There is generalized pallor especially in the areas of the nose, mouth and ears. Erythema of the cheeks and darkening around the eyes is a typical facial pattern seen in atopic patients, particularly children. This typical appearance of the eye is referred to as an "atopic shiner" because of the greyish purple infraorbital discoloration, perhaps due in part to frequent rubbing of the eyes.

Sweating induces intense itching and burning in the skin of AD patients. They will notice that their disease is worse on very hot, humid days. They may also report that the itching is worse after a bout of prolonged exercise or stress. Rapid changes in temperature are not well-tolerated. A rapid cooling of the skin will trigger an itch, for example removing clothes to get ready for bed.

16. Pityriasis alba

This is a self-limiting, recurrent, condition characterized by asymptomatic, hypopigmented, finely scaling patches often seen on the cheeks of children. These plaques can be found on outer parts of the upper arms and the thighs as well. Lesions are more obvious in the summer because they do not tan. This loss of pigmentation is not permanent.

This is generally more of an irritation and resulting inflammation rather than a contact allergic reaction. The irritation causes increased itching and the cycle begins.