atopic dermatitis affects each child differently both in terms of onset and severity of symptoms. in infants atopic dermatitis typically begins around 6 weeks to 12 weeks of age. it may first appear around the cheeks and chin as a patchy facial rash which can progress to red scaling oozing skin. the skin may become infected. once the infant becomes more mobile and begins crawling exposed areas such as the knees and elbows may also be affected. an infant with atopic dermatitis may be restless and irritable because of the itching and discomfort. many infants improve by 18 months of age although they remain at greater than normal risk for dry skin or hand eczema later in life. in childhood the rash tends to occur behind the knees and inside the elbows on the sides of the neck and on the wrists ankles and hands. often the rash begins with papules that become hard and scaly when scratched. the skin around the lips may be inflamed and constant licking of the area may lead to small painful cracks. severe cases of atopic dermatitis may affect growth and the child may be shorter than average. the disease may go into remission (disease-free period). the length of a remission varies and it may last months or even years. in some children the disease gets better for a long time only to come back at the start of puberty when hormones stress and the use of irritating skin care products or cosmetics may cause the condition to flare. although a number of people who developed atopic dermatitis as children also experience symptoms as adults it is less common (but possible) for the disease to show up first in adulthood. the pattern in adults is similar to that seen in children; that is the disease may be widespread or limited. in some adults only the hands or feet may be affected and become dry itchy red and cracked. sleep patterns and work performance may be affected and longterm use of medications to treat the condition may cause complications. adults with atopic dermatitis also have a predisposition toward irritant contact dermatitis especially if they are in occupations involving frequent hand wetting hand washing or exposure to chemicals. some people develop a rash around their nipples. these localized symptoms are difficult to treat and people often do not tell their doctor because of modesty or embarrassment. adults may also develop cataracts that are difficult to detect because they cause no symptoms. therefore the doctor may recommend regular eye exams.
what are the stages of atopic dermatitis?