Atopic Dermatitis, Eczema
Atopic dermatitis is a very common skin condition primarily seen in young children and associated with allergies and asthma. It commonly presents near the elbows and knees and is characterized by severe, persistent itching. The skin often scales, oozes, and may thicken over time. Infections are common and disease-control may be elusive.
The treatment of atopic dermatitis includes close consultation with an experienced primary-care physician or dermatologist. The treatment plan often includes moisturizers, topical steroids or anti-inflammatory agents, oral anti-itching medications, and perhaps oral immunosuppressive agents. Proper skin care is essential and should include:
* Warm, tepid baths (not hot) with the use of a mild, non-fragranced moisturizing soap
* Mild drying of the skin after bathing (tapping dry with a towel rather than rubbing dry)
* Immediate application of moisturizer or topical medication
* Repeated application of moisturizer as many times as possible during the day
Additional treatment options include using a room humidifier to prevent the skin from drying out; and/or the application of wet pajamas / clothing with an overlying dry layer of clothes after application of topical medication or moisturizer. To decrease the bacterial load on the skin, bleach baths (1 cup bleach per tub of warm water) may be helpful; be cautious to prevent contact with the eyes.
Environmental Precautions for Atopic Dermatitis Patients
Atopic patients respond directly to the control of external irritants and allergens, therefore, every effort should be made to avoid or at least, control a harmful environment.
-Control the temperature. The room temperature should be kept on the cool side. Overheating induces sweating wchich can further cause and adverse reaction. Do not overdress and infant or a child for the same reason.
-Increase the humidity, when possible
-Minimize dust. Dust can cause irriation, and some atopic dermatitis patients are quite allergic to dust.
-Avoid perfumes, deodorant spray, and insecticides
-Avoid cigarette smoke, house dust mites (regular vacuuming, plastic mattress covers should help), and animal dander
-Avoid new rough clothing. Cotton is the best fabric. Avoid wool.
-Choice of soap (Dove, Lever 2000, Purpose, Basis, Aveeno) may be helpful. Also, you may wish to consider hypoallergenic detergents such as All Free and Clear, or Cheer Free and Gentle.
Don Mehrabi MD, FAAD
Dermatologist, Certified by the American Board of Dermatology
Los Angeles, California
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