Atopic dermatitis: Signs and symptoms

Atopic dermatitis (AD) looks different in infants, children, and adults. The following gives you the signs (what you see) and symptoms (what you feel) for each age group.

Infants

AD can begin early. A child may be 2- or 3-months old when AD begins. When AD begins early, it often causes:

A rash that appears suddenly and:
- makes the skin dry, scaly, and itchy
- forms on the scalp and face, especially on the cheeks (can appear on other areas of the body)
- can bubble up, then ooze and weep fluid
- causes itching that may come and go
Rubbing against bedding, carpeting, and other things in order to scratch the itch
Trouble sleeping
Skin infections, common due to rubbing and scratching

Parents often worry that their baby is getting AD in the diaper area. Babies rarely get AD in their diaper area. The skin stays too moist for AD.

Atopic dermatitis. Infants often get atopic dermatitis on their cheeks, as did this 7-month-old boy.

Children

When AD begins between 2 years of age and puberty, the child often has these signs and symptoms:

A rash that often begins in the creases of the elbows or knees. Other common places for the rash to appear are the neck, wrists, ankles, and/or crease between the buttocks and legs.
Itchy, scaly patches where the rash appeared.

In time, the skin with AD can:

Get bumpy, looking like permanent goose bumps
Lighten (or darken) where AD appears
Thicken, turning leathery to protect itself from constant scratching
Develop knots (only on the thickened skin)
Itch all the time (only on the thickened skin)

The thickened skin can itch even when the AD is not flaring.
When talking about the thickened skin, your dermatologist may use the word lichenification. This word means thickened skin.

Atopic dermatitis. This 7-year-old girl says the thickened skin on the back of her knees is always dry and always itches.

Atopic dermatitis. This 6-year-old boy has atopic dermatitis in the creases of his elbows and on his feet — common places for AD to appear in children.

Adults

It is rare for adults to get AD. Most people (90%) get AD before age 5. About half (50%) of people who get AD during childhood continue to have milder signs and symptoms of AD as an adult. When an adult has AD, it often looks different from the AD of childhood. For adults, AD often:

Appears in the creases of the elbows or knees and nape of neck
Covers much of the body
Can be especially noticeable on the neck and face
Can be especially bad around the eyes
Causes very dry skin
Causes non-stop itch
Causes scaly skin — more scaly than in infants and children
Leads to skin infections

If a person has had AD for years, patches of skin may be thick and darker than the rest of the skin (or lighter). Thickened skin can itch all the time.
Adults who had AD as a child and no longer have AD can have the following: