In this article
- Meaning of atopic dermatitis
- How atopic dermatitis manifests itself
- What is the cause
- Bath and hygiene of children with atopic dermatitis
- How atopic dermatitis is treated
- Practical advice
- Pictures of atopic dermatitis
What is atopic dermatitis
Atopic dermatitis - but it's also called atopic eczema - is one chronic inflammatory skin disease quite frequent, which affects especially in children and manifests itself with the appearance of erythema, scales and itching. It is absolutely not contagious.
"It usually appears in the first two years of life, starting from 5/6 months of age, and it is typical of the first 6/7 years"explains pediatrician Elena Galli, head of the dermatitis commission of the Del Paesena Society of pediatric allergology and immunology. 2-3 out of ten children.
In many of the affected children, the disease disappears by puberty or adulthood, although the skin often tends to remain dry and sensitive.Read also: Children's dermatitis, a guide to the most common
How atopic dermatitis manifests itself
Atopic dermatitis is characterized by chronic-relapsing skin lesions. It means that periods in which the symptoms are particularly exacerbated (the so-called flares, acute phases) can be alternated with periods in which the skin returns to normal (remissions).
The characteristics and locations of the lesions are quite variable, also based on age:
- in the young child they often manifest themselves as roundish red and moist (exuding) patches located in particular on the face (with the exception of the area around the mouth, which tends to remain free) and on the limbs. Brownish-yellow flaking may also occur on the scalp and forehead;
- in the older child dermatitis is often localized in the folds of the elbows and knees;
- in adolescents and young adults hands and feet are often affected.
La severity is highly variable from person to person: sometimes these are mild forms, perhaps not very extensive and characterized above all by dry skin. Other times the severity is greater: very large areas can be affected and lesions can be associated with a also very intense itching, which can interfere with the child's quality of life and with his or her night's rest. In some cases the affected areas may undergo bacterial or viral infection: Eczema tends to get worse, the skin swells and pus can come out of the lesions.
Where dermatitis causes insomnia, this in turn can cause restlessness during the day, with school difficulties for the child and work difficulties for the parents. In addition, itching and aesthetic discomfort can affect the psychological development of child.9 PHOTOS
Atopic dermatitis in children: photos to recognize itgo to the gallery
It is a form of eczema, which involves about 30% of children, characterized by skin lesions, generally very itchy, with a chronic-relapsing course, which usually appear ...
What is the cause of atopic dermatitis?
In reality, the exact causes are not yet completely clear: there is probably one at the base constitutional predisposition (genetic), so much so that the children of parents with atopic dermatitis have an increased risk of developing this condition themselves. Among the genetic factors involved in the predisposition to atopic dermatitis, some probably concern the functioning of the immune system, others the activity of proteins such as filaggrina which helps to hold together some fundamental structural components of the epidermis.
However, genetic factors also add up environmental triggers. Among these, for example:
- exposure to irritants (such as synthetic clothing or wool) or environmental pollutants,
- cold and dry climate,
- emotional distress.
Atopic dermatitis: allergies and nutrition
While it is true that there may be reactive / allergic manifestations in the child himself with atopic dermatitis (or in his family members) such as asthma, rhinitis and allergic conjunctivitis, it is important to underline that atopic dermatitis it is not a form of allergy. "The child with atopic eczema should not be automatically considered allergic" states with emphasis Cesare Filippeschi, dermatologist specialist at the Meyer Children's Hospital in the city.
"Of course - continues the specialist - there can be a link with allergies, because there can be one common biological basis and because skin lesions, especially in the most severe and persistent forms, can facilitate the entry of antigens - the agents that trigger allergies - and this can facilitate the onset of future respiratory or food allergies "
But we repeat: the child with atopic dermatitis is not necessarily allergic and does not need to be tested immediately. Is worth investigate if allergies are present only if the dermatitis shows no signs of abating despite all the appropriate therapies. In some cases, doctors might even advise you to try to temporarily eliminate certain foods from the diet, but it shouldn't be a routine for all children with atopic eczema.Also read: 12 signs to tell if your child might have allergies
Bath and hygiene in children with atopic dermatitis
A proper hygiene it is essential for children with atopic dermatitis: on the one hand, in fact, washing helps to remove scabs, any irritants and microbes. On the other hand, however, we must be careful don't be too aggressive, so as not to damage the skin.
Here then are the advice contained in an official document published in 2022 by the experts of the Del Paesena Society of pediatric allergology and immunology and of the Del Paesena Society of pediatric dermatology:
- Don't stay too much in contact with water: washes should be daily but of short duration, about five minutes;
- To wash, lukewarm water and mild detergents, as poor as possible or free of preservatives and / or fragrances. If there is one bacterial superinfection bathrooms with diluted sodium hypochlorite;
- To dry no rubbing: yes to one instead gentle dabbing with soft towels, not rough.
- After washing, remember to spread a thin layer of emollient product.
How atopic dermatitis is treated: natural remedies and treatments
There is no specific and resolutive therapy and it is more correct to speak of therapeutic management by the physician (dermatologist or pediatrician treating), which varies according to the clinical manifestation of the dermatitis itself (red patches or skin color, moist or dry, thick or thin) and its severity.
in milder forms the simple one may suffice application of moisturizing and emollient creams, which help restore the skin's normal protective barrier. According to the Consensus Del Paeseno on the management of atopic dermatitis in children these products go applied on the entire skin surface one or more times a day, in sufficient quantity according to different variables, such as the extent of dryness, the climatic conditions, the possible practice of sports activities. It is very important to apply them even in remission of the disease, because it has been shown that this application prevents relapses and the need to resort to cortisone drugs.
Among the emollient creams, those of the latest generation, containing ceramides and lamellar lipids, which help replenish the damaged skin barrier. According to the aforementioned document, products with a higher lipid content are indicated above all in the winter season.
in more severe forms to the emollient products they must be added more specific anti-inflammatory products. The first line of treatment is represented by creams or ointments with cortisone, to be applied generally once a day, in the evening, until complete remission of the treated lesion. "Many parents are a little afraid to use these drugs: there is even talk of corticofobia" Filippeschi states. According to experts, however, there is nothing to fear: if applied according to the doctor's instructions, they are essential to reduce skin abrasions and improve the quality of life of the child, without important side effects.
In specific cases, the specialists treating the child will also be able to evaluate other therapies, for example with antibiotics against any bacterial infections, drugs immunosuppressants, oral cortisone or antihistamines. In particular, the latter can be used, again orally, for short periods of treatment in the event that itching disturbs sleep. Furthermore, for school-age children with atopic dermatitis that does not react to other therapies, the appropriateness of phototherapy.
Practical advice for managing atopic dermatitis in children
Some practical advice they help in the daily management of the child suffering from atopic eczema. For example:
- Avoid skin contact with synthetic clothing or raw wool, which cause irritation and itching;
- Garments can be washed with normal detergents, but they must be carefully rinsed;
- Avoid contact with "strong" detergents and with products for hygiene or cosmetics containing alcohol and perfumes;
- Keep the very short nails to reduce the risk of scratching injuries;
- If you do sports, wash well after activity, to prevent sweat from remaining in contact with the skin;
- Adapt the use of the emollient therapy to environmental conditions (if, for example, the climate is very cold and dry, it is worthwhile to insist a little more).
- Yes to the sun (with caution): dermatitis often subsides during the summer, especially at the seaside. Effectively, exposure to the sun it can have a positive effect. Of course, with all the necessary precautions, that is, avoiding the hottest hours and with adequate protection.
Spas can also be a useful strategy: in reality there are no conclusive studies on the subject, but according to the Consensus Del Paeseno, "thermal therapy can be an adjuvant therapy in the long-term management of atopic dermatitis". As if to say: on its own it hardly resolves, but combined with the therapeutic strategies described it can give an extra hand.Read also: Spas and children, that's why they are good
The importance of therapeutic education
Since atopic dermatitis is a skin disease yes, it can also have repercussions on the psychological and social level, it is important that the clinical approach is 360 °, that is, it takes into account these various aspects.
Some centers offer a real one therapeutic education, a strategy that allows you to teach the child and his family not only the correct application of therapy, but also the best ways to live with the disorder, which is certainly annoying, but it is neither serious nor contagious and can resolve spontaneously without success.
Centers that offer such an approach organize meetings with parents and children to help them understand well the nature of the disease and its evolution, perhaps playing it down a bit; the type of treatment prescribed (and how to best follow it); the importance of the advice provided.
Questions and answers
What can cause atopic dermatitis?
According to current knowledge, atopic dermatitis depends on a combination of genetic factors (individual predisposition) and environmental triggers.
How long does atopic dermatitis take to pass?
Often the disease goes away with puberty or adulthood, but the skin can remain dry and sensitive.
- eczema atopico