Atopic dermatitis – Everything you need to know

Eczema is a condition that leads to the inflammation and irritation of the skin. While there are many subtypes eczema, herein, we take a look at the most common type that affects more than 18 million adults in the country, i.e., atopic dermatitis.

Appearing as a red itchy rash, this condition manifests on the legs, arms, and even cheeks. Typically, babies are more prone to the condition, especially in the first six months. Sometimes, when the child gets older, the condition seems to disappear but there are also instances wherein some will have flares well into adulthood. There is no cure for this type of eczema, but it can be managed.

Causes of atopic dermatitis
No one knows the exact cause of this condition, but what’s certain is that it is accompanied by two allergic conditions: hay fever and asthma. Research has gone to prove that people with these allergic conditions or have a family history of hay fever or asthma are more likely to develop it. Implying that there is a genetic element to having this medical condition. If a parent has atopic dermatitis, asthma, or hay fever, there is an approximately 50% chance that the child will have at least one of these conditions. If both parents have any of these conditions, the probability that their child will have one of them is also greater.

Apart from genetic causes, there is a possibility that atopic dermatitis is just an immune reaction to an external or internal element. The immune system goes into overdrive leading to inflammation and itchy skin.

Another cause is a gene mutation leading to lower levels of filaggrin, which is a protein produced by the body to maintain a protective shield on top of the skin. Without the required levels of filaggrin, the skin loses moisture, making it dry and exposed to bacteria, viruses, and other infections.

How to identify atopic dermatitis?
This condition is chronic and, at times, severe. Here are some of the symptoms that should help identify it:

• Extremely itchy skin
• Dry skin leading to scales
• Rashes on arms and legs
• Open or crusted sores
• Redness of skin
• Cracking of the skin behind the ears

At times, the skin could get infected, leaving a yellow crust or pus-filled boils. These symptoms are very similar to those of other forms of eczema and it is possible to have multiple types of eczema at once.

Common triggers
When trying to figure out the triggers, it is possible to accidentally aggravate the condition. The symptoms can worsen after the exposure by causing flares on the skin. Some of the most common triggers for atopic dermatitis are

• Chemical irritants
  Exposure to products such as hand washes, sanitizers, baths, or even disinfectants could cause the skin to react in a severe manner. Metals, cigarette smoke, and even shampoos are also major contributors.
• Skin infections
  Any type of infection such as staph, herpes, and even some types of fungi could cause severe flares.
• Stress
  Excess stress could easily trigger an episode.
• Climate effect
  Changes in weather and temperature can cause extremely dry skin, leading to worsening of the condition.
• Allergies
  Allergic reactions to irritants like pollen dust, mold, and pet hair can trigger a flare.
• Hormonal imbalances
  Excess fluctuation in the levels of hormones in the body could be another trigger for flares.

Prevention and treatment options
A big part of managing this condition is knowing what the triggers are and being able to avoid them at all costs. Some other ways to manage it are

• Following a routine for bathing and moisturizing
• Using the prescribed medicine appropriately
• Avoiding scratching or rubbing the affected area
• Eliminating all allergens from home

Joining support groups and talking about it with others who are affected also helps cope with the effects.

The treatment of this condition is always based on severity. On a simpler scale, atopic dermatitis can be handled with topical medication such as over-the-counter creams that simply need to be spread over the affected area. Another option is opting for phototherapy, wherein certain forms of UV light are used to heal the skin.

In worse or more advanced cases, both broad and specific immunosuppressants are used. The specific immunosuppressants are used in extreme cases and are quite rarely recommended for this condition.

One such specific immunosuppressant is DUPIXENT®, which is also the first biologic medication approved by the FDA for this condition. Anyone with moderate to severe atopic dermatitis over the age of 12 can be injected with DUPIXENT®, provided they have the appropriate prescription. This medication can also be used with topical steroids.

Lastly, it’s important to remember that despite atopic dermatitis being chronic, it can be managed with proper care and medication.

This article is for information purposes only. Always consult and seek the advice of your physician/licensed healthcare professional with any questions regarding a medical condition or medication.