Very Dry Skin? It Could be Eczema…

Atopic Dermatitis aka Eczema

Defining Atopic Dermatitis – What is Eczema?

Atopic dermatitis is a chronic (long-lasting) disease that affects the skin. It is not contagious; it cannot be passed from one person to another. The word “dermatitis” means inflammation of the skin. “Atopic” refers to a group of diseases where there is often an inherited tendency to develop other allergic conditions, such as asthma and hay fever. In atopic dermatitis, the skin becomes extremely itchy. Scratching leads to redness, swelling, cracking, “weeping” clear fluid, and finally, crusting and scaling. In most cases, there are periods of time when the disease is worse (called exacerbations or flares) followed by periods when the skin improves or clears up entirely (called remissions). As some children with atopic dermatitis grow older, their skin disease improves or disappears altogether, although their skin often remains dry and easily irritated. In others, atopic dermatitis continues to be a significant problem in adulthood.

Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood.

Atopic dermatitis is often referred to as “eczema,” which is a general term for the several types of inflammation of the skin. Atopic dermatitis is the most common of the many types of eczema. Several have very similar symptoms. Types of eczema are described in the box on page 5.

Incidence and Prevalence of Atopic Dermatitis

Atopic dermatitis is very common. It affects males and females and accounts for 10 to 20 percent of all visits to dermatologists (doctors who specialize in the care and treatment of skin diseases). Although atopic dermatitis may occur at any age, it most often begins in infancy and childhood. Scientists estimate that 65 percent of patients develop symptoms in the first year of life, and 90 percent develop symptoms before the age of 5. Onset after age 30 is less common and is often due to exposure of the skin to harsh or wet conditions. Atopic dermatitis is a common cause of workplace disability. People who live in cities and in dry climates appear more likely to develop this condition.

More than 15 million people in the U.S. have symptoms of atopic dermatitis.

Although it is difficult to identify exactly how many people are affected by atopic dermatitis, an estimated 20 percent of infants and young children experience symptoms of the disease. Roughly 60 percent of these infants continue to have one or more symptoms of atopic dermatitis in adulthood. This means that more than 15 million people in the United States have symptoms of the disease.

Types of Eczema (Dermatitis)

Allergic contact eczema (dermatitis): a red, itchy, weepy reaction where the skin has come into contact with a substance that the immune system recognizes as foreign, such as poison ivy or certain preservatives in creams and lotions

Atopic dermatitis: a chronic skin disease characterized by itchy, inflamed skin

Contact eczema: a localized reaction that includes redness, itching, and burning where the skin has come into contact with an allergen (an allergy-causing substance) or with an irritant such as an acid, a cleaning agent, or other chemical

Dyshidrotic eczema: irritation of the skin on the palms of hands and soles of the feet characterized by clear, deep blisters that itch and burn

Neurodermatitis: scaly patches of the skin on the head, lower legs, wrists, or forearms caused by a localized itch (such as an insect bite) that become intensely irritated when scratched

Nummular eczema: coin-shaped patches of irritated skin-most common on the arms, back, buttocks, and lower legs-that may be crusted, scaling, and extremely itchy

Seborrheic eczema: yellowish, oily, scaly patches of skin on the scalp, face, and occasionally other parts of the body

Stasis dermatitis: a skin irritation on the lower legs, generally related to circulatory problems

Cost of Atopic Dermatitis

In a recent analysis of the health insurance records of 5 million Americans under age 65, medical researchers found that approximately 2.5 percent had atopic dermatitis. Annual insurance payments for medical care of atopic dermatitis ranged from $580 to $1,250 per patient. More than one-quarter of each patient’s total health care costs were for atopic dermatitis and related conditions. The researchers project that U.S. health insurance companies spend more than $1 billion per year on atopic dermatitis.

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Last modified: March 7, 2009