Typical of atopic dermatitis is not only the intense itchiness but also the changing distribution of the eczema on the body, depending on the age of the child. Parents often face the question of why skin changes appear in different places for infants, toddlers, and older children, and how atopic dermatitis evolves throughout childhood.

Atopic Dermatitis in Infants (0–2 years) and Toddlers (2-5 years)

Atopic dermatitis manifests in 60% of cases within the first six months of life. The eczema typically occurs in the following areas:

• Face: Atopic dermatitis often starts with reddened, weeping skin areas on the cheeks. The forehead and chin can also be affected.

• Scalp: Redness and adherent scales, known as cradle cap, appear.

• Trunk: The upper body is often diffusely affected.

• Extensor sides of arms and legs: Here, the typical dry skin patches appear.

The diaper area is usually spared and free from eczema.

Atopic Dermatitis in School-Aged Children (6–12 years) and Adolescents (from 13 years)

By school age, the condition stabilizes in many children, and by early adulthood, approximately 60% of children/adolescents are symptom-free.

• Flexural areas: These regions are almost always affected by eczema, especially the insides of the elbows, backs of the knees, and neck.

• Hands and feet: The older the child, the more likely it is for skin irritation to occur on the hands and feet.

• Lips and mouth area: Some children develop a so-called perioral eczema with dry and reddened skin around the mouth.

How Atopic Dermatitis Changes with Age

You can see: Atopic dermatitis presents many faces depending on age. In infants, it primarily appears on the face, scalp, and extensor sides of the arms and legs. As children grow, the eczema shifts to typical flexural areas like the insides of the elbows and backs of the knees. These age-dependent patterns help to recognize atopic dermatitis early and treat it effectively.

Sources

1. AWMF (2024). S3 Guidelines Atopic Dermatitis.