Atopic Dermatitis: Eczema in Children

Atopic dermatitis(eczema) is a chronic and very common skin condition, that is thought to be a type of skin allergy or severe sensitivity. Other chronic diseases that may be present in sufferers of atopic dermatitis are asthma and hay fever. There are known to be genetic factors at play in atopic dermatitis, as the disease has a hereditary component, and certain families have higher incidence of this skin disease than others do.

Atopic dermatitis is characterized by dry, itchy skin with inflamed red rash. In fact, the very meaning of the word “dermatitis” refers to inflammation of the skin. “Atopic” refers to the hereditary component of the disease, and to the fact that the disease is often present in conjunction with others, such as the asthma and hay fever mentioned earlier.

​In atopic dermatitis, more commonly known as eczema, the skin is extremely inflamed, often to the point of cracking and weeping, then forming crusts. Typically, those with eczema has extremely dry skin which contributes to the formation of the itchy and painful rashes.

​Most commonly, atopic dermatitis is present in very young children and infants. Eczema often follows periods of flare-ups and subsequent remission. As they grow up, many children affected by atopic dermatitis enter into complete remission, although the sensitivity and dryness of their skin may persist.

​Triggers for atopic dermatitis may include seasonal allergies due to plant pollens, use of harsh soaps or changing laundry detergents, introduction of new skin care products such as lotions. Cold weather is also known to trigger atopic dermatitis. Food allergies or exposure to animal dander can also trigger flare-ups of the disorder.

​The best strategy to help deal with the effects of atopic dermatitis is a very simple skin care regimen. Once a mild soap (or non-soap cleanser, depending on a physician’s recommendations) and moisturizer are found to be well-tolerated, other products should not be used. Frequently changing soaps and lotions may expose atopic dermatitis sufferers to fragrances and irritating ingredients which can cause itching, weeping and crusting of the skin.

​Long hot baths or showers should be avoided by persons with atopic dermatitis, as they can further dry the skin. One bathing is complete, air-drying the skin, or at the very least, avoidance of briskly toweling off the skin is recommended.

​Applying a recommended moisturizer within a few minutes of the completion of bathing helps to lock moisture into the skin, and prevents further skin dryness, which in turn leads to irritation. Creams are recommended for moisturizers over lotions, as the latter may contain drying or irritating alcohol content.

Symptoms of atopic dermatitis

​In extreme cases, tar-based preparations are used to heal extremely dry skin. In any case, careful attention should be taken to avoid moisturizers that are fragrance-free to avoid skin irritation.

​Use of antihistamines to alleviate itchiness may be required as well. Keeping the child’s nails very short will lessen the damage caused by constant scratching. This is very important, as constant scratching may lead to skin infections.

​Over-the-counter corticosteroids in cream or ointment form can help with severe itching, but they do come with side effects with constant use such as thinning of the skin, the stunting of growth in young children as well as infections.

​Newer prescription medication for atopic dermatitis in the form of topical creams called Protopic (Tracromlimus) and Elidel (pimecromlimus) is available. These creams can provide significant relief for suffers of atopic dermatitis, but there are concerns surrounding their use, as they are immune modulator drugs, and suppress the immune system. However, they do not cause the severe thinning of the skin as corticosteroids do.

​Other forms of treatment for atopic dermatitis includes light therapy with a machine that emits UV A or B waves, or a combination of both types of UV light. This can be quite effective for treatment of mild to moderate cases of atopic dermatitis. In more advanced cases, the UV light treatment is combined with a drug called psoralen. Physician’s carefully monitor the effects of phototherapy, and seek out the minimum amount of UV exposure that is effective for treatment.

​In extremely severe cases of atopic dermatitis, oral or injected corticosteroids are prescribed. Because of the notable side-effects of this class of drugs, they are only administered for very short periods of time.

​Systemic corticosteroids may cause thinning of bones, long-term skin damage, and even high-blood pressure, so long-term use is not recommended. Patients must be very carefully monitored for side effects, and it is important to follow physician instructions to the letter, and not suddenly discontinue the medication.

Douglas M. Jacobs

A Music, Video and TV enthusiast.

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