5 Tips for Managing Atopic Dermatitis as You Age

Even if you’ve lived with AD for decades, your treatment and skin-care routine may need to evolve over time. Here are five ways to manage AD as you get older — and how to recognize when it may be time to adjust your approach.

1. Expect Your Eczema to Change Over Time

Eczema doesn’t follow one predictable path, even when you’re older, says Chris Adigun, MD, a dermatologist in private practice in Chapel Hill, North Carolina.

“You don’t really grow out of it. You just grow into a new kind of version of it,” she says. “People can have terrible eczema in their childhood, and they come in [years later] for persistent hand dermatitis, and they have no idea what it is. It’s just that it’s shifted to their hands,” Dr. Adigun says.

• AD that may appear more on the hands, arms, and legs

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• Contact dermatitis, which occurs when irritation from soaps, creams, fragrances or chemicals increases, as aging skin becomes more sensitive

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• Asteatotic dermatitis, also known as the “winter itch,” which more frequently affects the legs and causes itchy, dry, or cracked skin. It can look like “crazy paving” or a “dried riverbed” on the skin.

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• Stasis dermatitis, which affects the lower legs in people with poor blood circulation as fluid leaks from veins and places pressure on the skin internally

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• Seborrheic dermatitis, which can cause flaky, greasy patches on the face, scalp, or chest

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2. Protect Your Skin Barrier — but Choose Products You’ll Actually Use

A daily skin-care routine is always a key priority when managing AD, says Renata Block, PA-C, a physician assistant and an assistant professor at Rush University in Chicago, where she specializes in dermatology and inflammatory skin conditions.

But don't assume aging automatically means switching to the thickest ointment available to combat dry skin, Van Onselen says. “A lot of people think if they have older skin, you need thicker, greasier emollients, but then you’ve got the problem of trying to wash your clothes.”

Ask your dermatologist about which creams, gels, and emollients are good options to try until you find one you can use consistently, she says.

3. Revisit Your Trigger List

The triggers that bothered your skin years ago may not be the only ones that matter now. Contact allergies can develop over time, Van Onselen says.

“The main thing is that as people get older, their skin barrier becomes a lot less efficient, and water will be lost through the skin, which means that there's more entry for allergens in the skin,” Van Onselen says.

It’s worth paying attention to allergens you’re especially sensitive to now, she says. These can include:

• Cosmetics and scented products

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• Household cleaners, detergents, and dishwashing soaps

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• Certain fabrics, such as wool, and synthetic materials like polyester and nylon

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• Certain antibiotics, such as bacitracin (Baciguent) and neomycin

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• Dust mites or animal dander

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Topical medications, dressings, and bandages used for other health conditions can also introduce new skin exposures, Van Onselen says.

4. Get a Rash Checked Again if Something Seems Different

When you've had eczema for decades it can be tempting to assume every itchy, red patch is more of the same. But a rash that looks different or stops responding to a treatment that normally works deserves another look, Van Onselen says.

“If somebody’s eczema changes in nature and starts appearing in another part of the body or becomes much more resistant to treatment, they should go and get reassessed,” Van Onselen says.

“It’s important that you do an annual skin cancer screening,” Block says.

5. Let Your Treatment Plan Evolve With You

Older skin may be thinner or more fragile, but that doesn’t automatically mean effective AD treatments have to be taken off the table.

As you get older, your dermatologist may need to consider more than your eczema when choosing a treatment. Take inventory of other medications you’re taking to manage chronic conditions, Block says. “It’s also good to be transparent about your health, social habits, and medications, including vitamins and supplements, so that the best treatment can be recommended,” she says.