Atopic Dermatitis (AD), also known as eczema, is a disease associated with inflammation of the skin typically seen in children during their first year after birth. Nonetheless, Atopic dermatitis affects about 20% of people at some point in their lives and affects women slightly more than men. In children, AD is characterized by red, swollen, cracked, and often itchy skin; commonly found on the scalp, forehead, and face. In adults, hands and feet are the most commonly affected areas. The itch can be so intense that scratching seems to be the only remedy; unfortunately, scratching can lead to skin infections. The risk of AD increases in those living in more affluent societal classes; family members who have/had hay fever or asthma; and in those with an increased mother’s age at birth. It is worth noting that AD is not contagious.
The cause of atopic dermatitis is still not known, yet there is evidence that genetics as well as being raised in a sanitary environment (known as the hygiene hypothesis) can influence the risk of AD. Foods do not cause AD, but some evidence does suggest that food allergies may make atopic dermatitis worse. For example, children who have AD often have food allergies to milk (e.g. yogurt and cheese), nuts, and shellfish.
Atopic dermatitis appears differently at varying ages. In infants, AD may appear as a scaly and sudden rash generally on the face (especially on the cheeks). The rash may ooze fluid and itchiness may vary during the course of AD. Infants will have trouble sleeping and can be found scratching on carpet, bedding, etc. In children (between 2 years old to puberty) AD may present as itchy and scaly patches that often begins in the creases of the elbows or knees. Other common places for the rash to appear are the neck, wrists, ankles, and/or creases between the buttocks and legs. The skin may also lighten, thicken, and develop bumps or knots. Some common symptoms in adults are: very dry and itchy skin; presents on the creases of the neck, elbows, or knees; can be especially bad around the eyes; and may lead to skin infections.
We may begin by collecting your chief complaint with an emphasis on how itchy your skin may feel as well as collect any relevant medical history; for example, if any blood relatives have had AD, asthma, or, hay fever. Next we may objectively assess your skin looking for any prominent rashes. In some cases of children, we may perform a patch test, which is a medical test used to find allergies. It involves placing tiny amounts of allergens (substances that cause allergies) on the child’s skin where the skin will be checked for any reactions. Checks are often done after a few hours, 24 hours, and 72 hours. Studies suggest that some allergens can make atopic dermatitis worse.
A treatment plan often includes medication, skin care, and lifestyle changes in the hopes of preventing flare-ups. Your treatment plan may seem overwhelming at first, but we will guide you with effective guidelines that will make sticking to your regimen much easier, thus increasing your chances for a better outcome. Treatment for atopic dermatitis is extremely important; yet it is worth noting that treatment cannot cure AD, but rather manages the symptoms. Our goal in your treatment plan is to stop the symptoms from getting worse as well as relieving as much discomfort that you may presently be experiencing.