Atopic Dermatitis (Eczema)

Atopic dermatitis is a chronic skin condition characterized by dry, itchy skin.

It is more commonly seen among children, but may develop at any age.

It is usually associated with other conditions like hay fever and asthma. It causes intense itching which is hard to resist.

Many factors, like

• low humidity,
• seasonal allergies,
• harsh soaps,

trigger exacerbation of the symptoms.

It is very common and is seen equally among males and females.

There is no cure for atopic dermatitis.

Treatment helps to relieve symptoms and to prevent flare ups.

Self-care measures like avoiding harsh soaps, using moisturizers, and applying medications help in controlling symptoms. 

Symptoms of atopic dermatitis vary from person to person.

Some common symptoms include

• Severe itching, which often worsens at night
• Reddish patches on skin
• Small bumps on the skin which leak and crust over
• Dry, scaly, and cracked skin
• Swelling of skin on scratching

The reddish patches are seen on

• hands,
• feet,
• upper chest,
• eyelids.

In infants the rashes can be seen on face and scalp. In most of the cases, the symptoms appear before 5 years of age, and persist in adulthood. Exacerbations of these symptoms are often seen periodically which resolves after some time.

Many people with atopic dermatitis have staphylococcus infection of the skin. Staph bacteria multiply within the skin and worsen symptoms of dermatitis.

Other factors that worsen symptoms of dermatitis include

• stress,
• dry skin,
• sweat,
• dust,
• pollen,
• pollution,
• certain foods,
• bacteria and viruses,
• scratching,
• some chemicals,
• changes in environmental conditions.

The actual cause of atopic dermatitis is not known. A number of factors are implied in the cause of this chronic skin condition.

This includes

• Dry skin that is irritable
• Genetic factors that affect the functioning of skin
• Abnormal functioning of immune system
• Staphylococcus aureus infection of skin
• Certain environmental conditions

Having a family history of

• allergy,
• dermatitis,
• asthma,
• hay fever

increases the risk of this skin condition.

Being in the healthcare profession also enhances the risk of hand dermatitis.

African-American children are more likely to have this skin condition.

Children who are attending child care and those who have attention-deficit hyperactivity disorder (ADHD) have more chances of getting atopic dermatitis.

Review of medical history and symptoms is the diagnostic method for atopic dermatitis.

Other skin diseases and conditions that cause similar symptoms are ruled out using patch test. 

Moisturizing and other self-care measures are the treatment for the symptoms of atopic dermatitis.

Medications and therapies are suggested when the person does not respond to usual self-management methods.

• Itching and inflammation can be controlled by using creams. Corticosteroid creams and ointments are usually prescribed to alleviate inflammation. Topical corticosteroids should be used with caution as it has many side effects like skin irritation, skin thinning, and stretch marks.

• Calcineurin inhibitors like tacrolimus and pimecrolimus are used to control itching and reduce the recurrence and exacerbations of atopic dermatitis. It is recommended only when other conventional methods are not effective in controlling the condition.

• Bacterial skin infection is controlled using antibiotics.

• Oral anti-histamines help in reducing intense itching.

• Oral corticosteroids, like prednisone, are prescribed to control inflammation.

Stress therapy, wet dressings, and light therapy are also used in controlling symptoms of this skin condition.

Severe atopic dermatitis is treated by covering the affected area with wet bandages and topical corticosteroids.

Phototherapy or light therapy is a procedure in which the affected skin is exposed to controlled amounts of sunlight, artificial UV A or narrow band UV B light. This may be used alone or in combination with medications. Phototherapy is effective in controlling symptoms, but may cause premature aging and also increase the risk of skin cancer.

Stress therapy helps to cope with the depression or anxiety associated with this skin condition.

In small children, extreme temperatures are totally avoided to control the symptoms of atopic dermatitis.

Special care should be taken to avoid skin irritations. Oils, lotions, and creams help to keep their skin well lubricated.

There are several methods to prevent Atopic Dermatitis.

Flares of atopic dermatitis symptoms can be controlled by avoiding exposure to triggers.

A shorter bath in warm water using bath oil and gentle soaps is recommended.

Drying the skin by gently patting with a towel also helps.

Using a moisturizer helps to keep the skin hydrated. Moisturizing creams and lotions should be used twice daily to lock the moisture in and to prevent drying.

Thick moisturizers and cosmetics containing moisturizers are better in preventing drying of skin. 

Homeopathic remedies used to control various symptoms of atopic dermatitis are:

• Sulphur,
• graphite,
• rhus tox,
• mezereum,
• natrum mur,
• sepia,
• lycopodium,
• pix liquida,
• galphimia gluca,
• histamimun

Chinese herbal medications are also indicated in reducing itching and inflammation associated with this skin condition.

Other approaches like

• dietary supplements,
• herbal remedies,
• acupuncture,
• aromatherapy,
• bath therapy,
• bioresonance,
• chromotherapy,
• massage therapy

are also used to manage atopic dermatitis.

But these alternative therapies do not have conclusive evidence regarding the use in controlling symptoms. 

Lifestyle modifications are necessary in order to cope with Atopic Dermatitis (Eczema).

Non-prescription allergy medications help in controlling symptoms. Applying calamine lotion and anti-itch cream in the affected area relieves itching.

Other self-care measures include

• Using moisturizers twice daily
• Avoiding scratching
• Applying wet, cool compress
• Taking warm bath with mild soaps
• Using humidifier
• Using cotton clothing
• Managing stress and anxiety

Psychological support from family, friends, and counselors will help in coping with the frustration and depression.

Atopic dermatitis may cause complications like:

• Asthma and hay fever
• Chronic itching
• Skin infections
• Vision problems
• Hand dermatitis
• Allergic contact dermatitis
• Poor sleep
• Behavioral problems