Atopic dermatitis - Symptoms, causes and 10 effective treatment methods

What is atopic dermatitis
Atopic dermatitis, also known as atopic eczema, is a chronic skin condition that manifests itself as dryness, scaling and itching. It affects both children and adults and, according to statistics, is even the most common skin disease in children (15 to 20% of children, including babies, suffer from it).
How to recognise atopic eczema
Atopic eczema is characterised by recurring cycles of improvement and deterioration.
The acute course of eczema (flare-up) is associated with dry, scaly, itchy or painful skin. It may be swollen, with red patches, pimples and blisters that are not sharply demarcated. This stage may be accompanied by wetting.
In the resting phase, the skin is less irritated but still dry and scaly. It may peel and itch slightly and may show healed cracks from the flare-up phase.
On which parts of the body does atopic dermatitis occur
Atopic eczema usually appears in the bends of the limbs (elbows, knee sockets), but also on the neck, face, wrists, backs of the hands, feet or all over the body.
Atopic dermatitis of the face can affect the forehead, cheeks, areas behind the ears and around the eyes, including the eyelids and mouth. Dry and chapped lips are a common manifestation of atopic eczema.
Atopic dermatitis in the hair arises as a reaction to chemicals in certain shampoos, hair dyes or other hair products. The scalp becomes itchy, scales form on the scalp and the hair becomes sparse and dry.
Atopic dermatitis of the hands is also common and is characterised by mild drying, redness, itching and possibly scaling. It can occur not only on the palms and backs of the hands, but also on the fingers. Cracked finger bellies and swollen and painful nail beds are typical.
The skin parts affected vary according to age:
Infantile eczema (from 2 months) - red pimples and small blisters with scaling or wetting on the face, neck, limbs and trunk.
Childhood eczema (school ) - dry skin, pimples, but also blisters and scabs on the elbow and knee sockets, neck and legs. Around the age of 7 years, 50% of iaget heals.
Adult eczema - can persist from childhood or develop in adulthood. Manifestations are similar to the childhood form - most commonly found on the face, neck, hair, hands, chest, shoulders and over the large joints of the feet.
Causes of atopic eczema
The development of atopic eczema is influenced by genetic factors, a breakdown of the skin barrier, the body's immunological response, environmental influences and various infections (bacteria, viruses, fungi). Genetic factors are mainly responsible for the breakdown of the skin barrier, where the skin is unable to retain moisture sufficiently to fulfil its protective function.
The most common triggers include:
Allergens: dust mites, pollen, animal hair and certain foods (e.g. milk, eggs, nuts).
Irritants: Soaps, detergents, perfumes and some cosmetic products.
Climatic conditions: Dry air, cold weather or, conversely, high temperatures and humidity.
Stress: Atopic eczema in adults can be associated with a long-term negative psychological state.
Infections: Skin infections caused by e.g. bacteria or viruses.
Hormonal changes: Hormonal fluctuations during puberty, pregnancy or menstruation can worsen eczema symptoms.
What not to eat with atopic eczema
Diet plays a crucial role in atopic eczema. Atopic eczema is often an accompanying symptom of allergy or intolerance. If you are allergic to a food, you should cut it out of your diet, as your condition may gradually worsen, and with it your atopic eczema.
Foods that aggravate atopic eczema include:
- Cocoa and chocolate,
- citrus fruits, strawberries, pineapple and other acidic fruits,
- tomatoes, celery, spinach, aubergines,
- sausages and smoked meats,
- aged cheeses,
- yeast,
- canned and fermented foods,
- vinegar,
- alcohol,
- cow's milk,
- eggs,
- nuts,
- fish and seafood,
- soya,
- wheat and foods containing gluten.
Try to limit consumption of processed foods, spicy and fatty foods as much as possible. Experts also recommend including probiotics in your diet. Some studies suggest that probiotics help to maintain the balance of the gut flora, which can have a positive effect on skin condition.
Prevention of atopic dermatitis
Although genetic predisposition cannot be changed, there are some practical steps you can take to help keep your skin in the best possible condition and reduce your risk of developing or worsening atopic eczema. These include:
Proper hygiene and regular skin hydration
Using mild, non-irritating soaps and taking short showers in lukewarm water helps prevent dry skin. After each bath, it is advisable to apply moisturising creams or ointments to the skin (preferably within 3 minutes).
Moisturising helps to maintain the skin barrier and prevent the skin from drying out, which is key to preventing eczema flare-ups.
Avoiding known allergens
Identifying and eliminating allergens that can aggravate skin conditions is important. This may include, for example, dietary modification.
Choosing appropriate clothing
Wear cotton and breathable materials that do not irritate the skin. Conversely, avoid synthetic materials that can aggravate itching.
Eliminating stress
As stress is a common trigger for atopic dermatitis, stress management techniques such as relaxation exercises, meditation or regular rest can help keep the skin in better condition.
Protection from extreme temperatures
Using humidifiers during the winter months and protecting yourself from excessive sun in the summer will help prevent flare-ups.
Proper care of the home environment
Vacuuming frequently, washing bed linens regularly and keeping your home clean will help eliminate dust and allergens that can aggravate skin conditions.
Diagnosing atopic dermatitis
The diagnosis of atopic dermatitis is usually based on a clinical examination, during which the dermatologist carefully assesses the patient's skin condition and medical history. There is no specific laboratory test that can conclusively confirm atopic dermatitis, so it is crucial to focus on the characteristic symptoms of the condition.
In some cases, the doctor may recommend additional tests, such as skin tests for allergies or blood tests to rule out other forms of dermatitis or allergic reactions.
Treatment of atopic dermatitis
Atopic eczema cannot be cured, but its symptoms can be alleviated with the right care.
The treatment of atopic dermatitis is complex and usually involves a combination of approaches to relieve symptoms, keep the skin moisturised and prevent flare-ups.
1. Moisturising creams and ointments (emolliencia)
The cornerstone of treatment is the regular use of moisturizers to help restore and maintain the skin barrier. These products should be applied several times a day, especially after bathing, to retain moisture in the skin.
One of the best creams for atopic dermatitis, for example, is Dermaguard, which not only moisturizes and protects the skin for up to 6 hours, but also promotes its natural regeneration. You can buy it in our e-shop.
2. Topical ointments or SOS sprays
Zinc ointment also works on atopic dermatitis, positively affecting the skin's defences and regeneration. A lack of zinc can cause dry skin and slow wound healing.
Topical ointments and SOS sprays reduce inflammatory reactions and relieve intense itching.
3. Topical corticosteroids
Topical corticosteroids are often prescribed to manage acute flare-ups of eczema. They help reduce inflammation and itching. It is important to use them as directed by your doctor as long-term use can lead to side effects (e.g. thinning of the skin).
4. Topical immunomodulators
For patients who cannot or do not want to use corticosteroids, topical immunomodulators such as calcineurin inhibitors are an alternative. These products help to regulate the local immune response and reduce inflammatory processes without the risk of skin damage.
5. Oral corticosteroids
In more severe cases, the doctor may prescribe systemic corticosteroids. These medications are very effective, but because of potential side effects, they are only used for a short period of time.
6. Immunosuppressants
Doctors prescribe them for severe cases of atopic dermatitis when other forms of treatment fail. These drugs reduce the activity of the immune system, which helps to reduce inflammation. Commonly used immunosuppressants include cyclosporine A or methotrexate.
7. Small molecules (Janus kinase inhibitors - JAKi)
New in the treatment of atopic dermatitis are Janus kinase inhibitors (JAKi), which are drugs in tablet form. These small molecules act directly inside the cells, where they control the inflammatory processes behind the development of eczema. The advantage of this treatment is the rapid onset of action - they relieve itching and other symptoms within a few days of the first dose.
8. Biological treatment
Newer treatment options include biologic drugs that target specific parts of the immune system involved in the inflammatory process. These drugs are usually indicated for patients with a severe form of atopic dermatitis who do not respond to other therapies.
9. Phototherapy
UVB light therapy can be effective in relieving the symptoms of atopic dermatitis, especially in patients who do not respond to topical treatments.
10. Other treatment options
In addition to the above methods, patients may be prescribed allergy medications or antibiotics if the eczema is complicated by a bacterial infection.
Another supportive method is, for example, climate therapy. People with atopic eczema benefit from being by the sea, as the salt water and sea air relieve itching, promote skin healing and reduce inflammation.
Grandma's advice for treating atopic eczema
In addition to conventional treatments, alternative treatments bring relief to some patients.
Ice compresses will soothe inflammation and help relieve itching.
Oatmeal baths are another great option. Oatmeal has natural soothing properties and helps reduce irritation and itching. Add finely ground oatmeal to a warm bath and relax in it for at least 20 minutes.
Some patients use natural oils such as coconut or calendula to help moisturize and soothe irritated skin.
Herbs (chamomile or lavender) are among the traditional natural remedies used to treat skin problems. Herbal baths bring relief, but some herbs can irritate the skin.
Conclusion
Effective treatment of atopic dermatitis often requires a combination of different approaches. It is also important to regularly consult with a dermatologist and adjust the course of treatment according to the current skin condition.