Atopic dermatitis is a common chronic skin condition that affects 10-30% of the population. It often begins in childhood and causes symptoms for babies as early as 2-3 months of age. This disease can be a frustrating to treat as it requires diligent attention to a skin care regimen on a daily basis.
In this post, we will look at the common distribution of atopic dermatitis by age, the causes, symptoms and treatment.
Location of symptoms based on age
Causes
Atopic dermatitis is caused by a combination of genetic and environmental factors. The root of the symptoms lie in the breakdown of the epidermal (top) layer of skin. As a result of this breakdown, the skin loses it’s ability to retain moisture. All of this sets off the vicious dryness, inflammation and itch cycle.
Experts think that about 20-50% of people with atopic dermatitis have a defect in the filaggrin gene. This gene codes for the protein filaggrin which is involved in making the epidermis (or top layer of skin) a strong barrier. Without enough of this protein, the top layer of skin allows moisture to leave and makes the skin permeable to bacteria and viruses.
Symptoms
- Dry, sensitive skin
- Red or inflamed skin
- Dark colored patches of skin
- Rough or leathery patches of skin
- Itching, scratching and itching some more!!
Atopic dermatitis is known as the “itch that rashes.”
Treatment
Since it is a chronic condition, you should have a daily skin care regimen to prevent flare ups.
Daily/Weekly regimen:
- Gentle skin cleanser/soap
- Fragrance free
- Avoid anything that says “baby” on it (unless it is fragrance free)
- Dove soap is a great option
- Emollients (moisturizers)
- Choose an ointment over a cream
- Avoid “lotions” as they are mostly made of water which causes them to evaporate easily
- Vasoline, Cerave and Cetaphil are good brand choices
- Put emollients on right after getting out of the bath while the skin is still wet
- Here is a list of products endorsed by the National Eczema Association
- Salt or Bleach baths twice a week
- Helps prevent colonization of the skin with Staph Aureus (bacteria)
- ¼ cup of household bleach or salt in a bathtub that is half filled with water
- Do not submerge head or get in eyes
- Topical steroids for flared spots (red spots)
- Hydrocortisone 2.5% ointment for babies, faces and flexural surfaces
- Triamcinolone 0.1% ointment for flared spots in older kids
- Use until redness/flare goes away
- Use daily on places that tend to flare more often
- Can be prescribed in a 1 pound (454 gram) jar
Wet wraps for flares
Start with two pairs of footed pajamas. Next, bathe your child in lukewarm water as usual. After that, put emollients and topical steroids on their damp skin. Then, soak one pair of pajamas in warm water. After you soak them, wring them out until they are only just damp. Put the damp pajamas on your child and lastly, put the pair of dry pajamas on top. (Make sure the room is warm while you are doing this). Finally, leave the wet wraps on for one hour up to overnight. You want your child to wear them for as long as possible (as long as they tolerate). Repeat this nightly until the flare has resolved
Many other treatment options exists and there are other things to consider if your child has frequent flares despite following these recommendations. Talk to your child’s pediatrician if you have been doing these things diligently and their skin does not improve. Most kids will do well with a good skin care regimen.
Final Thoughts
Always notify your pediatrician if your child has red spots with weepy yellow discharge/crusting or any other rapidly spreading rash on top of their eczema. Kids with eczema can be prone to impetigo (bacterial skin infection) or rapid spread of certain viral rashes that may require extra medication and close monitoring.
Additional Resources:
https://www.aad.org/public/diseases/eczema/atopic-dermatitis#symptoms
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