At the time of this update (Autumn 2016), I am 46 years old. As a newborn, my face was often red and irritated, especially my cheeks. My parents worried, but my condition improved with time. During my toddler years my skin was relatively symptom free, except my feet which were frequently itchy and peeling, like athlete's foot. As I grew, my feet healed, but the backs of my knees and the inside of my elbows became affected. These areas were red and blistered from scratching and the skin thickened. Still, my condition was something that I simply lived with or tried to ignore. It didn't occur to me that anything needed to be done to improve my condition.

During puberty the condition went downhill. My neck became involved, and also the area around my groin. Within the affected areas, the rash and itch intensified. The puritis (medical term for itching) was especially difficult to resist just when attempting to fall asleep. This affected my sleeping habits leaving me tired the following morning.

My parents took me to a dermatologist, who immediately diagnosed me as an "atopic", one who suffers from atopic dermatitis. The doctor lightly scratched a rashy part of my skin. That area of skin then blanched (became paler), which is a characteristic symptom of atopics. I had noticed this behavior before, but had simply believed that to be the nature of all rashes, rather than my rashes. He prescribed a two week course of oral corticosteroid, followed by application of topical corticosteroids. My skin responded after two days. After the treatment, my skin looked and felt normal.

I believe I was symptom free for about two months after that course of medication. When the symptoms returned, I obtained another prescription. When I used cortisone, my skin was good. When I ended the course, I would sooner or later have a flare-up. Apparently, skin loses its responsivity to cortisone after a time. The medication must be withdrawn to retain its potency for future use. So when I actually tried to apply cortisone for an extended period of time, my skin would eventually flare up again anyway. So I lived with this cycle, constantly chasing rashes.

As I aged the affected areas began to shift around my body. They also changed in character. The itching was always intense. But instead of blistering open sores, instead I got red swelling extended patches. Sometimes on my thighs. Sometimes on my stomach and chest. In my twenties, my face began to get rashy, especially on my eyelids, but also on my temples, on either side of my chin, my jawline, and my philtrum (the "ramp" between nose and lips). Curiously, my cheeks were spared. Apparently they had done their time during infancy. During my mid-twenties my back became very itchy and often was prone to hives. I don't think there is a single patch of skin on my body that has not been affected by atopic dermatitis, although not all simultaneously. At my worst, I estimate that I had about 50% of my skin inflamed at one time. Entering the 30s, my skin took a turn for the better, I'm not sure why, but perhaps because of more disciplined use of petroleum jelly as an occlusive for retaining moisture in the skin. Nowadays about 10-20% of my skin is affected, mostly on my face, neck, thighs, and lower arms / hands.

Atopic Dermatitis is not only a skin disease, but in a way also a psychological disease. Atopics may engage in some eccentric behavior. The itching is intense, it cannot be denied any more than, say, the throbbing pain of a toothache. Therefore, we tend to scratch a lot. Personally, when I am suffering from a flare up, I tend to take scaldingly hot showers. During these hot showers, my itchy areas will feel intense pleasure and relief from the puritis, rather than the pain of being burned. If I can't get to a shower, I will often apply ice to affected areas. Again, because the cold sensation (in the case of ice) acts to relieve the itch.

Corticosteroids are very effective in controlling the symptoms and the puritis. However, I am very reluctant to use prescription strength cortisone. In the past, I would often suffer for weeks during a flare-up before applying it. I developed a "cortisone-phobia" because of all the side effects that long term use of cortisone may cause. Whenever I do use the prescription I often feel as if I am "giving in" to my skin.

The connection with sleep is particularly frustrating. While in the process of falling asleep there is a window of time in which I am still conscious of itching but lack any willpower to ignore it, and then I scratch reflexively, which keeps me awake. This affected me greatly for a large chunk of my life, from puberty through my 30s. Now in my forties I still have problems with itch while falling asleep, but it is more manageable.