Atopic dermatitis/eczema starts in children in the first few years of life. It generally affects the skin over the face of the child, inside elbows, behind the knees, and even hands & feet.
The skin becomes dry, itchy, and red with a rough texture and may develop oozing skin lesions. The child keeps constantly touching and scratching the area. Over time the skin becomes thick, and the skin creases become more prominent with long-standing disease.
The condition is commonly present along with other allergies like- watery eyes, runny nose, and breathing difficulty. These may be present at the same time as eczema or may develop later in childhood/adolescence.
The disease is commonly present genetically.
For instance, there is around 50% chance of having atopic dermatitis if one of the parents is affected and 70% if both are affected.
Most children usually outgrow their eczema by the time they are around 4. It may persist less commonly in teenagers and adults, who can still have “dry skin” without any flares of eczema.
Are tests helpful for the management of atopic dermatitis?
Exposure to some allergens may cause disease flares of atopic dermatitis in children. However, undergoing either skin or blood tests for them produces results that don’t have much role in disease control per se. Instead, the tests indicate that a person might be allergic to a specific substance/food item. Allergy to the latter falls under the category of “Food Allergy.”
A child’s skin is more sensitive to environmental allergens like pollen, molds, animal dander, and dust mites. In addition, unlike traditional belief, food has little role in the causation of atopic dermatitis. Nevertheless, blood or skin tests usually can’t rule out the role of causative allergens. Therefore, it is NOT recommended to undergo tests for specific allergens.
Do certain foods cause eczema? Can restrictive diets help?
Food has a controversial underlying role in the causation of the disease.
The skin condition may worsen in children after eating foods like eggs, dairy, soy, peanuts, or wheat. However, it is usually not due to the disease itself but to associated food allergy, which commonly adds to the insult caused by persisting eczematous skin condition.
According to studies, about 40% of the infants and children with eczema have associated food allergies and about 6% of the general population have it.
So it is better to consult a doctor specializing in managing allergic conditions. Additionally, seek advice from a dietitian regarding avoiding certain foods. They might then tell you to undergo allergy tests for specific food items.
It is not advisable to put broad restrictions on the diet, limiting the diet itself to only 4-5 selective food items. Doing this can have an adverse effect on health over the long term due to a lack of nutritional content of the diet.
Treatment of atopic dermatitis
Topical treatments are the most common treatment options for atopic dermatitis, including creams, gels, ointments, lotions, sprays, cleansers, and shampoos. These topical treatments can be used to relieve itchiness and moisturize dry skin.
Moisturizers improve the appearance and function of the skin on application. They should be liberally applied to the diseased as well as the normal skin at least twice a day or as many times as needed, to achieve the best results.
The choice of moisturizer is your personal preference, however, some evidence suggests that moisturizers containing oatmeal, shea butter, etc., have additional anti-inflammatory properties, although this is not beyond doubt.
Some people with atopic dermatitis may not need a topical treatment because their skin becomes too dry or flaky to apply a cream or gel. In these cases, the patient must have an effective barrier cream on hand for quick relief from itching.
Mild topical steroid formulations are effective for temporary improvement of the skin condition, generally for a flare-up of inflammation. They are generally advised not to be used for the face, neck, and other delicate areas with thin skin over the long term because of increased absorption and harmful effects on the body.
