Atopic dermatitis: how to recognize and treat it?
Atopic dermatitis, or atopic eczema, is mainly manifested by dry skin and itching. Genetic and environmental factors play an important role in its appearance.
Atopic dermatitis is the most common type of eczema, a skin condition that is itchy and leaves red spots, usually on the face, arms, and legs. Although it occurs most often in children, it also affects around 18 million adults. The rashes tend to flare up and go away, but then come back.
Learn all about the causes, symptoms, and treatments for this chronic inflammatory skin disease.
What is atopic dermatitis?
Also called atopic eczema , atopic dermatitis is a chronic inflammatory skin disease caused by a genetic defect in the skin barrier . This anomaly is responsible for the excessive dryness of the skin and its permeability.
Affected people are genetically predisposed to "develop other manifestations of immediate hypersensitivity", for example allergic rhinitis , urticaria or asthma.
Atopic dermatitis is not a contagious or allergic disease . It usually sets in during the first months of life and most often disappears in late infancy, but it can continue in flare-ups into adulthood . Thus, 4.5% of over 15s suffer from this skin disease.
What are the causes of atopic dermatitis?
The causes of atopic eczema are multiple and vary from person to person. Heredity plays a major role.
Genetic predisposing factors
The skin of so-called “atopic” people is less waterproof and more permeable than normal. Consequences: it tends to dry out more and allow allergens from the environment to penetrate, which ultimately generates inflammation (inflamed skin).
The link between atopic dermatitis and genetic predisposing factors has been confirmed by family studies: between 50 and 70% of affected individuals have a first-degree relative who is also . If both parents are affected, the risk for the child of developing allergic eczema can reach 80%.
Other risk factors
- The environment : pollens, animal hairs, pollution , mites…;
- The skin contact with irritants (soaps, nickel, chemicals, scratchy fabrics ...);
- Certain foods;
- The temperature changes ;
- The sweat ;
- Fatigue, stress.
An imbalance in the intestinal microbiota (also called the intestinal flora) could promote allergic reactions such as eczema. This line of research, if it is confirmed, could contribute to the development of new therapeutic tools.
How to recognize atopic dermatitis?
The symptoms of atopic dermatitis are:
- a dry skin ;
- of itching (pruritus);
- lesions which may have several appearances depending on the stages of the disease;
- vesicular lesions (small water blisters), which often go unnoticed;
- of red spots ;
- oozing patches;
- thickening of the skin and sometimes scabs and swelling.
What parts of the body are affected by atopic eczema?
Depending on the age of the person, the location of the plaques varies:
- in the youngest , they are mainly found on the convex areas of the face : the cheeks, chin, forehead, but also the arms, legs and chest;
- From the age of two , the plaques are mainly concentrated in the folds behind the knees, in those of the elbow , ankles, wrists and the back of the ears.
Atopic dermatitis progresses in the form of flare-ups. Even if atopic dermatitis goes away often in childhood, the disease can persist into adulthood. It can also give way to allergic rhinitis or asthma .
How to prevent atopic dermatitis?
As the epidermis is weakened, actions and treatments are recommended on a daily basis, in order to prevent the appearance of new outbreaks:
- do not use irritating products or textiles (wool);
- favor surgras soaps or dermatological breads (without soap) ;
- moisturize the skin correctly and daily with oily products ;
- do not wash the child too often and cut his nails short;
- do not use too hot water but prefer lukewarm water;
- do not use too coarse towels;
- do not wear uncomfortable clothes and do not forget to cut the labels;
- use relaxation techniques if necessary to reduce stress.
These preventive measures are very useful but insufficient in isolation when the lesions begin to appear.
How to diagnose atopic dermatitis?
The diagnosis of atopic dermatitis is clinical , based on the observation of the lesions and on the questioning of the patient and / or his family.
How to treat atopic dermatitis?
As a basic treatment, moisturizers
So-called "atopic" skin must be moisturized daily with emollients (moisturizing creams or balms) . This treatment reduces the number and duration of outbreaks, calms itching, fights against water loss. By restoring the skin barrier, it also prevents the penetration of infectious and allergenic agents. Give preference to unscented emollients.
In case of flare-up and inflammation
As a first-line treatment , treatment is based on the immediate application of a corticosteroid-based cream (topical corticosteroid) , prescribed by the doctor. The cream is applied to the plaques as soon as the first symptoms appear and until they have completely disappeared.
The treatment should be repeated for each new outbreak. The duration of treatment is therefore variable depending on the patient and the intensity of the relapses. This treatment, well used, is safe and very effective.
In case of failure (very rare when the treatment is well conducted), the doctor may prescribe an anti-inflammatory cream based on immunosuppressants.or oral treatments in adults ( immunosuppressants such as cyclosporine or methotrexate).
Biotherapies for severe atopic dermatitis
Recently, biological drugs ( biotherapies ) have become available for adult patients with severe eczema resistant to conventional treatments, or in a situation of therapeutic impasse. These are drugs (antibodies) that are able to both precisely target and block the "key" molecule or cell involved in disease activity.
The dupilumab is the only biological therapy currently available for atopic eczema. It is administered by subcutaneous injection and is available, for adults, in city pharmacies. However, the treatment is not trivial and may not be suitable for some patients. It can cause side effects including eye (conjunctivitis) or outbreaks of facial eczema. Other biotherapies should soon be available.
Complementary drugs if needed
Depending on the situation, other treatments may be prescribed from time to time:
- of antibiotics (if a bacterial superinfection due to lesions generated by itching);
- the antiviral ( in case of herpes );
- of antihistamines (if associated allergies such as allergic conjunctivitis, rhinitis).
How to naturally treat atopic dermatitis?
- Applying cold to the skin quickly calms the itching!
- Relaxation, yoga, meditation ... anything that gently occupies your mind is recommended.
- A spa treatment is sometimes prescribed. An effective way to promote "therapeutic education" of parents.
Homeopathic treatment for eczema dermatitis , a natural solution
The homeopathic pharmacy PHC supports you in the treatment of eczema and advises you:
At the start of eczema flare-ups:
- Rhus toxicodendron 5 ch: 3 granules, 4 times a day.
- Apis mellifica 9 ch: 3 granules, 4 times a day.
- Belladonna 5 ch: 3 granules, 4 times a day
Vesicular phase of eczema:
- Cantharis 5 ch: 3 granules, 4 times a day
- Mezerum 5 ch: 3 granules, 4 times a day
- Croton tiglium 9 ch: 3 granules, 4 times a day
- Petroleum 9 ch: 3 granules, 4 times a day if the skin is very dry in winter.
- Graphites 9 ch: 3 granules, 4 times a day
Scaly phase of eczema:
- Arsenicum album 9 ch: 3 granules, 4 times a day
- Arsenicum iodatum 9 ch: 3 granules, 4 times a day
- Natrum sulfuricum 7 ch: 3 granules, 4 times a day
Notice
"Do not hesitate to consult a doctor or ask your pharmacist for advice. As soon as any symptom is unusual, see a doctor. As a reminder, so-called "soft" medicine is medicine with natural products. These, like plants for example, can have side effects or interactions. Do not change your medical treatment to so-called natural medicine without talking to your doctor. Homeopathy, plants, aromatherapy are also complementary treatments to your initial treatment".
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