Atopic dermatitis or atopic eczema is a very common recurrent condition that causes itching in children. Many patients already have a personal or family history of other atopic conditions (eg, asthma, allergic rhinitis, or allergic conjunctivitis). Many genes involved in the formation of the skin barrier and the skin’s immune system play a role in the development of atopic dermatitis. Many patients have dry skin that is easily irritated.
Most children with atopic dermatitis improve as they get older. However, the condition can worsen even after an inactive period.
How does atopic dermatitis (atopic eczema) start?
Atopic dermatitis usually begins in infancy, but some patients may develop the disease during childhood or later.
In infants, the disorder usually affects the scalp and face. In more severe cases, it can also affect the limbs and body.
In children and adolescents, atopic dermatitis usually affects areas of the physiological curves (eg, neck, elbows, and knees). It may become more extensive in patients with more severe consequences.
Atopic dermatitis appears as a red, scaly rash with scratching marks.
What causes or worsens the disease?
- Ecological situation.
- Constant climate change.
- Household dust mites, dust.
- Excessive sweating.
- Aggressive soaps, detergents, bubble baths.
- Pets, dusty carpets, toys.
- Some infections.
- Influenza, upper respiratory tract infections.
- Skin infections (eg, Staphyloccoccus aureus, herpes simplex virus).
- Insect bites (mosquitoes).
- Vaccinations. (However, we advise against avoiding your child’s vaccinations.)
If you suspect a food allergy worsening your child’s atopic dermatitis, talk to your doctor who will determine if additional testing or referral to a pediatric allergist is needed.
Treatment: general advice
Reduce the level of dust mites. Avoid stuffed toys, pets, and carpets in your home. Family members should avoid smoking.
Avoid alkaline soaps, chemicals, and bubble baths.
Use brief (10 minutes) baths or showers daily with cool or lukewarm water. Avoid hot showers or baths.
For patients with atopic dermatitis, it is recommended to replace the soap with a softer one. Sometimes an antiseptic may be prescribed for patients with recurring skin infections.
Avoid extreme temperatures. Avoid excessive sweating if possible. Consider stopping exercise when there is a severe flare-up.
Minimize scratches. Trim your nails regularly.
Moisturize your skin two to three times a day with an unscented moisturizer. Apply moisturizer to all skin surfaces, even normal skin. Your doctor will be able to recommend which moisturizer is right for your child.
Medication methods of treatment.
1. Topical steroids
Steroids are used as the main treatment for atopic dermatitis.
The strength of the steroids will depend on your child’s age and the location and severity of the eczema.
They should be used two to three times a day, depending on your child’s doctor’s instructions.
Steroids should be used on red, itchy and inflamed areas. Once the rash has subsided, reduce the frequency of use. Discontinue use when redness and itching have subsided.
Your child’s doctor can provide you with an Action Plan. Remember to follow the instructions in your Action Plan.
Long-term use of powerful steroids can lead to atrophic effects such as thinning skin, easy bruising, stretch marks (striae) and increased hair growth.
2. Oral antihistamines
They may be prescribed by your child’s doctor to relieve itching and help your child sleep better at night.
Different types of antihistamines can be prescribed day or night.
They should be given for as long as your child is itchy from eczema.
They may be prescribed if there are any signs of a skin infection making your child’s blood pressure worse.
Your child should receive the prescribed course of antibiotics.