Atopic Dermatitis

Atopic DermatitisAtopic dermatitis (AD) is the most common type of eczema, often called “the itch that rashes.” The itch can be overwhelmingly intense, especially in children, who are its primary sufferers. The disease usually begins in childhood – 90% of initial cases of the condition develop before age of 5 years, with 65% developing the condition during their first year.

It typically affects infants on the arms, legs, trunk, and face. The distribution can change in the first 2 years to include the bends of the elbows, backs of the knees, ankles, wrists, and neck. Symptoms are dry, itchy, scaly skin and cracks behind the ears. Scratching or infection can aggravate the condition, resulting in oozing or crusted sores, making AD patients more susceptible to developing skin infections. There are studies that suggest that symptoms may be associated with seasonal allergies, certain foods, and asthma in some patients.

The good news is that when the condition develops in infants or toddlers, it tends to improve with age. For some, the condition completely resolves by age 2. However, about half of those who develop AD as children have it as adults. Exposure to trigger factors, such as allergens, irritants, stress, heat and sweating, and infections, worsens the condition or causes flare-ups, so the key to controlling AD is to avoid or reduce exposure to those trigger factors. It is best to avoid fragrances or dyes in laundry detergents and soaps and skip the bubble bath and “baby-scented” lotions.
The nursing staff at my practice has developed a comprehensive educational program for the parents of children with AD, focusing on learning how to recognize the early signs of skin infections – pus-filled lesions (pustules), fever blisters, or increased redness. These youngsters are prone to Staphylococcus aureus (commonly known as staph) infections and other infections, which are hard to prevent and should be treated promptly.

There is no cure for AD, but most cases can be controlled with proper treatment. Controlling AD involves keeping the skin hydrated, reducing inflammation, avoiding infection, and alleviating the itch. In our clinic, we use a combination approach involving gentle cleansers, moisturizers, topical anti-inflammatory medicines, systemic agents (medications taken within the body), and the new and highly effective narrow-band UVB treatment.

New families of topical FDA-approved, nonsteroid medications that are now available (eg, tacrolimus, pimecrolimus) that inhibit the skin’s inflammatory response – the main cause of redness and itching.

The most effective in a variety of treatments is to control your environment and avoid the irritants, allergens, and stresses that cause flare-ups. Establish a skin care routine and follow your physician’s instructions. With the correct diagnosis and treatment, adult and childhood AD can be successfully managed.

Additional Atopic Dermatitis Help:
Crutchfield Dermatology

Published on 12/03/2009 | Last updated on 10/18/2018