What is atopic dermatitis in children?
Atopic dermatitis in children is the most common form of eczema and it is chronic. Atopic dermatitis usually begins in infancy or childhood. Children from families with atopic dermatitis, asthma, or hay fever are more likely to develop atopic dermatitis.
It is caused by a combination of atopic genes and external factors that are considered immune-mediated inflammatory diseases. The common symptoms of atopic (red, dry, and intensely itchy skin) occur when the immune system becomes overloaded and triggers something in the child’s environment.
Causes of atopic dermatitis in children
Children with eczema have the appearance of “sensitive skin” that can be easily irritated by sweat, heat, rough clothing, and certain detergents, soaps, and cleaners. Atopic dermatitis in children may be allergic to food, pets, or other animals, such as dust mites, tree pollen, and grass, although it is not clear that these allergies can “cause” eczema in many children.
In most cases, detecting these allergies will not help eczema. In rare cases, some children with atopic dermatitis develop an allergy to chemicals in their moisturizers, other skincare products, clothing, or topical substances.
What triggers atopic dermatitis?
- Certain soaps, cleaners, or detergents
- Long, hot baths or showers
- Rapid changes in temperature
- Low humidity
- Wool or man-made fabrics or clothing
- Dust or sand
- Cigarette smoke
- Certain foods, such as eggs, milk, fish, soy, or wheat
- Bacterial skin infection or colonization
Children with a family history of allergies, asthma, and atopic dermatitis are more likely to develop atopic dermatitis. Mutations in skin barrier genes, such as filaggrin, are commonly associated with atopic dermatitis.
Symptoms of atopic dermatitis in children
Symptoms can come and go, or occur more or less all the time. Any area of the body can be affected. In infants, symptoms usually affect the face, neck, skin, elbows, and knees. In children, symptoms usually affect the skin on the inside of the elbows, behind the knees, on the sides of the neck, around the mouth, and on the wrists, ankles, and hands.
The symptoms are slightly different for each child. They include:
- Dry and flaky skin
- Severe itching
- Redness and swelling
- Thickened skin
- Small, enlarged lumps may become scabbed and leak if scratched
- Rough bumps to the face, upper arms, and thighs
- Darkened skin around the eyelids or eyes.
- The skin around the mouth, eyes, or ears changes.
- Make sure your child sees their healthcare provider for a diagnosis.
Atopic dermatitis in children diagnosis
- There is no specific test to diagnose eczema. The doctor will examine the rash and ask about symptoms, the child’s past health, and family health. If family members have any atopic conditions, that is an important clue.
- The doctor has ruled out other conditions that can cause skin inflammation and may recommend that your child see a dermatologist or allergist.
- The doctor may ask you to ban certain foods (such as eggs, milk, soy, or nuts) from your child’s diet, change detergents or soaps, or make other changes to see if your child is responding to something.
Treatment for atopic dermatitis in children
Treatment depends on your child’s symptoms, age, and general health. It also depends on the severity of the situation. There is no cure for atopic dermatitis. The goals of treatment are to reduce itching and inflammation, add moisture, and prevent infection.
Treatment of atopic dermatitis includes:
- Stay away from irritation as recommended by your children’s healthcare provider.
- Luke should bathe regularly with lukewarm water or wash as recommended by the doctor. Sometimes bleach baths may be recommended.
- Keeping your child’s nails small and covering eczema areas with clothing or dressing can help prevent skin irritation and scratching that can lead to infection.
- Use the hydration rules recommended by your healthcare provider.
- Your child’s healthcare provider can also prescribe medicine. They can be used alone or together. The following are commonly used to treat atopic dermatitis:
- Corticosteroid cream or ointment: The cream or ointment is applied to the skin. Helps reduce itching and swelling.
- Drug: Oral liquids or tablets can be taken to treat the infection.
- This medicine can be taken before bed to reduce itching and improve sleep. It comes in liquid or tablet form and can be taken by mouth.
- Calcineurin inhibitor cream or ointment: The cream or ointment is applied to the skin. Helps reduce itching and swelling.
- Phototherapy (light therapy): Phototherapy can be done in the office or at home by a health therapy provider.
- Immunomodulatory medicine: It is a liquid or pill that is taken by mouth and that affects the immune system. It can be used when other treatments are not working properly. This medicine has side effects. Children are suggested for tests for any side effects.
Prevention of atopic dermatitis in children
The following tips can help prevent dermatitis (inflammation) and reduce the drying effects of the bath:
- Hydrate your skin at least twice a day: Creams, ointments, and lotions seal in moisture. Choose the product or products that best suit your needs. Applying petroleum jelly to your baby’s skin can help prevent the development of atopic dermatitis.
- Identify and prevent the triggers that make the situation worse: Things that make your skin react worse include sweat, stress, dirt, soaps, detergents, dust, and pollen. Reduce your exposure to your triggers.
- Babies and children can get burns from eating certain foods, such as eggs, milk, soy, and wheat. Talk to your paediatrician about identifying a possible food allergy.
- Take fewer baths or showers: Limit your baths and showers to 10-15 minutes. And use warm water instead of hot water.
- Take a bleach bath: The American Academy of Dermatology recommends considering a bleach bath to help prevent burns. The diluted bleach bath reduces bacterial and related infections on the skin. In a 40-gallon (151-litre) tub filled with warm water, add 1/2 cup (118 millilitres) of household bleach and concentrated bleach. Dimensions For a standard US size tub filled with overflow drain holes.
- Soak the affected skin areas up to the neck or for about 10 minutes. Do not sink your head. Do not take a bleach bath more than twice a week.
- Use only mild soaps. Choose mild soaps: Deodorant soaps and antibacterial soaps can remove most natural oils and dry out the skin.
- Dry yourself carefully: After bathing, keep your skin dry with a soft towel and apply moisturizer while your skin is still damp.
Complications of atopic dermatitis in children
Complications of atopic dermatitis in children can include:
- Asthma and hay fever: Eczema sometimes precedes these conditions. More than half of young children with atopic dermatitis develop asthma and hay fever by the age of 13.
- Chronic itchy and flaky skin: A skin condition called neurodermatitis (lichen simplex chronicus) begins with an itchy patch on the skin. This area is scratched, which is also itchy. Over time, you may get out of the habit. The skin affected by this condition becomes discoloured, thick, and leathery.
- Skin diseases: open sores and cracks can be formed by repeated scratching. These increase the risk of infection from bacteria and viruses, including the herpes simplex virus.
- Irritable dermatitis of the hands: Your hands often need to be moistened and exposed to harsh soaps, detergents, and disinfectants.
- Allergic contact dermatitis: This condition is more common in people with atopic dermatitis.
- Trouble sleeping: The itch and scratch cycle improves the quality of sleep.