Treatments

Atopic Dermatitis – Much More Than Dry Skin

The skin is much more than an outer covering. It is the largest organ in the body and serves as the first line of defense against harmful agents, thanks to an intact skin barrier and an active immune system within the skin.

In atopic dermatitis, also known as “skin asthma,” two major mechanisms are disrupted: the first is impaired skin-barrier function, and the second is overactivity of the immune system in the skin, which causes an inflammatory response.

The condition usually begins in infancy, sometimes as early as the first few months of life. It may be associated with other allergic conditions, such as food allergies, asthma, and allergic rhinitis, although not every child with atopic dermatitis will develop these conditions.

What does atopic dermatitis look like?

The hallmark of the condition is significant and persistent itching, accompanied by an inflammatory skin rash. The itching may occur throughout the day, worsen at night, and substantially affect quality of life.

The location of the rash varies with age. In older children and adults, it frequently appears in skin folds, such as the creases of the elbows and knees and the neck. However, it can occur anywhere on the body, including the face. In infants, the face and the outer surfaces of the arms and legs are commonly affected.

In adults, the condition may also affect less typical areas, such as the hands, face, and nipples.

Persistent itching can have significant consequences. It may disrupt sleep and impair concentration and daily functioning. In children, it may also affect mood, behavior, and performance at school or preschool. In severe cases, prolonged disruption of sleep and daily functioning may also affect development.

How is atopic dermatitis treated?

Because the condition involves both impairment of the skin barrier and inflammatory activity of the immune system, treatment should address both components.

Restoring the skin barrier: Regular use of moisturizers helps reduce water loss from the skin, improve its barrier function, and relieve dryness and irritation. This is a fundamental part of treatment, even during periods when the rash is not active.

Treating inflammation: Depending on the severity of the condition, the location of the rash, and the patient’s age, topical treatments such as anti-inflammatory ointments and creams may be used. When the condition is widespread, severe, or does not respond adequately to topical treatment, additional options are available, including phototherapy and systemic treatments administered orally or by injection. Systemic options also include biologic therapies and other targeted treatments, which can significantly improve both itching and the rash.

Treatment is selected individually according to the characteristics of the condition and the patient’s needs.

Does atopic dermatitis go away with age?

In many children, the condition improves over the years and may sometimes resolve completely. However, in some patients it continues into adolescence and adulthood, often with periods of flare-ups and improvement.

There is therefore no reason to wait for spontaneous improvement when a child or adult is experiencing itching, sleep disturbance, or a significant rash. A wide range of treatments is now available, allowing therapy to be tailored to the severity of the condition and the patient’s age while substantially improving quality of life.

If you or your child suffers from atopic dermatitis, it is advisable to consult a dermatologist for an evaluation and an individually tailored treatment plan. The condition can be treated at any age, and there is no need to accept itching and discomfort that can be relieved.