Itchy, discolored, or dry skin can be frustrating and overwhelming — not to mention uncomfortable. To find relief, it’s important to figure out what’s causing your skin problems. While a dermatologist will make the final diagnosis, understanding which conditions may be responsible for your symptoms can be helpful.

Atopic dermatitis (AD) and contact dermatitis (CD) are two common causes of rashes, itching, and skin discomfort. These skin conditions share many similar symptoms and can even occur together in some people. Here’s what you need to know about the key similarities and differences between atopic dermatitis and contact dermatitis.

What Are Atopic Dermatitis and Contact Dermatitis?

The word “dermatitis” means inflammation of the skin. Both atopic dermatitis and contact dermatitis are characterized by inflammation of the dermis, or skin, but they have different causes and triggers.

Atopic Dermatitis

Atopic dermatitis is a type of eczema. It’s a chronic skin condition that can cause the following symptoms:

• Itching
• Scaly or dry patches of skin
• Red, purple, darker, or gray patches on the skin (depending on skin tone)
• Small bumps on the skin (vesicles)
• Swollen skin, especially after scratching

AD is linked to genetics, environmental factors, and immune system issues, although it’s usually difficult to determine the exact cause. A common genetic factor is a mutation or damage to a protein called filaggrin, which helps maintain the skin’s barrier. These factors can make the immune system overactive, leading to inflammation and skin irritation.

Both atopic dermatitis and contact dermatitis are characterized by inflammation of the skin.

This type of eczema is not curable, but there are ways to manage symptoms and feel better. If you’re diagnosed with atopic dermatitis, your doctor will work with you to create a treatment plan tailored to your eczema and needs.

Contact Dermatitis

Contact dermatitis causes an itchy rash that can be very uncomfortable. It’s a skin reaction that happens when your skin reacts to something it touches, like an allergen or irritant. While treating the rash can make you feel better, symptoms may not go away completely until you identify the trigger and start to avoid it.

There are two main types of contact dermatitis:

• Allergic contact dermatitis — Caused by allergens like nickel, poison ivy, and mango
• Irritant contact dermatitis — Caused by irritating substances like bleach, solvents, or shampoos

How Are Atopic Dermatitis and Contact Dermatitis Similar?

Atopic dermatitis and contact dermatitis share several similarities.

Symptoms

Both atopic dermatitis and contact dermatitis cause a rash (which may appear red or pink on light skin tones and darker or purplish on dark skin tones) and itchy skin.

Causes

Both AD and CD can be brought on by exposure to certain substances or situations (known as triggers). However, the specific triggers are usually different for each condition.

Diagnosis

A family doctor or general practitioner can usually diagnose both atopic dermatitis and contact dermatitis. You may also be referred to a dermatologist, who specializes in diagnosing and treating skin conditions.

To diagnose your condition, your healthcare provider will likely review your medical history and perform a physical exam. If they suspect you have allergic contact dermatitis, they may recommend a patch test to identify the particular substance or substances that are contributing to your symptoms. Rarely, a skin biopsy may be performed to support the diagnosis.

Over time, atopic dermatitis may cause a thickening of the skin, while contact dermatitis often leads to blisters.

Treatment

While treatments for atopic dermatitis and contact dermatitis are different, they overlap in some areas:

• Corticosteroid creams — Hydrocortisone creams can reduce itching and inflammation. Itch relief helps prevent scratching, giving the skin a chance to heal. Topical steroids also limit the allergic response in contact dermatitis.
• Oral steroids — A short course of oral steroids may be used for severe itching and inflammation in both types of dermatitis. However, due to potential side effects, they should be used sparingly.
• Cool, wet dressings — Applying a cool, wet towel can reduce inflammation and itching for both AD and CD.
• Avoiding triggers — Avoiding triggers is key for managing both atopic dermatitis and contact dermatitis, although the specific triggers (like personal care products, stress, or allergens) may differ.

How Are Atopic Dermatitis and Contact Dermatitis Different?

Atopic dermatitis and contact dermatitis share similarities, but there are important differences between the two.

Symptoms

While the rashes seen in AD and CD may seem similar, they may differ slightly in feel and appearance. Over time, atopic dermatitis can cause thickened skin, while contact dermatitis often leads to blisters.

Causes

Atopic dermatitis is believed to be caused by a mix of genetics, environment, and immune system dysfunction. This leads to a damaged skin barrier, difficulty maintaining moisture, and overactive immune system responses. Dry skin is more prone to bacterial infection and other irritation, which can cause recurring eczema flares.

If your healthcare provider or dermatologist suspects allergic contact dermatitis, they’ll try to identify the specific substances causing your allergic reaction.

AD flare-ups, or periods when symptoms get worse, can be triggered by things like stress or certain foods. However, these triggers are not the root cause of the condition.

Contact dermatitis happens when your immune system reacts to a specific allergen or irritant, causing skin inflammation. Common triggers that can cause allergy or irritation include:

• Plants like poison ivy
• Metals like nickel and cobalt
• Personal care products like soap and sunscreen
• Hair dye
• Fragrances and perfumes
• Preservatives like formaldehyde and parabens
• Airborne substances including sawdust
• Fertilizers and pesticides

Diagnosis

The diagnostic process for contact dermatitis can be different than for atopic dermatitis. Since allergic contact dermatitis is often caused by exposure to allergens, if your healthcare provider or dermatologist suspects allergic CD, they’ll try to identify the specific substances causing your allergic reaction. Identifying these irritants can help you avoid known triggers and prevent future reactions.

Finding out what substances trigger your CD may involve extensive allergy and irritant testing. While this process can be time-consuming or frustrating, it’s often worth it, as you’ll come away knowing what to avoid.

Treatment

Atopic dermatitis and contact dermatitis share some treatments, but treatment for AD often requires more extensive, long-term care.

In addition to the above treatment options, atopic dermatitis may also be treated with the following:

Injectable Biologics

These medications target the immune system issues that cause atopic dermatitis, rather than just treating the rash. The U.S. Food and Drug Administration (FDA) has approved several injectable biologics for treating atopic dermatitis that isn’t controlled by other treatments.

JAK Inhibitors

JAK inhibitors are another treatment option for atopic dermatitis. These medications block cellular signals that cause inflammation. They come in topical creams or oral forms, depending on the severity of your condition.

Phototherapy

Phototherapy, or light therapy, involves exposing affected skin to controlled doses of UV light. This treatment is often used to help control skin responses in people with frequent flare-ups that don’t respond to other treatments for atopic dermatitis. However, phototherapy may increase the risk of skin cancer over time. Talk to your healthcare provider to decide if this treatment is right for you.

Cognitive Behavioral Therapy and Biofeedback

Cognitive behavioral therapy is a type of talk therapy that can help those with atopic dermatitis manage the emotional and physical challenges of AD. Biofeedback may also help people become more aware of and control sensations like itchiness caused by eczema.

Is It Possible To Have Both Atopic Dermatitis and Contact Dermatitis?

People can experience atopic dermatitis and contact dermatitis at the same time. However, it’s easy to mistake CD for AD, especially in people already diagnosed with AD.

Dermatology and immunology researchers are still studying how and why these conditions may be connected. One theory is that AD weakens the skin barrier, making it more susceptible to contact dermatitis from allergens in personal care products. More research is needed to fully understand the connection between AD and CD.

Talk With Others Who Understand

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 experiences with others who understand life with eczema.

Do you have atopic dermatitis, contact dermatitis, or both? How do you manage your symptoms? Share your thoughts in the comments below or by posting on your Activities page.