Atopic dermatitis is a chronic inflammation of the skin of obscure origin. Very common in children, it tends to mitigate with age. The itchiness can be very persistent and there is no real cure, although complications can be avoided with good skin care.
Atopic dermatitis is also known as eczema. It usually has an intermittent course with flares and remissions of unknown origin. Experts believe it may be due to a malfunction of the skin’s immune system, with genetic or environmental factors possibly contributing to its occurrence. The most characteristic symptoms are redness, dryness, blistering, oozing, crusting, scaling, itching, skin thickening and sometimes slight pigmentation. The itchiness may be felt before the rash appears.
Children are most affected
Atopic dermatitis particularly affects children – both sexes equally – under 12 months old, with 90% of patients developing it before the age of five years. Children breastfed until 4 months of age are less likely to develop atopic dermatitis. The condition is not contagious, although it can be inherited and tends to run in families prone to asthma and hay fever (allergic rhinitis).
All races and skin types can potentially develop the disorder. Atopic dermatitis rarely appears during puberty or in adulthood if it has not developed in infancy. In fact, half of all children who develop atopic dermatitis continue to have mild symptoms as adults.
Differences according to age
The type and location of the rash depends on age. In infants aged between 2 and 3 months old, atopic dermatitis manifests as blisters, dry, scaly skin and sporadic itchiness that mostly affects the scalp and face (especially the cheeks).
In children older than 2 years and adolescents, rashes may appear on the knees, neck, wrists, ankles, buttocks, legs and in elbow creases. With time the skin darkens, thickens and becomes itchy.
In adults, atopic dermatitis behaves differently. It appears mostly in the folds of the elbow and neck, but, in extreme cases, can cover most of the body; very common also is hand eczema.
Facial rashes can lead to serious eye problems if a rash develops near the eyes. The skin of adults with atopic dermatitis is easily irritated and is also extremely dry and flaky.
Good skin care is essential
There is no definitive cure for atopic dermatitis, but proper skin care alleviates much of the discomfort, reduces the frequency of outbreaks, inflammation and itchiness and prevents possible skin infections. It also helps reduce the emotional stress caused by the symptoms. By contrast, failing to take care of the skin may lead to permanent scarring of the skin.
The American Academy of Dermatology makes the following basic recommendations to control atopic dermatitis symptoms:
- Bathe or shower in lukewarm water, for a maximum of 5 or 10 minutes, using a hypoallergenic gel with a pH between 4.7 and 5.5.
- Avoid sudden temperature changes but, above all, the cold.
- Apply moisturizer at least twice daily, preferably a thick, unperfumed hypoallergenic cream, to prevent the skin from drying out and cracking.
- Use a special sensitive-skin detergent to wash clothes.
It is important to understand that atopic dermatitis can be longlasting and also that keeping the skin healthy and well cared for is the key to controlling outbreaks.
A dermatologist should be consulted if the appearance of the skin worsens or if any unusual symptoms appear.