National Eczema Association Publishes First Comprehensive National and State-Level Report on Atopic Dermatitis

The CDC-funded report spans all ages and major insurance types, offering a new baseline for AD diagnosis and care across the U.S.

• The National Eczema Association (NEA) published its State of Atopic Dermatitis Indicator Report and 51 state-level briefs, establishing a national and state reference baseline on U.S. atopic dermatitis care and diagnosed prevalence.
• The report reveals widespread healthcare system gaps in atopic dermatitis care, including a large discrepancy between estimated and diagnosed AD, wide variation in specialist availability and treatment patterns that differ from current guidelines.
• Tailored for all 50 states and Washington, D.C., the state-level briefs deliver regional data on local prevalence, specialist availability and treatment trends that set baselines for improving recognition, diagnosis and care.

NOVATO, Calif., Oct. 1, 2026 /PRNewswire/ -- The National Eczema Association (NEA) today published its State of Atopic Dermatitis Indicator Report, conducted by Milliman, establishing a national reference dataset on atopic dermatitis (AD) care and prevalence in the United States. Published alongside 51 state-level briefs representing all 50 states and Washington, D.C., the report details AD diagnosis estimates, treatment patterns and patient access to specialized care. It is the foundation for the State of AD, a four-year initiative funded by the Centers for Disease Control and Prevention (CDC), and anchors NEA's national campaign for Eczema Awareness Month throughout October.

The Disconnect Between AD Prevalence and Diagnosis
AD, the most common form of eczema, is a chronic condition that often begins in early childhood but requires care across the lifespan, and carries co-occurring health risks like asthma and skin infection. While the report summarizes published estimates of AD prevalence between 6.0% and 16.9% in children and 4.9% to 10.4% in adults, actual clinical documentation lags far behind. In 2023, approximately 6.9 million insured people in the U.S. had diagnosed AD, about one in five of those estimated to be affected.

"Atopic dermatitis too often goes unaddressed, both by patients who don't realize their symptoms are worth raising, and in visits where it isn't the main concern," said Kristin Belleson, President and CEO of NEA. "Primary care is a good place to start that conversation. With the first comprehensive national and state-level estimates, public health leaders and healthcare providers now have the evidence to close that gap in every state."

Geographic Variation in Specialized AD Care
Even when patients seek care, specialist availability varies widely by region. Thirteen percent of Americans live in a county with no dermatology or allergy/immunology practitioners, and where specialists do exist, supply is concentrated in higher-density counties.

Several states — for example, Alabama, Delaware, Hawaii and Nevada — have an above-average prevalence of diagnosed AD but fewer specialized practitioners per capita. While mild AD can typically be managed in primary care settings, this specialist gap creates a major hurdle for patients who could potentially benefit from advanced treatment options.

Treatment Trends Lag Behind Modern Guidance
Among diagnosed patients, AD treatment patterns have not kept pace with current guidance. Care remains heavily grounded in topical corticosteroids, filled by 42% to 52% of diagnosed individuals. Systemic corticosteroids continue to reach 4% to 5% of patients despite guidelines advising against routine use, whereas the most commonly used guideline-recommended biologic reaches only 2% to 4% depending on insurance market.

Additional Key Findings From the Report:

• Co-occurring conditions impact a high number of patients. In 2023, approximately 783,000 individuals with diagnosed AD also lived with documented asthma. Another 703,000 experienced secondary skin infections, reflecting the comprehensive health needs associated with AD, a condition that rarely occurs in isolation. 
• Atopic dermatitis affects patients across every stage of life. Diagnosed prevalence peaks in early childhood, impacting 10.4% of commercially insured children ages 0 to 2. However, diagnostic rates rebound in older adulthood, reaching 3.1% among Medicare fee-for-service beneficiaries 65 and older, the highest prevalence of any adult demographic surveyed.
• Much of AD care happens outside the specialist's office. Primary care practitioners deliver 36% to 52% of AD-related visits, and 1.2% to 4.6% of patients had an AD-related emergency or observation visit, with rates highest in Medicaid. 
• Telehealth accounts for a small fraction of AD care. Virtual visits remain relatively low across patient populations, accounting for just 1.2% to 1.3% of AD-related dermatology visits. By comparison, telehealth represented 5.0% to 5.5% of primary care appointments and 3.8% to 6.2% of allergy and immunology care.

"What stands out in this data is how much eczema touches all stages of life, from infants to adults 65 and older, often alongside conditions like asthma and skin infections," said Wendy Smith Begolka, Chief Program and Mission Officer at NEA. "It's a reminder that this disease has been underestimated and underappreciated for its impact. Our work now is helping move care from reactive treatment to proactive, lifelong disease management."

The complete State of Atopic Dermatitis Indicator Report and all 51 state briefs are available to view and download at StateofAD.org. NEA will unpack the findings during the virtual State of AD Symposium on Oct. 1 at 11 a.m. PT. Online registration is now open.

This project was supported by the Grant or Cooperative Agreement Number 1 NU58DP007726-01-00, funded by the Centers for Disease Control and Prevention (CDC). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the U.S. Department of Health and Human Services.

To learn more about NEA, visit nationaleczema.org.

About the National Eczema Association
Founded in 1988, the National Eczema Association (NEA) is a 501(c)(3) nonprofit and the largest patient advocacy organization serving the more than 31 million Americans living with eczema and those who care for them. NEA provides programs and resources to elevate the diverse lived experience of eczema, helping patients and caregivers understand their condition, actively engage in their care, find strength in one another, and improve their lives. NEA also advances critical eczema research and partners with key stakeholders to ensure the patient voice is represented and valued in education, care, and treatment decision-making. Learn more: nationaleczema.org 

SOURCE National Eczema Association