Atopic dermatitis

Atopic dermatitis is a chronic, relapsing skin disease that occurs among people with a tendency to allergic reactions (atopy). Those who suffer from it are mainly young children, with 60% being in the first year of life.

Atopic dermatitis is often seen in children allergic to cow’s milk. Skin lesions appear after the third month of life, initially located on the face. They resemble a flushed area, but with slight flaking on the surface. In older children, patches of reddened, dried, easily irritated skin can be seen behind the ears, in the bend of the elbows, and behind the knees. In children with atopic dermatitis, the protective water–lipid layer does not function properly. The skin lesions cause intense itching, which leads to scratching. The child becomes irritable and has trouble sleeping. Scratching the skin contributes to secondary infections and to persistence of the lesions. Any child, even a healthy child, needs proper skin care, but this is particularly important for children with atopic dermatitis.  

In atopic dermatitis, certain factors are responsible for exacerbating the disease: these include food allergens, inhalant allergens, and skin irritants such as detergents, woollen clothing, synthetic fibres, and overheating. The appropriate care of atopic skin is necessary, both during period of acute lesions and during the chronic stage of the disease.

In atopic dermatitis, damage can occur to skin barriers, such as the one formed by the lipid layer, leading to substantial transepidermal water loss. This barrier must be rebuilt so as to prevent further damage to the skin. If the lesions become inflamed, general and local pharmacological treatment is necessary. Local treatment is usually in the form of ointments containing steroids or calcineurin inhibitors. Steroidal ointments are an effective and safe form of treatment, but should only be used under the supervision of a dermatologist and for a short period of time. Other forms of treatment include phototherapy, antihistamines, psychological care, and antipruritic preparations. Once atopic dermatitis is in remission, only the avoidance of allergens and the systematic and proper care of the skin using moisturizing preparations will allow the clinical improvement to be maintained and relapse to be avoided. It is necessary to use preparations that nourish and protecting the dry skin (emollients), that do not contain fragrances or dyes, and that have a slightly acidic pH to protect against damage to the lipid layer of the skin.

Caring for dry and atopic skin

Good advice for people with dry skin:

  1. Bathe the affected area in a lipid replenishing oil at 37 °C.
  2. In the first 3 minutes after bathing, creams and emulsions should be applied to the skin while it is still wet.
  3. The effectiveness of the emollient may be increased by the wet dressing method: after immersion in the oil, apply more moisturizing cream to the affected area than can be completely absorbed; cover this with a wet layer of cotton gauze, and finally, by a dry layer.
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