A lot of skin conditions are united in the term eczema. The common symptoms of all these conditions are irritated, red and itching skin. The most common eczema is the atopic dermatitis.
Atopic dermatitis is a chronic inflammatory disease of the skin that starts usually in early childhood. About 10 – 20% of the children in the industrialized countries are affected by it. Around 1-3 % of adults suffer from it. According to the number of affected people, India is somewhere in the middle. Atopic dermatitis is much more common in the cities than it is in the rural areas.
It is not absolutely clear what causes atopic dermatitis. But most probably it is caused by a combination of genetic predisposition and environmental factors. People having close relatives suffering from the disease are at a higher risk. The so called Western lifestyle is another risk factor. People living in cities develop the condition more often. The immune system of the affected people reacts too vigorously causing inflammation of the skin.
Atopic dermatitis is often associated with asthma and allergic rhinitis. Children or adults having atopic dermatitis often suffer from some of these conditions or are at a greater risk of developing them.
The so called “hygiene theory” has been developed in order to explain why atopic dermatitis is more common in cities and in families having only one child and a higher standard of living. It says that allergic diseases are maybe prevented by mild infectious diseases transmitted in childhood by other family members, mainly brothers and sisters. So that is why people living in cities, in good conditions and having small families are at a greater risk of developing atopic dermatitis as well as asthma or allergic rhinitis.
Atopic dermatitis usually starts at infancy or early childhood. In infants it affects the skin of the face and scalp as well as the skin of the legs and arms. The skin looks irritated and inflamed. There may be small vesicles, red elevated inflammations, signs of scratching as the skin is extremely itchy.
In children and adults the affected areas are mainly the folds of the elbows and knees. The skin becomes harsh and very dry in these areas.
The majority of the children outgrow this condition by their teenage years. Still, their skin remains sensitive and is easily irritated by soap and detergents.
Atopic skin demands continuous care. It should be regularly hydrated as it is dry and often cracks. Especially designed for atopic skin moisturizers and soap free cleaning products should be used. In mild cases, this is enough to control the disease. Certain allergens are believed to cause flare-ups and should be avoided. Allergological testing may be useful. Emotional stress also causes exacerbations. The use of a lot of cosmetic products is not advisable.
In some cases, doctors may prescribe corticosteroids under the form of creams or lotions.
Patients with atopic dermatitis develop infections of the skin easily so in these cases they may need antibiotics.
Very rarely, patients need to be admitted to a hospital and treated systematically, i.e. not only with creams. Phototherapy is also used in the control of atopic dermatitis.
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