The skin barrier is weakened in people with atopic dermatitis, making it vulnerable to burns or wounds. However, treatment and management options are available.

Atopic dermatitis is a form of eczema that causes inflammation and irritation in the skin. In people with atopic dermatitis, the integrity of the skin barrier is compromised, which can leave the skin vulnerable to dehydration and injury.

Caring for injured skin with a chronic skin condition can be challenging. This article answers frequently asked questions about managing skin wounds or burns while living with atopic dermatitis.

The experiences and symptoms of atopic dermatitis differ from person to person. Some describe the pain and itchiness associated with atopic dermatitis as a burning sensation. Others may use words such as “throbbing,” “tingling,” or “sore.”

Some experts suggest that people with atopic dermatitis pain related to inflammation may be more likely to experience burning sensations compared with people who have pain due to scratching. People often describe the experience of cracked and dry skin using words such as “burning” or “stinging.”

Burning with atopic dermatitis can happen for a variety of reasons. Some types of pain, particularly pain caused by irritation or damage of nerve cells, can cause burning sensations.

People with atopic dermatitis may be more likely to get other forms of eczema that can cause burning.

Dyshidrotic eczema is another skin condition that commonly happens in people with other forms of eczema, including atopic dermatitis. It causes blisters on the hands and feet. As these blisters form, some people may experience burning or itchiness.

Irritant contact dermatitis, caused by exposure to certain types of chemicals that cause skin irritation, can also cause burning.

In some cases, certain types of medications used to treat atopic dermatitis can cause burning. Studies suggest that mild to moderate burning is a relatively common side effect with skin medications such as calcineurin inhibitors and the corticosteroid tacrolimus.

Burning or stinging sensations have also been reported in approximately two-thirds of people who experience withdrawal symptoms when stopping treatment with topical corticosteroids.

The main principles of wound and burn care are similar to atopic dermatitis care: keep the skin well-moisturized, prevent infection, and relieve pain.

The American Academy of Dermatology recommends petroleum jelly to keep minor wounds and burns moisturized. Petroleum jelly can also help soothe irritated skin from atopic dermatitis, especially for people who experience irritation due to products with fragrances.

Just like with atopic dermatitis, a mild soap or cleanser is recommended for cleaning wounds to avoid irritation and drying out the skin. Ointments with antibiotics are not necessary unless recommended by a medical professional.

If a person has frequent skin infections due to their atopic dermatitis, they may already be using an antiseptic wash or cream.

People can use pain medications such as acetaminophen or ibuprofen if needed. Keeping fingernails short and clean can help avoid more damage or potential infections caused by scratching.

A moisturizer can help the skin heal and prevent wounds from drying out, which can cause more tissue damage. Petroleum jelly is an inexpensive, fragrance-free option that works for many people.

Ointments may not be recommended for some types of wounds, such as burns, since they may increase the likelihood of infection.

Topical hydrocortisone is not recommended if the skin has any open wounds. However, a dermatologist can help provide guidance if itch relief is needed.

People can use sunscreen on wounds after they heal to help prevent scarring. Mineral-based sunscreens that have titanium dioxide or zinc oxide as the active ingredient and an SPF of 30 or greater are generally recommended for people with atopic dermatitis.

Covering wounds helps promote healing and avoid infections. After applying petroleum jelly, a person can use a bandage to wrap or cover the injury to help protect the skin.

Wearing gloves can also help protect hand wounds and prevent exposure to potential irritants. If clothing covers the wounds, opt for clothes made of cotton or cotton blends and avoid irritating fabrics such as wool.

Do not cover wounds with wet wraps or plastic if it looks like the wound may be infected since this can make the infection worse. If wet wrap or occlusion therapy is part of a person’s atopic dermatitis care plan, a dermatologist can help them determine if and when they can restart treatment.

Skin wounds of all types typically heal within 4–6 weeks after injury. Healing may take longer if atopic dermatitis causes itchiness or irritation that leads a person to scratch or rub the wound.

In rare cases, people with atopic dermatitis may experience chronic skin wounds, which are wounds that do not heal within 3 months. People with chronic skin wounds can talk with their dermatologist about options to help heal their skin.

Dryness caused by atopic dermatitis can lead to cracks in the skin, which can become infected. Skin infections can cause sores and other skin symptoms, including crusts, blisters, bumps, and rashes. A crusty, open sore may indicate a staph infection.

Sores can also be a symptom of eczema herpeticum, a form of eczema caused by herpes viruses that typically causes cold sores on the mouth. People with atopic dermatitis or other inflammatory skin conditions are more prone to developing eczema herpeticum than other people.

Eczema herpectium causes clusters of small, painful blisters that ooze when broken open. These blister rashes are usually found on the face and neck. However, they can also appear on the hands or other parts of the body.

Doctors treat herpes infections that cause eczema herpectium with antivirals.

Maintaining skin moisture and avoiding infections are guiding principles in managing both atopic dermatitis and skin wounds. Although it may be more challenging to treat a wound with the condition, people can typically help skin injuries heal with a combination of petroleum jelly, regular cleaning, and time.

If skin injuries make it more difficult to care for atopic dermatitis, a dermatologist can help identify new strategies to manage symptoms and promote skin healing.