With summer here, many patients are noticing their skin conditions worsen.  The dry heat can be an irritating factor for many, flaring their rash.  In this, part I of our series on Atopic Dermatitis or Allergic Eczema, we examine what atopic dermatitis is and what causes atopic dermatitis.

What is Atopic Dermatitis?

Atopic dermatitis (AD), the most common type of eczema, appears as a red, itchy rash or dry, scaly plaques of skin.  While it can develop at any age, it usually begins in infancy or young childhood.

What causes AD?

Not everything is known about AD but patients with AD tend to have a hyperactive immune system that responds with allergic inflammation.  Some patients with AD have a mutation in the connective tissue of the skin that is responsible for holding skin cells together and creating a skin barrier.  Without an intact barrier, allergens (substances that cause allergies), irritants, bacteria and viruses can easily enter the area beneath the skin where the cells of inflammation react and water is easily lost, making the skin dry and the patient prone to allergy, inflammation, and infection.

Picture:  Normal Skin v. Eczematous Skin

  1. Normal Skin is held together by connective tissue without disruption
  2. Mutated connective tissue causes fragile connections between skin cells, resulting in a dysfunctional skin barrier
  3. Entry of allergens, bacteria, yeast, mold and irritants to the layer underneath the skin results in inflammation
  4. Loss of water from the skin causes loss of cell function and makes the skin layer fragile


Patients with AD have higher rates of food allergy, environmental allergy and are more likely to develop asthma.  Because of the loss of the skin barrier, patients with untreated AD have among the highest rate of increase of allergies.  This means that if an allergy test were done at the age of 2 and the age of 20, without skin hydration and care, the allergies would be expected to increase in number far greater than other, non-AD patients.  Patients with AD have higher rates of anxiety and depression, thought to be due to an impaired quality of life


Next in Part II of our series, The SKIN-ny on Atopic Dermatitis and Eczema,….General Care and Hydration of Skin with Atopic Dermatitis and Eczema.