The dermatitis atopic is an allergy chronic causing inflammation and itchy skin.
The term “atopic” comes from the Greek attopos , which means “out of place”. This name refers to the varied distribution of wounds throughout the body, which change according to the patient’s age.
According to the International Study of Asthma and Childhood Allergic Diseases, among cases of atopic dermatitis in Brazilian children aged 6 and 7 years, 7.3% are moderate and 0.8% are severe. For the age group 13 and 14 years, there are 5.3% moderate cases and 0.9% severe cases.
Although it is a chronic disease, about 75% of patients heal after adolescence due to the development of the immune system.
Follow this article to the end to better understand about the disease, its causes, symptoms and treatment!
Contents
What is atopic dermatitis?
Atopic dermatitis is a chronic allergic disease that causes inflammatory reactions in the skin.
It has as main symptoms: intense itching, dry and scaly skin, itching (reddish lesions) and wounds.
In children under 2 years old, the wounds are concentrated on the cheeks and the external part of the arms and legs, and can also affect the scalp.
From 2 to 14 years of age there is a predominance of injuries in regions of greater flexion and perspiration, such as the folds of the arms, legs and neck.
After this age group, dermatitis remains in the folds of the body and can also occur on the feet, a region where the skin is naturally drier.
Caused by genetic factors, the condition is associated with a family history of allergic disorders such as asthma and rhinitis .
Dermatitis patients suffer from immune hypersensitivity. This triggers an excessive production of the immunoglobulin E (IgE) antibody when the body is exposed to allergens, such as dust, mites and animal hair.
Because it is hereditary, dermatitis is not a contagious disease. It is more common in childhood, manifesting itself in the first years of life.
In most cases, atopic dermatitis manifests itself in the first years of life.
The disease has a genetic origin and is prevalent in people with a personal or family history of asthma, allergic rhinitis or atopic dermatitis, diseases that form the atopic triad.
Like any chronic disease, atopic dermatitis shows cycles of improvement and recurrence (return of the disease).
Treatment is done through self-care of the skin and medication to control itching.
In ICD-10 you can find the disease under the code L20 – Atopic dermatitis.
Read more: Dermatitis: what it is and treatments
What are the causes?
The exact cause of atopic dermatitis is unknown, however, it is known that it has a genetic origin, manifesting itself in people from families with a history of allergic and respiratory diseases, such as asthma and rhinitis.
According to research, children who have at least one allergic parent are 2 to 3 times more likely to develop the disease. When both the father and the mother are allergic, the chances increase 3 to 5 times.
When exposed to certain allergens, such as dust, pollen or mold, our immune system produces an antibody called immunoglobulin E (IgE). IgE reacts by means of inflammation in an attempt to expel them from the body.
However, patients with atopic dermatitis suffer from an immune hypersensitivity that causes the body to produce an exaggerated amount of IgE, which results in allergic manifestations typical of dermatitis.
Atopic dermatitis in babies
Atopic dermatitis in babies consists of an allergic condition characterized by the appearance of reddish lesions and itchy skin.
In general, symptoms appear after the second month of life and are concentrated on the child’s cheeks, and may spread to the scalp, legs and arms.
Treatment includes the use of anti-inflammatory drugs and skin care, such as hydration, warm baths and cleaning of the injured areas to prevent infections.
To help control crises, another important measure is to prevent the baby from having contact with allergens, such as dust, pollen, animal hair and acrylic fabrics.
Risk factors
Risk factors for atopic dermatitis do not cause the disease, but they can aggravate symptoms. For most patients, the most common risk factors are:
- Family history of asthma, rhinitis or dermatitis;
- Dust;
- Mites and mold;
- Pollen;
- Animal hair;
- Fragrances (perfumes, cosmetics);
- Wool and synthetic fabrics;
- Heat and perspiration;
- Food dyes;
- Stress.
What are the symptoms of atopic dermatitis?
Atopic dermatitis has as main symptoms: dryness and inflammation of the skin, intense itching, reddish lesions and crusted wounds that are irregularly distributed throughout the body, affecting the folds of the legs and arms more markedly.
As dry skin is more porous, itching increases the chances of infection by microorganisms, and it is not uncommon for blisters to appear and itchy wounds.
Infection of the lesions can cause burning and disrupt the patient’s life.
Learn more about each symptom:
Dry skin
Patients with atopic dermatitis suffer from an immune dysfunction that impairs the production of protective proteins in the skin barrier.
Therefore, they have dry skin that is sensitive to environmental factors, such as microorganisms, high or low temperatures and low humidity.
Itch
The itching is related to the dryness of the skin, being aggravated by the appearance of wounds.
When scratching, reddish lesions are formed on the skin that can release a certain amount of blood plasma. Plasma is the liquid part of the blood and is yellowish in color.
Another problem linked to itching is the bacteria present on the patient’s nail, which end up being deposited on the wounds, facilitating the emergence of serious infections.
Wounds (eczema)
In more advanced cases, the formation of crusted wounds (peels) occurs in different parts of the body. They are irregularly distributed and vary according to the patient’s age.
Before the age of 5, the lesions are more concentrated on the cheeks, scalp and outer part of the legs and arms.
In older children and adolescents, they manifest mainly in regions of the body where there is flexion, such as the folds of the arms, legs and neck.
Difficulty sleeping
People with atopic dermatitis may have difficulty sleeping due to the itching, which tends to get worse at night, as there is usually greater heating of the wounds and itching when the patient is covered.
Sleep can also be impaired by the presence of respiratory problems, such as rhinitis or asthma, which often accompany atopic dermatitis.
When there is obstruction of the airways, the patient is unable to relax and ends up sleeping poorly.
Is atopic dermatitis contagious?
No . Atopic dermatitis is a genetic disease that manifests itself only in people with a family history of allergic diseases, such as rhinitis and asthma.
What can trigger or facilitate a crisis?
There are several environmental and dietary factors that can cause allergic attacks in patients with atopic dermatitis.
Existem, por exemplo, fatores ambientais, por exemplo, estar em contato com a poluição, poeira ou pólen pode ser um gatilho.
Ambientes com ar condicionado, perfumes ou fragrâncias podem gerar irritação.
Hábitos de higiene ou produtos que entram em contato com a pele também. Entre eles, os sabonetes, hidratantes, detergentes, tecidos de roupas e até os produtos usados para lavá-las podem estar associados.
Na alimentação, o consumo de produtos com algum ingrediente irritativo, como cereais, laticínios, ovos e produtos industrializados merecem atenção.
Algumas pessoas podem apresentar reações alérgicas a fatores mais específicos.
Nesse caso, é importante conversar com o médico e decidir se há ou não necessidade de fazer algum exame que ajude a identificar o que está piorando os sintomas.
How can stress make atopic dermatitis worse?
The discomfort caused by the symptoms of atopic dermatitis increases the stress levels of patients, generating psychological problems, such as anxiety , depression and low self-esteem .
On the skin, symptoms tend to get worse, increasing itching and redness.
Difficulty sleeping is also a factor that affects the patient’s disposition, increasing stress levels on a daily basis.
School-aged patients lack concentration and can be bullied by colleagues, a fact that increases the emotional burden of the disease.
The Atopic Dermatitis Support Association (AADA) recommends that parents and patients seek psychological support.
Therapy can help patients and families control stress and find ways to mitigate the psychological impacts caused by atopic dermatitis.
How is the diagnosis made?
The diagnosis is made in the doctor’s office and is based on the following criteria:
- Presence of chronic allergic diseases in the family;
- History of dry skin;
- Presence of pruritus (red and swollen skin);
- Eruption of wounds through the body;
The doctor will also ask a series of questions to find out at what age the symptoms started, with what intensity and frequency.
So watch your symptoms carefully so that you can describe them to your doctor. In addition, additional tests may be ordered.
The specialists most indicated for the diagnosis are:
- Dermatologist;
- Allergist;
- Pediatrician.
Exams
Although there is no specific test for the detection of atopic dermatitis, the dermatologist can use some auxiliary tests to check possible environmental factors that may worsen the symptoms. Some of these exams are the prick test and the intradermal test.
Puncture tests
It is the most used test to detect reactions to specific allergens.
In it, small perforations are made in the region of the patient’s forearm, each receiving a drop of a solution containing the allergen to be tested.
After a period of 15 to 20 minutes, the specialist examines the application points to check for irritation to a certain factor: reddened areas indicate an allergic reaction.
The exam is painless and does not cause complications, and can be done at the doctor’s office.
Among the allergens that can be tested on this test are:
- Types of mites;
- Pollen;
- Fur or feathers of domestic animals;
- Insect poison (bee, wasp);
- Cereals and animal products (rice, oats, barley, wheat, milk, meat, eggs);
- Fruits (strawberry, tomato, banana);
- Dyes;
- Medicines (penicillin, aspirin).
Intradermal test
The intradermal test is only recommended when the prick test does not detect an allergic reaction to any factor that has already triggered an allergic crisis in the patient.
It is performed by applying the allergens with a fine needle on the surface below the skin, also in the forearm region.
Therefore, the intradermal test can cause sensitivity and a little discomfort at the application site.
What can affect the results?
Both the prick test and the intradermal test may have its result altered by the use of antihistamines, being necessary that the patient inform the doctor if he is using these medications.
If so, it will be necessary to suspend the medication before the exams are carried out.
The recommendation is that some medications should be discontinued for 2 to 5 days, according to medical advice, as is the case with the following antihistamines:
- Acrivastine;
- Loratadina;
- Ketotifen ;
- Cetirizine ;
- Terfenadina;
- Promethazine ;
- Hydroxyzine ;
- Fexofenadina.
Patients undergoing treatment with astemizole should discontinue use 40 days before the exam or as directed by the doctor or the laboratory.
Failure to interrupt treatment can lead to false-positive or false-negative results.
Is dermatitis curable?
No. Atopic dermatitis is a chronic disease and, as such, shows signs of improvement and recurrence (return) of symptoms.
The good news is that according to research, about 75% of people who develop it in childhood recover early in adulthood. That is, there is control and symptomatic manifestations cease.
This is due to the maturation of the immune system, which becomes more resistant to factors that can cause allergic reactions, such as dust mites, dust, pollen and animal hair.
It is important to note that, although allergic skin symptoms may cease in adulthood, patients continue to suffer from other related allergic disorders, such as allergic rhinitis.
What is the treatment?
The treatment for atopic dermatitis must be carried out using 3 main measures, which are:
Skin hydration
Patients with atopic dermatitis should moisturize their skin with creams several times a day. Hydration helps to recover the skin barrier, which is formed by cells and lipids (fats).
This barrier prevents water loss and protects the skin from external aggressions caused by microorganisms, pollution and sudden changes in temperature.
From the adoption of some habits, it is possible to recover the health of the skin.
- Use moisturizers;
- Take warm baths;
- Use filtro solar;
- Drink a lot of water.
Medication use
Itching can be controlled by hydrating the skin and using antihistamines.
In the presence of more serious wounds, the doctor may prescribe other remedies to prevent infection from the wounds and speed up the healing process.
Clearance of allergens
Treatment with medication will only be effective if the patient avoids factors that may be worsening the symptoms of the disease, such as dust, pollen, mites, carpets, animal hair and even some foods, such as cow’s milk, eggs and gluten .
Do you have homemade treatment for atopic dermatitis?
Has! And it is essential to control the conditions and maintain the well-being of patients.
The home treatment for atopic dermatitis consists of the identification and elimination of irritating agents, dietary adjustment and stress reduction.
Keeping the house well ventilated and clean, without the use of flavorings or cleaning products is essential.
In addition, good nutrition to strengthen immunity is also necessary.
But another important habit is needed: hydration. Maintaining regularity in the use of indicated moisturizing creams is essential, as the skin of those who have atopic dermatitis can be quite sensitive and dry out easily.
So, depending on medical guidelines, it may be ideal to apply up to 3 times a day moisturizers.
Medicines: how to treat adult or childhood dermatitis?
Treatment for atopic dermatitis includes oral and topical remedies, most of which are antihistamines and corticosteroids. Know more:
Systemic (oral)
Oral medications are prescribed to relieve symptoms of itching and skin changes.
- Antihistamines ( Dexchlorpheniramine , Loratadine , Hydroxyzine );
- Corticosteroids ( Dexamethasone , Hydrocortisone ).
Topics (creams and ointments)
Some ointments and creams are used to contain skin irritations, helping with healing.
- Anti-inflammatory ointments, such as dexamethasone ( Neodex );
- Moisturizing creams.
Injectable
The medical community recently announced the arrival of a new treatment for patients with moderate or severe atopic dermatitis.
It is based on the application of an antibody (dupilumab) that acts by inhibiting the exaggerated production of proteins responsible for the patients’ allergic response.
The drug, sold under the name of Dupixent , should be administered once every two weeks.
The injection is painless and can be applied to the subcutaneous region (slightly below the skin) in the thighs, abdomen or forearm. The recommended amount ranges from 200 to 300 milligrams.
The treatment reduces inflammatory reactions when the body is exposed to allergens, improving the quality of life of patients.
Is the use of ointment for atopic dermatitis safe? Does it work?
There are several ointments or creams that can be prescribed for patients with atopic dermatitis. They are topical treatments, that is, for external and local use. In general, they promote good results, minimizing the symptoms and skin manifestations.
But these drugs act as controls for dermatitis, and it cannot, in fact, cure.
In addition, use should always be directed by a doctor, as the substances present, such as cortisone, can have adverse effects if used for long periods.
More recently, ointments and creams based on immunomodulators have been used, aiming to reduce the overuse of topical cortisone.
Living together
Living with atopic dermatitis is not easy. However, there is a series of self-care that allows the patient to mitigate the symptoms of the disease and have a better quality of life. Know more:
Keep your skin hydrated
The moisturizing cream is the greatest ally of the patient with atopic dermatitis. Hydration helps the skin regain its protective layer, preventing flaking and itching.
Therefore, apply moisturizing creams and non-perfumed oils to the skin several times a day, especially after bathing, preferably those indicated by the doctor.
Moisturizing the skin is essential to prevent itching and sores from forming!
Shower with warm water
Hot water and dry skin do not match. Hot baths remove the natural oil from the skin and reinforce the desquamation of dry areas.
Ideally, the bath water should be lukewarm, even over the winter.
Avoid wool and rough fabrics
Acrylic and wool fabrics are rough and cause friction on the skin when we move, which can cause injuries in healthy places or even open existing wounds.
Ideally, people with skin problems prefer light and soft fabrics.
If it is not possible to avoid woolen clothes during the winter, it is recommended that the patient wear cotton, silk or knitwear underneath to avoid direct contact with the skin.
Wash bedding frequently
Our bedding is populated by several microorganisms, including mites.
One way to avoid them is to wash the bedding frequently, always using neutral and little perfumed soaps.
Eat well
Food can also cause allergic reactions in some patients with atopic dermatitis, especially in people who have an intolerance to some substance.
Products derived from animals, such as cow’s milk and eggs, are often on the list of those that pose a danger to people with dermatitis.
It is common for foods high in sugar and dyes to aggravate the symptoms of itching and skin irritation, and moderate consumption is important.
Experts recommend that patients prefer natural and low-processed products. They improve immunity and leave your skin stronger.
Children with atopic dermatitis: tips for parents and guardians
Parents or guardians of children diagnosed with atopic dermatitis need to take a series of precautions so that the allergic condition is not aggravated. Know more:
Keep your child’s nails short
It is very common for children to be uncomfortable with the scabs that form on the wounds and develop the habit of pulling them out.
This needs to be avoided, as in addition to impairing the healing of wounds, nails serve as a home for various types of bacteria, such as Staphylococcus aureus , which causes serious skin infections.
To avoid this behavior, it is important to keep children’s nails always short and clean.
Watch for symptoms
Very young children find it difficult to express what they feel, so it is up to the parents or guardians to observe the period in which the symptoms appeared, the frequency of the cycles and what the allergens responsible for the crises may be.
Remember that the observation of the symptomatic picture is crucial for the diagnosis of atopic dermatitis.
Take her to the doctor periodically
Atopic dermatitis is a serious problem that needs to be treated by a specialist in order to avoid worsening symptoms.
Serious manifestations of the disease cause a lot of discomfort in patients and even harm their school and social life. Therefore, take your child to the doctor periodically to control the symptoms of the disease.
Prognosis
Most patients with atopic dermatitis experience significant improvement from late adolescence.
However, about 25% of them continue with it until adulthood.
For the second group, it is important to know that, like any chronic disease, atopic dermatitis shows cycles of improvement and recurrence (return of the disease).
The frequency and intensity with which the symptoms return is influenced by the presence of other allergic problems (asthma, rhinitis) and the patient’s exposure to allergens (dust, mites, pollen, etc.).
Pictures of atopic dermatitis
Atopic dermatitis is quite common in young children:
It also usually affects the hands, which are in constant contact with irritating substances:
Can you have complications?
Atopic dermatitis can present some complications if it is not properly treated. Know more:
Worsening of skin infections
Patients with atopic dermatitis have greater skin sensitivity, being more likely to contract bacterial and fungal infections.
It is common for the dry skin to present cracks that act as a gateway for these microorganisms, which, when penetrating the skin layers, infect wounds, causing itching and burning.
According to a study, 90% of the lesions present in patients with atopic dermatitis contain Staphylococcus aureus , while in the rest of the population it inhabits only 5% of the skin.
The presence of this bacterium on human skin is common and does not usually cause problems. However, if there are injuries, these microorganisms can penetrate the body and cause infections.
When there is infection, the itching and irritation of the wounds tend to get worse, with the appearance of blisters and pus.
Vision problems
When there is a manifestation of wounds and itching in the eyelid region, the patient tends to scratch his eyes, facilitating the deposit of microorganisms in the area.
According to research conducted in Denmark, people who suffer from severe atopic dermatitis are more likely to develop eye infections, such as conjunctivitis and keratitis .
The conjunctivitis is inflammation of the transparent membrane that lines the inside of the eyelids and the front of the eyeball. The main symptoms are:
- Itch;
- Redness;
- Lacrimation;
- Photosensitivity.
The keratitis is an inflammation of the cornea, transparent tissue that covers and protects the eyes from external factors.
It has some symptoms in common with conjunctivitis, however, it is also common for the patient to experience:
- Pain and discomfort;
- Blurred vision.
How to prevent atopic dermatitis?
Because it is a genetic disease, there is no way to prevent it. However, there are some very simple measures that help to alleviate symptoms or even prevent them. Know more:
Skin care
The use of moisturizing creams and unscented soaps helps to keep the skin hydrated and protected against external agents, such as microorganisms and sudden changes in temperature.
Patients with dry skin should apply moisturizers to their skin several times a day, especially after bathing, which should be taken with warm water.
The sunscreen is also important, as the heat from the sun burns and removes even more water from the skin. In winter, in addition to protecting from the sun, the sunscreen also protects the skin against cracking caused by low temperatures.
Avoid allergens
There are a number of factors that can cause allergic reactions in patients with atopic dermatitis. Are they:
- Dust;
- Mites;
- Folders;
- Mofo;
- Pollen;
- Fragrances (perfumes, cosmetics);
- Soaps and soaps;
- Disinfectants;
- Fur and feathers of domestic animals.
The best way to reduce the onset of dermatitis is to minimize or completely avoid contact with the triggering agent.
Canine atopic dermatitis
Anyone who thinks that atopic dermatitis is a disease exclusive to humans is mistaken: it also affects dogs.
As in humans, disease in dogs is caused by the interaction of genetic and environmental factors.
External agents (pollen, mites, dust, bacteria and fungi) are responsible for triggering allergic reactions, which are manifested in the skin through itching and wounds.
It is common for the animal to scratch itself a lot and lick the injured places, which are usually in the folds of the skin (armpits, groins), belly, face, lips and ears.
The treatment for canine atopic dermatitis also includes a series of precautions, such as medication, cleaning the place to keep the animal from allergens and a balanced diet containing easily digestible proteins and nutrients that strengthen the dog’s skin.
Common questions
Can I get atopic dermatitis from someone else?
No. Atopic dermatitis is a genetic disease that manifests itself in people with a family history of allergic diseases such as asthma and rhinitis. Thus, people who have no genetic predisposition are not at risk of developing the disease.
Does food cause atopic dermatitis?
No. Dermatitis is caused by genetic factors, such as a predisposition to allergic rhinitis or asthma. However, some foods can aggravate the symptoms of the disease if the patient has a specific type of allergy to them.
Recent research has pointed out a certain relationship between excessive sugar consumption and allergic skin reactions.
This type of reaction is even more serious for the skin of people with atopic dermatitis, so it is always a good idea to avoid over-processed foods.
Can you treat atopic dermatitis with bepantol?
Bepantol is a product indicated for intense hydration. The Bepantol line has a product specially developed for sensitive skin, which helps in the defense of the dermis.
The Bepantol Sensicalm , according to the package insert, stimulates the rebalancing of the skin tissue, helping in the recomposition of bacteria and microorganisms important for the health of the dermis. However, every product must be guided by dermatologists before being used.
What causes atopic dermatitis on the face?
The fact that the skin of the face is much more sensitive due to intense exposure to environmental factors, such as changes in temperature, sunlight and pollution, makes it more susceptible to the appearance of injuries.
The use of makeup, exfoliating creams and other cosmetics can also damage the skin tissue, contributing to its dryness.
By scratching the skin with the nails, the patient ends up depositing bacteria on the lesions, contributing to the appearance of wounds and infections.
One way to combat the symptoms of the disease on the face is to always use sunscreen, avoid aggressive cosmetics and clean the skin before bed, in order to prevent microorganisms or pollutants from damaging the skin.
What does the word “atopic” mean?
The term “atopic” comes from the Greek word attopos , which means “out of place”. The name refers to the irregular distribution of wounds throughout the body, which may exhibit different patterns depending on the patient’s age.
What is the best ointment for atopic dermatitis?
Atopic dermatitis is a chronic disease that can be controlled with the use of oral and topical medications (applicable to the skin) that help in the healing of wounds.
The ointments most prescribed by dermatologists, allergists and pediatricians are dexamethasone and betamethasone , both belonging to the group of corticosteroids.
Both are creamy ointments, which have the advantage of not drying the skin at the wound site.
Is atopic dermatitis the same as contact dermatitis?
No. While the symptoms of atopic dermatitis manifest in any area of the body, those of contact dermatitis are limited to those regions of the skin that have had direct exposure to certain allergens.
The factors responsible for causing allergic reactions in contact dermatitis can range from chemicals (cosmetics, perfumes, disinfectants) to objects (jewelry, fabrics).
As atopic dermatitis has a genetic origin, the allergens only aggravate the symptoms.
What is the difference between atopic dermatitis and psoriasis?
Atopic dermatitis is a chronic allergic disease that causes itching and inflammation of the skin due to hypersensitivity of the immune system.
When the patient is exposed to certain allergens, the body produces an exaggerated amount of an antibody called immunoglobulin E (IgE).
The release of this antibody causes allergic reactions in the skin, such as itching, sores and itching, and in the respiratory system, such as asthma and rhinitis.
Already psoriasis is caused by rapid multiplication of skin cells, which will grouping and forming parched skin layers that itch and burn.
Both are chronic, genetic and non-contagious diseases.
In addition to having different causes, atopic dermatitis and psoriasis also differ in their symptoms, where they appear on the skin and the complications they cause in patients.
In atopic dermatitis, skin lesions are characterized by itching (redness) or sores that are distributed on the cheeks, neck, feet, folds of the arms and legs. The itching in the affected areas is intense.
Unlike atopic dermatitis, psoriasis affects much more varied regions of the body.
It is very common in the area of the elbows and upper part of the knees, close to Organs genitals, breasts and even inside the mouth of the patients.
The itchiness caused by psoriasis is milder compared to the itchiness of atopic dermatitis.
The skin can suffer from several conditions that cause discomfort or complications to the patient. Therefore, care and medical monitoring are essential.
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