Atopic Dermatitis

Atopic dermatitis is a form of eczema that is also called infantile eczema because it is most common in babies and children. It is a chronic skin disorder in which symptoms almost always appear before the age of five. These symptoms can include dry, itchy, bumpy skin on the face or scalp that often results in a red rash. Sometimes the rash may crust over and spread to other areas of the body. A diagnosis of atopic dermatitis is typically made upon an examination of the affected skin after a medical and family history have been taken.

The condition often improves and worsens cyclically over time, with flare-ups commonly occurring at puberty, but most patients outgrow the condition by the end of adolescence. It tends to strike those with a family history of allergies and asthma, although the actual cause is unknown.

The hypersensitivity of the skin that causes atopic dermatitis eventually results in a long-term inflammation. Changes that may take place in the skin can include blisters; oozing, crusting or bleeding; lightening or darkening of the skin in the affected area; redness and leathery patches. Rashes tend to appear on the hands, feet, face and scalp in young children with atopic dermatitis. In older children and adults, rashes are more common around the elbows, knees, neck, hands and feet. In severe cases, a rash may appear on any part of the body. Itching typically begins before the rash is even present.

Atopic dermatitis is usually mild and can go away on its own, but may be more severe if it affects a larger area. Although atopic dermatitis cannot be cured, it can usually be helped with the use of moisturizing lotions and a few other simple measures.

Cold compresses can sometimes be successful in relieving itchiness. If your child has atopic dermatitis and has trouble refraining from scratching, keep his or her fingernails short and encourage wearing lightweight gloves to bed. Baths should be short in length and the water temperature should be lukewarm, since hot water can aggravate atopic dermatitis. Wash the skin gently and pat it dry instead of rubbing. Apply moisturizers immediately after a bath while skin is still damp to maximize the hydration of the skin.

Since rashes are caused by exposure to allergens in the environment (as opposed to contact dermatitis, which worsens when the skin physically touches an irritant), known triggers such as heat, wool, hot water, certain foods or skin products, soaps and detergents should be avoided or removed from the home. A child or teen who has been diagnosed with atopic dermatitis may be given steroid creams, antihistamines to relieve itching, and/or antibiotics to treat any infections caused by scratching. Trying not to scratch the area is also important and can reduce the likelihood of developing skin scales or lichenification, a thickening of the skin.

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Virginia Cleaver, PharmD, RPh, CPh

Virginia Cleaver is a clinical pharmacist with experience working in retail, mail-order pharmacy, institutional and managed care environments. She is an analytical, detail-oriented expert with in-depth knowledge of pharmacovigilanc

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