Atopic dermatitis is the most common form of eczema, a chronic inflammatory skin condition that causes intensely itchy, dry, inflamed patches, most often in the creases of the elbows and knees, on the hands, neck, and face. It affects about 1 in 10 Americans, usually beginning in early childhood, and about a quarter of adults with atopic dermatitis developed it as adults. It is not contagious. Moderate-to-severe disease disrupts sleep, work, and mental health, and a new generation of targeted treatments has changed what patients should expect.

What causes atopic dermatitis?

A combination of a weakened skin barrier (often related to variants in the filaggrin gene), an overactive immune response driven by type 2 inflammation, and environmental triggers. Flares are set off by dry air, sweat, heat, wool, fragranced products, stress, and allergens such as dust mites and pet dander. Many patients also have asthma, hay fever, or food allergies.

What are the symptoms of atopic dermatitis?

Itch, often worse at night; dry, scaly, or thickened skin; red patches in lighter skin and darker brown, gray, or purple patches in skin of color; oozing or crusting during flares; and skin infections from scratching. In infants it favors the cheeks and scalp; in older children and adults, the folds of the elbows and knees, hands, eyelids, and neck.

How is atopic dermatitis treated?

Daily moisturizing and gentle skin care are the foundation. Flares are treated with topical corticosteroids or non-steroid options (tacrolimus, pimecrolimus, crisaborole, ruxolitinib cream, tapinarof, roflumilast). For moderate-to-severe disease, biologics (dupilumab, tralokinumab, lebrikizumab, nemolizumab) and oral JAK inhibitors (upadacitinib, abrocitinib) control itch and clear skin in most patients and are approved for children and adults. Bleach baths and wet wraps help during severe flares; phototherapy is an option for some patients. Infections are treated promptly.

How Tono treats atopic dermatitis

Tono's board-certified dermatologists see patients with atopic dermatitis within days, not months, by video visit in 33 states and in person at Tono clinical centers. We treat children and adults with atopic dermatitis, including moderate-to-severe disease requiring biologics or JAK inhibitors, and we handle prior authorization. Most visits are by telehealth with photo follow-up between visits; our physicians have particular expertise in eczema in skin of color. Your visit ends with a written plan, prescriptions sent to your pharmacy, and follow-up scheduled with the same dermatologist. Most insurance is accepted and no referral is required.

When should I see a dermatologist for atopic dermatitis?

See a dermatologist if eczema is not controlled with moisturizer and over-the-counter hydrocortisone, if itch is disrupting sleep, if the skin is oozing, crusted, or infected, or if you have been using topical steroids for months without lasting improvement. Targeted therapy is now an option for most people who need it.