Atopic Dermatitis (Eczema)

Atopic dermatitis is a chronic inflammatory skin condition that occurs in flares and is characterised by dry skin, eczema patches and intense itching. It is not contagious and, with consistent basic skin care and flare-adapted treatment, can be well controlled in most people. In the video consultation, doctors can assess your skin using photo-based progress monitoring and, following medical assessment, issue follow-up prescriptions for corticosteroid and emollient products.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

Atopic dermatitis, often simply called eczema, is a chronic inflammatory skin condition that occurs in flares. Typical features are dry skin, intense itching and red eczema patches, in adults frequently in the elbow creases, backs of the knees, on the neck and on the hands. The condition is not contagious and its course varies considerably from person to person: phases of largely calm skin alternate with acute flares. The foundation of every treatment is consistent basic therapy with moisturising emollient products. During flares, anti-inflammatory drug classes such as topical corticosteroids or calcineurin inhibitors may additionally be used following medical assessment. In the OpenClinic24 video consultation, doctors can assess your skin using photos and discussion, monitor its course through structured photo documentation and, where medically appropriate, issue follow-up private prescriptions for established corticosteroid and emollient products billed according to the German GOÄ fee schedule. A cure is not possible according to current knowledge, but with good flare management most people can markedly reduce their symptoms.

Common causes

Atopic dermatitis is based on a genetically determined disturbance of the skin barrier: the skin loses more moisture and becomes more permeable to irritants and allergens. There is often a family predisposition to atopy, which also includes hay fever and allergic asthma. On this basis, various triggers can promote a flare. These include dry skin and dry indoor heating air, frequent washing with degreasing cleansers, scratchy textiles such as wool, sweating, infections and psychological stress. Allergens such as house dust mites, pollen or animal dander can also play a role; in some people, particularly children, certain foods contribute as well. Which factors are relevant in an individual case varies from person to person. A symptom diary and photo-based progress monitoring can help identify personal triggers and avoid them in a targeted way.

When to see a doctor

You should seek medical advice if itching and eczema increase despite consistent basic skin care, if a flare does not improve as usual, or if your sleep is severely disturbed by itching. Signs of a bacterial superinfection – such as honey-coloured crusts, increasing pain, warmth or purulent discharge – should be assessed by a doctor at short notice. Particular caution applies to eczema herpeticum: if rapidly spreading, grouped blisters appear on eczematous skin together with fever or marked malaise, go to a practice or emergency department without delay. Medical assessment is also advisable for eczema around the eyes or for unclear, newly appearing skin changes. In case of emergency signs such as shortness of breath, swelling of the face, lips or tongue, or circulatory problems, call the emergency number 112 immediately.

Symptoms & Indications

Intense, often distressing itching Dry, sensitive and flaky skin Red, inflamed skin patches (eczema) Eczema in the elbow creases, backs of the knees, on the neck and hands Weeping or crusted skin areas during acute flares Thickened, coarsened skin with longer disease duration (lichenification) Scratch marks and small skin fissures Sleep disturbance due to night-time itching

Treatment Options

Consistent basic therapy with moisturising emollient products
Topical corticosteroids during acute flares – follow-up prescriptions possible after medical assessment
Topical calcineurin inhibitors as a steroid-free alternative, for example for the face and sensitive areas
Antihistamines to relieve itching, especially when sleep is disturbed
Identifying and avoiding individual triggers (e.g. wool, sweating, irritating cleansers, stress)
Structured flare management with photo-based progress monitoring and a written treatment plan
Moisturising bath and shower additives and adapted skin cleansing

Important Notes

Telemedical assessment is based on photos and your description. If skin findings are unclear, symptoms do not improve, or another condition is suspected, an in-person dermatological examination may be necessary.
Seek prompt care at a practice or emergency department if rapidly spreading, grouped blisters appear together with fever or marked malaise – this may indicate eczema herpeticum, which requires immediate treatment.
Honey-coloured crusts, increasing pain, warmth or purulent discharge may indicate a bacterial superinfection and should be assessed by a doctor at short notice.
In case of shortness of breath, swelling of the face, lips or tongue, or circulatory problems, call the emergency number 112 immediately.

HOW IT WORKS

How OpenClinic24 works

STEP 01

Complete the questionnaire

Brief details about your symptoms

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STEP 02

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Video consultation within minutes

STEP 03

Receive your documents

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Video consultation with licensed doctors.

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can atopic dermatitis be treated via video consultation?

Yes, atopic dermatitis is often well suited to telemedicine, as its course can be documented with photos and discussed in the consultation. Doctors can review your basic skin care, adjust your flare management and answer open questions. If findings are unclear or symptoms do not improve, you will be advised to see a dermatologist in person.

Can I get a follow-up prescription for my corticosteroid or emollient online?

If your atopic dermatitis has already been diagnosed by a doctor and you are well established on a treatment, a follow-up private prescription for your topical corticosteroid or basic skin care can be issued after medical assessment. This is based on your information, current photos of the affected skin and the video consultation. There is no entitlement to a prescription; the decision always rests with the treating doctor.

How does photo-based progress monitoring work?

Before your appointment, you upload photos of the affected skin areas, ideally in daylight and from a consistent distance. At follow-up appointments, new images are compared with earlier ones, allowing improvement or deterioration to be assessed more objectively. On this basis, your treatment – such as the intensity of skin care or the use of anti-inflammatory products – can be adjusted.

What does treatment cost, and will my insurance cover it?

Billing is provided as a private service according to the German medical fee schedule (GOÄ). Privately insured patients can usually submit the invoice to their private health insurer; reimbursement depends on the individual plan. Self-paying patients receive a transparent GOÄ invoice, with the amount visible before treatment. Patients with statutory insurance can use the service as self-payers, but reimbursement by statutory insurers is generally not provided.

Is longer-term use of topical corticosteroids on the skin a concern?

Topical corticosteroids are a well-established part of flare treatment when used appropriately under medical supervision. Key factors are the right potency for the respective body region, time-limited use and consistent basic skin care between flares. In the video consultation, your use is reviewed regularly to keep both benefit and possible side effects in view.