CONDITIONS
Atopic dermatitis
Atopic dermatitis (AD), the most common form of eczema, is a condition causing dry, itchy and inflamed skin. Atopic dermatitis is long lasting (chronic) and tends to flare sometimes.
Atopic dermatitis affects 10% of adults and approximately 20% of the paediatric population in high-income countries while the prevalence of AD in India among all age groups ranges from 0.98 to 9.2%.
What are the symptoms of Atopic dermatitis?
Most people show the first signs of eczema before the age of 5. Infants may have red, crusted, scaly areas on cheeks, scalp, or the front of their arms and legs while children and adults may have following symptoms such as:
- Very itchy, red rashes on the back of the neck and knees and in elbow creases.
- Small bumps and flaky skin.
- Thickened, darkened, and scarred skin upon scratching while worsening itchiness at night while going to bed.
- Scratching leads to infection and red bumps that hurt and can be filled with pus.
- Scaly, dry skin
- Rash that bubbles up, then weeps clear fluid
- Skin creasing on the palms of the hand or under the eye
- Darkening of skin around the eyes
What are the causes and risk factors of Atopic dermatitis?
- Atopic dermatitis may be related to genetic variation that affects the skin’s ability to provide protection. A weakened barrier function results in less retention of moisture and protection against bacteria, irritants, allergens, and environmental factors — such as tobacco smoke.
- Too much of the bacteria Staphylococcus aureus on the skin may also cause AD.
Other common types are contact dermatitis and seborrheic dermatitis (dandruff).
In general, dermatitis isn’t contagious (does not spread from person to person).
Some factors may increase the chances of Atopic dermatitis. These are:
- Strong soaps and detergents
- Some fabrics, like wool or scratchy materials
- Perfumes, skin care products, and makeup
- Pollen and mold
- Animal dander (fur, feathers, etc.)
- Tobacco smoke
- Stress and anger
- Dry winter air/low humidity
- Long or hot showers/baths
- Dry skin
- Sweating
- Skin infections or especially dry skin
- Certain hormones
- Dust or sand
How is Atopic dermatitis diagnosed?
If the doctor suspects atopic dermatitis, a medical history and physical exam is conducted. Additionally, a skin patch allergy test may also be suggested.
Patch testing:
Skin patches containing small amounts of things that a person might be allergic to is applied to the skin and covered for a couple of days. About 2 days after the patches is taken off, the doctor assesses if there is a rash around any of them.
What are the treatment options for Atopic dermatitis?
Atopic dermatitis is a long-term disease, and various treatments may be required over months or years to control it. The treatment of AD may be started with regular moisturizing and other self-care habits. In case there is no improvement, the doctor may suggest medicated creams that control itching and help repair skin. These might include –
- Steroid creams or ointments for mild flares
- Oral medications like steroid for more severe cases.
- Antibiotics in case of infection
- Medications to control inflammation
- Injectable preparations (biologics) for moderate to severe disease who don’t respond well to other treatment
Can Atopic dermatitis be prevented?
Developing a basic skin care routine may help prevent eczema flares. The following tips may help in keeping the skin healthy:
- Moisturize skin at least twice a day – Ideally, the best cream or lotion is that is safe, effective, affordable, and unscented. Using petroleum jelly baby’s skin may help prevent development of atopic dermatitis.
- Taking daily bath or shower – limit the bath or shower to about 10 minutes.
- Use a gentle, nonsoap cleanser
- Pat dry – gently pat the skin with a soft towel. Apply moisturizer while your skin is still damp (within three minutes).
References
- De A, Karekar S, Adhav C. Current Burden of Atopic Dermatitis in India: A Systematic Literature Review. Indian J Dermatol. 2023 Jul-Aug;68(4):487.
- Atopic dermatitis. Mayo Clinic. April 2024. https://www.mayoclinic.org/diseases-conditions/atopic-dermatitis-eczema/diagnosis-treatment/drc-20353279
- Atopic dermatitis. WebMD. April 2024. https://www.webmd.com/skin-problems-and-treatments/eczema/eczema-basics
