Atopic dermatitis is the most common chronic skin disease in children, affecting 5-25% of children, especially in countries with a western lifestyle. Its frequency has tripled in the last 30-40 years.
It is a multifactorial disease, with manifestations resulting from the combination of environmental and genetic effects and is manifested by itching, dryness, redness (eczema).
Congenital predisposition
When one parent suffers from Atopic Dermatitis or Allergic Disease the probability that the child will be affected is 50%, while when both parents have Atopic Dermatitis or Allergic Disease then the probability that the child will be affected is of the order of 80%.
Environmental causes
• Irritants and allergens: Clothing materials, shower gels, detergents, fabric softeners, pool chlorine and more.
• Climatic conditions: Sunshine and a dry climate are beneficial for Atopic Skin, while cold and humidity are the opposite.
Atopic Skin is sensitive Skin. In recent years, special emphasis has been placed on the importance of the epidermal barrier, i.e. the skin’s ability to insulate the external environment. This is one of the reasons why daily hydration with the appropriate moisturizing cream “insulates” this sensitive skin and protects it like an invisible shield.
Forecast
50% of cases improve by the age of four, five years.
75% usually show improvement in adolescence, while in 10-20% the disease continues for life. 30-50% of children with atopy may develop allergic bronchial asthma or allergic rhinitis at an older age.
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50% of children with atopic dermatitis improve by the age of four or five.
How do we treat atopic skin?
The daily use of a suitable moisturizing cream is the main axis in the treatment of the disease in combination with the removal of environmental factors that have a negative effect on atopic skin.
The child’s bath must be done with special cleaners, without the use of sponges. Dry the skin without rubbing and dab with a well-rinsed cotton towel without washing softeners. Apply the moisturizing cream with a gentle massage until it is absorbed.
The child is dressed in cotton clothes, which have been thoroughly washed with detergents and no softeners have been used. The same applies to sheets and other bedding.
We take care of the absence of dust from the children’s room and remove sources of dust, such as stuffed animals, rugs, carpets. House dust mites are probably one of the first allergens that may sensitize the child with atopic dermatitis.
Treatment
During the year, the child’s skin shows flare-ups and remissions of atopy. The correct treatment includes daily care with the appropriate products and the immediate restoration of eczema and itching when they appear. A large percentage of children suffering from atopic dermatitis will need topical corticosteroids in doses and duration determined by the specialist Dermatologist to treat the flare-ups. Most of the time these are enough to restore the symptoms of the disease and treat the flare-ups.
Systemic treatment with immunosuppressants or the use of biological agents is recommended only in cases of severe form of atopy, which is not so common in Greece.
Written by:
Kyriakos Volonakis
Dermatologist – Venereologist
Director of Dermatology Department MITERA
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