Atopic Dermatitis in Adults: Complete Guide to Causes and Treatment

Atopic dermatitis in adults can cause dryness, itching, and inflammation. This guide explains the causes, symptoms, and treatments to manage and control flare-ups effectively.

Atopic Dermatitis in Adults: Complete Guide to Causes and Treatment

  • Category

    Dermatology

  • Published By

    GetWellGo Team

  • Updated on

    10-Jul-2025

Atopic Dermatitis in Adults

Atopic dermatitis (AD), is another name of eczema which is a persistent inflammatory skin disorder which may occur in adults, although it started during childhood or suddenly occurs during adulthood. It is defined by dry, itchy, red and inflamed skin.

How to treat atopic dermatitis in adults?

Adult Eczema Treatment

Eczema in adults is an ailment of the skin, which is recurring and requires a multilayered intervention to help decrease itching, inflammation, breakouts, and harm to the epidermis. This is how it can be organized:

Daily Skincare (Treatment basis)

Cleansing

  • Apply gentle, soap-free wash solutions (e.g. Cetaphil, Vanicream or Eucerin).
  • Never take hot showers; use warm water.
  • Limit 10-15 minutes baths/ showers.

Moisturizing (Very Important Step)

  • Thick moisturizers with no fragrance should be applied within 3 minutes of bathing.
  • Use Ointments/Creams instead of lotions (e.g. CeraVe, Aquaphor, Vaseline, Aveeno Eczema Therapy).
  • Rub on and reapply maintained in several times per day particularly when it is dry.

Topical Medicines (To Treat Flare and Maintenance)

Topical Corticosteroids

  • Examples: Mometasone, Hydrocortisone, Betamethasone
  • Apply in short term in flares.
  • Use thinly twice/day as recommended.
  • Should not be used on overly long skin areas such as face and groin.

Non-Steroidal Topicals

  • Tacrolimus (Protopic), Pimecrolimus (Elidel), Calcineurin Inhibitors
  • Safer to wear on the face / eyelids (long term)
  • Crisaborole (Eucrisa): Low-to-moderate eczema

Systemic Treatments (In case of severe moderately treated eczema)

Topical therapy is inadequate:

Oral Medications

  • Oral corticosteroids (e.g. prednisone) - used only in the short term
  • Immunosuppressants: Cyclosporine, Methotrexate, Azathioprine and Mycophenolate
  • Antihistamines (e.g. cetirizine, fexofenadine) - can lessen itch and even sleep

Biologic Therapy

  • Dupilumab (Dupixent): injectable approved biologic by the FDA
  • Treatment of average to severe atopic dermatitis
  • Non-toxic and safe in long term use

JAK Inhibitors

  • Upadacitinib (Rinvoq), Abrocitinib (Cibinqo)
  • In adults moderate-to-severe eczema
  • A rapid-acting, oral form Fast-acting, oral form

Phototherapy

  • NB UVB Light therapy (two to three times per week)
  • Applicable in cases topical medicines have failed or in large scale eczema
  • Needs supervision of dermatologist

Natural/Home support Care

  • Use wet wrap during flares
  • Do cold compresses to relieve itching
  • Use oatmeal bath, or bleach baths (with guidance)
  • Eradicate stress (yoga, meditation, CBT)

Life Style Tips and Triggers to Avoid

  • Dodge allergens/ irritants: wool, perfumes, abrasive detergents, cigarettes
  • Wear cotton clothes (soft)
  • Short fingernails
  • In dry weather use humidifier
  • Do not scratch, night-time is even better to wear gloves

Eczema Symptoms in Adults

Eczema in adulthood is usually different to childhood eczema in terms of appearance, distribution, and chronicity. It can continue since childhood or appear during adulthood. The symptoms may be mild, severe, and tend to be cyclical (cycle of flare-ups and remission).

Common Symptoms:

Dry Skin

  • Constant dryness and rough areas
  • May have a leathery (lichenified) texture resulting of chronic scratching

Itching (Pruritus)

  • It can be very strong and lasting
  • Makes worse during nighttime
  • May result in scratching leading to deterioration of the condition

Pink or Brown Spots

  • May be inflammed or blotchy
  • They are common in folds such as elbows, behind knees, neck and eyelids

Crusted, Cracked or Scaly Skin

  • Rubbing causes permanent thickening of the skin because of constant irritation and rubbing in the same place.
  • They are often found on hands, feet or the flexural parts

Bumps or Blisters

  • Raised bumps that are smaller and dry up or ooze fluid
  • More frequent from acute flares

Skin Discoloration

  • When healed an afflicted area can either be darker (hyperpigmented) or lighter (hypopigmented) compared to normal skin

Oozing/Crusting

  • Inflammation/ active inflammation Sign of infection
  • Crusts of yellow or honey-colored become secondary bacterial infection

Swelling

  • Swelling around the affected area when in flares or when infected

Burning/ Pain

  • Raw inflamed skin or cracks (particularly of hands/feet)

Atopic Dermatitis Causes in Adults

Atopic dermatitis (AD) is a complex, chronic inflammatory skin disease. It is the consequence of a complicated interplay between genetic susceptibility, immune system dysregulation, environmental exposures, and cutaneous barrier dysfunction. In adults, it can be an extension of childhood or can occur for the first time (adult-onset AD).

Genetic Factors

  • Family history of eczema, asthma, or allergic rhinitis (hay fever)
  • Filaggrin gene mutations: Filaggrin is a protein that is responsible for skin barrier function. Lack of it results in dry, permeable, and irritable, and allergen-susceptible skin.

Immune System Dysfunction

  • Exaggerated immune response to small irritants or allergens
  • Elevated levels of IgE and Th2-mediated inflammation encourage chronic inflammation of the skin
  • In adults, development of a shift toward Th1 and Th22 immune reactions can also result in persistent or hypertrophic lesions

Skin Barrier Dysfunction

  • The outer skin layer becomes defective or "leaky"
  • Failure to hold in moisture and keep out irritants, allergens, and microbes
  • Results in dryness, sensitivity, and heightened risk of infection

Environmental Triggers

These don't create eczema directly, but exacerbate or initiate flare-ups:

Irritants

  • Soaps, detergents, shampoos
  • Wool or synthetic clothing
  • Household cleaning products
  • Perfumes and skin care products

Allergens

  • Dust mites, pollen, pet allergen, mold
  • Food allergens (less frequent in adults than in children)
  • Airborne allergens (air pollution, smoking)

Weather

  • Dry or cold weather
  • Sudden temperature change
  • Low humidity

Psychological Stress

  • Stress may initiate or exacerbate eczema by compromising the immune system
  • Eczema may itself induce stress, which leads to a cycle of flare-ups

Hormonal Changes

  • More prevalent in women
  • Menstruation, pregnancy, or menopause may worsen eczema because of hormonal changes

Microbial Factors

  • Colonization with Staphylococcus aureus is frequent and exacerbates inflammation
  • Fungal overgrowth (such as Malassezia) can be involved in head/neck eczema

Lifestyle Factors

  • Poor skincare and lack of sleep
  • Increased bathing or exposure to hot water
  • Wearing occlusive or tight clothing
  • Smoking or exposure to tobacco smoke

Chronic Atopic Dermatitis Adults

Chronic atopic dermatitis (AD) in adults is a long-standing, relapsing inflammatory skin disease. It can persist from childhood or appear in adulthood (adult-onset AD). Chronic scratching, inflammation, and damage to the barrier over time result in thickened, itchy, discolored skin that has a marked impact on quality of life.

Common Features of Chronic AD in Adults

  • Lichenification: Leathery, thick skin from chronic rubbing/scratching
  • Chronic itching (pruritus): Frequently severe, nocturnal, causing sleep disturbance
  • Dry, scaly, or cracked skin: Persistent barrier damage leads to chronic dryness
  • Discoloration: Darker (hyperpigmented) or lighter (hypopigmented) patches
  • Frequent flares: Provoked by weather, stress, allergens, or irritants
  • Eczema patches: Frequent over hands, face, neck, flexures (elbows, knees), eyelids

Frequent Sites Involved in Adults

  • Hands and fingers (hand eczema is frequent)
  • Neck and top chest
  • Eyelids and periorbital areas
  • Elbows, behind the knees, ankles
  • Scalp and face

Reasons behind Chronic AD

Chronic atopic dermatitis is caused by:

  • Genetic skin barrier flaws (e.g., filaggrin mutation)
  • Dysregulated immune response (chronic inflammation)
  • Environmental triggers (pollution, allergens, irritants)
  • Chronic scratching and stress

Adult Eczema vs Atopic Dermatitis

Adult Eczema

  • Adult eczema is a broad term that encompasses any type of eczema (dermatitis) seen in adults. 
  • It encompasses a range of eczemas like atopic dermatitis, contact dermatitis, seborrheic dermatitis, nummular eczema, and dyshidrotic eczema. 
  • Each of these has a different cause, pattern, and treatment modality. 
  • The etiology of adult eczema varies according to the type. For instance, contact dermatitis results from exposure to irritants or allergens, and seborrheic dermatitis is related to yeast on the skin. 
  • Nummular eczema results from dry skin or injury, and dyshidrotic eczema can result from stress or humidity. 
  • Adult eczema has a wide range of symptoms based on the type. It can include red, itchy patches, blisters, scaling, thickening, or oozing skin. 
  • The distribution of rash also differs—for instance, seborrheic dermatitis affects the scalp and face, whereas nummular eczema causes coin-shaped eruptions. 
  • Adult eczema can start at any age during adulthood and does not necessarily have an antecedent history of eczema in childhood. 
  • Some conditions, such as contact dermatitis or seborrheic dermatitis, are more likely to first occur in adult life. 
  • Treatment for adult eczema varies on the basis of the underlying cause and type. 
  • Contact eczema can sometimes involve avoiding and identifying the offending allergen or irritant, whereas seborrhoeic dermatitis can be treated with antifungals. 
  • Topical corticosteroids, emollients, and lifestyle changes form part of general management.

Atopic Dermatitis

  • Atopic dermatitis is a unique, chronic form of eczema that usually starts during childhood but may continue into or start during adulthood. 
  • It is marked by allergic predisposition, imbalanced immune system, and impaired skin barrier. 
  • In contrast to its simple causes in allusions, atopic dermatitis is caused by more compounded factors including genetic predisposition (e.g., filaggrin gene mutation), immune dysregulation, and external precipitants. 
  • It tends to be linked with a personal or family history of hay fever, asthma, or allergies. 
  • Atopic dermatitis typically begins as dry, intensely itchy, and inflamed spots that become thicker with time because of scratching (lichenification). 
  • It typically occurs on the face, neck, hands, elbows, and the backs of the knees in adults. 
  • Atopic dermatitis tends to begin most frequently in early childhood. But it may also continue into adulthood or, less often, start for the first time over 20 years of age (adult-onset atopic dermatitis). 
  • Atopic dermatitis, being an immune and chronic condition, may need long-term treatment with moisturizers, topical anti-inflammatories, immunomodulators (such as tacrolimus), and in moderate to severe cases, systemic therapy in the form of biologics (e.g., Dupilumab) or JAK inhibitors. 
  • Phototherapy is also employed for recalcitrant cases.

Why Choose GetWellGo for Atopic Dermatitis Treatment?

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

  • Complete transparency
  • Fair costs.
  • 24 hour availability.
  • Medical E-visas
  • Online consultation from recognized Indian experts.
  • Assistance in selecting India's top hospitals for Atopic dermatitis treatment.
  • Expert dermatologist with a strong track record of success
  • Assistance during and after the course of treatment.
  • Language Support
  • Travel and Accommodation Services
  • Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
  • Local SIM Cards
  • Currency Exchange
  • Arranging Patient’s local food

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