Atopic dermatitis, also known as eczema, is a hereditary and chronic skin disorder that can occur at any age. It most often affects infants and young children, and may last until the child reaches adolescence or adulthood.
It typically causes the skin to itch, turn red, and flake. Different triggers can make it worse, including environmental irritants, allergies and stress. It flares up during times of stress, when the temperature is extreme, when the patient has a bacterial infection, or when the skin is irritated by fabrics or detergents.
What are the Causes?
The cause of atopic dermatitis is unknown, but likely caused by a combination of factors:
- Dry irritable skin, which reduces the skin’s ability to act as an effective barrier.
- A gene variation that affects the skin’s ability to be an effective barrier; hereditary.
- Immune system dysfunction.
- Bacteria, such as Staphylococcus aureus, on the skin that blocks sweat glands.
Atopic dermatitis symptoms worsen with an onset of different factors. Things that make it worse include:
- Wool or manmade fibers
- Soaps and cleaners
- Perfumes and makeup
- Substances such as chlorine, mineral oil, or solvents
- Dust or sand
- Cigarette smoke
Allergens from foods, plants, animals, or the air that can cause atopic dermatitis to flare up are:
- Eggs, peanuts, milk, fish, soy products, and wheat
- Dust mites
- Dog or cat dander.
Skin infections, temperature, and climate can also lead to skin flares. These include:
- Not using enough lubricants after a bath
- Low humidity in winter
- Dry year-round climate
- Long or hot baths and showers
What are the Signs and Symptoms?
Atopic Dermatitis can begin as early as 2 or 3 months old. When it occurs, it often causes a rash that appears suddenly and makes the skin dry, scaly, and itchy, especially at night. Other symptoms include:
- Red to brownish-gray patches.
- Small, raised bumps, which may leak fluid and crust over when scratched
- Thickened, cracked, dry, scaly skin
- Raw, sensitive, swollen skin from scratching
Common sites for babies show symptoms on their scalp and face, the front of the knees and the back of the elbows. In children, common sites include the neck, wrists, legs, ankles, the creases of elbows or knees, and between the buttocks. In adults, the rash often appears in the creases of the elbows or knees and on the nape of the neck.
How to Treat Atopic Dermatitis
Mild atopic dermatitis can be treated at home. Home remedies include:
- Moisturize often to treat and prevent dry skin. Thicker creams and ointments work best.
- Refrain from the use of harsh soaps and detergents, dander, and any other things you are allergic to.
- Minimize scratching. You may want to cover the rash with a bandage to avoid rubbing it.
- Putting mittens or cotton socks on infant’s hands may help from scratching.
- Bathe with lukewarm or warm water. Soak for about 10 minutes.
- Use medicine prescribed by your doctor.
Medications may include:
- Creams that control itching and inflammation. Your doctor may prescribe a corticosteroid cream or ointment.
- Creams that help repair the skin. Your doctor may prescribe drugs called calcineurin inhibitors – such as tacrolimus (Protopic) and pimecrolimus (Elidel). They can be used to control itching and reduce flares.
- Drugs to fight infection. Your doctor may prescribe antibiotics if you have a bacterial skin infection or an open sore or cracked skin caused by scratching.
- Oral anti-itch drugs. If itching is severe, your doctor may prescribe anti-histamines to help. Diphenhydramine such as Benadryl may cause sleepiness.
- Oral or injected drugs that control inflammation. Your doctor may prescribe oral corticosteroids such as prednisone or an injected version. While these drugs are effective, they can’t be used long term due to side effects.
Schedule a Consultation
Living with atopic dermatitis can be unpleasant. Multiple therapies and treatment options are available to safely and effectively treat this condition and help you manage your symptoms. Schedule a consultation with Dr. Shukla to determine which treatment is right for you. Contact us today to find out more information about the diagnosis and treatment of atopic dermatitis.