HealthInfo West Coast-Te Tai Poutini

Atopic eczema

Atopic eczema is a very common skin condition that causes your skin to be dry, itchy and red (inflamed). It is also called atopic dermatitis.

"Atopic" is a term used to describe a group of conditions such as asthma, eczema and hay fever. Atopic eczema is more common if you have one of these conditions or a whānau (family) member is affected with one.

Atopic eczema occurs most frequently in pēpi (babies) and tamariki (children). But it can sometimes occur for the first time when you are an adult. Many tamariki grow out of atopic eczema, but it can return years later.

The exact cause of eczema is not known. Health professionals believe it is caused by a combination of genes and environmental factors. Some people with atopic eczema have a lower amount of a protein called filaggrin. Filaggrin plays an important role in keeping the skin barrier healthy. So, having a lower level leads to dry skin and increases the risk of developing eczema.

People with atopic eczema also tend to have an overactive immune system. This can be triggered by a substance inside or outside of the body, causing inflammation. Watch this video to learn more about what causes eczema.

Symptoms of eczema

Itch is the main symptom of eczema. People often scratch their skin because of the itch, which can be moderate to severe and often worse at night. Skin may also be dry, inflamed and cracked.

Eczema can be mild, moderate or severe. When eczema worsens it is called a flare-up. Mild cases only involve 1 or 2 affected areas. With severe flare-ups, many areas of your skin can be affected, and it can last for several weeks.

Eczema can affect any area of the skin:

• in pēpi, it is often seen on their face, body, arms and legs
• in older tamariki, it is often the skin in the creases behind their knees, wrists, elbows and ankles
• in adults it can affect any part of the body with common areas being the wrists, inside elbows, back of knees, trunk and limbs. Sometimes it can affect the face and genital areas.

Sometimes your skin can become infected. Signs and symptoms of infection include:

• skin that is weepy and crusted
• lots of white or yellow pimples
• a sudden flare-up of eczema all over your body
• shivering
• painful skin
• painful blisters that look like chickenpox.

Triggers for eczema

A trigger is something that makes your eczema worse (flare-up) and can vary from person to person. Common triggers include:

• heat or changes in temperature
• irritants such as soap, bubble bath, detergent, fabric conditioner and perfumed products
• fabrics such as wool or synthetic materials, which can be prickly
• chemicals such as chlorine in a swimming pool or chemicals in a spa
• environmental allergens such as animal dander, pollen or house dust mites.

Diagnosing eczema

Your general practice team will usually diagnose eczema based on your medical history. They will talk to you about your symptoms and see what your skin looks like. Blood tests and skin tests are not usually necessary.

Treating atopic eczema

Treating atopic eczema involves looking after your skin. This includes moisturising and using medicated creams if needed. See Treating atopic eczema in adults and Treating atopic eczema in children for more information.

Eczema not only impacts your skin but can also affect your quality of life. It can affect sleep, self-esteem (particularly if it is visible on your hands or face), work and personal relationships. See your general practice team if your eczema is affecting your mood.

  HealthInfo recommends the following pages

• DermNet NZ:
  • Complications of atopic dermatitis

    Information about atopic eczema, what causes it and how it is treated.

  • Dermatitis

    Information about what eczema is, the different types and treatments.

• KidsHealth NZ – Eczema

  Information about eczema in tamariki, what causes it, signs and symptoms and management in 3 easy steps.

• NHS – Atopic eczema

  Information about atopic eczema, what causes it, treatment and complications.

On the next page: Treating atopic eczema in adults

Written by HealthInfo clinical advisers. Last reviewed February 2025.

Sources

Page reference: 314791

Review key: HICOD-326084