Researchers say they’ve noticed a U-shaped curve in eczema prevalence as it affects children and seniors alike.
Atopic eczema — an inflammation that causes a painful, itchy rash — is often thought of as a condition that’s mostly prevalent in younger children.
But new research suggests that while prevalence goes down as children grow older, it actually goes back up again later in life.
In a published in the academic medical journal Annals of Internal Medicine, researchers note a U-shaped curve in the prevalence of eczema. It’s high in children and teens, low in young and middle-aged adults, and high for adults over the age of 74.
Dr. Katrina Abuabara, an assistant professor of dermatology at the University of California San Francisco and a lead author of the study, told Healthline that the results were somewhat surprising.
“Similar to other reports, we found declining rates of active disease across childhood,” she explained. “We were surprised, however, to find steady rates of active disease throughout adulthood and increasing rates in older age.”
While more research is needed to better understand how eczema affects people of different ages, the data gathered should help primary care physicians better understand how the condition waxes and wanes over time.
Another specialist interviewed by Healthline says she also found the data somewhat surprising.
“In the clinic, I’ve seen adult-onset eczema pop up, but the U-shaped curve does surprise me,” said Dr. Flavia Cecilia Lega Hoyte, an allergist and immunologist at National Jewish Health in Denver. “Each individual practitioner has a small subset of adult-onset eczema compared to what a pediatric allergist might see, so maybe it’s just that my clinic is too small to observe such a curve.”
Hoyte says, in her opinion, adult eczema isn’t understood as well as the type that occurs in children. Part of the reason for this is that symptoms may appear in an adult patient that look like eczema but are in fact something else entirely.
“For a small child, you probably wouldn’t do a biopsy, but for an older patient, you’d want to make sure this isn’t mycosis fungoides, which is a type of skin cancer that can look just like eczema,” she said.
There’s also the fact that contact allergy, or contact dermatitis, is more common in adults than in kids.
So, an adult patient may be dealing with a number of ailments, none of which can be properly treated until they’re properly diagnosed and understood.
“You may be treating somebody’s rash with a topical steroid and now the rash seems to be spreading or getting worse, and it’s because the patient has underlying eczema with a contact allergy to a steroid,” said Hoyte. “So it’s important to keep in mind that a patient could have two separate processes going on, and the treatment for the first process may actually be making it worse because of the second process.”
Painful and itchy though it may be, eczema is generally a manageable condition.
That said, it doesn’t mean people — young or old — should suffer in silence.
“The quality of life issues for atopic eczema are very real for both children and adults,” said Hoyte. “That constant itch, that constant sensation that you need to scratch, and the more you scratch the more it itches… That will impact your ability to concentrate whether you’re in third grade or whether you’re an older adult. Even though it’s not life-threatening, quality of life, if [the ailment] is poorly controlled, is significantly impacted.”
For these reasons, Hoyte advises anyone who suspects they’ve developed eczema to see a doctor sooner rather than later.
“There’s no reason for somebody to be suffering and trying a bunch of over-the-counter stuff. The topical therapies that are available over the counter are very mild — that’s why they’re available over the counter. They’ll only work for the mildest eczema, generally,” she said.
A doctor or specialist, on the other hand, can tailor a prescription to a patient’s individual needs. Hoyte points out that specialists can prescribe numerous effective therapies, some of which have only become available in the past few years.
The research letter sheds new light on the prevalence of eczema in older patients, and this new information could change the way primary care physicians diagnose and treat eczema with that population.
Abuabara says that further research could help health professionals gain an even more nuanced understanding — including understanding if eczema in children varies from eczema in older adults.
“Additional research is needed to understand whether underlying causes of eczema and associations with other conditions like asthma and allergies vary across ages,” she wrote to Healthline. “The terminology and symptoms of eczema can be variable, and additional research is needed to understand whether the disease is the same across ages.”
For patients, the research — the first large study to examine rates of active physician-diagnosed disease across the entire life span — should raise awareness of the risk of what was thought to be a condition mainly seen in children.
“When an adult is told they have eczema, sometimes it can be disconcerting because it seems like it’s coming out of the blue,” said Hoyte. “But realizing that it does happen, and it just has to be kept in the differential at any age, whether it’s a small child or an older adult, it’s important to do our due diligence.”
Eczema isn’t an ailment that affects only children.
New research indicates the disease has a U-shaped curve, affecting children as well as adults over the age of 74, while being relatively uncommon in younger adults and people of middle age.
Experts say it’s more difficult to diagnose eczema in seniors, but any older adult who suspects they have eczema should see a healthcare professional.