Atopic Dermatitis vs Eczema: How Do They Differ?

The terms atopic dermatitis and eczema are often used interchangeably. Both refer to inflamed and irritated skin, but there are some key differences between the two conditions.

What Are the Differences Between Dermatitis and Eczema?

Dermatitis is a general term used to refer to inflammation of the skin. It can refer to things like rashes, acne, and even dandruff. Skin redness, dryness, and itchiness are the most common symptoms of dermatitis, but scaling, flaking, and blisters can also occur. 

Dermatitis can be temporary, but when it occurs on a more chronic and longer-lasting basis, it is usually referred to as eczema. While many forms of dermatitis are commonly referred to as different forms of eczema, the most common form of eczema is atopic dermatitis. According to the National Eczema Association, eczema affects more than 31 million Americans.

Atopic Dermatitis vs. Eczema

Atopic dermatitis is the most common form of eczema, and it typically begins during childhood. Atopic dermatitis often causes a red rash in the creases of the elbows and knees. Babies also often develop atopic dermatitis on the scalp and cheeks.

Atopic dermatitis is common among people with a personal or family history of hay fever or asthma, as the conditions commonly occur together. It can also sometimes be related to a food allergy. Affected areas of the skin may turn darker and develop small bumps that can become infected if they're scratched and the skin is broken.

The Types of Dermatitis and Eczema

There are seven different types of eczema, or chronic dermatitis, that occur from different causes. These are:

• Atopic dermatitis: A red rash that often forms in the creases of the knees and elbows or on the face and scalp during childhood with a genetic link, especially for people with a personal or family history of hay fever or asthma, or as an allergy to food
• Contact dermatitis: An itchy, red, dry skin rash that develops in response to an irritating chemical that comes in contact with your skin or as the result of an allergic reaction to metals, fragrances, or other substances
• Dyshidrotic dermatitis: Scaly, dry blisters that form on the hands and feet as a result of other forms of eczema, fungal infection, or allergic reaction
• Neurodermatitis: Thick, dry, leathery patches of skin, often worsened by stress or other forms of eczema
• Nummular dermatitis: Itchy, coin-shaped round patches of skin most commonly found on the arms and legs with an unknown origin
• Seborrheic dermatitis: Itchy, flaky, scaly patches on areas of the skin that contain a lot of oil glands as a result of inflammation from the Malassezia yeast
• Stasis dermatitis: Itchy lesions on the lower legs as a result of poor blood circulation

Diagnosis and Treatment Methods

Atopic dermatitis can be diagnosed by a primary care physician or dermatologist by examining your skin and assessing your medical history. 

Skin patch testing may be needed to determine if your condition is caused by an allergy. With a skin patch test, patches that contain small amounts of common allergens are applied to the surface of your skin. These patches are typically applied to your back or arm and left in place for 48 hours. During this time, you should avoid bathing, showering, swimming, and activities that cause a lot of sweating.

Redness and swelling of the skin at the site of application may indicate an allergy to a particular substance. If your patch test comes back positive for a specific allergy, you should avoid contact with this substance.

For all forms of eczema, topical treatment with steroid medication can be used to help relieve pain, redness, and itching. Topically applying coal tar, crisaborole ointment, or pimecrolimus cream can also help soothe symptoms. If more than 20% of your skin has been affected by contact dermatitis, oral steroid medications like prednisone are often required to reduce pain and inflammation within 12 to 24 hours.

In moderate to severe cases of eczema when topical prescription treatments have not worked well or aren't advised, biologics such as Dupixent (dupilumab) and Adbry (tralokinumab-ldrm), or Janus kinase (JAK) inhibitors including Cibinqo (abrocitinib) and Rinvoq (upadacitinib) are other treatment options.

Applying a cool compress to the affected areas and taking oral antihistamines may also help relieve the pain and itching caused by atopic dermatitis. 

If you have atopic dermatitis that does not improve with any of these treatment options, your doctor may recommend phototherapy or food avoidance if the condition is related to a food allergy. Phototherapy involves exposing affected skin areas to ultraviolet light two to three times a week to promote skin healing.

Ways to Prevent Dermatitis and Eczema

Atopic dermatitis and eczema can be prevented by managing triggers that can cause skin inflammation. Aim to:

• Avoid contact with irritating substances and known allergens.
• Manage stress to decrease inflammation throughout the body. 
• Moisturize your skin regularly with thick emollients.
• Avoid activities that dry and irritate your skin, such as using harsh soaps and cleansers, taking long hot showers, and wearing tight, restrictive clothing. 

Summary

Atopic dermatitis is a type of eczema, while eczema refers to a chronic case of dermatitis. (Dermatitis refers to skin inflammation in general.) There are also other types of eczema that can lead to dry, itchy, and inflamed skin. A primary care doctor or dermatologist can usually diagnose the two conditions through a physical exam. Keeping your skin hydrated and avoiding activities or habits that irritate your skin are the best ways to treat and keep flare-ups at bay.

A Word From Verywell

Atopic dermatitis and all other forms of eczema are inflammatory skin conditions. Avoiding contact with irritating substances and allergens can help decrease flare-ups and improve your symptoms. For atopic dermatitis and other forms of eczema that still persist even when minimizing exposure to irritants, topical steroid medications are typically the most beneficial for relieving redness, itching, and skin dryness.

Frequently Asked Questions

Can you have atopic dermatitis and symptoms of other types of eczema at the same time?

It is possible to have more than one type of eczema at a time, especially because dyshidrotic dermatitis and neurodermatitis often result from other forms of eczema like atopic dermatitis. You can also have atopic dermatitis and develop other types of eczema if your skin comes in contact with an allergen, irritating substance, or fungus.

How common is atopic dermatitis?

Atopic dermatitis is the most common type of eczema, affecting about 16.5 million American adults and more than 9.6 million children.

What triggers atopic dermatitis and eczema? 

Atopic dermatitis can be triggered by skin care products like soaps, cleansers, detergents, and lotions with harsh chemicals; extreme hot or cold temperatures; irritating fabrics like wool; fragrances; and stress. Other forms of eczema can be triggered by irritating chemicals in substances such as adhesives, glues, bleaches, cleaning products, paints, and acids, or by allergies to ingredients in skin care products, food, metals, or urushiol, the oil found in poison ivy, poison oak, and poison sumac. Other forms of eczema may be triggered by a fungal infection or as a side effect of taking certain medications.