From the Guidelines
Yes, you can develop new onset eczema (atopic dermatitis) at age 40, although it's less common than childhood onset. Adult-onset eczema affects approximately 1-3% of adults. If you develop symptoms such as dry, itchy, inflamed skin patches, see a dermatologist for proper diagnosis and treatment.
Key Considerations
- Initial management typically includes gentle skin care with fragrance-free moisturizers applied multiple times daily, especially after bathing.
- Topical corticosteroids like hydrocortisone 1% for mild cases or stronger prescription options like triamcinolone 0.1% for moderate cases are often prescribed for flare-ups, as suggested by 1.
- Apply these medications to affected areas twice daily for 1-2 weeks during flares.
- Trigger avoidance is crucial - common triggers include stress, certain fabrics, soaps, detergents, and environmental allergens.
Treatment Options
- For severe cases, your doctor might prescribe immunomodulators like tacrolimus ointment or systemic medications, such as dupilumab, tralokinumab, abrocitinib, baricitinib, and upadacitinib, which have been supported by strong recommendations in recent guidelines 1.
- The decision to initiate these more advanced therapies should be made using shared decision-making between patients and clinicians, taking into account the severity of AD, its impact on the patient, and the efficacy, safety, and accessibility of the available interventions.
Underlying Causes
- Adult-onset eczema often results from a combination of genetic predisposition, immune system dysfunction, and environmental factors that may only become significant enough to trigger symptoms later in life, as noted in 1 and 1.
- A family history of atopy and loss of function mutations in the filaggrin (FLG) gene are consistently and strongly associated with the development of atopic dermatitis, as highlighted in 1.
From the Research
Development of New Onset Eczema at Age 40
- It is possible to develop new onset eczema (atopic dermatitis) at age 40, as stated in the study 2, which mentions that initial manifestation of atopic eczema in adulthood is also possible.
- The study 3 also supports this, stating that onset of eczema can occur among older children, adolescents, and adults.
- Another study 4 analyzed 60 patients with elderly atopic eczema and observed a male predominance, existence of several patterns of onset and clinical course, and associations with immunoglobulin (Ig)E-allergic-status and asthmatic complication.
- Stress and psychological burden have been classified as the most important triggering factor of atopic eczema 2, which could contribute to the development of new onset eczema in adults.
- The study 5 mentions that difficult-to-treat atopic dermatitis may require re-evaluation of the initial diagnosis, especially if the onset of disease occurs in adulthood, and may necessitate evaluation for contact, food, and inhaled allergens that may exacerbate the underlying atopic dermatitis.
- Age-related changes can lead to an increase in skin problems, and around 70% of older people have a treatable skin condition, including eczema 6.