Atopic Dermatitis

Atopic dermatitis is a very common, often chronic (long-lasting) skin disease that affects a large percentage of the world's population. It is also called eczema, dermatitis, or atopy. Most commonly, it may be thought of as a type of skin allergy or sensitivity. The atopic dermatitis triad includes asthma, allergies (hay fever), and eczema. There is a known hereditary component of the disease, and it is seen more in some families. The hallmarks of the disease include skin rashes and itching.

The word "dermatitis" means inflammation of the skin. "Atopic" refers to diseases that are hereditary, tend to run in families, and often occur together. In atopic dermatitis, the skin becomes extremely itchy and inflamed, causing redness, swelling, cracking, weeping, crusting, and scaling. Dry skin is a very common complaint and an underlying cause of some of the typical rash symptoms.

Although atopic dermatitis can occur in any age, most often it affects infants and young children. In some instances, it may persist into adulthood or actually first show up later in life. A large number of patients tend to have a long-term course with various ups and downs. In most cases, there are periods of time when the disease is worse, called exacerbations or flares, which are followed by periods when the skin improves or clears up entirely, called remissions. Many children with atopic dermatitis enter into a permanent remission of the disease when they get older, although their skin may remain somewhat dry and easily irritated.

Multiple factors can trigger or worsen atopic dermatitis, including dry skin, seasonal allergies, exposure to harsh soaps and detergents, new skin products or creams, and cold weather. Environmental factors can activate symptoms of atopic dermatitis at any time in the lives of individuals who have inherited the atopic disease trait.

What causes atopic dermatitis?

The cause of atopic dermatitis is not known, but the disease seems to result from a combination of genetic (hereditary) and environmental factors. There seems to be a basic hypersensitivity and an increased tendency toward itching. Evidence suggests that the disease is associated with other so-called atopic disorders such as hay fever (seasonal allergies) and asthma, which many people with atopic dermatitis also have. In addition, many children who outgrow the symptoms of atopic dermatitis go on to develop hay fever or asthma. Although one disorder does not necessarily cause another, they may be related, thereby giving researchers clues to understanding atopic dermatitis.

  Irritants – soaps, solvents and drying compounds. Odorless, liquid detergent is preferable as well as loose fitting, cotton clothing.

  Allergens — airborne substances and foods. (these are not the only allergens for atopic dermatitis) One way to identify allergens is through allergy testing, but your doctor will decide what is necessary.

  Infections – bacterial, viral, and fungal infections can trigger flare‐ups. Severe flare‐ups can be caused particularly by Herpes simplex and Herpes zoster (chicken pox) Eliminating bacteria can be accomplished through a bleach bath. For 1 ½ feet of water in an average sized bath tub add 1/8 cup of Clorox bleach. After soaking for 20 minutes, rinse the skin thoroughly and take a shower or bath. Use a towel (white is preferable in case bleach is still present on the skin) to blot dry. This process can be performed two to three times a week. If skin has not improved in one week, notify your physician.

  Emotional Stress - While emotional factors and stress may in some cases exacerbate or initiate the condition, they do not seem to be a primary or underlying cause for the disorder. In the past, there was some thought that perhaps atopic dermatitis was entirely caused by an emotional disorder.