An itchy, pimply rash that comes and goes. Red, inflamed skin patches that “weep” when scratched. Dry or leathery skin. All are classic signs of atopic dermatitis, a chronic and recurring skin condition that people commonly call eczema. If you are bothered by one or more of these symptoms, rest assured you’re in good company. More than 30 million Americans have some form of this inflammatory skin condition. And, yes, many are adults.

Atopic dermatitis, or AD, the most common type of eczema, was once considered a childhood malady that many kids would eventually outgrow. It’s true that most people develop symptoms before the age of 5, and some children experience fewer or less severe symptoms as they enter young adulthood. But the latest evidence suggests it’s probably a lifelong illness, and there may be more adult-onset cases than researchers previously thought.

Atopic dermatitis is common in children and adults

Overall, about 12% of children in the United States are diagnosed with atopic dermatitis. The prevalence in the adult population—more than 10% according to a recent study—isn’t much different. Yet dermatologists don’t always recognize the extent to which adults are dealing with this disease, says study author Jonathan Silverberg, M.D., associate professor of dermatology at George Washington University School of Medicine in Washington, DC. Patients, too, are often caught off guard by the diagnosis.

“They are often surprised and wonder what triggered the disease in their adult life,” Silverberg says. “Adult onset or adult recurrence of AD is not an uncommon scenario.”

“They are often surprised and wonder what triggered the disease in their adult life.”
— Dr. Silverberg

How to tell if it's AD

How do you know if you have atopic dermatitis and not some other skin disease? It can be hard to tell sometimes because everyone’s symptoms are different. One telltale sign is a strong urge to scratch. Rubbing or scratching can cause the skin to become red, inflamed and weepy. Itchy skin patches can morph into itchy, fluid-filled blisters, and when you scratch, you’re only worsening your symptoms.

If you have atopic dermatitis, chances are you or someone in your family has allergies, hay fever or asthma. The condition is associated with a higher prevalence of asthma in adults. People with atopic dermatitis often have elevated levels of a protein called immunoglobulin E (IgE) in their blood. IgE causes the body’s immune system to wage a chemical attack against perceived allergens.

Ask yourself: Have you had allergic disease and skin symptoms since childhood? Have you developed thick skin patches that sometimes ooze and crust? Then you probably have atopic dermatitis.

It can develop in adulthood

Sometimes, atopic dermatitis pops up later in life. Often it’s a recurrence of prior symptoms, explains Jon Hanifin, M.D., professor of dermatology at Oregon Health & Science University in Portland, Ore.

“They either lose it and forget it or they move to a different climate and then it comes out because of certain stresses on their skin,” he says.

People who move to the southwestern corner of the U.S. from humid, tropical climates, for example, may suddenly start to itch. Even sitting on a plane, where the air is dry, can induce symptoms, Hanifin says.

If you think you have eczema, your doctor will likely examine your skin and ask about your medical history. Family and personal history of allergies and symptoms may help to narrow the cause of your condition.

“The person may need a (skin) biopsy to diagnose and rule out any other inflammatory skin disorders,” says Kim Nichols, M.D., a dermatologist and cosmetic surgeon in Greenwich, Conn

Sometimes allergy testing is conducted too.

What to do if you have AD

Managing symptoms can test anyone’s patience, but a regular bathing and moisturizing routine can set you on the right path. Treatments such as phototherapy—which exposes the skin to ultraviolet light—can help, too. Finally, the right medication can help keep your eczema at bay. “Corticosteroid creams and ointments are good to use to prevent flare-ups and worsening symptoms,” says Nichols.