Atopic dermatitis is one of the most common and troublesome dermatological conditions, with increasing incidence in recent years in both children and adults. It is a chronic inflammatory disease that causes dryness, itching and irritation, significantly affecting the daily life of patients. Although it is not contagious, its management requires consistency and proper information, as understanding the causes and triggering factors is crucial for the prevention and control of flare-ups.
What is atopic dermatitis?
Atopic dermatitis or atopic eczema is a chronic, recurrent inflammatory skin condition characterized by intense itching, dryness, scaling and inflammation. It is the most common form of eczema and is particularly widespread in developed countries, with increasing prevalence in recent decades.
The condition is not contagious, but it has a significant impact on physical and mental health, as the symptoms often affect sleep, work and social relationships. The disruption of the skin barrier leads to increased moisture loss and sensitivity to irritants, while immune system hyperactivity triggers a continuous inflammatory response.
Atopic dermatitis belongs to the so-called “atopic triad”, along with asthma and allergic rhinitis, and often coexists with these conditions in the same individual or within the family.
Who is most affected by atopic dermatitis?
The condition usually begins in childhood, often before the age of five. In 60% of cases, it appears already in the first months of life. Although it resolves during adolescence in many children, in a significant percentage it continues to recur or remain active into adult life.
People with a family history of allergic conditions are more vulnerable, as there is a genetic link that affects the function of the skin and the immune system. In adults, the condition may appear or recur due to hormonal changes, stress, or occupational irritants (e.g., exposure to chemicals or detergents).
The prevalence varies depending on the region and the climate. According to international data, the rate reaches up to 20% in children and 3–5% in adults. Despite its chronic nature, early diagnosis and proper guidance allow for effective control of flare-ups.
Causes and risk factors
Atopic dermatitis is caused by a combination of genetic, immunological and environmental factors. The dysfunction of the epidermal barrier leads to increased permeability and sensitivity to allergens, while the immune system reacts excessively to harmless stimuli.
Main factors that contribute to the development or worsening of the condition include:
- Genetic predisposition: Mutations in the filaggrin (FLG) gene reduce the skin’s ability to retain moisture, leading to dryness and inflammation.
- Immunological mechanisms: A disproportionate Th2-type inflammatory response leads to skin hyperreactivity.
- Environmental irritants: Dust, pollen, pet dander, detergents, chemicals, or smoke are common triggering factors.
- Climatic factors: Dry, cold, or excessively hot environments can destabilize the skin barrier.
- Stress: Psychological tension worsens inflammation through neurohormonal mechanisms.
- Diet: In children, foods such as cow’s milk, eggs and nuts may worsen symptoms, although they are not always the primary cause.
The identification of individual triggering factors is a significant step towards the better control of the disease.
Symptoms and manifestations
The symptoms of atopic dermatitis vary from person to person and may change over time. The most characteristic include:
- Intense itching, which leads to scratching and worsens the lesions.
- Dryness and roughness of the skin, especially in areas such as the elbows, knees and hands.
- Redness, peeling and inflammation, which may cause pain or a burning sensation.
- Rashes with small blisters, which in some cases may weep or become infected.
- Thickening and darkened areas in chronic lesions due to persistent irritation.
In infants, lesions are mainly located on the cheeks and the scalp, whereas in children and adults they affect the folds of the elbows, knees and the neck. Night-time itching is a characteristic symptom that affects sleep quality and increases discomfort.
Atopic dermatitis: Diagnosis
The diagnosis is made primarily clinically, based on the patient's history and the appearance of the skin lesions. The dermatologist evaluates the frequency, duration and characteristics of the flare-ups, while ruling out other dermatological conditions that may appear similar, such as psoriasis or contact dermatitis.
In certain cases, allergy tests (skin prick or patch tests) are performed to identify sensitivity to specific allergens. Genetic testing helps detect mutations that affect the skin barrier. Additionally, IgE levels in the blood may be measured, which are often elevated.
Accurate diagnosis is crucial for selecting the most appropriate treatment and developing a personalized prevention plan.
Treatment approach
Atopic dermatitis cannot be permanently cured, but it can be brought under full control with the right combination of treatment and daily care. Therapy aims to reduce inflammation, restore the skin barrier and prevent flare-ups.
Treatment options include moisturizing/soothing products, topical corticosteroids, calcineurin inhibitors (pimecrolimus, tacrolimus), antihistamines for itching, as well as biologic agents (dupilumab) in severe cases. Phototherapy is used in selected patients with excellent results.
Medication therapy is always combined with regular moisturization and avoidance of irritant factors. Guidance from a dermatologist is essential, as the improper use of steroids or inappropriate products may worsen the condition.
Daily care and flare-up prevention
Maintaining skin health requires consistent, daily care, even during periods of remission. The key preventive practices include:
- Frequent moisturization of the skin with hypoallergenic creams that restore the epidermal barrier.
- Use of lukewarm water and avoidance of prolonged, hot showers or baths.
- Mild cleansers without soap or alcohol.
- Avoid synthetic or wool fabrics, prefer cotton clothing.
- Daily change of bed linens and cleaning of the environment to remove allergens.
- Balanced diet rich in omega-3 fatty acids, fruits, and vegetables.
- Stress management through gentle exercise, meditation, or psychotherapy.
Consistently following these habits reduces the frequency of flare-ups and helps stabilize the condition over the long term.
Dr. Konstantina Mamali, Dermatologist – Venereologist, and Dr. Athanasios I. Pavlidis, Dermatologist – Venereologist, are two highly experienced and internationally trained physicians of AI Derma Clinic, with education and clinical expertise gained at leading centers in Germany and Italy. They specialize in the diagnosis and treatment of dermatological conditions such as atopic dermatitis, applying personalized therapeutic protocols that combine medical precision with modern technology. With respect for each patient’s needs and a focus on improving quality of life, the team at AI Derma Clinic offers comprehensive care for healthy, balanced, and resilient skin. Contact them to schedule your personal evaluation and receive the care your skin deserves.
