Description

Atopic dermatitis (eczema) is a condition that causes dryness, itching and inflammation of the skin. It is common in young children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to burst sometimes. May be irritating, but is not contagious.

People with atopic dermatitis are at risk of developing food allergies, hay fever, and asthma.

Moisturizing regularly and after other habits of skin care can relieve itching and prevent new outbreaks (flares). Treatment may also include medicated creams or ointments.

Symptoms

Atopic dermatitis (eczema) symptoms can appear in any part of the body and vary a lot from person to person. They may include:

  • Dry, cracked skin
  • Itching (pruritus)
  • Rash, inflamed skin that varies in color according to the color of your skin
  • Small bumps, in brown or Black skin
  • Oozing and crusting
  • Thickening of the skin
  • The darkening of the skin around the eyes
  • Raw, sensitive skin from scratching

Atopic dermatitis most often begins before the age of 5 years and may continue in the teen and adult years. For some people, flares, and then disappears for a time, even for several years.

When to see a doctor

Talk with a health care provider if you or your child:

  • You have symptoms of atopic dermatitis
  • It is so uncomfortable that the condition affects sleep and daily activities
  • Have a skin infection — look for new veins, pus, yellow crusts
  • Have symptoms even after attempting to self-care measures

Seek medical attention right away if you or your child has a fever and the rash looks infected.

Causes

In some people, the atopic dermatitis is related to a gene variation that affects the ability of the skin to provide protection. With a weak function of the protective barrier of the skin is less able to retain moisture and protect against bacteria, irritants, allergens, and environmental factors — such as tobacco smoke.

In other people, atopic dermatitis is caused by the excess of the bacteria Staphylococcus aureus in the skin. This displaces the helpful bacteria and alters the skin barrier function.

A weak skin barrier, the function could also trigger an immune system response that causes inflammation of the skin and other symptoms.

Atopic dermatitis (eczema) is one of several types of dermatitis. Other common types are contact dermatitis and seborrheic dermatitis (dandruff). The Dermatitis is not contagious.

Risk factors

The main risk factor for atopic dermatitis is having eczema, allergies, hay fever, or asthma in the past. Having family members with these conditions also increases your risk.

Complications

Complications of atopic dermatitis (eczema) may include:

  • The asthma and hay fever. Many people with atopic dermatitis develop asthma and hay fever. This can occur before or after the development of atopic dermatitis.
  • Food allergies. People with atopic dermatitis often develop allergies to food. One of the main symptoms of this condition is hives (urticaria).
  • Chronic itching, peeling of the skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, it provides only a temporary relief. Scratching actually makes the skin itchier because it activates the nerve fibers in the skin. Over time, you may scratch out of habit. This condition may cause the affected skin to become discolored, thick, and leathery.
  • Patches of skin are darker or lighter than the surrounding area. This complication after the rash has healed is called post-inflammatory hyperpigmentation or hypopigmentation. It is more common in people with brown or Black skin. It may take several months for fading discoloration.
  • Infections of the skin. Repeated scratching that breaks the skin, it can cause open sores and cracks. These increase the risk of infection from bacteria and viruses. These skin infections can spread and become life-threatening.
  • Irritant hand dermatitis. This applies in particular to the people whose hands are often wet and exposed to soaps, detergents and disinfectants in the work.
  • Allergic contact dermatitis. This condition is common in people with atopic dermatitis. Allergic contact Dermatitis is an itchy rash caused by touching the substances that you are allergic to. The color of the rash varies depending on their color of skin.
  • Sleep problems. The itching of atopic dermatitis may interfere with sleep.
  • Mental health conditions. Atopic dermatitis is associated with depression and anxiety. This may be related to the constant itching and sleep problems common among people with atopic dermatitis.

Prevention

The development of a basic skin care routine can help to prevent eczema flares. The following tips can help reduce the effects of drying bath:

  • Moisturize your skin at least twice a day.Creams, ointments, shea butter and lotion to seal in moisture. Choose a product or products that work well for you. Ideally, the best for you to be safe, effective, affordable and without perfume. The use of petroleum jelly on the skin of your baby may help prevent the development of atopic dermatitis.
  • Take a daily bath or shower. Use warm water instead of hot water, and limit your bath or shower about 10 minutes.
  • The use of a soft, nonsoap cleanser. Choose a cleaner that is free of dyes, alcohol and fragrance. For young children, who usually only need hot water to get clean — no soap or bubble bath necessary. The soap can be especially irritating to the skin of young children. For people of any age, deodorant soaps and antibacterial soaps can remove the excess skin of the natural oils and dry out the skin. Do not rub the skin with a cloth or a sponge.
  • Pat dry. After bathing, gently pat the skin with a soft towel. Apply moisturizer while the skin is still wet (within three minutes).

Moisturize your skin at least twice a day. Creams, ointments, shea butter and lotion to seal in moisture. Choose a product or products that work well for you. Ideally, the best for you to be safe, effective, affordable and without perfume.

The use of petroleum jelly on the skin of your baby may help prevent the development of atopic dermatitis.

The causes of atopic dermatitis vary widely from person to person. Try to identify and avoid the irritants that cause your eczema. In general, avoid anything that causes an itching due to scratching often triggers a crisis.

Common triggers of atopic dermatitis are:

  • Rough wool fabric
  • Dry skin
  • Infection of the skin
  • The heat and the sweat
  • Stress
  • Cleaning products
  • Dust mites and pet dander
  • Mold
  • Pollen
  • The smoke of tobacco
  • Cold and dry air
  • Fragrances
  • Other irritating chemicals

Babies and children can have eruptions triggered by the ingestion of certain foods, such as eggs and cows milk. Talk to your pediatrician regarding the identification of possible food allergies.

Once you understand what triggers your eczema, talk with your health care provider about how to manage their symptoms and prevent flares.

Diagnosis

To diagnose atopic dermatitis, your healthcare provider will probably talk to you about your symptoms, examine your skin and reviewing your medical history. You may need tests to identify allergies and rule out other skin diseases.

If you think that a certain food caused your child's rash, ask your health care provider about possible food allergies.

Patch testing

Your doctor may recommend patch testing on the skin. In this test, small amounts of different substances that are applied to the skin and then covered. During the visits in the next few days, the doctor looks at your skin for any signs of a reaction. Patch testing may help diagnose specific types of allergies cause of their dermatitis.

Treatment

The treatment of the atopic dermatitis can start with regular hydration and other self-care habits. If you don't help, your health care provider might suggest creams that control the itch and help repair the skin. These are sometimes combined with other treatments.

Atopic dermatitis may be persistent. You may need to try several treatments over a period of months or years for their control. And even if the treatment is successful, the symptoms may reappear (flare).

Drugs

  • Medicated products applied to the skin.Many options are available to help control the itching and the repair of the skin. The products are available in several strengths, and as creams, gels and ointments. Talk with your health care provider about the options and your preferences. Whatever you use, apply the instructions (often twice a day), before moisturizing. The excessive use of a corticosteroid product applied to the skin, can cause side effects, such as thinning of the skin. Creams or ointments with a calcineurin inhibitor may be a good option for those older than 2 years of age. Examples include tacrolimus (Protopic) and pimecrolimus (Elidel). Apply the instructions, before you moisturize. Avoid strong sunlight when the use of these products. The Food and Drug Administration requires that these products have a black box warning about the risk of lymphoma. This warning is based in the rare cases of lymphoma among people with the use of topical calcineurin inhibitors. After 10 years of study, no causal relationship between these products and lymphoma, and no increase in the risk of cancer have been found.
  • The medication to fight the infection. Your health care provider may prescribe antibiotics to treat an infection.
  • The pills control the inflammation. For more-severe eczema, the doctor may prescribe pills to help control their symptoms. The options may include cyclosporine, methotrexate, prednisone, mycophenolate mofetil and azathioprine. These pills are effective, but may not be used long-term due to possible serious side effects.
  • Other options for severe eczema. The injectable biologics (monoclonal antibodies) dupilumab (Dupixent) and tralokinumab (Adbry) could be options for people with moderate to severe disease who do not respond well to other treatments. Studies show that it is safe and effective in the relief of symptoms of atopic dermatitis. Dupilumab is for people over 6 years of age. Tralokinumab is for adults.

Medicated products applied to the skin. Many options are available to help control the itching and the repair of the skin. The products are available in several strengths, and as creams, gels and ointments. Talk with your health care provider about the options and your preferences. Whatever you use, apply the instructions (often twice a day), before moisturizing. The excessive use of a corticosteroid product applied to the skin, can cause side effects, such as thinning of the skin.

Creams or ointments with a calcineurin inhibitor may be a good option for those older than 2 years of age. Examples include tacrolimus (Protopic) and pimecrolimus (Elidel). Apply the instructions, before you moisturize. Avoid strong sunlight when the use of these products.

The Food and Drug Administration requires that these products have a black box warning about the risk of lymphoma. This warning is based in the rare cases of lymphoma among people with the use of topical calcineurin inhibitors. After 10 years of study, no causal relationship between these products and lymphoma, and no increase in the risk of cancer have been found.

Therapies

  • Wet dressings. An effective intensive treatment for severe eczema involves the application of a corticosteroid ointment and sealed in the medication with a wrap of moist gauze covered with a layer of dry gauze. Sometimes this is done in a hospital for people with injuries widespread because it is labor intensive and requires the expertise of nursing. Or ask your health care provider about learning how to use this technique at home safely.
  • The light therapy.This treatment is used for people who do not improve with topical treatments or quickly flare up again after the treatment. The simplest form of light therapy (phototherapy) involves exposing the affected area to controlled amounts of natural light. Other ways of using artificial ultraviolet a rays (UVA) and ultraviolet B narrow band (UVB), either alone or with drugs. Although effective, long-term light therapy has deleterious effects, including premature aging of the skin, changes in the color of the skin (hyperpigmentation) and an increased risk of skin cancer. For these reasons, the phototherapy is less common in young children and is not given to infants. Talk with your health care provider about the pros and cons of light therapy.
  • Counseling. If you feel embarrassed or frustrated by their condition of the skin, it can help to talk with a therapist, or other counselor.
  • The relaxation behavior modification and biofeedback. These approaches can help people who scratch out of habit.

The light therapy. This treatment is used for people who do not improve with topical treatments or quickly flare up again after the treatment. The simplest form of light therapy (phototherapy) involves exposing the affected area to controlled amounts of natural light. Other ways of using artificial ultraviolet a rays (UVA) and ultraviolet B narrow band (UVB), either alone or with drugs.

Although effective, long-term light therapy has deleterious effects, including premature aging of the skin, changes in the color of the skin (hyperpigmentation) and an increased risk of skin cancer. For these reasons, the phototherapy is less common in young children and is not given to infants. Talk with your health care provider about the pros and cons of light therapy.

Baby eczema

Treatment for eczema in babies (infantile eczema) includes:

  • Identifying and avoiding irritants of the skin
  • Avoid extreme temperatures
  • Give your baby a short bath in lukewarm water and apply a cream or ointment while the skin is still damp.

Consult your pediatrician if these steps do not improve the eruption, or looks infected. Your baby may need a medication to control the eruption, or treat an infection. Your doctor may also recommend an oral antihistamine to help reduce itchiness and cause drowsiness, which may be useful to the night itching and discomfort. The type of antihistamine that causes drowsiness, it may negatively affect the school performance of some children.

Lifestyle and home remedies

Taking care of sensitive skin is the first step in the treatment of atopic dermatitis and prevention of exacerbations. To help reduce itching and soothe inflamed skin, try these self-care measures:

  • Moisturize your skin at least twice a day. To find a product or combination of products that works for you. You can try to bath oils, creams, lotions, creams, shea butter, ointments, or sprays. For a child, twice a day, the regimen could be an ointment before bedtime and a cream before school. Ointments are greasier and it might hurt less when applied. Choose products that are free of dyes, alcohols, perfumes and other ingredients that can irritate the skin. Allow the moisturizer to absorb into the skin before dressing.
  • Apply an anti-itch cream to the affected area. A prescription cream that contains at least 1% hydrocortisone can temporarily relieve the itch. Apply no more than twice a day on the affected area before moisturizing. Once the reaction has improved, you can use this type of cream less frequently to prevent rashes.
  • Take an oral allergy or anti-itch medication. The options include the-counter allergy medicines (antihistamines) — such as cetirizine (Zyrtec Allergy) or fexofenadine (Allegra Allergy). Also, diphenhydramine (Benadryl, others) may be helpful if itching is intense. But it causes drowsiness, so it is best to bedtime. The type of antihistamine that causes drowsiness, it may negatively affect the school performance of some children.
  • Do not scratch. Instead of scratching when you itch, try to press on, or patting the skin. Cover the affected area if you can't avoid scratching it. Keep nails trimmed. For children, it can help to cut your nails and I use socks or gloves for the night.
  • Take a daily bath or shower. Use warm water instead of hot water. If you are taking a bath, sprinkle the water with colloidal oatmeal, which is finely ground oatmeal, made for the bath (Aveeno, other). Soak for about 10 minutes, and then dry. Apply moisturizer while the skin is still wet (within three minutes).
  • The use of a soft, nonsoap cleanser. Choose one without dyes, alcohols or fragrances. Soaps can wash your skin with natural oils. Be sure to rinse off the cleaner completely.
  • Taking a bath bleach.The American Academy of Dermatology recommends a bath of bleach for the relief of severe or frequent eruptions. Talk with your health care provider about whether this is a good choice for you. A diluted bleach bath and decreases bacteria on the skin and related infections. Add 1/2 cup (118 milliliters) of bleach, non-bleach, concentrated to a 40-gallon (151-liter) bathtub filled with warm water. The measurements are for the united states standard size bathtub filled to the overflow drain holes. Soak from the neck down or just the affected areas for 5 to 10 minutes. Do not put your head under the water. Rinse the chlorine from the water with tap water. Taking a bath bleach 2 to 3 times a week.
  • The use of a humidifier. Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or humidifier connected to your furnace adds moisture to the air inside your home.
  • Wear fresh, soft texture of the clothes. Avoid clothes rough, difficult, or irritated. Also, in the hot weather or while exercising, choose lightweight clothing that allows your skin to breathe. When washing your clothes, avoid detergents and fabric softeners added during the drying cycle.
  • Deal with stress and anxiety. Stress and other emotional disorders can worsen atopic dermatitis. Be aware that stress and anxiety and take steps to improve your emotional health can help your skin too.

Taking a bath bleach. The American Academy of Dermatology recommends a bath of bleach for the relief of severe or frequent eruptions. Talk with your health care provider about whether this is a good choice for you.

A diluted bleach bath and decreases bacteria on the skin and related infections. Add 1/2 cup (118 milliliters) of bleach, non-bleach, concentrated to a 40-gallon (151-liter) bathtub filled with warm water. The measurements are for the united states standard size bathtub filled to the overflow drain holes.

Soak from the neck down or just the affected areas for 5 to 10 minutes. Do not put your head under the water. Rinse the chlorine from the water with tap water. Taking a bath bleach 2 to 3 times a week.

Alternative medicine

Many people with atopic dermatitis have tried alternative (integrative) approach in medicine to relieve your symptoms. Some approaches are supported by clinical studies.

  • The cannabinoids. When applied to the skin, creams that contain cannabinoids have shown to relieve the itching and thickening of the skin. Several studies over more than 10 years showed some benefit.
  • The natural oils. When added to bath water, natural oils can help to improve dry skin. Examples of such oils are soybean oil, and mineral oil. Be careful with the oils in a tub as it can make the bathtub slippery.
  • The Manuka honey. When applied to the skin, manuka honey has been shown to calm reactions in the skin. It has been used for centuries as an antimicrobial. Do not use on children under 1 year of age, because it carries with it the risk of infant botulism.
  • Acupuncture and acupressure. Several studies show that acupuncture and acupressure may reduce the itching of atopic dermatitis.

If you are considering the possibility of alternative therapies, talk to your health care provider about their pros and cons.

Coping and support

Atopic dermatitis may make you feel uncomfortable and self-conscious. It can be especially stressful, frustrating or embarrassing to adolescents and young adults. You can interrupt your sleep, and even lead to depression.

Some people may find it helpful to talk with a therapist, or other counselor, a family member or a friend. Or it can be helpful to find a support group for people with eczema, you know what it's like to live with the disease.

Preparing for your appointment

It is likely to start by seeing your primary care provider. Or you can see a doctor who specializes in the diagnosis and treatment of skin conditions (dermatologist) or allergies (allergist).

Here's some information to help you prepare for your appointment.

What you can do

  • List of the symptoms, when they occurred and how long they lasted. Also, it can help to the list of factors that trigger or worsen their symptoms — such as soaps or detergents, tobacco smoke, sweat, or long, hot showers.
  • Make a list of all the medications, vitamins, supplements, and herbs you are taking. Better yet, take the original bottles, and a list of the dose and directions.
  • List of questions to ask your health care provider. Ask questions when you want something clarified.

For atopic dermatitis, some basic questions you could ask your health care provider include:

  • What could be the cause of my symptoms?
  • The tests are necessary to confirm the diagnosis?
  • What treatment do you recommend, if any?
  • Is this condition temporary or chronic?
  • Can't wait to see if the condition goes away on its own?
  • What are the alternatives to the approach that you're suggesting?
  • What skin care routines do you recommend to improve my symptoms?

What to expect from your doctor

Your health care provider is likely to ask you a few questions. Be prepared to respond to them can free up the time to go through any of the points that you want to devote more time. Your health care provider might ask:

  • What are the symptoms and when do they start?
  • Is there something that seem to trigger your symptoms?
  • Do you or a family member has allergies or asthma?
  • They are exposed to potential irritants from your work or hobbies?
  • Have you felt depressed or have you been under a lot of stress lately?
  • Do you come in direct contact with pets or other animals?
  • What products do you use in the skin, such as soaps, lotions, and cosmetics?
  • What household cleaning products do you use?
  • How much your symptoms affect your quality of life, including your ability to sleep?
  • What treatments have been tried up to now? Nothing has helped?
  • How often do you shower or bathe?
Symptoms and treatment of Atopic dermatitis (eczema)