Eczema affects 10-20% of children and 1-3% of adults. The cause of atopic dermatitis is unknown, but genetic factors play a strong role. The symptoms are secondary to a dysfunctional outer layer of the skin known as the epidermis. Normally, an intact epidermis keeps out environmental irritants, allergens, and microbes. Because the skin is not working properly, these substances get into the body which lead to inflammation. In children with moderate to severe atopic dermatitis, up to 2/3 of them may have some underlying food allergy.
Most people with atopic dermatitis have symptoms before the age of five. Intense itching of the skin, patches of redness, small bumps, and skin flaking are common symptoms. Scratching can lead to additional inflammation, which causes a cycle of itching and scratching that worsen the disease and can potentially lead to decreased sleep and quality of life. In severe exacerbations, the skin may actually start oozing which can be a sign of infection.
There is no specific test to diagnose atopic dermatitis. The diagnosis is based on clinical information like the patient history and physical examination. Testing done by a well-qualified allergist can identify potential triggers like environmental or food allergens.
SKIN CARE, SKIN CARE, SKIN CARE! Appropriate skin care is the cornerstone of treatment for atopic dermatitis. Aggressive moisturizing with a good quality, hypo-allergenic lotion or cream is the key to preventing skin dryness.
The lotion should be applied at least twice a day and within 3 minutes after bathing. Both intermittent and daily bathing are appropriate, but a fragrance free soap and pat-down drying should be used.
Avoiding known triggers can reduce the intensity of atopic dermatitis. Irritants, stress, heat/sweating, infections, and allergens can all cause exacerbations.
Topical steroids or anti-inflammatory creams should be used as needed on red inflamed areas of skin. Only low potency creams should be used on the face because the skin on this part of the body is thin.
Medications like oral anti-histamines can be prescribed to attempt to control itching, but this is controversial.
Treatments like bleach baths and wet wraps can be used in select cases as determined by your physician.
How We Can Help
An allergist can help identify environmental or dietary triggers and work with patients and their families in creating an effective and practical treatment plan. Skin testing to identify these potential triggers should be performed by a trained professional.