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Atopic dermatitis:hyper-reactive skin

Atopic dermatitis is a chronic skin disease that appears from an early age. Apart from periods of calm, baby's skin shows patches of itchy eczema. Skin hydration and hygiene measures help prevent flare-ups of atopic eczema.

Understanding atopic dermatitis

atopic dermatitis is the most common skin disease (or dermatosis) in children in France. It needs to be diagnosed by a doctor.

Atopic dermatitis, a skin disease from childhood

Atopic dermatitis is a chronic skin disease that combines periods of outbreaks and periods of calm. It is also called atopic eczema . Most often, it occurs in children from the first trimester of life. Affected individuals have an atopic terrain , that is, they are prone to allergies. For more information, you can read Understanding Allergies.

Most often, this atopic eczema disappears in adolescence but it can sometimes persist in adulthood.

Symptoms and locations of atopic eczema

Symptoms of atopic dermatitis

Atopic dermatitis causes:

  • Very inflammatory lesions during pushes. These are red, raised patches. In infants, there are sometimes vesicles, that is to say small blisters of the skin that contain a translucent liquid. These blisters can rupture, ooze, and scab over. Some lesions even end up becoming chronic and appear drier.
  • itching important (or intense "pruritus"), are localized at the level of the lesions. There is a risk of infection when scratching.
  • Xerosis is a dryness of the skin found especially in older children and less frequently in infants. It can be localized or generalized.

Localization of lesions

The localization of the lesions evolves according to the age of the individual:

  • Up to the age of 1 year, the lesions affect the convexities of the body:the cheeks, the forehead, the outer faces of the arms and thighs. Sometimes the damage can affect the whole body.
  • From 1 to 3 years old, it is the hands, ankles, elbow and knee folds that are particularly affected.
  • From 3 to 4 years old, lesions of the folds and the face are associated.
  • In adolescents and adults, the lesions reach the triad of the neck, face and hands, but the cutaneous involvement can be generalized.

The causes of atopic dermatitis

These are genetic and hereditary factors that predispose to atopic dermatitis. In affected individuals, the hydrolipidic film of the skin is altered. It is a protective film that lines the epidermis and is made up of fatty substances and water. In addition, the intercorneocyte cement is also degraded:it normally ensures cohesion between the superficial cells of the skin.

As the skin's protective mechanisms are altered, the result is:

  • an increase in skin permeability:the water in the epidermis evaporates more, which explains the dryness of the skin;
  • easier penetration of allergens and irritants into the skin, which explains eczema and significant skin inflammation;
  • of skin infections which develop more easily:consultation is necessary at the slightest sign of infection!

Excess hygiene can further alter the skin barrier, it is also very important to choose your hygiene products carefully. This is also the case for excessively hot and prolonged showers and baths.

As a general rule and unless medical advice to the contrary, it is considered that diet is not an aggravating factor in atopic dermatitis. However, according to several studies, certain strains of probiotics absorbed orally could prevent the onset of atopic dermatitis in infants. These are good bacteria that make up the microbial flora of the digestive tract, the genitals, but also of the skin. Some emollient balms or creams, to be applied to the skin, are also formulated to strengthen the skin's microbial balance!

Atopic dermatitis:hyper-reactive skin

Fighting atopic dermatitis

Fighting against atopic dermatitis is first of all preventing inflammatory flare-ups from occurring.

Changing your habits to avoid flare-ups of atopic dermatitis

To space out the inflammatory outbreaks of atopic dermatitis as much as possible, changing your hygiene habits is an essential prerequisite:

  • The temperature of the water in showers and baths must remain lukewarm and always below 37°C, with an ideal of 34°C.
  • It is better not to prolong your exposure to water too much:5 minutes is enough for a shower, and 15 minutes is a great maximum for a bath.
  • The soap is too harsh for the skin of someone with atopic eczema. Contrary to popular belief, Marseille soap is particularly drying. It is better to use a syndet (dermatological cleansing product without detergent), a dermatological surgras product , or even cleansing oils . Pharmacists and doctors will be able to advise you.
  • Drying the skin by dabbing with a towel rather than rubbing, respects the skin tissue.

Other habit changes can improve symptoms and prevent flare-ups:

  • Avoid using fabric softener and excessive amounts of detergent which remain in the fibers of the laundry.
  • Prefer natural fibers to dress like cotton.
  • Perspiration promotes itching:avoid overdressing children, and respect an ambient temperature for the habitat (18°C to 20°C).
  • Avoid hanging clothes outside during pollen season.
  • Cut nails short to lessen scratching lesions.

Hydrate to limit flare-ups of atopic dermatitis

Properly moisturizing your skin restores its protective hydrolipidic film. Adapted products are available in pharmacies and help fight against flare-ups of atopic dermatitis and the associated itching. They also prevent outbreaks from resurfacing during periods of calm.

To be applied daily on the advice of your doctor or pharmacist, emollient treatments in the form of milks, creams, balms or cerats restore the skin barrier. They allow:

  • To fight against dehydration of the epidermis by evaporation of water;
  • Reduce the permeability of the skin to allergens and irritants;
  • Capture water with humectants.

Applied after showering on slightly damp skin, emollient treatments are all the more effective.

Treating flare-ups of atopic dermatitis

On medical prescription only, creams containing a cortisone derivative help fight against the inflammation of eczema plaques during flare-ups of atopic dermatitis. One of the main obstacles to the correct management of this disease is also called “corticophobia”. This is the fear associated with the use of these corticosteroids. It is felt by many people, especially parents of children with atopic dermatitis.

To reduce itching, symptomatic treatments (such as antihistamines) can be implemented in addition to emollient care.

Oral treatments exist for the most severe forms of atopic dermatitis. To learn more about drug treatments for atopic dermatitis, read consultation and treatment for atopic eczema.