Atopic dermatitis is a chronic skin condition that can significantly impact a person’s quality of life. It is considered a widespread skin disorder, affecting millions of people worldwide. According to recent estimates, approximately 10–20% of infants and young children develop atopic dermatitis, which often persists into adult life for some.

The main features of atopic dermatitis are skin inflammation and itching. If someone believes they may be suffering from atopic dermatitis, it is essential to see a specialised dermatologist who can confirm the diagnosis and recommend appropriate treatment.

What is atopic dermatitis?

The term “atopic dermatitis” refers to an inflammatory skin disease that is chronic, with dryness and itching as its main features. Throughout life, the patient may experience remissions and flare-ups. Atopic dermatitis is most common during the winter months.

Atopic dermatitis is divided into 3 age groups:

  • Infantile atopic dermatitis, which includes children aged 2 months to 2 years.
  • Childhood atopic dermatitis, which includes children aged 2 to 10 years.
  • Adolescent atopic dermatitis, which includes individuals aged 10 and over.

In about 50% of cases, the disease first appears between the second month of life and the age of 5. 30% of patients show symptoms between the ages of 5 and 12, while the remaining 20% develop symptoms during adolescence and adulthood.

What are the causes of atopic dermatitis?

Understanding the underlying causes of atopic dermatitis is essential for effective management and treatment of the disease. Several factors contribute to worsening this condition, including:

  • Heredity: Atopic dermatitis often appears in families, indicating a genetic predisposition. If you have a family history of atopic dermatitis, you may be at greater risk of developing the disease.
  • Environmental factors: Exposure to allergens such as pollen, dust mites, pet dander, and certain foods can trigger or worsen the symptoms of atopic dermatitis.
  • Immune dysfunction: Individuals with atopic dermatitis may have an overactive immune system that responds aggressively to allergens, leading to inflammation and itching.

What are the symptoms of atopic dermatitis?

The clinical picture of atopic dermatitis, as well as the location of lesions, varies depending on the patient’s age group. Thus, in infantile atopic dermatitis, eczema is mainly found on the cheeks and neck; in childhood atopic dermatitis, rashes appear at the joint creases of the knees and elbows and around the eyes; while in adolescent atopic dermatitis, the rash can cover the entire body.

Recognising the symptoms of atopic dermatitis is essential for prompt management. Common symptoms include:

  • Itching: Itching is the hallmark symptom of atopic dermatitis. It can be so intense that it disrupts daily activities and sleep.
  • Redness: Areas of skin affected by atopic dermatitis often appear red or inflamed.
  • Dryness: Atopic dermatitis can make the skin extremely dry, rough, and flaky. This dryness can lead to cracking of the skin and possible infection.

What is the treatment for atopic dermatitis?

Treatment of atopic dermatitis requires a multifaceted approach, and dermatologists are equipped to provide comprehensive care. The therapeutic approach starts with informing patients and their families about the factors that can trigger flare-ups, so they can avoid them. Such factors may include, for example, prolonged contact with water, wearing woollen clothing, and contact with substances containing potential allergens. From there, the frequent use of moisturisers to improve the natural barrier of the epidermis is very important.

Medical options include:

  • Topical corticosteroids: These medications help reduce inflammation and relieve itching.
  • Topical calcineurin inhibitors: These can be used long-term to reduce inflammation and prevent flare-ups.
  • Systemic medication: In more severe cases, options may include systemic corticosteroids and systemic antibiotics in case of secondary infection. In individuals with more severe conditions, where flare-ups are very frequent and uncontrolled, ciclosporin, methotrexate, or azathioprine can be administered.
  • Phototherapy: Phototherapy can be effective in reducing inflammation and improving skin texture.

When should you visit a specialist?

You should definitely schedule an appointment with a dermatologist if you or your child:

  • Show symptoms of atopic dermatitis.
  • Have symptoms severe enough to affect sleep and daily activities.
  • Show signs of a skin infection (new streaks, pus, yellow crusts).
  • Have symptoms that persist even after some treatment.

Seek immediate medical assistance if you or your child has a fever and the rash appears to be infected.

Why is it important to seek the help of a specialised dermatologist?

While atopic dermatitis is a common and quite widespread condition, the patient needs to seek the professional care of a specialised dermatologist. A dermatologist can help in many ways, including:

  • Accurate diagnosis: Dermatologists possess specialised knowledge and tools to accurately diagnose atopic dermatitis and distinguish it from other skin conditions that may look similar.
  • Personalised treatment plan: Each case of atopic dermatitis is unique, and dermatologists can create treatment plans based on each patient’s needs, depending on the symptoms and causes of the disease.
  • Advanced treatments: Dermatologists have access to the latest treatments for atopic dermatitis, including topical creams, oral medications, and phototherapy.
  • Preventive guidance: Dermatologists can provide valuable guidance for preventing flare-ups and effectively managing the condition, improving the patient’s overall quality of life.

What does the prevention of atopic dermatitis involve?

While atopic dermatitis cannot always be completely prevented, there are steps a patient can take to minimise flare-ups and effectively manage the condition:

Avoiding irritants

Identifying and avoiding the factors that may trigger flare-ups of atopic dermatitis is crucial. The patient should pay attention to potential allergens that may worsen symptoms, such as certain foods, fabrics, and environmental factors. Since each body is different, the patient should learn to recognise exactly what affects them and limit it.

Proper skin care

The patient should follow a gentle skincare routine, using mild soaps and fragrance-free moisturising products. Harsh soaps and hot water should be avoided as these can worsen dryness.

Moisturising the skin at least twice a day

The patient should find a product or combination of products that suits them. Products should not contain dyes, alcohol, fragrances, or other ingredients that may irritate the skin. It is best to allow the moisturiser to be absorbed by the skin before getting dressed.

Avoiding scratching

The patient should avoid scratching the skin. Ideally, they should cover the area causing the itching if they cannot control it. Keeping nails trimmed is also recommended. For children, you can try using socks or gloves during sleep.

Stress management

Stress can trigger or worsen atopic dermatitis. Practising stress-reduction techniques can help manage anxiety.

Conclusions

Atopic dermatitis is a common, chronic skin condition that requires careful management. Seeking the knowledge and expertise of a dermatologist is essential for accurate diagnosis, tailored treatment, and improvement of the patient’s quality of life. By understanding the causes, symptoms, and prevention strategies, you can take the necessary steps to manage your condition effectively.