Signs and symptoms of atopic dermatitis (eczema) include:

  • Red to brownish-gray colored patches
  • Itching, which may be severe, especially at night
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Thickened, cracked or scaly skin
  • Raw, sensitive skin from scratching

Though the patches can occur anywhere, they most often appear on the hands and feet, in the front of the bend of the elbow, behind the knees, and on the ankles, wrists, face, neck and upper chest. Atopic dermatitis can also affect the skin around the eyes, including your eyelids. Scratching can cause redness and swelling around the eyes.

Atopic dermatitis most often begins in childhood before age 5 and may persist into adulthood. For some, it flares periodically and then subsides for a time, even up to several years. Itching may be severe, and scratching the rash can make it even itchier and cause more inflammation. Once the skin barrier is broken, the skin can become infected by bacteria, especially Staphylococcus aureus, which commonly live on the skin. Breaking this itch-scratch cycle can be challenging.

Factors that worsen atopic dermatitis

Most people with atopic dermatitis also have Staphylococcus aureus bacteria on their skin. The staph bacteria multiply rapidly when the skin barrier is broken and fluid is present on the skin, which in turn may worsen symptoms, particularly in young children.

Other factors that can worsen signs and symptoms of atopic dermatitis include:

  • Dry skin
  • Long, hot baths or showers
  • Stress
  • Sweating
  • Rapid changes in temperature
  • Low humidity
  • Solvents, cleaners, soaps or detergents
  • Wool or man-made fabrics or clothing
  • Dust or sand
  • Cigarette smoke
  • Living in cities where pollution is high
  • Certain foods, such as eggs, milk, fish, soy or wheat

Infantile eczema

When atopic dermatitis occurs in infants, it's called infantile eczema. This condition may continue into childhood and adolescence.

Infantile eczema often involves an oozing, crusting rash, mainly on the skin of the face and scalp, but it can occur anywhere. After infancy, the rash becomes dryer and tends to be red to brown-gray in color. In adolescence, the skin may be scaly or thickened and easily irritated. The intense itching may continue.

When to see a doctor

See your doctor if:

  • You're so uncomfortable that you're losing sleep or are distracted from your daily routines
  • Your skin is painful
  • You suspect your skin is infected
  • You've tried self-care steps without success

If you suspect your child has atopic dermatitis or you notice the above signs and symptoms, see your child's doctor.

Early, effective treatment helps keep atopic dermatitis from worsening. The more severe it becomes, the more difficult it is to control.

Aug. 23, 2011

You Are ... The Campaign for Mayo Clinic

Mayo Clinic is a not-for-profit organization. Make a difference today.