How Eczema changes with age

Eczema (atopic dermatitis) usually occurs in people who have an atopic (allergic) tendency. This means they have inherited the tendency to allergic disorders and may develop any or all of three closely linked conditions; eczema, asthma or allergic rhinitis (hay fever). Often these conditions run within families with some close relatives also affected. A family history of these conditions is useful in helping to diagnose eczema in infants.

Eczema patterns usually change with increasing age.

There is no cure for eczema but for most people it can be managed very well, and the good news is that 70% of children grow out of it.

Infants

Infants less than one year old often have a rash over most of their body. The skin is often dry, scaly and red. The cheeks of infants are often the first place to be affected by eczema.

Eczema in the nappy area is not common because nappies help to keep the area moist.

Children

As a child grows, the eczema becomes more localised (that is not all over the body) and the skin becomes thickened. Toddlers scratch a lot, and the rash can look very red, raw and uncomfortable. Eczema in this age group often affects the outer aspects of joints, particularly the wrists, elbows, ankles and knees.

Older children tend to have eczema in the creases of the joints, especially the elbow and knee creases. The affected skin often becomes dry, hard and thick from constant scratching and rubbing. Other areas involved include the eyelids, earlobes, neck and scalp.

Eczema is often worst between the ages of two and four years, but it generally improves during school years, and it may completely clear up by the time of high school, although the barrier function of the skin is never normal.

Adults

Adults who have eczema may present in various ways. They commonly have ongoing localised eczema affecting the hands, eyelids, elbows/knees/ankles, nipples or all of these areas. Repeated bacterial infections may be a problem.  Eczema affecting the hands is more common in adults with eczema.

The main cause is a defective skin barrier function meaning that the skin is easily damaged from irritants such as soap, changes in the weather and temperature, and other triggers.

It happens because of a combination of genetic and environmental factors. The primary problem is a defective skin barrier function making the skin more likely to be damaged by things that irritate the skin such as soap, changes in the weather and temperature, and other non-specific triggers