Is Atopic Dermatitis the Same as Eczema?

Is eczema and atopic dermatitis the same thing? People often use the two terms interchangeably, but they are two different conditions. Eczema is a general term for inflammation of the skin. Atopic dermatitis, the most common type of eczema, causes itchy, red, and swollen due to an overactive immune system.

There are several types of eczema, and some cause unique symptoms and involve special treatments. Here, Health breaks down atopic dermatitis and eczema and what other skin conditions might present similarly.

What Is Eczema and Atopic Dermatitis?

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Many people refer to atopic dermatitis as eczema. However, atopic dermatitis is technically just one specific form of eczema. Eczema, or dermatitis, is inflammation of the skin. It's essentially an umbrella term for different types of skin irritation and swelling.

Atopic dermatitis is the most common type of eczema. This long-lasting inflammatory skin condition causes a weak skin barrier that becomes itchy, red, and swollen. Atopic dermatitis can occur anywhere on the body but most commonly affects the eyelids, hands, and feet in adults.

Other Types of Eczema 

All forms of eczema typically cause intense itching. There are several types of eczema, which vary by what causes it and how it physically manifests on the skin.

Contact Dermatitis

This type of eczema shows up as an itchy rash that flares up after you touch or come into contact with an allergen or irritant. Contact dermatitis typically shows up on the hands but can appear on other parts of your body, such as your armpit, face, feet, neck, and scalp.

Contact dermatitis flares up quickly, usually within 24–72 hours of contact. In contrast, atopic dermatitis develops slowly, David Kim, MD, a dermatologist based in New York, told Health.

Dyshidrotic Eczema

Dyshidrotic eczema manifests as small, very itchy blisters on your hands and feet. This type of eczema is most common in younger adults, usually people aged 20–40, especially females. Like atopic dermatitis, dyshidrotic eczema is often long-lasting. You'll likely have flares, followed by periods of no symptoms.

The exact cause of dyshidrotic eczema is unknown. Certain situations can trigger flares, such as excessive handwashing or sweating, Dendy Engleman, MD, a dermatologist based in New York, told Health. Certain metals (e.g., nickel) and extreme stress may also cause symptoms.

Neurodermatitis

Neurodermatitis affects about 12% of people in the United States. This type of eczema most commonly shows up on the ankles, arms, groin, legs, neck, or scalp.

Neurodermatitis results from intensely itching patches of the skin. The more you scratch, the itchier your skin becomes. Intense, repeated scratching may cause lichenification, a process that results in dry, leathery, and thick skin.

Nummular Eczema

This type of eczema creates coin-shaped patches of irritated, itchy skin, said Dr Engelman. Like other eczema types, there is not a clear cause of nummular eczema. You might have flares due to sensitive, very dry skin or trauma from insect bites, burns, and scrapes. Nummular eczema can pop up at any age, but it's more common in males than females.

Seborrheic Dermatitis

Seborrheic dermatitis, which is similar to dandruff, may appear on your body where there's an abundance of oil-producing glands. That includes your chest, face, and scalp. In contrast to other eczema types, seborrheic dermatitis is an inflammatory reaction to an overgrowth of certain yeast that normally lives on your skin's surface. Seborrheic dermatitis causes itching, redness, and scaling where it shows up.

Stasis Dermatitis

This type of eczema typically occurs in people aged 50 and older. That's because stasis dermatitis most frequently affects people with poor circulation. Stasis dermatitis shows up mainly on the ankles and lower legs. Ankle swelling and orange-brown speckles of discoloration, sometimes called "cayenne pepper spots," often occur with lesions.

How To Identify Eczema 

It may be difficult to identify whether you have eczema. Many symptoms, such as dry skin, itching, and rashes, might resemble other skin conditions. It's essential that you see a healthcare provider, such as a dermatologist, if you have eczema symptoms. They'll be able to run diagnostic tests and figure out whether you have eczema and what type.

Lesion Characteristics

Atopic dermatitis causes itchy patches of skin. Intense itching leads to scratching, which often results in a rash. You might develop dry, scaly lesions that appear red in lighter skin tones and dark brown, purple, or gray in darker skin tones. People with darker skin tones are also likelier to have small, rough bumps than others.

The lesions and bumps may leak fluid. You might scratch so much that blister form, ooze, and crust over. Patches of your skin may appear lighter or darker than before after your lesions go away.

Location

You might notice atopic dermatitis flares anywhere on your skin and scalp. Atopic dermatitis most commonly occurs on the eyelids, feet, and hands in adults. In contrast, infants and young children are likelier to get atopic dermatitis on their checks, forehead, and scalp.

Other Symptoms

You may notice other skin changes over time, such as:

• Dry, raw skin
• Ear discharge and bleeding
• Redness 
• Scratch marks
• Skin that's warm to the touch or swollen, which are signs of inflammation
• Thick patches of skin that feel and look like leather

Treatments

The goal of treatment is to hydrate your skin and reduce the risk of infections from broken, cracked areas. You might reduce eczema flares by avoiding allergens and irritations, such as harsh, fragranced soaps and non-breathable clothing.

Treatment usually depends on the type of eczema. For example, you'll need to identify and treat the underlying cause, such as poor circulation, to alleviate stasis dermatitis symptoms. You may require topical steroids, along with a topical antibiotic, to treat nummular eczema.

Other eczema treatments might include:

• Antifungal shampoo: This helps reduce yeast overgrowth on the scalp that causes seborrheic dermatitis.
• Antihistamines: These help relieve itching that disturbs your sleep.
• Biologics: These help control your immune response and reduce inflammation. The Food and Drug Administration has approved two biologics, Adbry (tralokinumab-ldrm) and Dupixent (dupilumab), to treat atopic dermatitis. A healthcare provider will instruct you to inject those medications under your skin.
• Cognitive behavioral therapy (CBT): Eczema might take a toll on your mental health. CBT is a form of counseling that may help you cope with constant itching, broken skin, and trouble sleeping.
• Immunosuppressants: These oral or injectable medications help regulate your immune response. Some people use topical non-steroidal, anti-inflammatory drugs to help inhibit an overactive immune system.
• Light therapy: This uses ultraviolet (UV) light on the skin to alleviate inflammation and intense itching.
• Pain relievers: Non-steroidal anti-inflammatory drugs (NSAIDs) lower pain, inflammation, and swelling.
• Steroids: This includes topical steroids—available in creams, gels, lotions, and ointments—to heal your skin and stop the itching-scratching style. You might require oral steroids if topical treatments do not work.

Prevention

It's not possible to prevent some types of eczema completely since the skin conditions sometimes run in families. For example, you are likely to develop atopic dermatitis if you have a parent with allergies and asthma. Other non-modifiable risk factors include food and respiratory allergies and your environment (i.e., cities and dry climates).

Still, you might be able to prevent atopic dermatitis and other types of eczema by:

• Avoiding allergens, such as certain food, pet dander, and pollen
• Limiting your exposure to irritants, including harsh, fragranced lotions and soaps and non-breathable clothing
• Keeping your stress under control

A Quick Review

Atopic dermatitis and eczema are not necessarily the same thing. Eczema is a general term that includes inflammatory skin conditions that cause similar symptoms. Atopic dermatitis is the most common type of eczema, in which an overactive immune system causes dry, itchy skin and rashes.

You cannot always prevent eczema, which often runs in families. Still, there are a few ways to prevent flares, including avoiding allergens, irritants, and stress. Contact a healthcare provider if you develop eczema symptoms. They can diagnose the type of eczema and prescribe the appropriate treatment.