The word “atopic” comes from the ancient Greek word “a topos,” literally “without place,” which can also mean “unusual.” Ironically, atopic dermatitis is anything but unusual. In fact, atopic dermatitis is the most common type of eczema, affecting as many as 13 percent of children and 10 percent of adults in the United States.

Every type of eczema causes scaly and itchy skin, which may appear red, dark brown, or purple, depending on your skin tone. All eczema involves skin inflammation resulting from abnormal immune system reactions. People with eczema tend to have a damaged or “leaky” skin barrier that causes dry skin and lets in irritants and allergens.

Atopic dermatitis — sometimes called atopic eczema — is considered a long-lasting and severe eczema type. For many people with atopic dermatitis, the condition can greatly affect daily life and lead to high medical costs.​

Atopic Dermatitis Is Different From Other Types of Eczema

Different types of eczema have different triggers, symptoms, and treatments. If you have atopic dermatitis, gaining a better understanding of your skin condition can be a good first step to improving it.

Atopic dermatitis is likely to be chronic (ongoing) and recurrent (having repeated episodes). It goes through periods of worsened symptoms, called flares or flare-ups, and remission, or resolution of symptoms.

The condition is believed to be part of the “atopic triad” or “atopic march” — a genetic tendency to also develop asthma and allergic rhinitis (hay fever), food allergies, or other allergic conditions.

Unfortunately, it’s possible to have more than one type of eczema at the same time. If your symptoms worsen or fail to improve while you’re correctly using treatments prescribed for atopic dermatitis, you may also have contact dermatitis. It’s possible to develop a contact allergy to topical (applied on the skin) medications for atopic dermatitis.

What Makes Atopic Dermatitis Challenging To Treat?

Atopic dermatitis is a chronic skin disease, and dermatology research indicates it’s likely a lifelong condition. Symptoms of atopic dermatitis can be confusing because they often come and go, with flare-ups sometimes years apart. However, in people with atopic dermatitis, even skin that appears normal shows evidence of impaired skin barrier function and allergic and inflammatory changes, when skin cells are examined under a microscope.

The good news is that there are many new medications for atopic dermatitis recently approved by the U.S. Food and Drug Administration (FDA) or in the late stages of development. More treatment options are available for atopic dermatitis now than ever before.

In people with atopic dermatitis, even skin that appears normal shows evidence of impaired skin barrier function and allergic and inflammatory changes under a microscope.

Depending on your specific case of atopic dermatitis, topical treatment options may include:

• Corticosteroid cream or ointment, such as hydrocortisone (like Cortizone 10 Intensive Healing Eczema Lotion), or prescription corticosteroid (steroid) topicals
• Pimecrolimus cream (Elidel) or tacrolimus ointment (Protopic), which are topical medications known as calcineurin inhibitors
• Crisaborole ointment (Eucrisa)
• Ruxolitinib cream (Opzelura), a type of medication known as a Janus kinase (JAK) inhibitor
• Roflumilast cream (Zoryve)

Systemic medications that work throughout the body include:

• Dupilumab (Dupixent) and tralokinumab (Adbry), biologic drugs that are taken by injection
• Abrocitinib (Cibinqo) and upadacitinib (Rinvoq), which are JAK inhibitors that are taken in tablet form

Older immunosuppressant medications that are taken orally and are still appropriate for some people with atopic dermatitis include:

• Cyclosporine
• Azathioprine
• Mycophenolate mofetil
• Methotrexate

All medications come with potential side effects, which you should discuss in detail with your doctor when considering a new treatment.

It’s Essential To Stick With Your Treatment Plan

People living with atopic dermatitis may have trouble with treatment adherence. Treatment adherence is defined as taking over-the-counter and prescription medications as directed for the necessary length of time. Adherence can be especially poor for topical treatments, which may need to be applied daily on affected areas of the body.

Some common reasons for not adhering to atopic dermatitis treatment include:

• Difficulty affording treatment
• Confusion about instructions from doctors
• Complexity of treatment regimens with multiple medications and steps
• Concerns about the risks and side effects of medications, especially topical corticosteroids

Some people use their atopic dermatitis medication incorrectly and then believe it’s not working. This sometimes results in switching to a more powerful medication when it might not be needed.

Some people use their atopic dermatitis medication incorrectly and then believe it’s not working.

If you have difficulty affording your prescribed atopic dermatitis medication, taking medications as directed, or sticking to the schedule for phototherapy (light therapy) treatments, discuss these issues openly with your doctor. Your health care provider may be able to recommend ways to overcome these obstacles. Your dermatologist, allergist, or family doctor can also help you weigh the risks and benefits of each medication if you’re concerned about safety and side effects.

Think Long-Term, Act Daily

There are steps you can take to protect your skin barrier and keep your skin its healthiest. Sticking to a daily skin care regimen can help control atopic dermatitis and decrease the need for medications.

Managing stress, avoiding your atopic dermatitis triggers, and getting enough sleep are also important factors in keeping your skin healthy.

Keep reading to learn about basic skin care and lifestyle tips for managing atopic dermatitis.

Create Eczema-Safe Bathing Habits

Bathing is an important part of managing atopic dermatitis, but how you bathe can make a big difference. The right habits can help protect your skin’s natural barrier and reduce irritation, while the wrong ones may worsen dryness or trigger flares. Keep these tips in mind to make your bathing routine eczema-friendly:

• Avoid taking long, hot showers, as hot water dries out the skin. Instead, bathe once daily for no more than five to 10 minutes in cool or lukewarm water.
• Use cleansers rather than soap because they are gentler on sensitive skin. During a flare, skip cleansers altogether. Always avoid antiseptic cleansers and cleansers with fragrance or dyes.
• Rinse cleansers and shampoos off your skin thoroughly.
• If you have crusting lesions or recurrent skin infections associated with your atopic dermatitis, talk to your health care provider about whether adding a small amount of bleach to your bath could help. Bleach baths, if recommended, should only be taken once or twice a week to avoid irritation.

Moisturize Daily

Moisturizing is essential for managing atopic dermatitis, as it helps maintain the skin’s barrier and prevents dryness. The right products and timing can make a big difference in keeping your skin hydrated and comfortable. Follow these tips to help make moisturizing more effective:

• Apply lotions, creams, ointments, or moisturizers with a high oil content immediately after bathing — within three minutes — to lock in moisture.
• Use moisturizers without fragrance or dyes.
• Moisturize your hands after every time you wash or come into contact with water.

Make Adjustments to Your Environment

Your surroundings can have a big impact on managing atopic dermatitis. Small changes to your environment can help reduce irritation and prevent flare-ups. Consider these ideas to make your environment more skin-friendly:

• Choose soft, loose, full-sleeved clothing that will not irritate the skin.
• If you live in a dry climate, consider using a humidifier. To prevent the spread of bacteria, make sure to properly clean any humidifiers according to their directions.
• In hot, humid weather, try to stay in air-conditioned areas or near a fan.
• Regular vacuuming, damp dusting, and mopping can help keep down dust mite populations. Dust mites are a common irritant for people with atopic dermatitis.
• Avoid swimming in chlorinated pools during flare-ups. Limit swimming and water exposure if it seems to irritate your skin.

Apply lotions, creams, ointments, or moisturizers with a high oil content immediately after bathing — within three minutes — to lock in moisture.

Manage Your Stress

Stress can worsen atopic dermatitis symptoms, so finding ways to manage it is an important part of your care routine. Taking steps to reduce stress and build emotional resilience can help you feel more in control. Try these strategies:

• Identify which triggers cause emotional distress and try to avoid or modify activities that you find stressful.
• Don’t try to do too much, and focus on a few tasks each day that are a priority.
• Spend time outside and get fresh air to help clear your mind.
• Try relaxation techniques such as mindfulness training, deep breathing exercises, or yoga.
• Talk to family, friends, or a support group such as MyEczemaTeam about your feelings.
• Talk to your doctor if you’re experiencing anxiety, depression, or stress that affects your quality of life.

Avoid Triggers

Identifying and avoiding triggers is an important part of managing atopic dermatitis. By minimizing exposure to irritants or allergens, you can help reduce flare-ups and keep your symptoms under control. Keep these suggestions in mind:

• Identify any foods that may trigger your atopic dermatitis, which may sometimes be related to a food allergy.
• Protect your skin from irritants in household products by choosing gentle, fragrance-free options, wearing gloves during use, and washing clothes with mild, fragrance-free laundry detergents.
• Some people with atopic dermatitis may be triggered by pollen in trees, grass, or ragweed.
• Pet dander may also trigger atopic dermatitis symptoms.

Practice Good Sleep Hygiene

Getting quality sleep is crucial for managing atopic dermatitis, as poor sleep can worsen symptoms and affect overall well-being. Adopting healthy sleep habits can help you rest better and wake up feeling refreshed. Consider these steps:

• Stick to a consistent sleep schedule and follow healthy sleep habits.
• Avoid looking at your phone or any other screen at least 60 minutes before bedtime.
• Don’t eat late because digestion can interfere with sleep.
• Reduce your consumption of alcohol.
• Stay away from caffeinated beverages in the afternoon and at night.
• Create a calming routine before bed and dim lights, read, or practice relaxation techniques.
• Ensure a cool sleeping environment: The optimal sleeping temperature, according to Sleep Foundation, is around 65 degrees Fahrenheit.

Find Your Team

On MyEczemaTeam, the social network for people with eczema and their loved ones, more than 54,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Do you have atopic dermatitis? Share your experience in the comments below or by posting on your Activities page.