The core cause of atopic dermatitis involves three interconnected factors: genetic predisposition + impaired skin barrier + immune dysregulation (Th2 bias). If one parent has an allergic condition, the child's risk is 50%; if both parents are affected, it rises to 75%. Mutations in the filaggrin gene, which forms a key protein in the skin barrier, allow external antigens and irritants to enter the skin easily, triggering chronic inflammatory responses.

Adult relapse is commonly triggered by a combination of workplace stress, sleep deprivation, dry air-conditioned environments, and unidentified food or cosmetic ingredients. Even if symptoms improved in infancy or childhood, the underlying vulnerability of the skin barrier remains, so a relapse can occur at any time when triggers accumulate.

Korean Medicine Perspective

In Hyeongsang constitutional medicine, we assess both constitution and the state of qi and blood together. Adult-onset relapsing atopic dermatitis commonly follows a pattern of yin-blood deficiency (陰血不足): in lean individuals, when blood-deficiency heat (血虛火盛) progresses, the skin becomes dry and heat and itching intensify. We use Si-mul-tang (四物湯) with modifications to replenish blood and clear heat, and needle the Four Gates (Hegu LI4 + Taichong LR3) to improve qi and blood circulation for better skin nourishment.