Atopic dermatitis (eczema) is an itchy inflammation of your skin. It’s a long-lasting (chronic) condition that may be accompanied by asthma or hay fever.

Dr Nguyen Thi Hai Van

Signs and symptoms of atopic dermatitis (eczema) include:

·        Red to brownish-gray coloured patches;

·        Itching, which may be severe, especially at night;

·        Small, raised bumps, which may leak fluid and crust over when scratched;

·        Thickened, cracked or scaly skin;

·        Raw, sensitive skin from scratching;

·        Most often this eczema occurs on the hands and feet, the bend of the elbow, behind the knees, and on the ankles, wrists, face, neck and upper chest. Usually begins in childhood before age 5 and may persist into adulthood.

Factors that worsen atopic dermatitis:

·        Dry skin

·        Long, hot baths or showers

·        Stress

·        Sweating

·        Rapid changes in temperature

·        Low humidity

·        Solvents, cleaners, soaps or detergents

·        Wool or man-made fabrics or clothing

·        Dust or sand

·        Cigarette smoke

·        Living in cities where pollution is high

·        Certain foods, such as eggs, milk, fish, soy or wheat

·        Infantile eczema

·        Infantile eczema often involves an oozing, crusting rash, mainly on the skin of the face and scalp, but it can occur anywhere.

Causes

The exact cause of atopic dermatitis (eczema) is unknown, but it’s likely due to a combination of dry, irritable skin with a malfunction in the body’s immune system. It may be connected to asthma and hay fever.

Complications include:

Neurodermatitis (lichen simplex chronicus). An area of skin that’s frequently scratched becomes thick and leathery.

Skin infections. Sometimes, scratching can break the skin and cause open sores and fissures that can become infected.

Eye complications. Severe atopic dermatitis around the eye may lead to permanent eye damage. Hence see your doctor promptly.

Atopic dermatitis (eczema) is typically diagnosed based on an examination of your skin and a review of your medical history.

Treatments and drugs

Medications: Corticosteroid creams or ointments.

Antibiotics - for a bacterial skin infection due to fissures caused by scratching.

Oral antihistamines - if itching is severe, oral antihistamines may help. Diphenhydramine (Benadryl, others) can make you sleepy and may be helpful at bedtime.

Oral or injected corticosteroids - for more severe cases, short term oral corticosteroids, such as prednisone.

Immunomodulators - tacrolimus (Protopic) and pimecrolimus (Elidel) affect the immune system and may help maintain normal skin texture and reduce flares of atopic dermatitis.

Light therapy (phototherapy) - controlled amounts of natural sunlight, artificial ultraviolet A (UVA) or ultraviolet B (UVB) light or narrow band ultraviolet B (NBUVB). However harmful effects include premature skin aging and an increased risk of skin cancer.

Lifestyle and home remedies

To help reduce itching and soothe inflamed skin, try these self-care measures:

·        Try to identify and avoid triggers that worsen the inflammation. Rapid temperature change, sweating and stress can worsen the condition. Avoid wool products as well as harsh soaps and detergents.

·        Apply an anti-itch cream or calamine lotion to the affected area.

·        Avoid scratching whenever possible.

·        Apply cool, wet compresses.

·        Take a warm bath. Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal e.g. (Aveeno).

·        Choose mild soaps without dyes or perfumes.

·        Moisturize your skin. Use an oil or cream to seal in moisture while your skin is still damp from a bath or shower.

·        Use a humidifier. Hot, dry indoor air can parch sensitive skin. A home humidifier may help.

·        Wear cool, smooth-textured loose cotton clothing.— Family Medical Practice Vietnam