Atopic Dermatitis (Eczema) Basics Part 2

The exact cause of atopic dermatitis is unknown, but the tendency to develop atopic dermatitis runs in families. People with atopic dermatitis are more likely to suffer allergies and/or symptoms of asthma. The connection between these disorders appears to be an overactive immune system.
T-cells, a type of white blood cell that fights infections, appear to be more active in people with atopic dermatitis. Changes beneath the skin make the skin of people with atopic dermatitis more susceptible to losing water quickly, leading to dry, cracked skin.
Although the immune system is overactive in people with atopic dermatitis, it is not always effective at fighting infections. In fact, people with atopic dermatitis are more susceptible to skin infections, such as impetigo.
What triggers atopic dermatitis?
Not everyone with atopic dermatitis will have the same triggers, so people with the disorder will have to keep track of their particular sensitivities. Because identifying triggers can be tricky (for example, sometimes there is a delay between eating a certain food and seeing a resulting flare-up), it’s a good idea to keep a journal of any atopic dermatitis symptoms and possible causes.
Some commonly reported atopic dermatitis triggers include:
  • Irritants-These are substances that contact the skin directly, causing redness and inflammation. They include wool or other synthetic fabrics, soaps and detergents, perfumes and makeup, cigarette smoke, and chemicals (such as chlorine).
  • Allergens-Allergens are more indirect triggers, where the skin becomes inflamed and itchy because of an allergic reaction, such as from pollen, mold, or animal and pet dander.
  • Stress-While stress isn’t a known cause of atopic dermatitis, it can aggravate flare-ups.
  • Temperature-Many people with atopic dermatitis have chronically dry skin that is sensitive to certain climate conditions, such as cold winter weather, indoor heating, or warm baths. Humid environments, such as a sauna, may cause sweating that could trigger a flare-up.
What are the treatment options for atopic dermatitis?
The goals of atopic dermatitis treatment are to heal the skin, prevent new flare-ups, and reduce the urge to scratch, which can further irritate and prolong symptoms.
Atopic dermatitis treatment may last for many months, and treatments often need to be repeated.
There are several treatment options available. A treatment plan will be recommended based on several variables, including:
  • The person’s age
  • The location of the rash (face vs. knee)
  • The severity of the flare
  • Acute vs. chronic (long-lasting symptoms may require more potent medications)
  • Results of past treatments
  • Personal preferences
It is generally recommended that all people with atopic dermatitis do their best to avoid known triggers and apply a moisturizer regularly.
Additional treatment options include:
  • Topical corticosteroids. Mild to mid-potency corticosteroids are applied to the skin on a short-term basis to bring the flare under control
  • Calcineurin inhibitors (Elidel(r), Protopic(r)). Calcineurin inhbitors are non-steroidal medications may be used as an alternative to corticosteroids or in between use of corticosteroids. They too help to reduce inflammation.
  • Antihistamines (Benadryl(r), Claritin(r), Xyzal(r), Zyrtec(r)). Antihistamines help to reduce the itching and scratching that can prevent the skin from healing
  • Antibiotics. These may be prescribed to treat an underlying bacterial infection of the skin that can be worsening symptoms of atopic dermatitis.
  • Oral corticosteroids (prednisone). These may be used to bring severe cases of atopic dermatitis under control quickly. Due to the wide variety of side effects caused by oral corticosteroids, they are generally prescribed for only a few days.
  • Immunosuppressants (cyclosporine). These may be considered for severe cases of atopic dermatitis that do not respond to other treatments.
How can I prevent atopic dermatitis flare-ups?
Basic skin care measures may help to prevent atopic dermatitis flare-ups.

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