Medical Encyclopaedia › Atopic eczema (short definition)
In brief: Atopic eczema, technically atopic dermatitis, is a chronic inflammatory, non-contagious skin disease with dry skin, eczema and severe itching. It usually runs in flare-ups and often begins in infancy.
Causes
A disturbed skin barrier is central: the skin lacks protective lipids and moisturising factors, often due to a hereditary change in the filaggrin gene. At the same time, the immune system overreacts (type 2 inflammation). Atopic eczema frequently occurs together with hay fever, asthma and food allergies – this is called the atopic group of diseases.
Typical symptoms
In infants, the cheeks, scalp and extensor surfaces are often affected (cradle cap can be an early sign). In older children and adults, the eczema is typically found in the elbow creases, the backs of the knees, on the neck and on the hands. Itching often disturbs sleep; scratching can cause the skin to become infected and thickened.
Triggers of flare-ups
Common triggers are dry air from heating, sweating, wool, irritants in soaps, stress, infections and, in some of those affected, certain allergens such as house dust mites or pollen. Triggers vary greatly from person to person; a diary can help to identify them.
Treatment
The basis is daily basic skincare with emollient creams, even during symptom-free periods. During a flare-up, anti-inflammatory agents such as corticosteroid creams or calcineurin inhibitors (tacrolimus, pimecrolimus) are used, sometimes also preventively twice a week. For moderate to severe forms, phototherapy and systemic medicines are available, including biologics such as dupilumab and JAK inhibitors, which are prescribed and monitored by a doctor. Education programmes help patients and parents to manage the disease.
When to see a doctor?
Medical advice is advisable if the skin remains inflamed despite care, itching disturbs sleep, weeping or pus-filled areas appear, or painful blisters form – the latter can indicate a herpes infection (eczema herpeticum) and is an emergency.
Related terms in the encyclopaedia
Atopy, Skin barrier, Basic skincare, Itching, Corticosteroids, Tacrolimus, Dupilumab, JAK inhibitors, Hay fever
Sources
- Deutsche Dermatologische Gesellschaft (DDG): S3-Leitlinie Atopische Dermatitis, AWMF-Register 013-027
- EuroGuiDerm: Guideline on atopic eczema
- IQWiG: gesundheitsinformation.de – Gesundheitsinformationen des Instituts für Qualität und Wirtschaftlichkeit im Gesundheitswesen
Note: This article is for general information and does not replace advice, diagnosis or treatment from a doctor or pharmacist. Last updated: October 2026.