Why Atopic Dermatitis Can Change Throughout Your Life

Atopic dermatitis is a chronic condition that can last a lifetime. But that doesn’t mean it will always look or feel exactly the same as it does right now.

Dermatologist G. Cheyana Ranasinghe, MD, offers a closer look at some of the factors that can cause atopic dermatitis to change throughout the course of your life.

Eczema by age: An overview

An estimated 10% to 30% of people who had atopic dermatitis in childhood continue to experience it as adults. And flare-ups can come and go, depending on what’s going on in your life — and in the rest of your body.

Atopic dermatitis may:

• Flare up more often
• Cause more severe symptoms
• Affect different areas of your body

Here’s a broad look at when and how eczema may change throughout your lifespan:

• In babies: Baby eczema is common, often affecting the cheeks. But it doesn’t always continue through childhood. “In some kids, atopic dermatitis clears up as they get older,” Dr. Ranasinghe says.
• In childhood: In kids who continue to experience eczema, symptoms often appear in areas where the skin bends or folds with movement, like the elbows, backs of knees and under the neck.
• In adolescence: As puberty kicks in, changing hormone levels can cause some tweens and teens, especially girls, to experience an increase in atopic dermatitis symptoms.
• In adulthood: “Changing factors like stress, pregnancy, medications, certain personal care products and environmental exposures can contribute to atopic dermatitis flares,” Dr. Ranasinghe says. Eczema rashes often show up on the hands, eyelids and neck.
• Later in adulthood: Your skin changes as you get older, which can trigger eczema issues. In women, perimenopause and menopause may bring new atopic dermatitis symptoms or more frequent flare-ups.

“There are periods throughout your life when your eczema may be much better or much worse,” Dr. Ranasinghe confirms. “And there can be lots of different reasons for that.”

Why atopic dermatitis can change as you age

Let’s take a closer look at some of the factors that can contribute to eczema changes throughout the course of your life.

1. Hormones

Hormones and eczema are closely connected. At different periods of your life, shifting hormone levels can contribute to an impaired skin barrier. And that’s often a trigger for atopic dermatitis symptoms to flare.

Possible times of flare-ups include:

• Adolescence: Girls, in particular, may deal with atopic dermatitis right after puberty. That’s likely because of shifts in estrogen and progesterone.
• Before your period: “A drop in estrogen levels may cause atopic dermatitis to flare up in the week or so before your period begins,” Dr. Ranasinghe explains.
• Pregnancy: More than half of pregnant women with a history of eczema experience a flare during pregnancy, thanks to shifts in sex hormones.
• Perimenopause and menopause: Your body makes fewer sex hormones with age, which can cause eczema to return or even appear for the first time.

And don’t forget about stress hormones. Long-term stress can affect your cortisol levels, which can, in turn, affect your skin barrier and — you guessed it — contribute to eczema flares.

“We all experience periods of stress throughout our lives,” Dr. Ranasinghe acknowledges. “For people living with atopic dermatitis, stressful times at home or at work can sometimes lead to a flare in symptoms.”

2. Aging skin

Your skin changes as you get older — and any time your skin changes, atopic dermatitis symptoms can crop up. Aging skin tends to:

• Get thinner
• Lose moisture
• Become less elastic
• Slow its natural oil production process
• Heal more slowly

“All of these factors weaken your skin barrier, which can make you more susceptible to eczema flares,” Dr. Ranasinghe explains. “Age-related skin changes can also make it harder for your skin to heal and recover when you’re dealing with a flare.”

3. Your environment

“Environment” doesn’t just mean, well, the environment. Yes, nature can trigger atopic dermatitis symptoms. But so can certain aspects of your environment, like where you live, work, travel or otherwise spend time.

Here are some of the ways the world around you can contribute to eczema flares throughout your life:

• Time of year: Extreme cold and extreme heat can be powerful triggers for atopic dermatitis. If you live somewhere where the temperature changes significantly with the seasons, your eczema may be worse at certain times of the year.
• Geographic location: “Mild temperatures and stable, mid-range humidity tend to have the least effect on eczema,” Dr. Ranasinghe notes. “But places that are very hot, cold, humid or dry could also trigger eczema changes.”
• Where you live: Certain factors in your home can trigger eczema flares, like dust mites, mold growth and pet dander. So, your eczema might flare if you bring home a new cat, or it might calm down if you move into a new home with different environmental exposures.
• Where (and how) you work: “Eczema may get better or worse if something about your job changes,” Dr. Ranasinghe says. “For example, it could flare if you start or stop working with certain chemicals, soaps, metals or compounds.”

4. Your health

We’ve already talked about how stress can trigger eczema symptoms. But other aspects of your overall health can also play a role — and take a toll.

“At times in your life when you’re dealing with certain medical conditions, or flares in those conditions, you may notice an increase in your atopic dermatitis symptoms,” Dr. Ranasinghe points out.

Conditions that may trigger eczema flares include:

• Allergies: Hay fever and food allergies can both trigger eczema flare-ups. If your allergies are worse at certain times of year or periods of your life, your atopic dermatitis may be worse, too.
• Asthma: Asthma and eczema are thought to be closely linked, though researchers aren’t yet sure exactly why. If you’re living with both, you may notice that your flare-ups happen at the same time.
• Autoimmune disorders: Many autoimmune diseases are associated with inflammation throughout your body. And in some people, inflammation may set off eczema symptoms.
• Injuries and skin infections: Anything that damages your skin barrier can trigger your atopic dermatitis symptoms. So, your eczema may reappear or worsen when you’re dealing with cuts, scrapes, burns and other wounds.
• Certain medications: Sometimes you need to take medication to manage other health conditions. But some medicines, such as those used to lower your blood pressure or cholesterol, may trigger atopic dermatitis flares.

“If you’re dealing with another health condition, make sure your provider knows that you have atopic dermatitis,” Dr. Ranasinghe advises. “And stay in touch with your dermatologist so you can work together to manage your eczema while you tend to other aspects of your health.”

When to talk to your healthcare provider about eczema changes

It’s common for atopic dermatitis symptoms to wax and wane throughout your life, depending on a seemingly endless list of factors. And it can be hard to figure out exactly what’s contributing to those changing symptoms.

So, don’t hesitate to make an appointment with your provider if your symptoms are:

• Becoming more severe
• Spreading to new areas
• Disrupting your sleep or your everyday life
• No longer responding to treatment

“If you notice changes in your atopic dermatitis, it’s important to reach out to your dermatologist,” Dr. Ranasinghe emphasizes. “They can help determine the cause and work with you to both manage your symptoms and try to prevent them from going forward.”