Atopic dermatitis: Signs and symptoms
Atopic dermatitis (AD) looks different in infants, children, and adults. The following gives you the signs (what you see) and symptoms (what you feel) for each age group.
AD can begin early. A child may be 2 or 3 months old when AD begins. When AD begins early, it often causes:
- A rash that appears suddenly and:
- makes the skin dry, scaly, and itchy.
- forms on the scalp and face, especially on the cheeks (can appear on other areas of the body).
- can bubble up, then ooze and weep fluid.
- causes itching that may come and go.
- Rubbing against bedding, carpeting, and other things in order to scratch the itch.
- Trouble sleeping.
- Skin infections, common due to rubbing and scratching.
Parents often worry that their babies are getting AD in the diaper area. A babies rarely gets AD in his or her diaper area. The skin stays too moist for AD.
When AD begins between 2 years of age and puberty, the child often has these signs and symptoms:
- A rash that often begins in the creases of the elbows or knees. Other common places for the rash to appear are the neck, wrists, ankles, and/or crease between the buttocks and legs.
- Itchy, scaly patches where the rash appeared.
In time, the skin with AD can:
- Get bumpy, looking like permanent goose bumps.
- Lighten (or darken) where AD appears.
- Thicken, turning leathery to protect itself from constant scratching.
- Develop knots (only on the thickened skin).
- Itch all the time (only on the thickened skin).
The thickened skin can itch even when the AD is not flaring.
When talking about the thickened skin, your dermatologist may use the word lichenification. This word means thickened skin.
It is rare for adults to get AD. Most people (90%) get AD before age 5. About half (50%) of people who get AD during childhood continue to have milder signs and symptoms of AD as an adult. When an adult has AD, it often looks different from the AD of childhood. For adults, AD often:
- Appears in the creases of the elbows or knees and nape of neck.
- Covers much of the body.
- Can be especially noticeable on the neck and face.
- Can be especially bad around the eyes.
- Causes very dry skin.
- Causes non-stop itch.
- Causes scaly skin — more scaly than in infants and children.
- Leads to skin infections.
If a person has had AD for years, patches of skin may be thick and darker than the rest of the skin (or lighter). Thickened skin can itch all the time.
Adults who had AD as a child and no longer have AD can have the following:
- Extremely dry skin.
- Skin that is easily irritated.
- Hand eczema.
- Eye problems (eczema on eyelids, cataracts).
Images used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides