Atopic Dermatitis vs. Eczema: Dermatologists Explain

Red, itchy, and scaly skin from atopic dermatitis and eczema can be uncomfortable, confusing, and all too familiar. These chronic (meaning they can last a long time) inflammatory conditions can appear in childhood or remain dormant until adulthood, with a wide scale of severity along the way.

“Once you have atopic dermatitis, you will have it for life, though symptoms may not always be prevalent,” dermatologist Corey L. Hartman, MD, tells PS. While it may sound bleak, these long-term skin conditions are common and totally manageable — both at home and in a derm’s office.

So, what’s the difference between atopic dermatitis and eczema? We’ve tapped the experts to break down everything you need to know about these skin conditions. Keep reading to learn more about the symptoms and how to treat them.

Experts Featured in This Article

Corey L. Hartman, MD, FAAD, is a board-certified dermatologist and the founder of Skin Wellness Dermatology in Birmingham, AL.

Naana Boakye, MD, MPH, FAAD, is a board-certified dermatologist and the founder of Bergen Dermatology in Englewood Cliffs, NJ.

What Is Eczema?

The terms atopic dermatitis and eczema are used somewhat interchangeably because they’re ultimately part of the same family. “Eczema is a general term for inflammatory skin conditions. And atopic dermatitis is a specific form of and the most common type of eczema,” dermatologist Naana Boakye, MD, says. It’s a widespread condition, affecting one in 10 people, according to the National Eczema Association, that spans all ages, ethnicities, and skin colors.

It’s important to note that eczema can also be an umbrella term that refers to conditions like dermatitis, discoid eczema, and dyshidrotic eczema.

What Is Atopic Dermatitis?

Atopic dermatitis as a type of eczema that appears as itchy patches of dry skin. These patchy lesions typically pop up on the arms and the backs of the legs, with colors ranging between red and brown depending on your skin color. The skin may crack, flake, or thicken (also known as lichenification). The condition is most commonly seen among children, though adults can certainly be affected as well. And it’s often hereditary. “If one parent has atopic dermatitis, there is a 50 percent chance that their child will have it,” Dr. Boakye says.

Atopic dermatitis has another little family of its own, alongside allergic rhinoconjunctivitis and asthma; they’re known as the atopic triad.

What Causes Atopic Dermatitis and Eczema?

Despite being widespread, the exact cause of atopic dermatitis is unknown — though there is increasing belief that it may begin as an autoimmune condition, according to a study published in the British Journal of Dermatology. Per Dr. Boakye, the causes of atopic dermatitis or eczema can “be complex and involve genetics and environmental factors that lead to skin and immune system disruption.” For example, a family history of asthma or allergies (like hay fever) can increase the prevalence of atopic dermatitis.

Eczema flare-ups can also be triggered by external factors (cold weather, mold, and pollen) or irritants like cigarette smoke and certain fragrances. And last but not least, overdoing it on skin care can also be problematic. “Damaged skin barriers can also contribute to irritation-prone skin,” Dr. Boakye says.

What Are the Symptoms of Atopic Dermatitis and Eczema?

Irritation is the most common symptom. It commonly manifests as red, itchy, or dry skin — with swelling common in more moderate cases. “In severe cases, the skin may develop a rash that may bleed when scratched or may ooze or secrete a clear fluid,” Dr. Hartman says. If you are experiencing persistent irritation, a trip to the dermatologist can help provide clarity and a course of treatment.

How Can You Treat Atopic Dermatitis and Eczema?

Before you can accurately treat atopic dermatitis, dermatologists believe it’s important to understand and avoid your triggers. “Avoid foods that can cause an inflammatory response in the body, like citrus and certain spices like cinnamon and cloves,” Dr. Hartman says, adding that “alcohol can also trigger atopic dermatitis symptoms.”

This could mean shifting your lifestyle to reduce stress, increase exercise, and eat a more wholesome diet, or adjusting your routine to moisturize immediately after showers/baths and transition to gentle, fragrance-free products. Dr. Hartman recommends adding inflammation-fighting steps to your skin-care regimen.

“There is evidence to suggest that red-light phototherapy can help treat signs of atopic dermatitis,” he says.

For moderate to severe cases, Dr. Boakye notes that treatments could include topical steroids, nonsteroidals, biologics, or phototherapy. When in doubt, your derm will know what’s best for you.

Hannah Cassidy is a PS contributor.