Does your child have itchy, red skin? She or he might be suffering from Atopic Dermatitis.

Atopic Dermatitis (A.D.) is an inflammatory chronic eczematous disease of the skin and the most common type of eczema.

It is not a contagious disease. It usually begins in childhood but can also affect adults.
The exact causes of A.D. are not known. They combine a predisposition to A.D., often inherited; immune system and environmental factors; as well as the disturbance of good intestinal and skin bacteria. The condition can become more serious through abuse of antibiotics.

A.D. is often associated with asthma and has fever. It affects 10 to 20% of children in Europe and in the United States. The percentage of affected children has been rapidly increasing in developing countries as well, more so in cities than in rural areas.

A.D. is often mixed up with Allergic Contact Eczema; which is an allergic reaction against a substance or product that manifests as eczema. In some circumstances, a child can have both types at the same time.

How to recognise Atopic Dermatitis

Your child’s skin is:

• Dry, rough and scaly

• Very itchy

• Inflamed

The skin also shows redness, very small blisters, weeping, cracking and crusting.

The skin areas affected can be the cheeks, the arm folds, the back of knees, cracks behind the ears, but can really be anywhere on the body.

It predominantly affects infants and young children, usually beginning before the age of six months, and occasionally adults.

• Atopic Dermatitis is a long lasting disease. During some periods symptoms may worsen followed by periods when the skin improves, sometimes healing completely, a state that is called remission.

• 50% of A.D. symptoms disappear around the age of five, although the skin may always seem dry and remain easily irritated.

Treatment

• First of all you, will have to avoid triggers that worsen A.D.

It can be aggravated by:

• Irritants such as detergents, antiseptics, hot baths, harsh soaps.

• Synthetic fibers, wool

• Temperature:

- In summer, sweating causes itching

- In winter, cold weather dries the skin

• Super infection:

Bacteria, viruses, fungi (impetigo, herpes…)

• Allergens:

Seasonal pollen, dust mites, animal dander and mold.

• Stress

•Hormones

It is very important that you take due care of your child’s skin, protecting and hydrating it daily by:

• Giving lukewarm baths with lye free soap

• Moisturising the skin immediately following the bath with emollient cream

• Keeping finger nails short

• Choosing soft breathable cotton clothing

• Breastfeeding your infant and introducing other foods progressively.

• Keeping the child cool

Recently, the use of probiotics (lactobacillus…) found in probiotic yoghurt has proven to be very efficient in avoiding flare ups.

In case of a flare up your doctor may prescribe some of the following:

• Antihistaminic medicine, if itching is very severe.

• Corticosteroid creams or ointments.

• Tacrolimus  or Picrolimus non-steroid topical ointments referred to as immune modulators

• Phototherapy using ultraviolet A or B light for adults only.
In case of severe A.D. and after specialist advice only, the following drugs can be prescribed

• Immunosuppressive drugs (cyclosporine)

• Biologic drugs as dupilumab

In conclusion, Atopic Dermatitis is known as a long term disease. Although it is a very uncomfortable disease for your child it can be successfully managed with cooperation of the child, the family and the doctor.

To repeat, don’t forget simple things like daily moisturising and avoiding triggers can help your child get through Atopic Dermatitis comfortably.

(Source: by Dr. Nelly Gerard/ the Ha Noi French Hospital)