The prefix “a” in Latin means “not.” One might then reasonably assume that atopic dermatitis is a form of dermatitis that’s completely off-topic and not at all what we were talking about. But of course, atopic dermatitis is the topic of this article about dermatitis that’s atopic. It’s in the title and the topic!
Has your head exploded yet?
According to the dictionary, the word “atopic” refers to an allergic reaction that occurs in a part of the body that didn’t come into contact with the precipitating allergen. That definition is kind of a mouthful. Really when we use the word “atopic” or “atopy” in medicine we are referring toward an inherited tendency towards allergic disease like “hay fever” a.k.a. allergic rhinitis, asthma, or eczema which is the common name for atopic dermatitis. People that have any one of these conditions many times also get one or two of the other associated conditions.
Atopic dermatitis is an itchy skin condition marked by red patches, commonly on the arms, legs, and face (though they can appear in other places as well.) The rashes generally aren’t permanent, but when a flare-up occurs, it can be very uncomfortable. This article will discuss common symptoms, causes, and treatments.
Atopic Dermatitis Symptoms
The condition is most commonly found in young children, but it can affect older kids and adults as well. It is characterized by dry skin and extremely itchy, red rashes that flare up for a time, retreat, and then reappear sporadically.
In children under the age of 2 years old the rash is predominantly found on the cheeks, outer elbows and outer knees. Around the age of 2 years old to the beginning of adolescence the rash tends to move to the inside of the elbows and the knees and occurs on the wrists and ankles. From adolescence through adulthood the rash continues to be found in the folds of the arms and legs, on the wrists and ankles and is also found on the neck and eyelids.
In some cases, other symptoms may accompany the rash, including:
- Raised bumps that weep when scratched
- Thick, scaly skin, particularly in areas that are scratched heavily
- Cracked, bleeding skin (most commonly caused by scratching)
As you likely picked up, scratching makes atopic dermatitis symptoms worse and should be avoided as much as possible. How? We’ll get into that. But first, let’s explore precipitating factors.
Atopic Dermatitis Causes
Atopic dermatitis is caused by skin barrier dysfunction. There are many types of connections in skin that make it an excellent barrier to the outside world. If one of the many connections is not working correctly then this barrier does not work like it should and irritants from the outside world can penetrate into the body more readily and cause inflammation. Many different genes are responsible for regulating the skin’s ability to retain moisture and protect itself. These little weak spots in the skin barrier can be inherited.
As mentioned earlier, if you have atopic dermatitis there is a strong chance you may develop allergic rhinitis or asthma. Furthermore, children with a parent that suffers from allergies are more likely to develop atopic dermatitis.
Causes of flare-ups of atopic dermatitis can vary from person to person but commonly include:
- Harsh soaps and other cleansers
- Perfumes and dyes commonly found in skincare products
- Rough fabrics
- Mold, pollen, and animal dander
- Dry skin
- Low humidity
- Extended showers and baths at elevated temperatures
Avoiding these triggers can help reduce flare-up frequency. But wait — there’s more!
Atopic Dermatitis Treatment
There is no cure for the condition. The best you can do is avoid flare-ups and ease your, or your child’s symptoms when they occur.
Wear loose-fitting, soft, natural fibers like cotton as much as possible. Trade your aromatic soaps and shampoos for an atopic dermatitis shampoo and body wash that is free of perfumes, dyes, and other additives that can further disrupt the skin barrier and promote moisture loss. Protect and restore your skin with a hypoallergenic moisturizing cream for atopic dermatitis, especially right after a lukewarm bath or shower and use at least 2 to 3 times a day. A humidifier may also be helpful for fighting dry skin.
Antihistamines can provide temporary relief, particularly at night, when the itching is worse. You might be tempted to scratch, but don’t. Wear soft gloves to reduce the impact if you just can’t fight it.
If these interventions aren’t enough, please consult your doctor as there is a large arsenal of prescription cream both steroidal and non-steroidal that can soothe the rashes you can see and take the itch away. For severe cases of atopic dermatitis there are immunosuppressive drugs, new very promising injectable biologics, and light therapy.
When a flare-up makes your life difficult, know that it will fade eventually, and treatments exist to help. You’re not alone.