The term ‘atopic’ refers to a personal and family tendency to develop eczema, asthma and/or hay fever. While these conditions tend to be hereditary, they are not always passed directly from parent to child and may skip a generation.
Although we still do not know exactly why atopic eczema develops in some people, research has shown that a combination of genetic and environmental factors play a part.
In atopic conditions the body’s immune system overreacts to things that would not normally do any harm – often environmental factors that are all around us, such as irritants (soaps, fragrance, detergents) and allergens (e.g. animal dander, house-dust mite droppings and pollens) – which make the skin inflamed and itchy. Dry skin in atopic eczema is now thought to be due to a defective skin barrier. For some this is caused by changes within the Filaggrin gene. Filaggrin is a structural protein in the skin and in some people with atopic eczema,deficiency leads to skin barrier breakdown.
Atopic eczema in children
Atopic eczema (sometimes called infantile or childhood eczema) is the most common form of eczema. It can affect people of all ages, but children in particular. Most children with eczema find that their skin improves as they get older (usually by puberty) and for some the eczema will clear, but there is no way of telling in advance whether this will happen. As a general rule, children whose eczema is more severe tend to retain the condition into adulthood. Even if the eczema improves significantly, people who had atopic eczema as a child often have ‘sensitive’ skin as adults.
What is it like to have atopic eczema?
Atopic eczema is a dry skin condition that may become red and sore – called a ‘flare-up’. The skin may then calm down for a time, but tends to be dry and itchy. Itch is the chief characteristic of atopic eczema and can be almost unbearable, making you want to scratch constantly, especially at night, which interrupts sleep. Atopic eczema can be present in large or small patches in any body area, usually starting on the face in babies and often affecting the skin creases, neck, back of the knees, inside of the elbows and the wrists.
Asian, African and Afro-Caribbean skin types tend to have different patterns of eczema from white skin types. These include eczema around the front of the knees and the back of the elbows (called the ‘reverse flexural pattern’) as well as in the skin creases. Red bumps (a papular pattern) can also appear over the chest and abdomen. Dark and light patches of eczema can also be present, but skin tone will usually return to normal (although this can take some months).
Spontaneous flare-ups are often the result of triggers. Triggers are not the same for everyone, but there are a number of common ones:
- Soap, detergents and perfume/fragrance
- Changes/extremes in temperature, humidity and sweating
- Skin infection
- House-dust mite droppings
- Animal dander (fur, hair) and saliva
- Tree/grass/weed pollens
- Wool/synthetic clothing
Many families and people with atopic eczema find that there is a connection between eczema and stress, although whether the stress causes the eczema or vice versa is less clear.
Learning what your triggers are can help you to take control of your eczema. However, what has provoked a flare-up may not always be immediately apparent.
The eczema itch
The chief characteristic of atopic eczema is the ‘itch’, which at times can become almost unbearable leading to sleep loss, frustration, stress and depression.
It is crucial to acknowledge that atopic eczema can affect the whole family, not just the person with eczema. Although there is currently no known cure for atopic eczema, when it is well managed it is possible to limit its impact on day-to-day life.
What to do next? Find out about treatment
You can find out about the range of treatments options for different types of eczema in our comprehensive Treatment area of the website.
The chief characteristic of atopic eczema is the ‘itch’ which at times can become almost unbearable.