Skin knowledge Guide Do I have atopic eczema? Background, signs and symptoms of atopic eczema

Do I have atopic dermatitis? Background, signs and symptoms of atopic dermatitis

Atopic dermatitis affects 15-20% of children and 5-10% of adults in Europe, making it one of the most widespread skin diseases in Europe. Now even referred to as a “disease of civilization”, the number of adults and children affected has continued to rise in recent years in Europe.

This article was written in collaboration with our skin expert Dr. Buder-Bakhaya, specialist in dermatology, venereology, and allergy.

What are the signs of atopic dermatitis? How can I tell that I have atopic dermatitis?

Groups of people frequently affected by atopic dermatitis

The typical age groups that suffer from atopic dermatitis include mainly children and infants, but also adults. In Germany, around 2 million children and 2.5 million adults are affected by atopic dermatitis.

Often, atopic dermatitis first appears in infancy and childhood and typically recurs in episodes. Symptoms can alleviate or even disappear with advancing age.

Recognize symptoms of atopic dermatitis

Patients have to struggle primarily with the symptoms of dry and scaly skin, which is accompanied by eczema (skin rashes). The affected areas are red, inflamed and, if they persist for a long time, wrinkled. In addition, sometimes pustules, crusts and blisters can develop, which often weep. This is usually accompanied by severe itching, which is also particularly pronounced at night and can lead to fatigue and difficulty concentrating in those affected due to sleep disturbance. However, the cycle is aggravated by scratching and the symptoms are thus intensified. The recurring inflammations can lead to a thickening of the respective affected skin area (technical term: lichenification) in the long term and mostly occur on the wrists as well as the crooks of the arms and the backs of the knees.

In the following, you will find common body parts where symptoms occur in the different age groups.

Regions of the body where atopic dermatitis occurs in infants:

Face, especially cheeks and head

Arms and legs

Bend

Excursus: Cradle cap is an inflammatory rash on the scalp and face of infants. It often appears after the third month of life and heals after some time. It may be associated with the onset of atopic eczema.

Important: However, cradle cap alone is not directly a sign of atopic dermatitis.

Areas of the body where atopic dermatitis occurs in young children and adolescents:

Face, especially forehead, eyes and mouth

Neck and nape of the neck

Wrists

Hands

Bending wrinkles

Areas of the body where atopic dermatitis often occurs in adults:

Scalp

Eyelids

Earlobes and lip area

Neck and face

Hands and feet

Genital area

Of course, the body areas cannot be generalized and differ from person to person. In children and adolescents it is more often the case that atopic dermatitis is often likely to “grow out” over time. In adults on the other hand it often persists and recurs in a certain body region, e.g. through eyelid eczema, head eczema, hand/foot eczema or genital eczema.

Do I have atopic dermatitis?

Since the independent differentiation from dry skin as well as from other skin diseases is difficult, finally only a physician can make a specific statement about whether skin changes are atopic dermatitis.

Nevertheless, there are signs that speak for atopic dermatitis:

Other atopic diseases (asthma, hay fever, allergies) in oneself or within the family

Relatives with atopic dermatitis

Recurring eczema, especially episodic

atopic eczema manifestations at an early age

Characteristic expression and distribution of eczema for age

Itching

The skin turns white after scratching (usually it turns reddish as soon as you scratch) – this is the so-called white dermographism.

What can I do against atopic dermatitis?

Since a complete cure of atopic dermatitis in the strict sense is not yet given, the goal of treatment or therapy is to alleviate the symptoms of those affected as far as possible and to stabilize/extend the symptom-free interval as much as possible. On the one hand, the therapy consists of basic care, which should ideally be carried out every day and also always directly after showering/bathing. Creams and lotions containing urea and glycerine play the main role here. In addition to the daily application, it is also important to use a sufficient amount.

Besides the basic care, treatment of inflammatory relapses and also the maintenance therapies for relapse prophylaxis are necessary.

Within the conventional medical approach, the following therapies are applied:

Basic care (creams/ointments with moisturizing factors such as glycerine and/or urea).

Avoidance of triggers

Prevention and treatment of infections

Anti-inflammatory external therapies (e.g. calcineurin inhibitors, modern cortisone creams/ointments with high therapeutic index, i.e. few side effects with very good efficacy)

Light therapies (Psoralene bath plus UVA for hands/feet for hand-foot eczema, salt bath plus narrowband UVB)

Internal therapy with immunosuppressants (Ciclosporin A) – very rarely used now because of side effects

Modern immunomodulating therapies in the form of subcutaneous injections/pens (Dupilumab, Tralokinumab)

Modern oral therapies in tablet form (JAK inhibitors).

In case of allergies: Allergen avoidance and if this is not sufficient: hyposensitization.

As an alternative or supplement to conventional medicine, many patients familiarize themselves with complementary medicine. These include, for example, homeopathy or acupuncture. Although these approaches have not yet been scientifically proven, they can also have positive effects on an individual basis.

Basically, it is above all important for those affected to get to know themselves well or to manage themselves well. There is the possibility to participate in so-called atopic dermatitis training courses, in which one can learn an optimal handling of the disease. In addition, it makes sense to take care not only of the physical concerns, but also of the psychological factors and to find an individual way to deal with them in a targeted manner, even in more difficult phases.