Atopic Dermatitis and Atopic Eczema

The Atopic in Atopic Dermatitis is derived from the Greek word “atopy” and is generally used to refer to a class of skin rashes caused by a hypersensitivity to a known allergen. The particular area of skin that develops a skin rash (often itchy) may not necessarily be the part that was in direct contact with the allergen.

Atopic dermatitis is present in about 10 - 15% of the general population. Most people who end up with the condition will exhibit symptoms by the age of five (5), over half by the age of one (1). In about half of these cases, the condition will disappear around or prior to the teenage years.

Atopic eczema is a chronic skin inflammation that usually develops after skin contact with irritants (i.e. chemicals), allergens (i.e. pollens, animal hair, etc.) – or the ingestion of certain foods. Atopic dermatitis is not contagious.

On babies, patches of affected skin may appear on the face, around the scalp, diaper area, hands, feet, arms and/or legs. The irritation is often present as an area of redness, with resultant oozing and crusting from scratching. Large portions of the infant’s body may be affected. This condition is often referred to as infantile eczema.

In adults and younger children, the rash will usually appear – and reappear in just a few spots, generally on the hands, inside elbow area and upper arm, and occasionally in the skin area behind the knee.

The sometimes intense itching and scratching can lead to exposure of the deeper layers of skin to bacteria, which can result in an infection.

ROOT CAUSE

The primary reason behind this hypersensitivity and resulting skin reaction is not fully understood, but existing evidence seems to point to genetics, or inherited characteristics. An abnormally functioning immune system seems to be the primary suspect. And - this condition tends to run in families.

Other environmental factors such as stress or fatigue may also contribute to the severity and frequency of the eruptions. It is common for affected individuals to have a history of allergic disorders, such as asthma or hay fever.

ATOPIC DERMATITIS TREATMENT

The best way to treat the problem is really to work on identifying and reducing or eliminating contacts with the allergens producing the skin reaction. If you have a history of allergies and have already been tested (patch testing), you will know what to stay away from . . .

Common food allergens can be avoided by shopping at specialty health food stores that carry products free of these allergens (i.e. milk products, nuts, tomatoes, wheat, yeast, and soy). It’s important to note that avoiding these allergens earlier rather than later can have a positive impact on reducing the likelihood of future occurrences.

For babies and very young children, breast feeding is one possible solution. If this is not an option, then the use of hydrolysed formulas is recommended.

Besides trying to limit your exposure to dust and other airborne irritants, other environmental conditions such as stress, anger or sleeplessness can also worsen the symptoms of atopic eczema. Extreme temperature and humidity swings can also impact the severity of an outbreak, or cause one altogether.

Although there is not a singular treatment option that will eliminate future occurrences of atopic dermatitis, there are some ways to lessen the severity of the inflammation and itching associated with the skin reaction.

Corticosteroids

Often dispensed as a cream or ointment, this type of drug can be purchased over-the-counter (OTC) or by prescription. The over-the-counter varieties should be used first since the active ingredient (normally hydrocortisone) is at a lower dosage level (usually 1%). Higher concentrations are available as a prescription. This drug is usually effective in reducing the itching.

Corticosteroid tablets are available by prescription, but generally are used only in the most stubborn cases. Tacrolimus and Pimecrolimus are creams or ointments that help to regulate the immune system and are sometimes used to limit the need for long-term corticosteroid use. In very severe cases, Cyclosporine, Mycophenolate or Azathioprine can be dispensed to help suppress the immune system response.

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