Understanding the disease

What are eczema and atopic dermatitis?

ECZEMA

A family of inflammatory skin conditions

Eczema describes skin that becomes inflamed, dry and itchy. There are several types, and atopic dermatitis is the most common.1

ATOPIC DERMATITIS

Chronic, relapsing and intensely itchy

Atopic dermatitis comes and goes in flares. It often begins in early childhood and, for many people, continues into adolescence and adulthood.1,2

THE ATOPIC FAMILY

Linked to asthma, hay fever and food allergy

"Atopic" refers to a tendency toward allergic conditions. People with atopic dermatitis are more likely to also have asthma, hay fever or food allergy.1

What drives atopic dermatitis

Atopic dermatitis results from an interplay of skin-barrier dysfunction, immune dysregulation, changes in the skin microbiome and environmental triggers.1 Loss-of-function variants in the filaggrin gene, which encodes a key skin-barrier protein, are a major genetic risk factor.3 Molecular studies show that the immune profile of the disease differs with age and ethnic background, which helps explain why people respond differently to the same treatment.4

The atopic dermatitis cycle 01 Barrier dysfunction 02 Allergen & microbe entry 03 Type 2 inflammation 04 Itch & scratching Genetics (e.g. filaggrin) Environment & triggers
Simplified from published reviews of atopic dermatitis pathophysiology.1 Each step reinforces the next, and the weight of each step differs between individuals.
  • 01

    Skin barrier

    Reduced barrier function increases water loss and lets irritants and allergens penetrate the skin.1,3

  • 02

    Environment and microbiome

    Climate, irritants, allergens and the skin microbiome influence flares differently from person to person.1

  • 03

    Immune activity

    Type 2 inflammation is central, and other immune pathways vary between individuals and populations.4

  • 04

    Itch

    Itch and scratching damage the barrier further, which keeps the cycle going.1

Because the weight of each factor differs from person to person, two people with the same diagnosis can experience the disease, and respond to treatment, very differently.

The scale of the challenge

How big is the problem?

Atopic dermatitis affects well over a hundred million people worldwide, and in the United States more than one in ten children. These figures come from large national surveys, health records and the Global Burden of Disease Study.

People worldwide, 2021

129M

people were living with atopic dermatitis, up from 107.5 million in 19905,6

Children under 15

72.4M

children aged 0 to 14 have atopic dermatitis; it is most common between ages 5 and 97

Disease burden

#1

highest burden of any skin disease, measured in disability-adjusted life-years8

More people are affected, even as the age-adjusted rate dips slightly

Global estimates for atopic dermatitis, 1990 and 2021

People with atopic dermatitis, millions

107.5M 129M 19902021

Age-standardized prevalence, per 100,000 people

1,885 1,729 19902021
View data
Measure19902021
People with atopic dermatitis107.5 million129 million
Age-standardized prevalence per 100,0001,885.41,728.5

The number of cases rose mainly because the world population grew and aged; the age-standardized rate removes that effect. By 2050, 148 million people are projected to have atopic dermatitis. Sources: Global Burden of Disease Study 2021.5,6

More than one in ten children has had eczema

Eczema in schoolchildren across 25 countries, %

Current symptomsEver had eczema
View data
Age groupCurrent symptomsEver had eczema
Children 6–7 (n = 101,777)5.9%13.4%
Adolescents 13–14 (n = 157,784)6.4%10.6%

Questionnaire survey of 259,561 children and adolescents. "Current symptoms" means a recurring itchy rash in typical eczema areas in the past 12 months, reported on a questionnaire rather than diagnosed by a doctor. Source: Global Asthma Network Phase I.9

Burden varies widely between countries

Age-standardized DALYs per 100,000 people due to atopic dermatitis, 2017

View data
LocationDALYs per 100,000
Sweden326.9
United Kingdom284.2
Iceland277.0
Global123.3
Uzbekistan, Armenia, Tajikistan85.1

*Uzbekistan, Armenia and Tajikistan. DALY: disability-adjusted life-year, one year of healthy life lost. Source: Laughter et al.8

References
  1. Langan SM, Irvine AD, Weidinger S. Atopic dermatitis. Lancet. 2020;396(10247):345–360. doi:10.1016/S0140-6736(20)31286-1
  2. Abuabara K, Yu AM, Okhovat JP, Allen IE, Langan SM. The prevalence of atopic dermatitis beyond childhood: a systematic review and meta-analysis of longitudinal studies. Allergy. 2018;73(3):696–704. doi:10.1111/all.13320
  3. Palmer CNA, Irvine AD, Terron-Kwiatkowski A, et al. Common loss-of-function variants of the epidermal barrier protein filaggrin are a major predisposing factor for atopic dermatitis. Nat Genet. 2006;38(4):441–446. doi:10.1038/ng1767
  4. Czarnowicki T, He H, Krueger JG, Guttman-Yassky E. Atopic dermatitis endotypes and implications for targeted therapeutics. J Allergy Clin Immunol. 2019;143(1). doi:10.1016/j.jaci.2018.11.001
  5. GBD 2021 Asthma and Allergic Diseases Collaborators. Global, regional, and national burden of asthma and atopic dermatitis, 1990–2021, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Respir Med. 2025;13(5):425–446. doi:10.1016/S2213-2600(25)00003-7
  6. Zheng X, Wang J, Tang S, Lei X, Duan YJ. Global, regional, and national burdens of atopic dermatitis from 1990 to 2021: a trend analysis. Allergol Immunopathol. 2026;54(3). doi:10.15586/aei.v54i3.1613
  7. Jin L, Ge J, Cheng Y, Deng D, Wan P. Worldwide prevalence of atopic dermatitis in children between 2000 and 2021: a systematic analysis. Ann Allergy Asthma Immunol. 2025;134(5):603–609.e6. doi:10.1016/j.anai.2024.12.005
  8. Laughter MR, Maymone MBC, Mashayekhi S, et al. The global burden of atopic dermatitis: lessons from the Global Burden of Disease Study 1990–2017. Br J Dermatol. 2021;184(2):304–309. doi:10.1111/bjd.19580
  9. García-Marcos L, Asher MI, Pearce N, et al. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. Eur Respir J. 2022;60(3). doi:10.1183/13993003.02866-2021
  10. Chan KR, Keddie SH, Flohr C, Tsoi MF. Prevalence of atopic dermatitis in the United States from 2021 to 2024: data from the National Health Interview Survey. J Am Acad Dermatol. 2025. doi:10.1016/j.jaad.2025.10.022
  11. Ng AE, Boersma P. Diagnosed allergic conditions in adults: United States, 2021. NCHS Data Brief, no. 460. National Center for Health Statistics; January 2023. doi:10.15620/cdc:122809
  12. Sun C, Zhang X, Su Z, Yao WH, Chen HD, Zeng YP. Global, regional, and national burdens of atopic dermatitis from 1990 to 2021: a trend analysis from the Global Burden of Disease Study 2021. J Am Acad Dermatol. 2025;93(4):1008–1017. doi:10.1016/j.jaad.2025.06.042
  13. Canadian Dermatology Association. What is eczema? dermatology.ca
  14. Stirton H, Kosowan L, Queenan J, Katz A, Singer A, Protudjer J, Abrams E. Primary care provider diagnosed eczema within electronic medical records from seven Canadian provinces. Ann Fam Med. 2022;20(Suppl 1):2895. annfammed.org
  15. Barbarot S, Auziere S, Gadkari A, et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy. 2018;73(6):1284–1293. doi:10.1111/all.13401
  16. Eczema Society of Canada. Atopic Dermatitis Quality of Life Report. 2017. eczemahelp.ca
  17. Eczema Society of Canada. Burden of Eczema Report. 2025. eczemahelp.ca
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