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Atopic Dermatitis (cont.)

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Can atopic dermatitis affect the face?

Yes. Atopic dermatitis may affect the skin around the eyes, the eyelids, the eyebrows, and lashes. Scratching and rubbing the eye area can cause the skin to change in appearance. Some people with atopic dermatitis develop an extra fold of skin under their eyes, called an atopic pleat or Dennie-Morgan fold. Other people may have hyperpigmented eyelids, meaning that the skin on their eyelids darkens from the inflammation or hay fever (allergic shiners). Patchy eyebrows and eyelashes may also result from scratching or rubbing.

The face is very commonly affected in babies, who may drool excessively, and become irritated from skin contact with their abundant saliva.

The skin of a person with atopic dermatitis loses excessive moisture from the epidermal layer. Some patients with atopic dermatitis lack a protein called filaggrin that is important in retaining moisture. This defective genetic trait allows the skin to become very dry, which reduces its protective abilities. In addition, the skin is very susceptible to infectious disorders, such as staphylococcal and streptococcal bacterial skin infections, warts, herpes simplex, and molluscum contagiosum (which is caused by a virus).

Skin features of atopic dermatitis

  • Lichenification: thick, leathery skin resulting from constant scratching and rubbing
  • Lichen simplex: refers to a thickened patch of raised skin that results from repeat rubbing and scratching of the same skin area
  • Papules: small, raised bumps that may open when scratched, becoming crusty and infected
  • Ichthyosis: dry, rectangular scales on the skin, commonly on the lower legs and shins
  • Keratosis pilaris: small, rough bumps, generally on the face, upper arms, and thighs. These are also described as gooseflesh or chicken skin and may have a small coiled hair under each bump.
  • Hyper-linear palms: increased number of skin creases on the palms
  • Urticaria: hives (red, raised bumps), often after exposure to an allergen, at the beginning of flares, or after exercise or a hot bath
  • Cheilitis: inflammation of the skin on and around the lips
  • Atopic pleat (Dennie-Morgan fold): an extra fold of skin that develops under the eye
  • Dark circles under the eyes: may result from allergies and atopy
  • Hyperpigmented eyelids: scaling eyelids that have become darker in color from inflammation or hay fever
  • Prurigo nodules also called "picker's warts" are not really warts at all. These are small thickened bumps of skin caused by repeated picking of the same skin site.
Picture of eczema on the leg
Picture of nummular eczema on the leg
Medically Reviewed by a Doctor on 12/21/2016


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