Atopic Dermatitis and Aging

What is atopic dermatitis, and why might you be experiencing flare-ups now? We spoke with dermatologist Julia Carroll to learn about this type of eczema and how to best treat your skin.

 Experiencing itchy, inflamed skin in patches and wondering how you’ve developed atopic dermatitis now at your age? After all, don’t you experience eczema and dermatitis more as a kid? It’s actually not as straightforward as that. People often use these terms interchangeably, but they’re not one and the same. Atopic dermatitis is one type of eczema that is rooted in genetics, explains Dr. Julia Carroll. “It’s one specific type and mostly thought to be a genetic disease that affects the skin barrier, but we don’t know the whole story,” says the dermatologist.

 “Onset is usually before the age of one, and as children grow older, they often grow out of it, though not everyone–some may have it settle down and flare up when they’re older,” explains Dr. Carroll. It’s for this reason that if you’re experiencing red, flaky patches for the first time in your 40s, 50s and 60s, she questions whether it is, in fact, atopic dermatitis given that it’s genetic, you’d have experienced symptoms at an earlier age.

Atopic dermatitis triggers

We chatted more with Dr. Carroll of Compass Dermatology in Toronto to learn more about atopic dermatitis and aging in particular. Did you know that where you have patches of atopic dermatitis may differ depending on your age? Growing up, you may have experienced it on your face, inside your wrists, elbows or behind your knees, but now as an adult, you may find your skin inflamed on the outside of your arms and legs, perhaps around your eyes. “The distribution does change with your age,” says Dr. Carroll.

 However, while atopic dermatitis is genetically based, if you’ve had symptoms in your childhood and are noticing atopic dermatitis flare-ups now, there could be a number of reasons behind this. Have you moved to a different climate? Dr. Carroll has worked with patients who have moved from warmer climates, such as Asia–climates that are more supportive to your skin–to Canada, with its dry, harsh winters, who’ve experienced flare-ups thanks to the climate damaging the skin barrier.

 Going through menopause may be a contributing factor as well. “As women go through menopause, the skin barrier doesn’t function as well, and your skin may be drier, and you may see a flare-up then,” she says. Our skin tends to be drier as we experience menopause, says Dr. Carroll (“It’s a common complaint I hear at the office,” she says), adding that this goes back to the change in our hormonal levels and our bodies are not producing as much natural moisture as before menopause.

 And while the stresses we experience as we age might seem tied to atopic dermatitis flaring up, Dr. Carroll notes that it’s more complicated than that. “Stress won’t cause atopic dermatitis, but it could physiologically trigger it. But also, when you’re stressed–whether it’s divorce, the death of a loved one or because of an illness, often your self-care can fall to the wayside, and your immune system is down. So it’s two parts,” she explains.

How to manage your atopic dermatitis

Finding relief for your irritated skin is, of course, important, but you do want to start by getting ahead of it, according to dermatologist Dr. Julia Carroll. This starts with the products you choose to use and setting up routines and lifestyle habits that’ll help minimize any potential triggers.

Moisturize regularly

Your impaired skin barrier is dry, so you’ll want to be moisturizing regularly to hydrate your skin. As for what products to choose, above all, you want to keep it simple. “Look for a smaller ingredient list and avoid fragrance as it can be irritating,” says Dr. Carroll. Avoid both lanolin and alcohol as ingredients since they can be triggers, too. She also notes that you’ll want to be careful with retinoids in your skincare–ultimately, you can use them in your routine, but it’s best if you do so under the supervision of a dermatologist.

Recognize that natural isn’t better for your skin

“I generally tell patients to avoid products with a lot of natural ingredients,” says Dr. Carroll. People often look to essential oils, plant-based products and ones with natural fragrances, but they don’t have benefits to the skin, she says.

Be mindful of the climate

“As much as you can, be mindful of the climate you’re in,” says Dr. Carroll. This isn’t always possible if you live in a cold, dry climate–but perhaps you can opt for your travels to take you to destinations that are less harsh on your skin.

Avoid hot showers

As much as you may enjoy a long, hot shower after a tough day, this can be irritating to your skin. Look to warm showers instead (and moisturize your damp skin once you’re done bathing).

Consider changing up your wellness routine

Hot yoga can trigger an inflammation of your skin, so you may want to change your practice if you’ve been focusing on hot yoga. Similarly, saunas may not be great for your atopic dermatitis either.

Add a humidifier (or two) to your home

You want less dry air, so having a humidifier where you spend a lot of time can help your skin. So consider one in the bedroom for when you sleep and one for your office. “Since many people work from home now, I suggest getting one for the home office,” says Dr. Carroll.

See your family doctor or a dermatologist

You can start with your family doctor if you’re noticing atopic dermatitis flare-ups, especially if your case is mild. You may get referred to a dermatologist, though. “As derms, we act like detectives–we go through your skincare, your environment, self-care habits and find things that are triggering, while also considering your genetics,” she says. In terms of what they may prescribe: A topical cortizone product is what your GP or dermatologist will usually recommend as a first line of defense for milder cases or for maintenance. A newer category called biologics is more powerful and can provide great relief for people with more severe atopic dermatitis; your dermatologist can work with you to determine if this injectable medication is one you’re best suited for.

The Atopic Dermatitis Triad

“Atopic dermatitis often comes as a triad with the individual or family,” says dermatologist Dr. Julia Carroll. “If you have atopic dermatitis, you may also have hay fever and asthma, or you may have atopic dermatitis, your brother has asthma, and your mom has hay fever,” she explains, noting that this grouping together goes back to atopic dermatitis’s cause being genetic.