What is atopic dermatitis?
Atopic dermatitis, also called eczema, is an allergic
skin disorder that usually appears in babies or very
young children, and may last until the child reaches
adolescence or adulthood. Eczema causes the skin to
itch, scale, and flake.
Parents with eczema are more likely to have children
with eczema. Different triggers can make eczema worse,
including stress, other allergies, and sweating. Of
children who have eczema, 60% will show signs in their
first year of life and 85% will show signs of eczema
in the first 5 years.
What are the symptoms of eczema?
The location on the body that is affected by eczema
tends to change with age. In infants and young children,
the dry skin is usually located on the face, outside
of the elbows, and on the knees. In older children and
adults, eczema tends to occur on the hands and feet,
the front of the arms, and on the back of the knees.
The following are the most common symptoms of eczema:
- dry, scaly skin
- small bumps that open when scratched
- redness and swelling of the skin
- a thickening and hardening of the skin (with chronic
eczema)
Excessive rubbing and scratching can tear the skin and
cause an infection. Some children only have a few episodes
of flare-ups, while other children will have atopic dermatitis
throughout adulthood.
The symptoms of eczema may resemble other skin conditions.
Always consult your child's physician for a diagnosis.
How is eczema diagnosed?
Atopic dermatitis is very common. The National Institute
of Arthritis and Musculoskeletal and Skin Diseases estimates
that about 10% of infants and children have atopic dermatitis.
Diagnosis is usually based on a physical examination and
complete medical history. Diagnosis may also include the
following:
- family history (children born to a mother who has
allergic conditions are more prone to eczema.)
- personal history of allergies or asthma
- blood tests
- skin test
Treatment for eczema:
Specific treatment for eczema will be determined by your
child's physician based on:
- your child's age, overall health, and medical history
- extent of the reaction
- your child's tolerance for specific medications,
procedures, or therapies
- expectations for the course of the reaction
- your opinion or preference
There is no cure for eczema. The main goal of treatment
is to remove any irritants and decrease the amount of
dryness and irritation. Management of eczema
symptoms:
The following are suggestions for the management of eczema:
- Avoid contact with irritants, as determined by your
child's physician.
- Bathe your child less frequently, use moisturizers,
and practice good skin care techniques.
- Do not use harsh soaps. Ask your child's physician
for a brand he/she would recommend that will not cause
the skin to become further irritated.
- Make sure your child's fingernails are short, as
scratching may cause an infection.
- Use lubricating lotions at least once a day. Ask
your child's physician for a brand he/she would recommend
that will not cause the skin to become further irritated.
- Dress your child in light clothes-sweating can make
eczema worse.
- Avoid oils and grease on the skin-this may cause
more sweating and itching.
Your child's physician may also prescribe medications
in severe cases. The following medications are most commonly
used to treat eczema:
- Antihistamines These medications
help to decrease the amount of itching. Some examples
are diphenhydramine (Benadryl? or hydroxyzine (Atarax¢ç).
These medications may cause drowsiness. Some new antihistamines
are also available that do not cause drowsiness. Consult
your child's physician for more information.
- steroid creams These topical
medications help to decrease the inflammation in the
skin, thus, decreasing the itching and swelling. This
helps with itching and swelling. Some examples are
hydrocortisone ointments, mometasone (Elocon¢ç),
or triamcinolone (Kenalog¢ç).
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