In its milder, textbook form, especially in children, atopic dermatitis tends to lodge in the bends and joints: the wrists, elbows, back of the knees and neck. These areas become diffusely red, dry, itchy and flaky. At this stage, the condition responds well to a straightforward treatment of cooling and wind-scattering herbs.

In severe cases, however, the inflammation proceeds to cover most of the body with mixed lesions: scattered red bumps, weepy crusty lesions, dry red patches, cracks and fissures, hives, bloody scratch marks, and thickened areas of extremely dry skin with deep creases. Whereas the classic form is confined to the inside of joints, the severe form covers the back and front of limbs and trunk, and also affects the face and scalp.

Severe atopic dermatitis presents with a bewildering array of seemingly contradictory symptoms: obvious dryness, manifested by the creases, cracks and toughness of the skin; and dampness, manifested by the tendency of fluid to seep out of the skin and form crusts. The face can look pale and red at the same time. At first glance the complexion is pale, but a closer look reveals a deep, patchy redness underneath. This is the raging heat of inflammation, which obstructs proper blood circulation to the skin, giving it a superficial and deceptive pallor.