What is Atopic Dermatitis?

Atopic Dermatitis (AD) is a chronic dermatological condition, characterized by dry, scaly, and itchy skin. The condition may develop and diminish in childhood, occur sometimes, or persist forever. Furthermore, atopic dermatitis varies in appearance according to a person's skin color. For instance, it may manifest as red rashes in light colored skin and purple or gray in darker skin shades.  

While the condition is not curable, atopic dermatitis clinical trials are an efficient approach to find potential management strategies to minimize its symptoms.  

The Difference between AD and Eczema? 

Now here's the catch. While people generally regard eczema as a simpler term for atopic dermatitis, the two conditions differ. Both dermatitis and eczema refer to skin inflammation, the latter is a broad, umbrella term to describe a group of conditions. To put it simply, atopic dermatitis is the most common type of inflammation (eczema). 

Who is Most Likely to be Affected by AD? 

While atopic dermatitis is most likely to be present in infants, it can occur at any age. Furthermore, it is equally common in men and women, however, black people are a little more likely to develop the condition. Studies show that out of all the people affected by AD, more than half develop the condition within the first year of life. Moreover, 90% develop AD before they reach the age of 5, which continues to the teen and adult years.  

How Common is AD? 

You might not know it, but atopic dermatitis is a common dermatological condition, especially in infants. On an estimate, one out of even ten babies present symptoms of AD, whereas two-thirds continue to experience flare-ups even as adults. 

Furthermore, many people with AD can develop food allergies, hay fever, and asthma before or after developing atopic dermatitis. This is most likely to occur due to:  

• The immune system is prone to reacting to external substances. 
• Chronic inflammation affects other parts of the body, leading to other kinds of allergic reactions.  
• Genetic predisposition to develop multiple allergic conditions over time.

What are the Symptoms of Atopic Dermatitis? 

While the symptoms of atopic dermatitis may vary from person to person, the common presentation includes: 

• Dry and cracked skin 
• Severe itching 
• Swelling 
• Inflammation 
• Rashes (red, brown, and/or purple) 
• Small pustules with or without crusting 
• Thickened skins 
• Dark skin arounds the eyes 
• Sensitive skin due to frequent itching 

You will find these signs mostly in the areas where the skin bends, such as behind the knee or inside the elbows. However, AD can develop in other parts of the body too, such as: 

• Hands 
• Fingers 
• Arms 
• Legs 
• Face, including eyelids and lips.

When Should You See a doctor? 

If not managed and treated on time, AD can be infected leading to complications. Therefore, it is important to visit a physician when you or your child: 

• Experience signs and symptoms of atopic dermatitis. 
• Are unable to complete routine tasks due to pain and discomfort.  
• Has a skin infection, marked by oozing rashes. 
• Has persistent symptoms despite self-care regimen. 

Why Causes Atopic Dermatitis? 

Atopic dermatitis is a multifactorial dermatological condition, which means it has more than one cause. It may occur due to a gene variation that impairs the skin’s ability to offer protection. This weakens the barrier function and skin is less capable of retaining moisture and protecting against external factors. 

However, in some people, atopic dermatitis may occur due to accumulation of bacteria, Staphylococcus aureus on the skin, overpowering the friendly bacteria and impairing the skin’s barrier function.  

Atopic dermatitis primarily occurs due to internal factors, such as: 

• Immune system attack 
• Impaired skin barrier 
• Genetic 

However, at times there are certain substances that can flare up inflammation. These triggers, irritants, and environmental factors when contacted with skin lead to rashes and flare-ups. This type of dermatitis (inflammation) is known as contact dermatitis.

Is Atopic Dermatitis Contagious? 

No, atopic dermatitis is not contagious, even during a flare-up. However, if the rashes develop and oozes pus, it is an indication of underlying infection. The infection can be spread to others through physical contact.

Atopic Dermatitis Diagnosis 

Your healthcare provider will diagnose atopic dermatitis through a physical examination and by reviewing your medical history. Physicians also run tests like blood or patch tests to check for the cause of the rash and skin biopsy. 

Treating Atopic Dermatitis 

 AD can cause you pain and discomfort and hence it is crucial to opt for timely intervention. The treatment of atopic dermatitis includes: 

• Topical steroid creams: Creams or ointments consisting of corticosteroids lessen itch while healing the skin. However, it is crucial to use such topical creams as indicated, as overuse can lead to thinning skin.  
   
• Oral steroids: Oral corticosteroids are prescribed by physicians in severe AD cases to control inflammation. Such class of drugs may lead to short-term adverse effects, such as hyperglycemia (high blood sugar), glaucoma, and slower wound healing - hence should be used as per instructions. 
   
• Wet Dressings: It is a procedure of applying steroid creams and then wrapping it with a wet bandage.  
   
• Antibiotics: Antibiotics, antivirals, or antifungals are prescribed when the AD rash is infected and begins to weep. 
   
• Light therapy: Phototherapy can be beneficial for people with severe flare-ups especially after conventional treatments. However, the therapy is not recommended for long-term due to the risk of skin-cancer and premature aging. 

Managing Atopic Dermatitis 

You can manage your AD symptom and relieve inflamed skin and itching through the following tips: 

• Moisturize 

Hydration is the key to dry, itchy skins. You can use creams, ointments or other emollients in your daily skin-care regimen to manage AD.  

• Don't itch 

The best way to reduce itch in an AD rash is by not itching it. Instead, pressing on the rash to subside the itchy sensation.  For kids, it is important to keep their nails trimmed and make them wear gloves, especially during sleep.  

• Oatmeal bath 

Oatmeal bath helps lock the moisture the skin, reducing inflammation and dryness. After the bath, pat dry yourself and put moisturizer on the damp skin. 

• Use a humidifier 

Humidifiers help add moisture to the air, particularly helpful in dry environments which can worsen AD symptoms.  

• Wear loose clothing 

Wear loose clothes and a non-irritating fabric that does not stimulate itch. 

• Avoid fragrance 

Mild, unscented soaps and creams are ideal to use for AD as they do not trigger inflammation. 

Does Atopic Dermatitis Go Away? 

Only if you manage it the right way. In children, the condition might diminish as they grow, or the flares reduce with time. While the condition isn't curable, it can be managed with the right treatments and strategies. People who diligently follow their skincare routines can still experience flare-ups. In such cases, it is better to understand symptomatic treatment during the flare-ups. 

Dealing with Atopic Dermatitis - For a Better Lifestyles 

Understanding atopic dermatitis is the first step to managing it. Ongoing research at clinical research institute is advancing our understanding and management of AD, offering hope for better outcomes. If you or loved ones are struggling with AD, see a physician for a personalized approach and a comfortable life.