A Complete Atopic Dermatitis Glossary

Atopic dermatitis is the most common form of eczema , but the language used to describe this chronic, inflammatory skin condition can be confusing. Not sure what a "flare" is, or how a topical can help? Use this handy glossary to understand some key terms.

Atopic Dermatitis Glossary

allergen A substance that is usually harmless but can trigger an immune system response in some people that results in an allergic reaction. Common allergens include pollen, animal dander, mold, dust mites, medications, insect venoms, and various foods. Allergens can trigger atopic dermatitis flare-ups.

allergy A chronic condition in which an ordinarily harmless substance, known as an allergen, causes an abnormal response by the immune system. An allergic reaction can trigger an atopic dermatitis flare-up.

antihistamine A type of medicine used to counteract histamine, a chemical that contributes to inflammation and is released by the body during an allergic reaction. Doctors may recommend certain antihistamines for atopic dermatitis to make it easier to sleep through the night, and to reduce inflammation and itch if you have allergies.

Examples of antihistamines are diphenhydramine (Benadryl) and doxylamine (Unisom). asthma A chronic disease in which the airways become inflamed and cause breathing problems. A family history of atopic dermatitis, asthma , or hay fever can make you more likely to develop atopic dermatitis, and about half of children with moderate to severe atopic dermatitis develop asthma.

atopic dermatitis The most common form of eczema, atopic dermatitis is a chronic inflammatory skin condition that is associated with an overactive immune system. Symptoms include itchy, dry, scaly skin that may weep with clear fluid when scratched. The exact cause of the condition is unknown, but risk factors include a family history of atopic dermatitis, asthma, or hay fever. Atopic dermatitis is not contagious.

atopic triad Atopic dermatitis, hay fever (allergic rhinitis), and asthma form the atopic triad, meaning they all often occur together. Children who have early-onset, moderate to severe atopic dermatitis are more likely to develop asthma and allergic rhinitis. Meanwhile, more than 20 percent of adults with atopic dermatitis also have asthma, and they have two to four times the risk of having allergic rhinitis.

bath treatment Immersing the skin in water will hydrate it and can help relieve atopic dermatitis symptoms. Bath treatments are often followed by oily moisturizers to seal in moisture. Bath water can contain bath oil, baking soda, a mild bleach solution, vinegar, or salt.

biologics Biologic drugs, or biologics , essentially use human DNA to create antibodies to treat certain diseases at the immune system level. As a result, these medications are among the most targeted therapies available to treat atopic dermatitis. Biologics are injected subcutaneously (through the skin) or intravenously (in the vein).

The two biologic drugs approved by the U.S. Food and Drug Administration (FDA) for the treatment of atopic dermatitis are Dupilumab (Dupixent) and Tralokinumab-ldrm (Adbry) .

bleach bath therapy This potential treatment for atopic dermatitis involves using 6 percent bleach dissolved in bathwater. Experts advise using half a cup of bleach for a full bathtub of water or a quarter cup of bleach for a half-full bathtub. If you're using a smaller tub for your baby or toddler, add 1 teaspoon of bleach per 1 gallon of water. Check with your dermatologist before trying a bleach bath .

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ceramides If you have atopic dermatitis, fatty substances in the skin called lipids can contain less ceramide, a substance that helps lock in moisture. Not having enough ceramide can lead to dryness, irritation, and skin dysfunction. Certain moisturizers for atopic dermatitis contain ceramides.

dermatitis A common condition that causes skin irritation and swelling of the skin. It can have many causes and typically leads to itchy, dry skin or a rash. Atopic dermatitis is a form of dermatitis.

eczema A group of inflammatory skin conditions that can cause dry, itchy skin along with rashes, scaly patches, blisters, and skin infections. The most common type is atopic dermatitis, which is often referred to simply as eczema. Other types include contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis.

eczema herpeticum If you have atopic dermatitis and you become infected with the herpes simplex virus, the virus behind cold sores, you are at risk of developing a potentially very serious condition called eczema herpeticum . Eczema herpeticum occurs when the herpes virus infects large areas of the skin. It usually appears on the face and neck, but can also appear on other parts of the body, such as the hands. Symptoms may include clusters of itchy, painful blisters that look red, purple, or black, and ooze pus when they are broken open.

epidermis The top layer of the skin, which consists of cells that reproduce, move upward, and then are shed as dead skin cells. It also contains nerve receptors and chemical mediators.

filaggrin About 20 to 30 percent of people with atopic dermatitis have a mutated or altered FLG gene.

FLG is the gene responsible for creating filaggrin, a protein that helps your body maintain a healthy, protective barrier on the top layer of the skin. Without enough filaggrin, moisture can escape from the skin and bacteria, viruses, and other irritants can enter.

flare or flare-up A sudden appearance or worsening of symptoms in a disease or condition. In atopic dermatitis, triggers such as allergies and environmental factors can bring on a flare-up.

immunosuppressants In moderate to severe cases of atopic dermatitis, doctors may prescribe a systemic (whole body) immunosuppressant, such as cyclosporine (Neoral, Sandimmune, or Restasis) , azathioprine , methotrexate (Trexall or Rasuvo) , or mycophenolate mofetil (CellCept) .

These drugs help control or suppress the immune system to stop the itch-scratch cycle, allow the skin to heal, and reduce the risk of infection. When prescribed for atopic dermatitis, immunosuppressants are considered "off-label" because they are not approved by the FDA for this use. They can have potentially serious side effects, and are not recommended for long-term use. inflammation The immune system's response to an irritant. Signs of skin inflammation can include swelling, pain, itchiness, warmth, and redness.

irritant A substance that can cause your skin to burn, feel itchy, or become dry and red. Common household products and even natural substances can be irritants, such as hand and dish soap, laundry detergent, shampoo, bubble bath and body wash, perfume or other items with added fragrances, surface cleansers and disinfectants, and juice from fruits and vegetables.

itch-scratch cycle A condition in which itchy skin makes you scratch, and the more you scratch the itchier skin gets, in a continuous cycle. It can lead to skin injuries, infections, and scarring.

JAK inhibitors are medicines that block certain enzymes involved in the pathways of immune system messengers that can cause inflammation. Ruxolitinib ( Opzelura ), the only topical JAK inhibitor approved by the FDA to treat atopic dermatitis, can help reduce itch, rash, and redness.

Oral JAK inhibitors can also block immune system messengers that can lead to inflammation and thereby reduce inflammation and itch.

The oral JAK inhibitors currently approved for treatment of moderate to severe atopic dermatitis are upadacitinib (Rinvoq) and abrocitinib (Cibinqo). lichenification Thickened, dry, scaly, leathery, and discolored skin caused by chronic irritation. Repeated scratching from atopic dermatitis can lead to it.

PDE4 Inhibitors These topical medications work by blocking an enzyme called phosphodiesterase 4 (PDE4) from producing too much inflammation in the body. Crisaborole (Eucrisa) is currently the only PDE4 inhibitor approved by the FDA for the treatment of atopic dermatitis.

phototherapy (light therapy) Light therapy , also called phototherapy, uses ultraviolet waves to help improve itch and inflammation. The treatment is typically prescribed for people whose atopic dermatitis hasn't improved with topical treatments.

potency Topical corticosteroids come in varying degrees of strength or potency, with 1 being the most powerful and 7 being the weakest. For example, the ultra-high-potency steroid clobetasol is a class 1 medication, while over-the-counter hydrocortisone creams are in the least potent class 7.

skin barrier The skin barrier is located in the uppermost layers of the epidermis, called the stratum corneum. In normal skin, this barrier protects the underlying skin from irritants and prevents water loss from the body. In atopic dermatitis, the skin barrier is altered, so natural moisturizing factors are decreased. A defective skin barrier also means that irritants are able to enter the skin more easily.

soak-and-seal treatment This atopic dermatitis treatment involves taking a lukewarm bath for five to 10 minutes, patting the skin lightly with a towel (leaving it slightly damp), applying topical medication as directed, then moisturizing the skin within three minutes to combat dry skin and reduce flares.

systemic steroids If topical corticosteroids (steroids) aren't working, or in more severe cases of atopic dermatitis, doctors may prescribe a systemic steroid such as prednisone to control inflammation. Taking these drugs, which are also immunosuppressants, can result in a "rebound effect," where symptoms can return and be even worse once you stop taking these medications, so doctors only recommend taking them for short periods of time. Using systemic steroids for more than a month can also cause serious side effects including skin thinning and infections.

topicals A medication applied to the skin. Many atopic dermatitis treatments are topical, and they are typically used to manage symptoms and reduce inflammation.

topical calcineurin inhibitors (TCIs) TCIs are a category of topical prescription medications for atopic dermatitis. These drugs can help control inflammation and reduce flare-ups by suppressing the immune system . Tacrolimus (Protopic) and pimecrolimus (Elidel) are TCIs.

topical steroids (topical corticosteroids) Topical corticosteroids (steroids) are the standard, go-to treatment for atopic dermatitis flare-ups.

Applied directly to the affected areas of skin, these ointments, creams, or lotions can reduce inflammation and itch. topical steroid withdrawal (TSW) Topical steroid withdrawal is a rebound response that can occur when people suddenly stop using these medications. Symptoms of topical steroid withdrawal include burning, weeping (skin oozing liquid), flaking, shedding, peeling, spreading, swelling, redness, wrinkling, thin skin, pus-filled bumps, cracking, itching, nodules, pain, insomnia, hair loss, shivering, fatigue, depression, and disability.

trigger A substance or condition that causes symptoms to appear. Atopic dermatitis triggers can include dry skin, allergens, irritants, stress, becoming too hot or cold, sweating, infections, and hormones.

wet wrap therapy Wet wrap therapy can help rehydrate and calm the skin during intense atopic dermatitis flares. It can also help topical medications work better. In wet-wrap therapy, fabric wraps are soaked in water and applied to the affected skin, typically after bathing, moisturizing, and applying medication.

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