How common is atopic dermatitis in the US? Not nearly as common as other research has shown, according to this study

A study of prevalence of atopic dermatitis in the U.S. using claims data found the skin condition to be much less common than previous studies of prevalence. The study, which was published in the American Journal of Clinical Dermatology last week, also showed wide variation in the prevalence of atopic dermatitis at the state and county level.

The findings also show that topical (56.3%), oral (22.6%) and injectable corticosteroids (11.8%) were the most frequently filled prescriptions for the treatment of atopic dermatitis. Corresponding author Myriam Cordey, Ph.D., M.P.H., of the Center for Observational Research at Amgen, and her colleagues noted systemic corticosteroids are still frequently prescribed, according to their findings, even though they are not recommended in recent treatment guidelines for atopic dermatitis.

The prevalence figures are important to providers, payers and drugmakers because they indicate how common a condition is and show treatment and delivery needs. The prescription statistics are an indication of the treatment choices that clinicians are making, perhaps with input from patients or the caregivers of patients in the case of children.

This study, which was published on Octt. 25, 2026, found 7.2% of children have atopic dermatitis, 3.6% of adolescents and 1.4% of adults. Cordey and her colleagues note that the results of other studies have shown a prevalence of 7.3% among adults, which is approximately five times higher than the prevalence they found, and a prevalence among children of 10.8%, which is 50% higher than the prevalence figure they are reporting.

Cordey and her colleagues used an IQVIA database and codes from the International Classification of Diseases, Tenth Revision, to conduct their study, which covered the period from Jan. 1, 2019, to Dec. 31, 2023. Those higher prevalence estimates of atopic dermatitis have come from studies that used data from the 2021 National Health Interview Survey, which is conducted by the Centers for Disease Control and Prevention. Discrepancies between prevalence studies that rely on claims data and those that depend on people reporting their own health conditions, as the National Health Interview Survey does, are not usual, the researchers note, and are especially large when it comes to atopic dermatitis. Claims-based data on how common a disease is influenced by people’s access to healthcare and insurance coverage as well as how diseases are coded, Cordey and her co-authors explained. Moreover, atopic dermatitis symptoms are intermittent, so claims-based data may be more likely to capture those with active disease who both seek and then gain access to care.

According to this study, the states with the highest prevalence of atopic dermatitis were Washington, D.C. (4.5%), which is often grouped with states when it comes to health statistics; New York (4.2%) and Maryland (3.9%). The states with the lowest prevalence were Missouri (1.3%), Oklahoma (1.3%) and Montana (1.4%). The researchers said the pattern of many of the high-prevalence states being on the East Coast is consistent with prevalence studies of atopic dermatitis that have depended on self-reporting.

Overall, the study identified 5,573,454 patients as having an atopic dermatitis diagnosis during the five years the study covered. More than half (57%) were female. Despite the East Coast skew in the prevalence on a state-by-state basis, the largest proportion of patients overall resided in the South (40.6%). Most of the patients were covered by commercial insurance (71%).

The county-by-county data that the researchers analyzed shows a large variation in prevalence of atopic dermatitis, from 0% to 19.6%. The counties with the highest prevalence were Grant County in New Mexico (19.6%), Union County in Illinois (17.2%), and Cumberland County in Kentucky (15.3%). There is a catch to the county-level data, however. The patient’s county was inferred from the ZIP code of the healthcare provider, so it may obscure the common scenario of patients living in one county and traveling to other nearby counties to get medical care.

Cordey and her colleagues wrote their findings on prescriptions for atopic dermatitis were consistent with real-world studies. They cited a 2022 abstract published in Value Health as showing similar usage of Dupixent (dupilumab). They noted that state-level variation in the prevalence of diagnosed atopic dermatitis did not necessarily correlate with the use of advanced systemic therapies, pointing to Washington, D.C. as an example: a high atopic prevalence but a smaller proportion of prescriptions for biologics or oral Janus kinase inhibitors, which include Rinvoq (upadacitinib) and Cibinqo (abrocitinib). Among the possible explanations, they said, are access to specialist care and the type of insurance that patients have. They also said that in this analysis, patients were not sorted out by the severity of their disease, so unaccounted for differences in disease severity may influence the picture of prescription patterns that their study paints.