Atopic dermatitis is one of about eight different types of the chronic, non-infectious skin condition called eczema. When people talk about “severe eczema,” they’re usually referring to atopic dermatitis. And according to CNN, the symptoms can be very challenging to cope with.
People with mild-to-moderate eczema experience some itching, but people with severe eczema tend to experience much more intense, even uncontrollable itching. In fact, their skin itches so much they scratch it until it bleeds–a phenomenon dubbed the “itch-scratch cycle.” These dry, itchy spots can develop anywhere, but they’re especially common in places like the crook of your arms, the back of your knees, your neck and your face.
Red, dry, irritated skin is common in most cases of eczema. But when your skin is extra-dry and extra-red and extra-irritated, you know you’re dealing with a much more severe case. It may also be spread out over larger areas.
Another of the most common severe eczema signs is blistering or weeping skin. When you have a flare-up of atopic dermatitis, it can cause sores or blisters to form. Often, those blisters then break open, weeping fluid.
With all the scratching and rubbing that comes with an itchy case of severe eczema, it’s common over time to develop thick, raised patches of skin. These patches of skin often feel and look leathery. Your skin may feel rougher overall, too.
Most mild-to-moderate cases of eczema respond fairly well to the use of topical treatments like gentle moisturizers on a daily basis along with corticosteroid creams or ointments for flare-ups. When your skin stops responding well to those treatments, it can be a sign your eczema has developed into a more severe case.
When your doctor begins talking about second-line treatments, you know your eczema is a more serious condition. Your doctor may want to see how you respond to oral or injected systemic corticosteroids or light therapy. Another possible option is a combination treatment regimen of light therapy and a light-sensitive drug called psoralen. There’s also a new biologic drug on the market called dupilumab (Dupixent) that can be used to treat severe eczema in people who haven’t had luck with other treatments.
Atopic dermatitis tends to develop in young children and babies–and is less common in adults. But when a child’s eczema symptoms persist into adulthood, they are often more severe, although the symptoms can cycle back and forth.
Someone who’s not familiar with severe eczema might be confused by this sign, but anyone who suffers from the condition knows why sleeplessness is a problem. The severe itching prevents many people with atopic dermatitis from sleeping well at night.