This is a common skin disease in children.
It is so common that people have given it a few names: Eczema (the name most people use), Dermatitis, Atopic (a-top-ic) eczema, Atopic dermatitis. Children often get atopic dermatitis (AD) during their first year of life. If a child gets AD during this time, dry and scaly patches commonly appear on on the scalp, forehead, and face. No matter where it appears, AD is often very itchy. Infants may rub their skin against bedding or carpeting to relieve the itch.
In children of all ages, the itch can be so intense that a child cannot sleep. Also, scratching that breaks the skin can lead to a skin infection. Because atopic dermatitis can be long lasting, it is important to learn how to take care of the skin. Good skin care for prevention and appropriate treatment can alleviate much of the discomfort.
Signs and symptoms
Atopic dermatitis (AD) looks different in infants, children, and adults. In infants, a rash that appears suddenly and makes the skin dry, scaly, and itchy is common. It usually presents on the scalp and face, especially on the cheeks but can appear on other areas of the body.
When AD begins between 2 years of age and puberty, the child often has a rash that begins in the creases of the elbows or knees (sometimes the neck, wrists, ankles, and/or crease between the buttocks and legs). It can be itchy with scaly patches where the rash appeared. In time, the skin with AD can get bumpy, looking like permanent goose bumps; lighten (or darken) where AD appears; thicken (or lichenify), turning leathery to protect itself from constant scratching; develop knots (only on the thickened skin); or itch all the time (even if not flaring).
It is rare for adults to get AD. Most people with AD develop it before age 5 and about half of people who get AD during childhood continue to have milder signs and symptoms of AD as an adult. When an adult has AD, it often looks different from the AD of childhood. For adults, AD often appears in the creases of the elbows or knees and nape of neck, covers much of the body (especially noticeable on the neck, face, or around the eyes), causes very dry skin, leads to non-stop itch, causes scaly skin, and predisposes to skin infections. If a person has had AD for years, patches of skin may be thick and darker (or lighter) than the rest of the skin. Adults who had AD as a child and no longer have AD can have the following: extremely dry skin, skin that is easily irritated, hand eczema, eye problems (eczema on eyelids, cataracts).
What causes atopic dermatitis?
Researchers are still studying what causes AD. Through their studies, they have learned that AD is not contagious and it runs in families. People who get AD usually have family members who have AD, asthma, or hay fever. This means that genes play a role in causing AD. Children are more likely to develop AD if one or both parents have AD, asthma, or hay fever. About half of the people with severe AD will get asthma and about one-third will get hay fever.
Can certain foods cause atopic dermatitis?
Foods do not cause AD but some studies suggest that food allergies can make AD worse. Children who have AD often have food allergies to these foods — milk and foods that contain milk (e.g., yogurt and cheese), nuts, and shellfish. Before you stop feeding your child any foods, talk about this with your child’s dermatologist. Children need certain foods to grow and develop normally. Researchers continue to study what causes this complex disease. They believe that many things interact to cause AD. These things include our genes, where we live, and the way our immune system works.
How do dermatologists treat atopic dermatitis?
Treatment cannot cure AD, but it can control AD. Treatment is important because it can prevent the AD from getting worse, relieve pain and itch, reduce emotional stress, prevent infections, and stop the skin from thickening. A treatment plan often includes medicine, skin care, and lifestyle changes. Skin care and lifestyle changes can help prevent flare-ups. Adhering to all of the recommendations might seem bothersome, but sticking to the plan can make a big difference.
There is currently no cure for AD. It is easy to find products that guarantee to cure eczema in just a few weeks. These claims give parents false hope. The truth is AD cannot be cured. Most cases can be controlled with proper treatment. Dermatologists recommend early treatment. AD can be a chronic (long-lasting) condition. Receiving proper treatment early helps prevent the disease from becoming worse. The more severe eczema becomes, the more difficult it is to control. For best results, combine treatment with skin care and prevention. Many parents and patients are looking for one treatment or thing that delivers relief. Studies show that the best way to control AD is to combine skin care, proper treatment, prevention (stop doing things that irritate the skin).
The medicines that dermatologists prescribe are safe when used as directed. This fact is often difficult for parents to believe. The information that comes with topical (applied to the skin) medicine prescribed for eczema contains warnings that can be frightening. The American Academy of Dermatology believes these warnings confuse and unnecessarily worry people. Studies prove that with proper use, medications such as pimecrolimus and tacrolimus are not dangerous. When applied to the skin, virtually none of the medicine gets inside the body. When used properly, the medicines reduce the debilitating effect of eczema and allow millions of people to live normal lives. Alternative therapies are not a substitute for proven medical treatment. A completely safe, all-natural treatment that eliminates eczema certainly sounds wonderful. If such a therapy existed, your dermatologist would tell you. The truth is that there are thousands of alternative treatments. This suggests that we do not have a natural treatment that works very well and that is proven for everyone.