissions can be observed in many atopic dermatitis affected children when they grow older, yet their skin often remains dry and easily becomes irritated.

Environmental factors greatly influence the symptoms of atopic dermatitis at any time in the lives of people inheriting the trait of atopic disease.

Eczema refers to many types of skin inflammation or dermatitis whereas atopic dermatitis is the most common type of eczema.

Causes of atopic dermatitis?

The exact cause of atopic dermatitis is yet to be ascertained, but the disease seems to be caused by a combination of genetic (hereditary) and environmental factors.

Researchers believe that disease also involves symptoms of several other so-called atopic disorders like hay fever and asthma that can affect people having atopic dermatitis.

Hay fever or asthma may continue to develop in many children outgrowing the symptoms of atopic dermatitis. Though one disorder does not show symptoms of another, yet they may be linked together, giving clues to the researchers to understand the true nature of atopic dermatitis.

Atopic dermatitis was earlier believed to be caused by an emotional disorder. Emotional factors such as stress does not lead to the disease, although they may aggravate the condition.

Is atopic dermatitis contagious?

Undoubtedly atopic dermatitis cannot be transmitted from one person to another and therefore it is not a contagious disease. Hence there is no point in feeling concern of being with a person having an active case of atopic dermatitis.

Symptoms of atopic dermatitis?

Symptoms in one atopic dermatitis affected person may not necessarily be the same in another affected person. However, dryness and itchiness in skin, cracks behind the ears and rashes on the cheeks, arms and legs are commonly seen in persons with atopic dermatitis.

According to researchers itchy feeling can be an important factor influencing atopic dermatitis since scratching and rubbing to respond this feeling aggravates the skin inflammation, which is the main characteristic of atopic dermatitis.

Persons having atopic dermatitis are found to be more sensitive to itching. Such persons feel like scratching longer in response to itchiness developing what is referred to as the "itch-scratch" cycle.

The extremely itchy skin compels the person to scratch, worsening the condition of the skin. The problem of itching becomes severe especially during sleep, when one is less conscious of controlling scratching and itchiness becomes more noticeable with the absence of other external stimuli.

The effect of atopic dermatitis on the skin depends upon the patterns of scratching and subsequent skin infections. Development of red and scaling skin can be found in some people having atopic dermatitis with the activation of immune system in the skin. Whereas others resorting to scratching and rubbing in response to feeling of itchiness tend to develop thick and leathery skin. This condition is called lichenification.

Development of papules, or small raised bumps on skin can also be seen after constant scratching. The scratching leads to excoriations of papules turning them crusty and infected.

Can my face be affected by atopic dermatitis?

Yes. The skin around the eyes, the eyelids and the eyebrows and lashes may be affected by atopic dermatitis. Scratching and rubbing the eye area may lead to change in the facial look.

In some cases, an extra fold of skin may develop under the eyes. This extra fold is known as atopic pleat or Dennie-Morgan fold. In other cases persons with atopic dermatitis may also develop hyper-pigmented eyelids with the darkening of the skin on eyelids after inflammation or hay fever (allergic shiners). Scratching may also result in patchy eyebrows and eyelashes.

Treatment of atopic dermatitis

The guaranteed cure for atopic dermatitis (eczema) has not been available yet. Since the major part of the tendency towards eczema is hereditary or genetic, the chances of a cure anytime in the foreseeable future are miniscule. However, several treatments are available to control the eczema and restore the original look of the affected skin.

The treatment for atopic dermatitis mostly varies in accordance with the pattern, severity and duration of eczema. It is necessary to avoid the trigger factors for eczema as much as possible. Moreover it may take several months and even years for the treatment of atopic dermatitis.

The treatment nearly necessitates reduction of exposure to trigger factors as much as possible, regular emollients (moisturizers) and intermittent topical steroids. This is the effective atopic dermatitis treatment.

Management of Atopic Dermatitis

Topical calcineurin inhibitors such as pimecrolimus cream or tacrolimus ointment

Antibiotics

Antihistamines

Photo therapy

Oral corticosteroids

Ciclosporin

Azathioprine