Eczema Atopic Dermatitis
Eczema, also known as atopic dermatitis, is a common skin condition in children. It affects 10 to 20 percent of children. In adult incidence is less, 1 to 3 percent.
Cause of Eczema/Atopic dermatitis
- Disruption of the skin barrier leads to dry skin, irritation and inflammation
- Food sensitization
- Faulty gene in their skin called filaggrin.
Most common symptoms of eczema
- Dry Skin
- Skin redness
- Irritated and itchy skin
- Scaly and thick skin
- Fissured and oozing skin
Itching in atopic dermatitis can be very severe and extremely irritating.
There may be associated skin infection. It is seen that several patients with eczema also suffer from asthma, allergic rhinitis, and food allergies.
Location of rash in infant and children
- Scalp
- Knees
- Elbows
- Cheeks
Location of rash in Adult
- Wrists
- Elbows
- Ankles
- Knees
- Face
- Neck
There may be personal or family history of any form of allergic disorder.
Diagnosis of Atopic Dermatitis
Consultation with an allergist is necessary.
Symptoms and signs
Skin test
Allergen specific IgE
Eczema treatment & management strategy
The major goals of treatment are
- Improve quality of life.
- Ability to maintain normal daily activity.
- Feel healthy and satisfied with skin appearance.
- Minimal side effects from medication.
- No sleep disturbances.
Avoidance of Possible Triggers
Irritants: like chemicals, detergents, soaps, fragrances, and smoke.
Steps to perform to reduce irritant exposures:
Wear suitable and comfortable clothing.
Wash garments prior to wearing.
Cut fingernails short and smooth
Use broad-spectrum UV protective sunscreen lotion (SPF of 15 or higher).
Bathe immediately after swimming
Inhaled Allergens:
House dust mites are most important. Follow HDM preventive measures.
Foods:
Certain food can aggravate eczema symptoms. Consult with allergist. Do allergy testing. Then elimination of certain food can be done as per your doctor’s advice.
Stress:
Stress, including anger and frustration, can aggravate itching. So be stress free.
Treatments
Topical Moisturizers
- Moisturizing your skin is an important eczema management
- Apply moisturizer on the slightly wet skin after bathe.
Topical Steroids
- Are anti-inflammatory medications
- Apply on the red and inflamed areas of the skin
- Mild topical steroids are usually safe
Avoid application of potent steroid in areas, such as the underarms, groin area, and face.
Other Topical Anti-Inflammatory agents
If topical steroids are ineffective, then other topical anti-inflammatory medications so called topical immunomodulators can be tried.
Wet-Wrap Therapy
Wet wrap therapy is usually used for people with severe and difficult to manage eczema
Antihistamines Drugs
itching of eczema is not caused by histamine. Therefore, anti-histamines will not control the symptoms.
Sedative antihistamines are sometimes used.
Treatment of Associated Infections
Give antibiotics if associated skin infection present.
Stress-Relieving Therapies
Vitamins
Vitamin D supplements
Biologic Medicines
Consult with allergist
Probiotics
Not for routine use. May be helpful in some cases.
Immunotherapy
Allergy shots are currently approved for the treatment of asthma and allergic rhinitis. It is also helpful in some cases of eczema.
In conclusion, eczema is usually treatable condition. Consultation with an allergist is important. Proper management strategy enable someone to lead normal life style.
