What is Atopic Dermatitis?

Atopic Dermatitis (AD) is an inflammatory, pruritic, chronically relapsing skin disease that affects up to 20% of young children in the world. It is the most common skin disease affecting children. Parents with an history of allergy or atopic conditions have an increased risk of having a kid with an allergic condition.

Children with AD typically develop red, dry, itchy patches on the skin. Along with frequent scratching, the skin may develop blisters, oozing, crusting, or sores from infection.

In infants, eczema commonly affects the face, scalp, arms and legs. In older children, eczema may involve only the insides of the elbows and the back of the knees.

This sensitive skin may react to sweating, heat, rough clothing with irritating fabrics and fibres. It can also react to some detergents, soaps and cleansers. Some kids may have allergy to foods (milk or egg), animals, dust mites, tree pollens and grasses, but the link of AD lesions and allergen exposure is not always clear.

In most cases AD is diagnosed during a routine check-up, but if your child develops any of the symptoms or signs described above you should consult your doctor.


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What treatments are recommended for AD?

Even with an optimized treatment, patients will have periods of exacerbation which are known to impact patients and caregivers’ quality of life.

There are several treatments approved for use in children, including topical corticosteroids and calcineurin inhibitors to control the skin inflammation, and oral antihistamines to control itching. More severe cases may also need systemic (IV, SC or orally administered) treatments, but all patients, irrespective of the AD severity, should be given basal treatment with emollient to help restore and keep skin healthy properties.

Environmental triggers should be avoided, and extra care should be considered regarding sun exposure, with adequate sunscreen products used followed by extra emollient application. Baths should not last more than 5 to 10 minutes, using warm water and adequate amounts of non-soap cleansers; skin rubbing with towels should be avoided and topical medicines and/or emollient applied as quick as possible after the bath.

The application of emollient increases hydration of the skin and reduces xerosis with proved benefit on itching, erythema, fissuring, and lichenification. They also help in preserving and restoring the skin barrier function, decreasing the risk of bacterial superinfection, preventing future exacerbations and the need for other topical treatments. As such, emollient are recommended to be used daily, even when your child is not showing signs of active eczema.

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You should apply emollient at least 2 times a day, especially after baths, on the whole body and not only in areas with active lesions.

When used with other topical treatments, there is no clear evidence on the order nor on the time to apply emollient. It is suggested to wait for 30 minutes before applying emollient on top of those treatments.

Measures to prevent contamination of emollient with bacteria should be considered:

a) avoid sharing between patients;
b) prefer pump dispensers;
c) use a clean spoon or spatula if the emollient is in a pot (never insert your fingers into pot).