Atopic dermatitis: Taking care of your skin

Atopic dermatitis is a long-lasting (chronic) skin condition that causes intense itching and then a red, raised rash . It usually develops in early childhood and continues into the teen years. Adults also may have it or have milder symptoms than they did as children, along with sensitive-skin problems.

If you have atopic dermatitis, your skin is very sensitive to irritants and is prone to becoming itchy and developing a rash. Scratching may seem to relieve the itch, but it often results in a rash and leads to a self-perpetuating cycle of itching, scratching, and rash.

Test Your Knowledge

1. Scratching helps soothe atopic dermatitis itch.

   1. True

      This answer is incorrect.

      Although scratching is the most natural response to an itch, it is also the most damaging. With each scratch, the skin becomes more inflamed and damaged, making the itch worse than before. Over time, the skin can become raw and infected or thick and leathery (lichenification), either of which makes it harder for the skin to heal.

   2. False

      This answer is correct.

      Although scratching is the most natural response to an itch, it is also the most damaging. With each scratch, the skin becomes more inflamed and damaged, making the itch worse than before. Over time, the skin can become raw and infected or thick and leathery (lichenification), either of which makes it harder for the skin to heal.

Skin affected by atopic dermatitis (atopic skin) must be kept well hydrated. Although researchers have yet to fully understand the causes of atopic dermatitis, it is known that skin dryness plays a big part in worsening symptoms.

Dry, atopic skin:

• Is overly sensitive to irritants.
• Lacks a moisture barrier that protects it from irritants.

Keeping the skin hydrated makes atopic skin:

• Less sensitive to irritants.
• More responsive to medication treatment.

Test Your Knowledge

1. Once I find the right medication for atopic dermatitis, I won't have to be so careful about skin care.

   1. True

      This answer is incorrect.

      Keeping skin well lubricated and hydrated is important when treating atopic dermatitis. For medication to be effective, it must be well absorbed by healthy, moisturized skin. Sometimes good skin care is all that is needed to control a mild itch and rash.

   2. False

      This answer is correct.

      Keeping skin well lubricated and hydrated is important when treating atopic dermatitis. For medication to be effective, it must be well absorbed by healthy, moisturized skin. Sometimes good skin care is all that is needed to control a mild itch and rash.

Good skin care is an essential part of controlling the itch and rash of atopic dermatitis. To help prevent a cycle of scratching, itching, and rash, keep your skin hydrated and identify and avoid skin irritants.

Keeping your skin hydrated

To care for your skin:

• Soak in clean, warm-not hot-water for 3 to 5 minutes. Your skin will absorb water and still retain its natural oils. Losing the natural oils makes the skin drier. You may shower when atopic dermatitis is under control or when an outbreak is mild.
• Avoid washing with soap during every bath. When soap is needed, use a gentle, nondrying product, such as Aveeno, Dove, Basis, or Neutrogena. Use soap regularly only on the underarms, groin, and feet, and rinse immediately afterward. Don't let children affected by atopic dermatitis sit in soapy water.
• Avoid adding bath oils and bubble bath to the bathwater, because they can reduce your skin's ability to absorb water.
• Avoid using scrub brushes or washcloths.
• Pat your skin dry after a bath or shower. While your skin is still moist or even wet, apply a moisturizer immediately-within 3 minutes of leaving the bath or shower. Waiting longer allows the skin to dry out. Moisturizers include Aquaphor, Eucerin, or Purpose. For severe dryness, try petroleum jelly, mineral oil, or an all-vegetable shortening such as Crisco. Also apply the moisturizer several times a day.
• In warm, humid climates, greasy lotions or moisturizers may block sweat glands and make your skin uncomfortable. For greater comfort, use:
  • An oil-free lotion, such as Cetaphil or Aquanil.
  • Cream-based or gel-based medications and cream moisturizers.
• Talk to your health professional about using a wet bandage over the affected area. It can help relieve symptoms but may not be a good idea if medication is being used on the skin.

Avoiding skin irritants

Try to avoid skin irritants, such as:

• Many soaps, lotions, and perfumes.
• Scratchy clothing or bedding.
• Places with low humidity.
• Sunburn.
• Sudden changes of temperature.
• Excessive sweating.
• Damp hands or feet.
• Emotional stress.

Test Your Knowledge

1. Daily washing with soap and water is an important part of skin care for atopic dermatitis.

   1. True

      This answer is incorrect.

      While soaking in clean, warm water is important for hydrating the skin, soaking too long or washing with soap removes the skin's layer of natural oils.

   2. False

      This answer is correct.

      While soaking in clean, warm water is important for hydrating the skin, soaking too long or washing with soap removes the skin's layer of natural oils.

For more information about skin care for atopic dermatitis, talk to your:

• Doctor, nurse practitioner, or physician assistant.
• Dermatologist.
• Allergist (immunologist).

If you would like more information on skin care for atopic dermatitis, the following resources are available:

Organizations