What is atopic dermatitis (eczema)?
Atopic dermatitis (commonly known as eczema) is one of the most common skin diseases and is a chronic allergic skin condition that runs in families. The most common symptoms of atopic dermatitis (eczema) are dry skin, rashes and intense itching. Scratching aggravates the lesions and increases the likelihood of bacterial infection if the skin is scratched.
Most patients develop the disease between the ages of 2 months and 6 months after birth, when it is also known as “pediatric eczema or ringworm”. 60% of children will improve by the age of 2 years, and about 90% will improve or even recover completely by the age of 5 years, but the skin will still be dry and prone to allergies. A small percentage of children with atopic dermatitis have a chronic course of symptoms that recur with the change of seasons.
When children with atopic dermatitis grow up, they are prone to allergic rhinitis and allergic asthma, even though their skin symptoms disappear.
What are the causes of atopic dermatitis?
1, genetic factors: autosomal dominant inheritance
2, environmental factors: socio-economic status, migration, environmental pollution
3, immune factors: T-cell immune dysfunction, 80% of patients with elevated IgE.
4, skin barrier function abnormalities: manifested as the patient’s dry flaky skin, genetics, inappropriate care, excessive use of bathing products can increase the degree of dryness.
Allergic factors: substances that may trigger atopic dermatitis
1, food allergens, common are eggs, peanuts, milk, nuts, soy, wheat, seafood, etc.
2, inhalation allergens, such as pollen, dust mites, pets such as dog and cat dander, etc.
3, microbial allergens, such as Staphylococcus aureus, mold spores, etc.
The danger of atopic dermatitis
As atopic dermatitis recurs, patients often scratch their skin due to severe itching, affecting their appearance and thus interpersonal communication. For children, due to their delicate skin, the scars are more obvious after scratching, causing embarrassment and low self-esteem in public places, and even affecting their character development. For infants and young children, the lack of sleep caused by intense scratching seriously affects the growth and development of children and the quality of family life. The restrictions on the daily diet of patients with atopic dermatitis and the recurrent attacks of the disease increase the economic burden on the family. Child patients can develop allergic rhinitis and asthma in adulthood.
Atopic dermatitis is not only a disease of children, but has become a growing public health concern worldwide.
Principles of treatment for atopic dermatitis
The acute exudative phase is treated with wet compresses and other methods combined with topical anti-inflammatory drugs, such as glucocorticoids and non-hormonal topical immunomodulators. To reduce itching, oral antihistamines or topical antipruritic agents can be used; topical or oral antibacterial drugs should be used at the same time in the acute phase of concurrent infection.
Get into the habit of bathing correctly
1, if conditions allow, daily or every other day bath, preferably in a tub, bathing helps to increase skin moisture, bathing with warm water close to body temperature (34-37 ℃) . Do not use hot water to scald.
2, minimize the use of alkaline detergents, choose mild soap and shower gel with moisturizing effect, avoid scrubbing hard with towels or other items when bathing; at the end of the bath, before the skin is completely dry whole body rubbing emollient.
3, find the most suitable emollient: insulation and emollient a wide variety of prices vary greatly, generally fragrance-free, formulated for sensitive or dry skin skin skin care products is appropriate, reasonable use of skin care products can relieve dry skin and improve the skin barrier function.
How to choose topical anti-inflammatory drugs
Topical anti-inflammatory drugs should be used correctly under the guidance of a doctor, and regular medication should be adhered to in order to completely control the condition.
Topical glucocorticosteroids are weak, medium, strong and super strong. Patients should choose topical preparations reasonably according to their conditions and skin lesion areas, and for children, weak to medium-acting topical glucocorticosteroids should be used.
When topical anti-inflammatory drugs are used, a burning sensation, itching and other uncomfortable sensations may occur at the site of application in the first 3 days. After the lesions have significantly improved or even completely subsided, maintenance treatment should be continued, such as topical medication twice to three times a week, to consolidate the effect. After the lesions have subsided, attention should still be paid to skin care and frequent use of skin care agents to keep the skin moist and smooth. This is especially important in the northern autumn and winter seasons and in dry climates.
How to deal with itching and scratching at night Even if you have taken a good bath every night before going to bed, carefully applied emollients and topical medications, and taken good medications, sometimes your child will still cry in the middle of the night because of itching, which is very disturbing to the peace of family life.
At this time you can take cold compresses on the itchy area or use topical emollients to relieve the itch. In severe cases, you can consult your doctor and prescribe some antihistamines to calm down and help you sleep. Resolutely avoid scratching: for example, wrap the affected hand before bedtime to avoid unconscious scratching during sleep.
Daily precautions for patients
1. Atopic dermatitis often develops in infancy, so diapers, clothing, and bedding for infancy should be soft cotton products, not man-made fibers or woolen textiles, and diapers should avoid plastic and products with waterproof materials.
2.In infants and children, allergy to food is easy to occur, parents should pay attention to observe, once the allergy should immediately stop eating.
3. Children may be allergic to animal fur, such as dander from dogs and cats, pollen from blooming flowers, dust from carpets or curtains, all of which may become inhalation allergens and should be avoided by patients with atopic dermatitis.
4. For children with a genetic background, it is advisable to add a single food each time when adding complementary foods during infancy and observe for a few days to understand whether it will cause allergies.