What is Atopic Dermatitis ?
Atopic dermatitis manifests itself as irritated red areas of skin. These areas are usually found in the folds of the skin and on the inner sides of the elbows, behind the knees and around the eyes. In difficult cases, especially in children, the inflammation and irritation can also appear on the skin of the face, palms, scalp and back. In certain cases the irritation is so severe that it causes sleepless nights and difficulties in school and at work. Sometimes scratching the skin with unwashed hands causes topical bacterial infections which exacerbate the redness and pain. Since atopic dermatitis usually appears in families with a tendency to asthma or to allergic rhinitis, it is sometimes called “asthma of the skin.”
At which age it appears ?
Atopic dermatitis first appears in infant-hood or childhood, but it can continue into adolescence or even adulthood. Its cause is not completely known, but it would seem to be linked to the fact that the skin of the affected person reacts more strongly to irritations. The irritation can be external, e.g. cold weather, hot weather, pollen, dust or certain foods, and it can be internal, e.g. nervous tension. There are dermatologists who believe that a small percentage (about 10%) of infants and children who suffer from atopic dermatitis are sensitive to cows’ milk, eggs or fish, which worsen the symptoms of the disease. On the other hand, as far as adults are concerned, no link has been found so far between foods and atopic dermatitis.
Do we know its causes ?
The tendency towards atopic diseases (diseases linked to hyper-sensitivity to certain substances which do not, however, appear at the point of contact with those substances) such as asthma, allergic rhinitis or atopic dermatitis, can be identified in some of the cases by testing the level of the antibody immunoglobulin E, or IgE for short, in the blood.
Most dermatologists do not advise that allergy tests be performed in cases of atopic dermatitis. These tests involve the injection of substances into the skin of the patient and generally give a wide variety of positive results. Since it is difficult to isolate the specific substance responsible for the attacks of atopic dermatitis, it is therefore difficult to implement the results of these tests.
How to treat ?
Atopic dermatitis must be treated by a dermatologist. For the duration of the treatment, the patient must make frequent and regular use of a fat-based salve or ointment which protects the skin from the external irritations to which it is sensitive.
It is important to take a bath using bath oil at least once a day, to leave the skin slightly damp and to immediately smooth on a generous amount of cream or ointment.
Steroids are substances which suppress inflammation of the skin and other organs. Preparations which contain steroids in varying strengths can lessen the redness and irritation of the inflamed areas. Continued use of these preparations causes harmful side effects, and therefore they should be used as infrequently as possible. There are preparations which contain “weak” steroids and which can be used with relative safety for long periods of time.
Some tips !!
Avoid sudden, drastic changes in temperature.
Avoid strenuous actions and exercise which cause excessive perspiration.
Avoid exposure to animal hair and to dusty rugs and curtains.
Avoid bathing with strong soaps which damage the body’s natural layer of protection.
Use a fragrance-free moisturizing lotion, and be sure to apply it to the skin at least twice a day.
In addition, antihistamines are often given, lessening the irritation. In especially difficult cases of atopic dermatitis it is possible to take steroids orally for short periods of time or to use special phototherapy, the combined use of UVA and UVB ultra-violet rays.
Side effects of steroids
The excessive use of steroids can cause both local and general side effects.
Local side effects:
Thin skin (atrophy) and stretch marks (striae)
Distention of the capillaries in the skin (telangiectasia)
Pinpoint bleeding (purpura)
The initiation or worsening of acne
Irritation around the mouth (perioral dermatitis)
Aggravation of fungal and viral infections of the skin
General side effects:
(These side effects occur only after prolonged use of steroids administered orally or of preparations using steroids which are absorbed by the blood.)
Suppression of hormone secretion by the hypothalamus, the hypophysis and the adrenal glands
Weight gain
Stretch marks and pinpoint bleeding of the skin
Increased growth of hair
Hypertension (high blood pressure)
Initiation or worsening of diabetes
Initiation or worsening of glaucoma (excessive pressure in the eye)
Suppression of growth in children
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