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Atopic dermatitis - self-care

Eczema is a chronic skin disorder characterized by scaly and itchy rashes. Atopic dermatitis is the most common type.

Atopic dermatitis is due to a skin reaction pattern, similar to an allergy that causes long-term inflammation of the skin. Most people with atopic dermatitis also are missing certain proteins from the surface of the skin. These proteins are important in maintaining the skin barrier function. As a result, their skin is more easily irritated by minor irritants.

Taking care of your skin at home may reduce the need for medicines.

Alternative names

Eczema - self-care

Help for Itching and Scratching

Try not to scratch the rash or your skin in the inflamed area.

  • Relieve the itch by using moisturizers, topical steroids, or other prescribed creams.
  • Keep your child's fingernails cut short. Consider light gloves if nighttime scratching is a problem.

Antihistamines taken by mouth may help with itching if you have allergies. Often you can buy them over-the-counter. Some antihistamines can cause sleepiness. But they may help with scratching while you sleep. Newer antihistamines cause little or no sleepiness. However, they may not be as effective in controlling the itch. These include:

  • Fexofenadine (Allegra)
  • Loratadine (Claritin, Alavert)
  • Cetirizine (Zyrtec)

Diphenhydramine (Benadryl) or hydroxyzine may be taken at nighttime to relieve itching and allow for sleep.

Day-to-day Skin Care

Keep your skin lubricated or moisturized. Use ointment (such as petroleum jelly), cream, or lotion 2 to 3 times a day. Moisturizers should be free of alcohol, scents, dyes, fragrances, or chemicals you know you are allergic to. Having a humidifier in the home may also help.

Moisturizers and emollients work best when they are applied to skin that is wet or damp. These products soften the skin and help it retain moisture. After washing or bathing, pat the skin dry and then apply the moisturizer right away.

Different types of emollients or moisturizers may be used at different times of the day. For the most part, you can apply these substances as often as you need to keep your skin soft.

Avoid anything that makes your symptoms worse. These may include:

  • Foods, such as eggs in a very young child. Always discuss with your health care provider first.
  • Wool, and other scratchy fabrics. Use smooth, textured clothing and bedding, such as cotton.
  • Sweating. Be careful not to over dress during warmer weather.
  • Strong soaps or detergents, as well as chemicals and solvents.
  • Sudden changes in body temperature and stress, which may cause sweating and worsen your condition.
  • Triggers that cause allergy symptoms.

When washing or bathing:

  • Bathe less often and keep water contact as brief as possible. Short, cooler baths are better than long, hot baths. The same is true for showers.
  • Use gentle skin care cleansers rather than traditional soaps. Use these products only on your face, underarms, genital areas, hands, and feet, or to remove visible dirt.
  • Do not scrub or dry the skin too hard or for too long.
  • After bathing, it is important to apply lubricating cream, lotion, or ointment on the skin while it is damp. This will help trap moisture in the skin.

The rash itself, as well as the scratching, often causes breaks in the skin and may lead to infection. Keep an eye out for redness, warmth, swelling, or other signs of infection.

Medicines From Your Doctor

Topical corticosteroids are medicines used to treat conditions where your skin becomes red, sore, or inflamed. "Topical" means you place it on your skin. Topical corticosteroids may also be called topical steroids or topical cortisones. These medicines help "calm" your skin when it is irritated. Your provider will tell you how much of this medicine to use and how often. Do not use more medicine or use it more often than you are told.

You may need other prescription medicines such as barrier repair creams. These help to replenish the normal surface of your skin and rebuild the broken barrier.

Your provider may give you other medicines to use on your skin or take by mouth. Be sure to follow the directions carefully.

When to Call the Doctor

Contact your provider if:

  • Eczema does not respond to moisturizers or avoiding allergens
  • Symptoms worsen or treatment is ineffective
  • You have signs of infection (such as fever, redness, or pain)
Open References

References

Dinulos JGH. Atopic dermatitis. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 5.

Eichenfield LF, Boguniewicz M, Simpson EL, et al. Translating atopic dermatitis management guidelines into practice for primary care providers. Pediatrics. 2015;136(3):554-565. PMID: 26240216 pubmed.ncbi.nlm.nih.gov/26240216/.

James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Eczema, atopic dermatitis, and noninfectious immunodeficiency disorders. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin: Clinical Dermatology. 13th ed. Philadelphia, PA: Elsevier; 2020:chap 5.

Ong PY. Atopic dermatitis. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2023. Philadelphia, PA: Elsevier; 2023:1045-1048.

  • Atopic dermatitis

    Animation

    •  

    Atopic dermatitis - Animation

    Your skin used to be soft and smooth, but now it's itchy and scaly. It's gotten so bad that you're wearing long sleeves every time you go out, even in the summer. There's a chance you could have eczema, and if you do, there are treatments to smooth out your skin and get you back into t-shirts again. Eczema is like an allergic reaction on your skin. Instead of your eyes watering or your nose running, your skin swells up in response to an allergy trigger. A lot of people who have eczema also have allergies to pollen, mold, animal fur, dust, or sensitivities to products they use around the house. It could be that the detergent you're using or the perfume you're wearing is leaving its mark on your skin. To know if you have eczema, when you look at your skin, you'll see redness, dryness and maybe swelling, and blisters that may ooze or crust over. In babies and young kids, you'll see these sores mainly on the face, scalp, hands, and feet. In older kids and adults, the spots are typically on the insides of the knees and elbows, as well as on the neck, hands, and feet. But really, if you're having a bad eczema flare-up, you might see red patches on any part of your body. Eczema patches get so itchy that you'll probably be tempted to scratch at them. After a lot of scratching, they'll get red, thick, and irritated. Your doctor should be able to tell that you have eczema just by looking at your skin. If allergies are causing your eczema, you may need allergy tests to find out just what's setting off your skin reaction. To treat Eczema, you can apply creams or lotions to soothe and moisturize your skin. Just pick a product that's free from dyes and scents, which could irritate your skin even more. Your doctor can also prescribe a steroid cream or ointment to relieve the swelling. Medicines called antihistamines can calm the reaction that's causing your eczema and relieve the itchiness. There are a number of other eczema treatments if these don't work for you. Eczema is a chronic condition. Although kids usually outgrow it by age 5 or 6, most adults tend to get stuck with it for a long time. When you've got an eczema flare-up it will be itchy, but try not to scratch. You could give yourself an infection, or leave your skin permanently scarred. Instead, keep your skin moisturized and avoid whatever trigger is causing your eczema.

  • Dermatitis - atopic on the arms

    Dermatitis - atopic on the arms - illustration

    This person has inherited allergic skin inflammation (atopic dermatitis) on the arms. Red (erythematous), scaly plaques can be seen on the inside of the elbows (antecubital fossa). In adults, atopic dermatitis usually involves the body creases, or flexural areas (antecubital fossa and popliteal fossa).

    Dermatitis - atopic on the arms

    illustration

  • Hyperlinearity in atopic dermatitis - on the palm

    Hyperlinearity in atopic dermatitis - on the palm - illustration

    This picture shows a manifestation of atopic dermatitis on the palm. Individuals with atopic dermatitis characteristically have increased numbers and depth of skin lines (hyperlinearity) on the palms with little redness (erythema).

    Hyperlinearity in atopic dermatitis - on the palm

    illustration

  • Atopic dermatitis

    Animation

    •  

    Atopic dermatitis - Animation

    Your skin used to be soft and smooth, but now it's itchy and scaly. It's gotten so bad that you're wearing long sleeves every time you go out, even in the summer. There's a chance you could have eczema, and if you do, there are treatments to smooth out your skin and get you back into t-shirts again. Eczema is like an allergic reaction on your skin. Instead of your eyes watering or your nose running, your skin swells up in response to an allergy trigger. A lot of people who have eczema also have allergies to pollen, mold, animal fur, dust, or sensitivities to products they use around the house. It could be that the detergent you're using or the perfume you're wearing is leaving its mark on your skin. To know if you have eczema, when you look at your skin, you'll see redness, dryness and maybe swelling, and blisters that may ooze or crust over. In babies and young kids, you'll see these sores mainly on the face, scalp, hands, and feet. In older kids and adults, the spots are typically on the insides of the knees and elbows, as well as on the neck, hands, and feet. But really, if you're having a bad eczema flare-up, you might see red patches on any part of your body. Eczema patches get so itchy that you'll probably be tempted to scratch at them. After a lot of scratching, they'll get red, thick, and irritated. Your doctor should be able to tell that you have eczema just by looking at your skin. If allergies are causing your eczema, you may need allergy tests to find out just what's setting off your skin reaction. To treat Eczema, you can apply creams or lotions to soothe and moisturize your skin. Just pick a product that's free from dyes and scents, which could irritate your skin even more. Your doctor can also prescribe a steroid cream or ointment to relieve the swelling. Medicines called antihistamines can calm the reaction that's causing your eczema and relieve the itchiness. There are a number of other eczema treatments if these don't work for you. Eczema is a chronic condition. Although kids usually outgrow it by age 5 or 6, most adults tend to get stuck with it for a long time. When you've got an eczema flare-up it will be itchy, but try not to scratch. You could give yourself an infection, or leave your skin permanently scarred. Instead, keep your skin moisturized and avoid whatever trigger is causing your eczema.

  • Dermatitis - atopic on the arms

    Dermatitis - atopic on the arms - illustration

    This person has inherited allergic skin inflammation (atopic dermatitis) on the arms. Red (erythematous), scaly plaques can be seen on the inside of the elbows (antecubital fossa). In adults, atopic dermatitis usually involves the body creases, or flexural areas (antecubital fossa and popliteal fossa).

    Dermatitis - atopic on the arms

    illustration

  • Hyperlinearity in atopic dermatitis - on the palm

    Hyperlinearity in atopic dermatitis - on the palm - illustration

    This picture shows a manifestation of atopic dermatitis on the palm. Individuals with atopic dermatitis characteristically have increased numbers and depth of skin lines (hyperlinearity) on the palms with little redness (erythema).

    Hyperlinearity in atopic dermatitis - on the palm

    illustration

A Closer Look

 

Self Care

 
 

Review Date: 6/7/2023

Reviewed By: Elika Hoss, MD, Assistant Professor of Dermatology, Mayo Clinic, Scottsdale, AZ. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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