In recognition of National Eczema Awareness Month (NEAM) this October, it seems fitting to dig deeper into atopic dermatitis (AD) – the most common type of eczema2. AD is a chronic condition that can affect a person’s daily life, both physically and emotionally3. However, understanding the science behind AD can help people living with it have more productive discussions with their dermatologists and work together to create a management plan for their specific symptoms.
Atopic Dermatitis: An Overview
As a chronic inflammatory skin condition, AD is caused by an over-activation of the immune system3. It can show up anywhere on the skin as relentless, itchy red lesions that may ooze and crust, or appear as dry, scaly patches3. While AD commonly manifests before age five, it can occur at any age2,4.
What’s Happening Beneath the Skin?
Research shows that AD does not have just one singular cause. The complexity of the condition means that many things can trigger AD flares, including stress, climate, allergens and other environmental factors4.
For people with AD, the immune system can become overactive when out-of-control cytokines (a type of protein) affect other proteins that help maintain healthy skin5. The result? Inflammation that leads to dry, itchy skin6. In fact, AD can lead to an ongoing cycle of itching and scratching, which can worsen symptoms3.
Dr. Rebecca Smith, board-certified dermatologist, explains, “There are usually checks and balances with the immune system, but in people with AD, the immune system is overactive and causes them to become even itchier. This leads to more scratching and more damage to the skin barrier.”
What’s It Like Living with Atopic Dermatitis?
The symptoms of AD – especially itch – can lead to sleep disturbances and/or lack of participation in work or school activities. A recent survey of more than 1,500 people living with eczema and their caretakers7 showed:
- Roughly 79% of respondents identify itch as one of the most challenging symptoms7 (in the top three).
- Approximately 40% of adult respondents say AD has negatively impacted their social and intimate relationships7.
What Are Tips for Those Managing Atopic Dermatitis?
People experience AD differently, so what works for some might not work for others. The complex factors behind AD also increase the need for an individualized management plan, which can prove to be difficult. This is why it is essential to see a board-certified dermatologist regularly and build a trusting relationship with them. By doing so, people with AD can find a management plan that helps address their specific symptoms, triggers and concerns.
While AD is a chronic and unpredictable condition, people can feel confident that management options exist. Dr. Smith shares these tips:
- Understand the root causes of AD so you feel empowered to proactively manage your condition in partnership with your dermatologist.
- Determine what triggers a flare-up or worsens your AD and avoid them. Keeping a journal of symptoms and triggers can help.
- Be your own advocate! If new symptoms arise—or your management plan isn’t working—have a conversation with your dermatologist.
Where Can I Learn More?
Schedule an appointment with your dermatologist to discuss a personalized management plan and visit Start from Scratch for more resources to help you better understand your AD.
1. Silverberg JI, Gelfand JM, Margolis DJ, et al. Atopic dermatitis in US adults: from population to health care utilization. J Allergy Clin Immunol Pract. 2019;7(5):1524-1532.
2. American Academy of Dermatology Association. “Eczema Types: Atopic Dermatitis Overview.” 2022. Accessed: August 9, 2022. https://www.aad.org/public/diseases/eczema/types/atopic-dermatitis
3. National Eczema Association. “Atopic Dermatitis.” 2022. Accessed: August 9, 2022. https://nationaleczema.org/eczema/types-of-eczema/atopic-dermatitis/
4. Cleveland Clinic. “Eczema.” October 28, 2020. Accessed: August 10, 2022. https://my.clevelandclinic.org/health/diseases/9998-eczema.
5. Journal of Allergy and Clinical Immunology. “The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies.” April 2017. Accessed: August 10, 2022. https://www.jacionline.org/action/showPdf?pii=S0091-6749%2817%2930205-1
6. International Journal of Molecular Sciences. “New Cytokines in the Pathogenesis of Atopic Dermatitis—New Therapeutic Targets.” October 9, 2018. Accessed: August 10, 2022. https://www.mdpi.com/1422-0067/19/10/3086/htm
7. “More Than Skin Deep. Understanding the lived experience of eczema.” March 2020. Accessed: August 23, 2022. https://www.aafa.org/media/2628/more-than-skin-deep-voice-of-the-patient-report.pdf
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