Atopic Dermatitis 

Atopic dermatitis, also known as eczema, is a skin condition that causes the skin to become red and itchy. It is most common in children, though it can also happen at any age. Atopic dermatitis is typically a chronic condition that flares up from time to time. Asthma or hay fever may accompany it. 

There is no cure for atopic dermatitis. Treatments and certain self-care measures, on the other hand, can help alleviate itching and avoid more outbreaks. While some children and adults outgrow this condition, others will have it for the rest of their lives. 

General Signs and Symptoms of Atopic Dermatitis 

The signs and symptoms of atopic dermatitis vary greatly from one person to another. They can include the following; 

• Skin dryness
• Itching that can be severe, particularly during the night
• Patches that appear red to brownish-gray, mainly on the feet, hands, ankles, neck, wrists, eyelids, upper chest, inside the elbow and knee bends, and the scalp and face in infants and toddlers with atopic dermatitis. 
• When scratched, small, raised bumps may leak fluid and even crust over.
• Skin that is thickened, scaly, or cracked
• Sensitive, raw, and swollen skin due to scratching 

Atopic Dermatitis Symptoms in Infants

The symptoms of atopic dermatitis in infants and babies below two years include:

• Rashes on the cheeks and scalp
• Rashes that explode before fluid leakage
• Rashes that can lead to severe itching and interfere with sleep

Symptoms of Atopic Dermatitis during Childhood 

In children aged two and above, these atopic dermatitis symptoms are likely to occur:

• Rashes developing behind the elbow or knee creases
• Rashes on the wrists, neck, ankles, or the crease between the legs and buttocks
• Rashes that appear bumpy
• Rashes that get light or dark
• Thickening of the skin (lichenification) that could lead to permanent itchiness.

Atopic Dermatitis Symptoms in Adults

Adults are more likely to experience these atopic dermatitis signs and symptoms:

• Rashes which are scalier, unlike those seen in children
• Rashes that appear in the elbows and knees creases, as well as the nape of the neck
• Rashes covering a large portion of the body
• Skin that is extremely dry in the affected parts
• Itchy rashes that last a long time
• Infections of the skin

Atopic dermatitis usually starts before the age of five and can last till adolescence and even adulthood. It tends to flares up for some people from time to time and then subsides for a certain period (even years). 

Causes of Atopic Dermatitis 

The exact cause of atopic dermatitis is unknown. However, it is thought to occur due to an overactive body immune system that aggressively reacts from irritants exposure. 

Sometimes, atopic dermatitis is caused by an abnormal reaction to proteins found in the body. The immune system usually ignores the proteins that are naturally present in the body. Instead, it only attacks proteins from invading organisms like bacteria or viruses. 

However, in atopic dermatitis, the immune system tends to lose its capacity to distinguish between the two, resulting in inflammation. 

When one or more symptoms of atopic dermatitis develop on the skin, it is referred to as a flare-up. The following are the common causes of atopic dermatitis flare-ups: 

• A rough and scratchy material, such as wool
• A sudden decrease in humidity
• Allergies to certain foods
• Animal dander
• Chemicals present in detergents and cleaners that cause skin dryness
• High body temperature
• Shifts in temperature
• Stress 
• Sweating
• Synthetic fabrics
• Upper respiratory infections 

Risk Factors of Atopic Dermatitis

A number of factors can increase your chances of developing atopic dermatitis. This condition is more common among children with asthma or hay fever. Also, adults who develop these disorders later in life, normally before they turn 30, are at risk. 

In addition, individuals with a family history of atopic dermatitis eczema are also more likely to develop the disease. 

Atopic Dermatitis Diagnosis 

There are no particular diagnostic tests that dermatologists can use to identify atopic dermatitis. However, if your provider has previously seen the disease, he or she can determine it based on your symptoms. 

Sometimes, a patch test can help identify specific allergens that cause symptoms, such as skin allergies related to the problem. The provider applies an allergen to the patch on the skin during a patch test. Your skin will irritate and get inflamed in case you are allergic to the allergen. 

Atopic Dermatitis Treatment 

Atopic dermatitis can be chronic. To manage it, you may have to try out several treatment options for some months or years. Even when treatment is effective, the signs and symptoms may reappear or flare. 

It is critical to identify the condition as soon as possible so that treatment can begin. If routine moisturizing and some self-care measures are ineffective, your dermatologist can recommend one or more of these treatments:

Medications:

Your dermatologist or medical provider can prescribe a variety of medications to help manage and treat atopic dermatitis symptoms, including: 

• Topical corticosteroid ointments and creams

Your provider can recommend these anti-inflammatory medications to assist in alleviating the primary symptoms of atopic dermatitis, including itching and inflammation. They can be applied to the skin directly. Prescription-strength drugs can be beneficial for some people. 

• Oral medications

When topical treatments fail to work, your provider can recommend oral medications such as systemic corticosteroids or immunosuppressants. They are usually available in the form of injections or as tablets taken orally. 

Oral medications should only be used for a short period. It is also essential to note that if you are not already using a different drug for the disease, the symptoms can get worse if you stop taking these medications.

• Antihistamines

Since antihistamines result in drowsiness, they can help limit the possibility of having scratching during the night. 

• Antibiotics

Your doctor can suggest antibiotics when atopic dermatitis coexists with a bacterial infection of the skin. 

• Topical calcineurin inhibitors

This medication suppresses the immune system's activity. As a result, it reduces inflammation and aids in the prevention of flare-ups. 

• Barrier repair moisturizers

These medications function by repairing the affected part of the skin and by reducing the loss of water.

• Injected biologic medications

These drugs inhibit immune system proteins, hence limiting immune system reactions.

Although atopic dermatitis is not treatable at the moment, everyone should see a dermatologist to get a personalized treatment regimen. Even when the skin area has already healed, it is critical to take care of it because it can easily get irritated or inflamed again. 

Light therapy:

This treatment is suitable for patients who either do not improve with the topical treatments or relapse quickly following treatment. The most basic form of light therapy (phototherapy) includes exposure of the skin to regulated levels of natural sunlight. Other types use artificial ultraviolet A (UVA) and narrowband ultraviolet B (UVB) alone or in combination with medications.

Phototherapy treatment entails being exposed to UVA or UVB waves. Phototherapy can be used to treat mild atopic dermatitis. Throughout your treatment regimen, your doctor will keep a close eye on your skin. 

Wet dressings:

Wrapping the affected spots using topical corticosteroids as well as wet bandages is an efficient and intensive cure for serious atopic dermatitis. Since it is labor-intensive and necessitates nursing skills, this is sometimes done within a hospital setting, especially for patients with severe lesions. Alternatively, speak with your medical provider on learning the necessary ways of using this method while at home. 

Other therapies:

Alternatively, your doctor can recommend the following atopic dermatitis treatment options:

Counseling: Individuals who get frustrated or embarrassed with their skin condition may benefit from speaking with a therapist or counselor.

Relaxation, behavior change, and biofeedback: All these methods may be beneficial to individuals who are constantly scratching their skin. 

Complications of Atopic Dermatitis 

Atopic dermatitis complications can include:

Asthma and hay fever: These conditions are at times preceded by atopic dermatitis. By the age of 13, more than half of young minors with atopic dermatitis acquires hay fever and asthma. 

Itchy, scaly skin that persists: Neurodermatitis (lichen simplex chronicus) is a skin condition that begins with an itchy patch of skin. One scratches the area, making it itch even more. You may eventually scratch out of habit. The affected skin may be discolored, leathery, or thick as a result of this condition.

Irritant hand dermatitis: This is especially true for people with atopic dermatitis on hands and whose jobs require them to frequently wet their hands and expose them to harsh detergents, soaps, and disinfectants.

Skin infections: Scratching that breaks the skin repeatedly can result in open sores or cracks. Hence, these raise the risk of bacterial and viral infection. 

Allergic contact dermatitis: This is a common condition for patients who have atopic dermatitis.

Sleep issues: The itching and scratching cycle can lead to a lack of sleep.

Conclusion 

Atopic dermatitis is a common skin inflammatory condition. It is more common among children, although the majority of them will outgrow it by the time they get to the adolescent stage. Atopic dermatitis can be painful and can range in severity. It can manifest differently based on the age of the person. The symptoms may be more difficult to detect in people with dark skin tones. 

While there is no cure, people can use home remedies, moisturizers, medications, and lifestyle changes to treat and prevent flare-ups.