Disease: Atopic dermatitis (eczema)

Overview

Atopic dermatitis (eczema) is a condition that makes your skin red and itchy. It's common in children but can occur at any age. Atopic dermatitis is long lasting (chronic) and tends to flare periodically. It may be accompanied by asthma or hay fever.

No cure has been found for atopic dermatitis. But treatments and self-care measures can relieve itching and prevent new outbreaks. For example, it helps to avoid harsh soaps, moisturize your skin regularly, and apply medicated creams or ointments.

Source: http://www.mayoclinic.com

Symptoms

Atopic dermatitis (eczema) signs and symptoms vary widely from person to person and include:

  • Dry skin
  • Itching, which may be severe, especially at night
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees, and in infants, the face and scalp
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Thickened, cracked, scaly skin
  • Raw, sensitive, swollen skin from scratching

Atopic dermatitis most often begins before age 5 and may persist into adolescence and adulthood. For some people, it flares periodically and then clears up for a time, even for several years.

When to see a doctor

See a doctor if you or your child:

  • Is so uncomfortable that the condition is affecting sleep and daily activities
  • Has a skin infection — look for red streaks, pus, yellow scabs
  • Continues to experience symptoms despite trying home remedies

Seek immediate medical attention for your child if the rash looks infected and he or she has a fever.

Source: http://www.mayoclinic.com

Causes

Healthy skin helps retain moisture and protects you from bacteria, irritants and allergens. Eczema is related to a gene variation that affects the skin's ability to provide this protection. This allows your skin to be affected by environmental factors, irritants and allergens.

In some children, food allergies may play a role in causing eczema.

Source: http://www.mayoclinic.com

Diagnosis

No lab test is needed to identify atopic dermatitis (eczema). Your doctor will likely make a diagnosis by examining your skin and reviewing your medical history. He or she may also use patch testing or other tests to rule out other skin diseases or identify conditions that accompany your eczema.

If you suspect a certain food caused your child's rash, tell the doctor and ask about identifying potential food allergies.

Source: http://www.mayoclinic.com

Complications

Complications of atopic dermatitis (eczema) may 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 age 13.
  • Chronic itchy, scaly skin. A skin condition called neurodermatitis (lichen simplex chronicus) starts with a patch of itchy skin. You scratch the area, which makes it even itchier. Eventually, you may scratch simply out of habit. This condition can cause the affected skin to become discolored, thick and leathery.
  • Skin infections. Repeated scratching that breaks the skin can cause open sores and cracks. These increase the risk of infection from bacteria and viruses, including the herpes simplex virus.
  • Irritant hand dermatitis. This especially affects people whose work requires that their hands are often wet and exposed to harsh soaps, detergents and disinfectants.
  • Allergic contact dermatitis. This condition is common in people with atopic dermatitis.
  • Sleep problems. The itch-scratch cycle can cause poor sleep quality.

Source: http://www.mayoclinic.com

Prevention

The following tips may help prevent bouts of dermatitis (flares) and minimize the drying effects of bathing:

  • Moisturize your skin at least twice a day. Creams, ointments and lotions seal in moisture. Choose a product or products that work well for you. Using petroleum jelly on your baby's skin may help prevent development of atopic dermatitis.
  • Try to identify and avoid triggers that worsen the condition. Things that can worsen the skin reaction include sweat, stress, obesity, soaps, detergents, dust and pollen. Reduce your exposure to your triggers.

    Infants and children may experience flares from eating certain foods, including eggs, milk, soy and wheat. Talk with your child's doctor about identifying potential food allergies.

  • Take shorter baths or showers. Limit your baths and showers to 10 to 15 minutes. And use warm, rather than hot, water.
  • Take a bleach bath. The American Academy of Dermatology recommends considering a bleach bath to help prevent flares. A diluted-bleach bath decreases bacteria on the skin and related infections. Add 1/2 cup (118 milliliters) of household bleach, not concentrated bleach, to a 40-gallon (151-liter) bathtub filled with warm water. Measures are for a U.S.-standard-sized tub filled to the overflow drainage holes.

    Soak from the neck down or just the affected areas of skin for about 10 minutes. Do not submerge the head. Take a bleach bath no more than twice a week.

  • Use only gentle soaps. Choose mild soaps. Deodorant soaps and antibacterial soaps can remove more natural oils and dry your skin.
  • Dry yourself carefully. After bathing gently pat your skin dry with a soft towel and apply moisturizer while your skin is still damp.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

To help reduce itching and soothe inflamed skin, try these self-care measures:

  • Moisturize your skin at least twice a day. Find a product or combination of products that works for you. You might try bath oils, creams, ointments or sprays. For a child, the twice-a-day regimen might be an ointment before bedtime and a cream before school. Ointments are greasier and sting less when applied.
  • Apply an anti-itch cream to the affected area. A nonprescription hydrocortisone cream, containing at least 1 percent hydrocortisone, can temporarily relieve the itch. Apply it no more than twice a day to the affected area, after moisturizing. Using the moisturizer first helps the medicated cream penetrate the skin better. Once your reaction has improved, you may use this type of cream less often to prevent flare-ups.
  • Take an oral allergy or anti-itch medication. Options include nonprescription allergy medicines (antihistamines) — such as cetirizine (Zyrtec) or fexofenadine (Allegra). Also, diphenhydramine (Benadryl, others) may be helpful if itching is severe. But it causes drowsiness, so it's better for bedtime.
  • Don't scratch. Rather than scratching when you itch, try pressing on the skin. Cover the itchy area if you can't keep from scratching it. For children, it might help to trim their nails and have them wear gloves at night.
  • Apply bandages. Covering the affected area with bandages helps protect the skin and prevent scratching.
  • Take a warm bath. Sprinkle the bath water with baking soda, uncooked oatmeal or colloidal oatmeal — a finely ground oatmeal that is made for the bathtub (Aveeno, others). Soak for 10 to 15 minutes, then pat dry. Apply moisturizer while the skin is still damp.
  • Choose mild soaps without dyes or perfumes. Use soap that's superfatted and nonalkaline. Be sure to rinse off the soap completely.
  • Use a humidifier. Hot, dry indoor air can parch sensitive skin and worsen itching and flaking. A portable home humidifier or one attached to your furnace adds moisture to the air inside your home.
  • Wear cool, smooth-textured clothing. Reduce irritation by avoiding clothing that's rough, tight or scratchy. Also, wear appropriate clothing in hot weather or during exercise to prevent excessive sweating.
  • Treat stress and anxiety. Stress and other emotional disorders can worsen atopic dermatitis. Acknowledging those and trying to improve your emotional health can help.

Source: http://www.mayoclinic.com

Coping and support

Atopic dermatitis can be especially stressful, frustrating or embarrassing for adolescents and young adults. It can disrupt their sleep and even lead to depression. And close family members of people with this condition may face financial, social and emotional problems.

Seek psychological support from counselors, support groups, friends or family.

Source: http://www.mayoclinic.com

Risk factors

The primary risk factor for atopic dermatitis is having a personal or family history of eczema, allergies, hay fever or asthma.

Source: http://www.mayoclinic.com

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