OBJECTIVES: Atopic dermatitis (AD), also known as eczema, is a common chronic skin condition in childhood that has a negative impact on both patients and their families. A survey was conducted to evaluate the disease burden, financial and quality of life impact of moderate to severe AD across 12 countries in the Asia Pacific region. In this analysis, we examine the costs incurred by households surveyed in managing pediatric atopic dermatitis. METHODS: A cross sectional survey was conducted in Australia, China, Hong Kong, India, Indonesia, Korea, Malaysia, Philippines, Singapore, Taiwan, Thailand, and Vietnam in January 2011. An online questionnaire was administered to 1028 parents with children diagnosed with moderate to severe AD (aged 1 - 16 years). Household expenditure measured included expenses for healthcare services, treatment and investigations, cost of associated conditions and missed days of work. Local currency costs were converted to USD using 2011 exchange rates. RESULTS: Median household expenditure on AD was an average of USD 794 per annum, ranging from USD 258 in the Philippines to USD 1706 in Hong Kong. Across the various countries, spending on health care services and physician fees ranged from USD137 in India to USD622 in Singapore, while spending on treatments and investigations ranged from USD100 in Indonesia to USD721 in Hong Kong. Working mothers missed an average of 13.5 days of work in the past year to care for their children with AD. Missed work days ranged from 4.8 days in Korea to as high as 20 days in China. Median productivity losses ranged from USD34 in Vietnam to USD844 per year in Hong Kong.  CONCLUSIONS: The results of the survey indicate that pediatric AD places considerable burden on household expenditure and productivity in the countries surveyed.