How to Identify Eczema in Children

atopic dermatitis and scratches on the back of a toddler's knees

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Atopic dermatitis is the most common form of eczema. It affects infants and young children, but it can also continue later into life. Atopic dermatitis is recurrent, and children with atopic dermatitis have symptoms that come and go. As many children get older, the frequency and severity of symptoms lessen until the condition may seem to be gone. However, the skin often stays dry and is easily irritated. Environmental factors, such as contact with harsh soaps or other chemicals, can bring the symptoms back at any time, even in adults.

Atopic Dermatitis Skin Changes

In normal skin, the outer layer of the epidermis—the stratum corneum—contains dry, dead, flattened skin cells that form a barrier that protects the other layers of skin from irritants and keeps them moist. People with atopic dermatitis lose too much moisture from the outer layer, causing the skin to dry and crack, thus decreasing the skin's protective ability (also known as the skin's barrier function). A person with atopic dermatitis is more susceptible to recurring infections like bacterial infections, warts, herpes simplex, and molluscum contagiousum.

Symptoms in Infants

The appearance of atopic dermatitis is highly variable among individuals. Different age groups have distinct classic presentations, although some people will have unique features. In infants, the rash is most often seen on the trunk, face, and extensor surfaces. The rash typically consists of red, itchy skin that can ooze and crust over. The diaper area is typically not affected.

Symptoms in Young Children

As children get older, the rash can continue on extensor surfaces, but also becomes more prominent on flexor surfaces, such as in the bend of the arm and behind the knees. Affected skin is typically red and itchy. In some children, it can appear as tiny red bumps, also known as papular eczema.

Symptoms in Older Children and Adults

In older children, adolescents, and adults, a dry, itchy red rash may be seen on the face, neck, flexor surfaces, trunk, hands, or feet. Areas of the body that have been chronically affected may have thickened skin that is leathery in appearance.

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