Rashes in atopic dermatitis

Rashes in atopic dermatitis vary. The type of rash you have often determines your treatment.

Oozing rash

A rash may develop fluid-filled sores that ooze fluid or crust over. This may happen when the skin is rubbed or scratched or if a skin infection is present. Treatment for an oozing rash includes:

• Taking frequent sponge baths (4 to 6 times per day) or soaking in a bath of clean, warm (not hot) water for 10 to 30 minutes, 2 to 4 times a day. Adding colloidal oatmeal to the bath water [3 Tbsp (44 mL) per tub] can help relieve the itching. Colloidal oatmeal is available in the health and beauty section of a pharmacy.
• Using a cloth dampened with a soothing medication or water to cover small rashes that cover small areas on extremities, such as the hands.
• Using a high-strength (for adults) or low- to mid-strength (for children) corticosteroid ointment or lotion (not a cream) no more than 2 times a day. Apply the corticosteroid immediately after bathing. Treatment with a high-strength corticosteroid usually lasts 7 to 10 days. A lower-strength corticosteroid is then used for 2 to 3 weeks or until the rash clears up.

If a bacterial infection has developed, you will need to use an antibiotic. In severe cases, an oral corticosteroid may be necessary.

Subacute scaly rashes

Subacute scaly rashes are typically dry, red, and itchy. Medium- to high-strength corticosteroids are applied 2 times a day as an ointment or cream until the rash is cleared and itching is reduced. At this point, begin reducing the amount of corticosteroid used from 2 times a day to 1 time every other day over 2 to 4 weeks.

Thick skin (lichenified)

Skin thickened (lichenified) by atopic dermatitis is treated with high-strength corticosteroid ointments for 2 to 6 weeks. A dressing is sometimes used to cover the affected area after the medication is applied. Coal tar preparations may be used if the corticosteroids are not effective.